MEDICAL & HEALTHCARE EXPERT GUIDE 2019 EXPERT GUIDE www.corporatelivewire.com Expert Guide | Litigation & Dispute Resolution 2018 2 Fenice Media Ltd 101 The Big Peg 120 Vyse Street Birmingham West Midlands B18 6NF United Kingdom | | | | | | | Tel: +44 (0) 121 270 9468 Fax: +44 (0) 121 345 0834 www.corporatelivewire.com | | | Chief Executive Officer Osmaan Mahmood Research Managers David Bateson Chris Barry Editor-in-Chief James Drakeford Art Director Timothy Nordan Senior Designer Dan Harvell Publishing Division Jake Powers John Hart John Peterson Awards Directors Kevin Norden Benjamin Pugh Max Bond Clint Stevens Marketing Development Manager Dilan Parbat Administration Manager Jenny Njuki Alan Davis Data Administrators Dan Kells Ryan Winwood Account Managers Rocky Singh Anthony Okome Chris Bather Sonny Plant Head of Finance Joseph Richmond Senior Credit Controller Michael Atkinson Credit Controllers Shad Rahman Jack Speed Innovatively transforming the brick-and-mortar pharmacy Tackling Alzheimer’s Disease Achieve maximum impact in healthcare communications from INNOTIO GmbH Sintetica: Leadership by innovation Exploring the deadly risk of Colorectal Cancer Getting the best deal in the U.S. healthcare insurance market Innovation in Cancer Care As Proton Beam Therapy Arrives in the UK Learning through LabRoots - The Leading Global Scientific Social Network 6 8 12 14 16 18 20 22 Contents 3 20 14 8 6 Expert Guide | Litigation & Dispute Resolution 2018 4 In healthcare’s modern landscape, pharmacists are presented with a wide range of challenges. Not only do they struggle to garner the same respect and trust as other healthcare professionals, but they are also tasked with tackling an image problem that has been decades in the making. Combined with the rising cost of drugs and the new central role of online drugstores, brick-and-mortar pharmacies have been forced to innovate. And that’s just what Cadham Pharmacy, headed by Bernadette Brown, has done. Corporate LiveWire spoke to her about her community pharmacy, and how she stays ahead in a challenging and ever-changing industry. The image problem of the pharmacy With pharmacies traditionally providing over-the-counter remedies with little consultation, the role of the pharmacist has taken a backseat. Rather than treating patients , the focus is often on customers who have self-diagnosed medical conditions, and rarely seek the professional opinion of those behind the counter. As Bernadette told us: “When I looked around and saw a sea of retail shelves and over-the-counter conversations, I could see why the public would not fully understand what I could do for them, other than get their prescriptions ready. If my pharmacy was to be taken seriously by GPs and the community, I had to change its retail image to a more clinical one.” In order to revive the stale image of community pharmacy, Bernadette took symbolic action. “I removed all retail stock and replaced it with public health screens,” she said. “Conversations with people accessing care were moved to private rooms rather than being over-the-counter, so that the right medicine could be found.” She also shadowed local GPs and nurses, in order to earn their trust and garner respect in her community. “My health board then allowed me to run a two-year pilot. The results were analysed over nine months, after I had triaged 3,500 patients.” In 2019, she secured a formal Service Level Agreement (SLA) between her health board and seven local GP practices; the first of its kind in Scotland. Cadham Pharmacy now provides triage services, where patients have face-to-face appointments with pharmacists to diagnose illnesses, treat them directly, or refer them to alternative healthcare providers. Not only does this improve the credibility of the pharmacy and benefit those patients who seek quick, easy medical support, but it also has a huge positive impact on the NHS. In one pilot in North London, a GP practice offered pharmacist-led telephone triage services to patients, and the surgery saw a 50% reduction in same-day appointments. Bernadette sees 25 patients a day at Cadham; 150 patients per week that may have otherwise visited a GP surgery. “We are saving hundreds of GP appointments at a time when it is increasingly difficult to access them,” she says. www.cadhampharmacy.com Innovatively transforming the brick-and-mortar pharmacy With Bernadette Brown, the entrepreneurial pharmacist behind Cadham Pharmacy 5 The skills and expertise at Cadham Pharmacy As a health centre for minor ailments, the scope of practice at Cadham includes chest infections, ear infections, throat infections, sinus infections, skin infections, shingles, asthma and chronic obstructive pulmonary disease (COPD) flare ups. Though the team treat or refer patients who are affected by these illnesses and others, the biggest focus at Cadham is prevention. Through their Healthera app, patients can access public health information on weight management, smoking cessation, diabetes, blood pressure