Infectious Disease

This case study describes how Industry and the NHS successfully entered into a joint working project to achieve mutually rewarding objectives that ultimately served an important clinical need for many patients.

I was given responsibility for launching a new intravenous antibiotic in 2003 which brought me face to face with the world of infection and infection control here in the UK and abroad. My role was to find a rational position for the brand in a market whose leading customers are always interested but also very questioning about new agents. Their role is to safeguard existing antibiotics from resistance development and encourage thoughtful use of these important medicines.

Contact was made with the leaders at FIS (Federation of Infection Society), BSAC (British Society of Antimicrobial Chemotherapy) and HPA (Health Protection Agency). Key individuals on the executive committees were invited to join Expert Forum meetings to discuss current challenges to microbiology in the UK during which reference was made to another new superbug has recently emerged. These are so co called ESBL - “extended spectrum beta lactamase” producing bacteria that have evolved a mechanism of neutralising most if not all of the front line antibiotics that doctors commonly use to treat infections. The first ESBL epidemic in the UK was observed shortly afterwards. A project was designed to systematically measure the size and spread of ESBL producing pathogens in a given location. 18 labs in a region of England were recruited and confirmed the existence of a problem. Two national meetings were arranged to advise UK microbiologists. An expert committee was formed and Guidelines were written. Treatment recommendations included reference to the brand class.

The approach employed at each step was to consult and listen carefully to what the experts were advising which helped to identify “drivers” and “barriers” in the market. This allowed us to define behavioural changes that would be needed in the way that microbiologists and their clinical colleagues would need to identify and treat of high risk patients with life threatening infection to save future lives. Resources were used from a very wide range (within the U.K. organisation and from Europe and the USA) to assist a cash limited problem.

The outcome has led to ESBL screening to becoming mandatory in all UK hospitals (if you don't look for it it could be missed). All labs are required to demonstrate competency in this regard as part of their annual competence assessments. Guidelines now exist which direct consultants on how best to test, diagnose and treat high risk patients who present with ESBL infections.

The project demonstrated the possibility of Industry working with the NHS to make complicated projects come to a successful conclusion in a cost effective and timely manner.

Product launches in the UK pharmaceutical industry are typically conducted by bringing together a team of marketing staff working in collaboration with business planning and medical colleagues to prepare a team of sales representatives for a hospital product launch. I was given the task of launching the product I described in the previous question alone. This was achieved. A very small sales team was set up 3 years after launch once a clear position for the brand had been proven.

Sales of the brand and class continue to grow in line with expectations.

“Brian and I have worked together on a variety of educational projects and initiatives since 2004. Brian is an extremely personable and professional individual whose expertise and knowledge led to the successful execution of projects that were of benefit not only to both our companies, but also to those working in infectious disease management and antimicrobial chemotherapy.”
August 8, 2008. Tracey Guise , Executive Director, British Society for Antimicrobial Chemotherapy

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