and asthma. Cadham also deliver a range of clinics, in areas such as pain management, diabetes prevention and treatment, blood pressure management, smoking, asthma, chicken pox and acne. As Bernadette notes, the team at Cadham are highly trained to offer such services. “Pharmacists spend five years becoming qualified, and then like other healthcare professionals, face a lifetime of continued learning and development,” she says. Asthma is one area that is focused on, and she has introduced a community pharmacy pathway to support high-risk patients. The National Review of Asthma Deaths (NRAD) investigation found that people over-rely on blue rescue inhalers containing salbutamol, and underuse life-saving preventer inhalers that contain anti-inflammatory medicines. Cadham has successfully identified those overusing the wrong inhalers, shown patients efficient breathing techniques to help medicines reach the lungs, and has taught families to respond properly to asthma-related emergencies. Cadham’s prevention methods have proven extremely successful for patients. “Motivating people to take control of reducing their risks of a severe fatal asthma attack has been transformational for my asthma patients,” Bernadette says. “Their quality of life has massively improved and their risk of hospital admissions has reduced, with none of my patients requiring an admission since they have changed their habits.” This is also the case for those with diabetes, who are given blood tests to identify haemoglobin A1c (HbA1c) levels at Cadham, just as they would receive in their GP practices. “I can offer the same clinical care with my NHS prescription pad as the GP practice,” she continues. Staying competitive in a digital age Though community pharmacies like Cadham have innovated and adapted to the modern market, there are still challenges to be faced in a digital age. “Online pharmacies are now a real threat to brick-and- mortar pharmacies like my own,” Bernadette tells us. “They invest in free, recurring delivery, apps, websites and national advertising campaigns, and this is grabbing the attention of consumers.” However, the glue holding the community pharmacy together is the public trust and support that places like Cadham have garnered. “The public value what I have done for them, and realise that I have invested in their health as well as innovative ways to access care and prescriptions,” Bernadette says. The Healthera app is one way that Cadham has embraced innovation, allowing patients to message their highly skilled pharmacists, check availability, book appointments, receive reminders, and order repeat prescriptions with the same ease as ordering online. This 24/7 access to pharmaceutical services is ideal for local residents, particularly those who lack the time for phone calls and face-to-face appointments. The pharmacy has also utilised other technological advancements, with two drug dispensing robots which are used by 600 patients per week. The German-engineered BD Rowa Smart® robots save 85% of the time required for stock maintenance, serve 33% more customers per day, and efficiently package and dispense medicines. “Time is a precious commodity in any pharmacy, and the robots allow us to reinvest it into valuable consultations and providing the most important care,” Bernadette says. The pioneering technology has been a success for patients of all ages, and was funded by the Scottish government’s Prescription for Excellence programme. Cadham also received a significant asset finance facility from Bank of Scotland, who recognised the pharmacy’s forward-thinking approach and the fact that it “isn’t afraid to embrace new ways of doing things to improve the service of customers.” When it comes to competing in the digital age, Cadham have led the way for the community pharmacy. Looking to the future The future of Cadham Pharmacy looks extremely promising, with an 11% increase in gross margins since its founding and further pioneering ideas in the pipeline. “I have more plans to innovate this year, by connecting and networking with amazing pharmacists who have been innovators in their own right,” Bernadette tells us. “I have already started a pain management clinic, utilising bio- electronic medicines and supporting our elderly in residential care with medicine management.” As Cadham continues to push the boundaries of the traditional pharmacy, it shows no signs of slowing down, and has established itself as a staple of the local community. Bernadette’s commitment to serving the public and shaping their perception of her profession is clear, and she sets a precedent for those triage services finding their feet in an industry that continues to face a wide range of challenges. As she clarifies, however, she cannot stay still, and plans to carry on working tirelessly to meet the ever-changing needs of her patients, and the changing digital world around them. “The old way of working is no longer enough for the public,” she says. “And I believe that we have a huge opportunity to thrive, rather than just surviving.” Expert Guide | Litigation & Dispute Resolution 2018 6 First identified in 1906, leading experts in science and medicine have been thwarted in their efforts to find a cure for Alzheimer’s disease for more than a century. Today, the progressive neurodegenerative disorder is the only leading cause of death that is still on the rise with a total number of affected individuals predicted to increase to 13 million in the United States and over 100 million worldwide by 2050. It is without doubt one of the biggest public health problems of the 21 century. st Founded in 2006, Cenna Biosciences Inc. has made one of the biggest breakthroughs to date in the on-going quest to find a cure for this deadly disease. Corporate LiveWire recently spoke with Dr. Nazneen Dewji, President & CEO of Cenna Biosciences Inc., to find out more about how this innovative company has set its sights on making a significant impact in both treatment and prevention through new therapeutic approaches. What is Alzheimer’s disease and why is it a growing concern around the world? Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that results in memory loss and a decline in mental function over time, eventually resulting in death. It is the most common form of dementia, making up between 60-80% of all dementia cases. Age is a risk factor. The disease affects one in 10 people over the age of 65, one in two by age 90 . With improved nutrition and health care, we are all living very much longer these days and most of us in the developed world can expect to live to be 90. The developing world is also catching up with longer life spans and in the coming years will be the areas of the world with the greatest increase in numbers of people affected with AD. The financial and emotional burden of caring for people with AD is enormous. That is the reason why it is such a growing concern around the world. Tackling Alzheimer’s Disease An Interview with Dr. Nazneen Dewji (President & CEO of Cenna Biosciences Inc.) Dr. Nazneen Dewji is the President and CEO of Cenna Biosciences Inc. in La Jolla, CA and an Associate Adjunct Professor of Medicine at the University of California, San Diego. Nazneen was born in Tanzania and raised in England. She was educated at the University of London, where she earned her B.Sc. (Hons.) and Ph.D. degrees. In 1986 she accepted a faculty position in the department of Medicine at UCSD. Since then she has worked on the molecular and cellular mechanisms in Alzheimer’s disease (AD). The discoveries made in her laboratory at UCSD support the development of new disease-modifying drug candidates for the treatment of AD. These are currently being developed at Cenna Biosciences Inc, a start-up company that she, along with her colleague the late Dr. S. J. Singer, founded in 2006. Cenna’s proprietary technology addresses the underlying cause of the disease, the inappropriate deposition of the toxic species, ß-amyloid (Aß). The Company has developed novel targets and is developing several lead peptide and small molecule compounds as disease- modifying drug candidates for the treatment of AD. About Dr. Nazneen Dewji One in 10 people over the age of 65 ALZHEIMER’S AFFECTS One in two people over the age of 90 7 At a time when scientific breakthrough and discovery is leading to decreasing numbers of those affected by many serious diseases and illnesses, Alzheimer’s is the only leading cause of death that is still on the rise. Why is this? Because, as already mentioned above, we are living so much longer and there is still no disease-modifying drug available that can arrest the underlying cause of the disease. Why exactly have previous efforts to find a cure failed? The basic pathology of the disease includes the production and accumulation of Aß. Earlier therapeutic attempts by others at lowering total Aß production were unsatisfactory as they directly targeted the catalytic activities of ß- or -secretase, enzymes γ responsible for the cleavage of Aß from its precursor, the amyloid precursor protein (APP). These enzymes also cleave as many as 60-90 other proteins besides APP, including Notch, many with critical cellular functions, and inhibiting or modulating their activities can produce many undesirable effects. Several - and γ ß-secretase inhibitors have been in clinical trials, although most have now stopped development because of toxicity and off-target effects. Thus while inhibiting or modulating the activities of these enzymes successfully reduced Aß, they also inhibited as many as 60 other reactions in the cell, producing many detrimental off-target effects. Another reason for their failure is they were administered too late in the disease progression, when the damage to the brain was already done. New therapeutic approaches that can inhibit total Aß production early without targeting the activities of the ß- or the -secretase are therefore urgently needed. Cenna’s γ technology does just that. What is Cenna Bioscience doing differently? Cenna’s approach is completely different and does not target the secretases. Cenna’s candidate drugs are peptides derived from Presenilin-1 which is part of the -secretase complex. Cenna’s γ compounds inhibit the production of Aß by specifically binding APP at a different site from the ß- and -secretase cleavage sites γ and arresting its further processing to Aß (Dewji, N.N. et al (2015) PLoS ONE 10(4): e0122451. doi:10.1371/journal.pone.0122451). Importantly, these peptide-induced reductions of total Aß and Aß40 and 42 do not modify or inhibit either ß- or -secretase activities. γ Our lead candidate P8 inhibits the production of Aß in vitro, in a Tg mouse model of AD and in patient-derived stem cells by over 50%, is stable, and can be delivered to the brain. New therapeutic approaches that can inhibit total Aß production early without targeting the activities of the ß- or the γ-secretase are therefore urgently needed. Cenna’s technology does just that. Expert Guide | Litigation & Dispute Resolution 2018 8 What have been the biggest challenges you have had to overcome to date? Funding. It is always difficult to attract money at the early stages of developing a new idea. We have been very fortunate to have been funded entirely by non-diluting NIH grants. I think we are now ready for investors – we have a disruptive, novel approach, a technology platform (multiple shots on goal) and data in transgenic animals and patient-derived stem cells. Investment in Cenna could lead to a mega-million dollar strategic deal and a high level return to investors. Where are you currently at in terms of development? We are at late preclinical stage. We hope to file an IND with the FDA this year for Phase 1 clinical trials to begin soon afterwards. What is the next stage? Filing an IND with the FDA once our GLP toxicology studies are completed and Phase 1 clinical trials to follow. What are Cenna Bioscience’s goals for the coming years? Key milestones over the next 12 months are to complete the pre- clinical development of our lead candidate and prepare a preclinical scientific package that will include the necessary experimentation in animals to satisfy the preclinical requirements for filing an IND. Clinical safety and efficacy will be established up to the filing of a Phase IIA NDA with the FDA. Further clinical testing, product license manufacturing, distribution and sales will be accomplished by means of a joint venture with an appropriate industry partner. Cenna’s model is to build value toward an exit through leveraged strategic partnerships. The primary activities are to develop Cenna’s existing technology to complete the pre-clinical development of its drug candidate. Cenna will develop a preclinical scientific package that will include the necessary experimentation in animals required for filing an IND. Once Cenna’s drug candidate has IND clearance, the company will be sufficiently advanced to attract Series A venture capital to move the compound on to Clinical Phase I and II trials. We will also enter into strategic collaborative partnerships with pharmaceutical companies to complete remaining clinical efforts and regulatory approvals. Such partnerships can provide the resources required, operating scale, manufacturing capacity, and distribution channels to successfully take a drug to market. Cenna can offer an exclusive license to its technology with a commitment to advance the science through the right partnership. Is there anything else you would like to share with our readers? It is anticipated that Cenna’s therapeutics will have a significant impact in both treatment and prevention modes and be useful throughout the course of disease. An effective disease-modifying therapeutic that slows progression or prevents AD will have significant commercial and societal benefits related to the quality of life for an ageing population. It is estimated that the revenue potential for disease-modifying agents in Alzheimer’s disease is >$15 billion per year, worldwide. Once the long-term use of Cenna’s drug is deemed safe, the drug may be taken as a prophylactic by everyone over the age of 65, in much the same way as statins are used for heart disease. That could be the opportunity to perhaps eliminate AD altogether, with an impact that would indeed be transformational. Investment in Cenna could lead to a mega-million dollar strategic deal and a high level return to investors. 9 Cenna Biosciences Inc. is dedicated to the discovery and development of novel drugs to prevent and treat Alzheimer’s disease (AD). Cenna was founded in 2006 as a California C-corporation, to translate over a decade’s academic research at the University of California at San Diego (UCSD) by the inventors of its technology. The proprietary technology addresses the underlying cause of the disease, the inappropriate deposition of the toxic species, ß-amyloid (Aß), in the brains of patients with AD. The Company has developed a novel target and is developing several lead peptide compounds as disease-modifying drug candidates for the treatment of AD. Cenna’s novel technology does not target ß- or γ-secretase, thus avoiding the inhibition or modulation of their other numerous substrates besides APP, including Notch, that have confounded previous therapeutic efforts in the reduction of Aß. Cenna’s technology is also the earliest in terms of intervention, as it stops the Aß from being produced, as opposed to dealing with the effects of Aß once it has accumulated. It is anticipated that these therapeutics will have a significant impact in both treatment and prevention modes and be useful throughout the course of disease. The work is at Pre-clinical stage and has so far has been funded by non-diluting NIH and other grants. The Intellectual Property that forms the basis of Cenna’s approach is covered by U.S. and foreign Patents, filed by UCSD and exclusively licensed to Cenna by UCSD. Expert Guide | Litigation & Dispute Resolution 2018 10 Healthcare is evolving at an increasing rate. New technologies are continually being introduced, creating excitement among medical practitioners, researchers and patients alike. As a result, effective communication is more critical than ever before to ensure the impactful implementation of the latest findings and new advancements in healthcare. In this article, we take a look at how Swiss-based independent healthcare communications agency, INNOTIO GmbH has developed a comprehensive range of services tailored to enable clients to meet and exceed specific requirements of their therapeutic field and business objectives. Achieve maximum impact in healthcare communications from INNOTIO GmbH 11 Engaging content INNOTIO believe that communications is about tiny, perfect revelations. One of the biggest challenges in medical writing is ensuring the content is both informative and digestible. A deep understanding of the subject matter is often necessary to present the information in a way that is concise and uncomplicated. Not only does this pertain to the written word but also its presentation. Written content takes on various forms in healthcare communications ranging from the text on websites to newsletters, brochures, programme summaries and study findings. Expertly incorporating graphs, tables, diagrams and infographics, INNOTIO can ensure all content is presented in an engaging and eye- catching manner. The agency’s seasoned team of medical writers are committed to providing clients with the documents they need when they need them. Flawless meetings, conferences and events INNOTIO has an unrivalled reputation for planning and executing small to major international conferences & meetings as well as imagining unique ideas for enthralling congresses & exhibitions. Many different components need factoring into the planning and execution of a successful conference. From event space set up, AV management, to incentive activities, INNOTIO supports the smooth running of corporate conferences with an always agile and determined team. Never crumbling under pressure, the INNOTIO team prides itself on demonstrating the ability to work rigidly within a designated venue space creating innovative solutions for layout and staging. In addition, INNOTIO has a proven track record for flawlessly organising educational conferences filled with exciting discussions from industry leaders on critical topics that will ultimately advance patient care around the world. They believe that ‘if you can organise an event for 400 people and they all show up, you can do anything.’ Eye-catching launch campaigns and branded booths Not only is INNOTIO able to support the smooth execution of corporate meetings and scientific conferences from an organisational perspective, but their creative team are also able to add exciting style and substance through eye-catching features and creative presentations. The team always strives to use these opportunities to create something special and unique such as supporting the release of a new brand during an annual conference on the client booth. In this instance, INNOTIO ensured their client’s booth took centre stage by implementing an eye-catching custom made and shaped skylight, changing lightboxes and LED flooring, as well as a large LED screen which counted down to the big reveal, the following morning. Effective branding solutions When most people think of brands, they typically think of mainstream, commercial names. However, strong branding is just as important in healthcare communications. It helps differentiate a product, service or event from another while also establishing familiarity and making it easily identifiable. INNOTIO’s expert brand and design team develop dynamic and strategic branding solutions to ensure results always resonate with the target audience – driven to create innovative and attention grabbing communications while also ensuring consistency throughout all visual platforms. About INNOTIO GmbH INNOTIO GmbH is a boutique healthcare communications agency with a global vision. They specialise in reimagining scientific, brand and corporate communication solutions to meet the demand of evolving medical environments. With long-standing clients and partners and a team of experts boasting more than 25 years of industry experience, INNOTIO succeed in making healthcare communications live up to expectations. For more information visit www.innotio.eu Expert Guide | Litigation & Dispute Resolution 2018 12 Sintetica S.A. is a pharmaceutical company delivering injectable anaesthetics and analgesics to patients worldwide through innovative science and excellence in development, production and marketing. Corporate LiveWire sat down with Elisabetta Donati, Scientific Affairs Corporate Director, who provides an insight into the success of the firm and its achievements. Leadership by innovation Barbara Piccagli (l) | Elisabetta Donati (c) | Clara Bianchi (r) 13 www.sintetica.com Sintetica S.A. - Elisabetta Donati Via Penate 5, 6850 Mendrisio, Switzerland Established 1921 in Switzerland, Sintetica possess sites which are based in Switzerland, Germany, Austria, Italy and United Kingdom, with its headquarters in Mendrisio, Switzerland. With 300 people employed around Europe, the workforce is diverse, coming from 29 different countries across the globe. Sintetica’s primary focus is on local anaesthesia and pain relief. As of 2012, Sintetica established its global division, which was the first international corporate structure. The global division was tasked with pursuing international growth under two distinct models, being a B2B licensing strategy and somewhat later a B2C strategy in selected markets. Elisabetta outlines Sintetica’s overall mission, discussing what steps are taken in order to achieve the leadership, and how employees integrate innovation into every aspect of its work. Here at Sintetica, we are fully committed to innovating therapies and drugs in local anaesthesia, pain management and neuromodulation. As such, we move forward with passion and competence in the full respect of people and the environment. All our efforts and resources are focused on becoming a leader in these fields, by developing novel medicine and better treatment options for physicians and patients worldwide. Sintetica recently gained approval in the US for a New Drug Application – Clorotekal (spinal Chloroprocaine mainly conceived for the fast track anaesthesia in day surgery cases, enhancing the recovery after surgery). Elisabetta added: “This is an outstanding achievement. In fact, we are one of the few small medium-sized companies in the world which actually managed to register an original innovative medicine in the United States”.  Sintetica managed all trials from cell and animal toxicity, to clinical research on human beings, obviously going through pharmaceutical development. Moreover the firm has submitted over 400 product registrations in over 100 different countries world-wide, via the network of partners it has built. The impressive technological enhancement of the last decade has strongly changed many surgical procedures and perioperative practices. Novel therapies and treatments require more and more the redevelopment of existing drugs. “As such, we enhance drug formulation, assuring the fitting of our ‘Premix’ medicines to the current standard of care” Clara Bianchi, Pharma R&D manager reflects. Surgical procedures become less and less invasive and their duration reduces, while there is an increased cost pressure on the health system which is leading to a shift towards day surgery. “Modern short and medium acting local anaesthetics are our ‘One Day Surgery’ proposal, enabling physicians to adapt the length and the conditions of anaesthesia to the novel surgical needs, allowing patients to go home on the same day” concludes Barbara Piccagli, Clinical R&D manager. Expert Guide | Litigation & Dispute Resolution 2018 14 CRC Screening Clinical Pathway CRC SCREENING Provider/Patient Discussion Preventive removal of polyps/ adenomas; continue screening advised. INVASIVE VISUAL METHOD Colonoscopy ADHERENCE 63% 2 DETECTION/PREVENTION Cancer detection with appropriate intervention and CRC case management. At Home Stool Test Epi proColon Test ® ADHERENCE 7–50% 2,26 ADHERENCE 99.5% 26 Continue participation in a regular CRC screening program. Referred for diagnostic colonoscopy. DETECTION/ PREVENTION NON-INVASIVE METHODS CLINICAL MANAGEMENT Provider/Patient Discussion Patients with a positive non-invasive test are managed based on results from their referral standard- of-care colonoscopy. Exploring the deadly risk of Colorectal Cancer How one firm has developed an innovative new screening to boost early detection Colorectal Cancer is the fourth most common cancer and second highest cause of cancer-related death, accounting for about nine percent of all diagnosed U.S. cancers. In this article, we explain what colorectal cancer is, outline the symptoms, and highlight the importance of early detection. 15 What is Colorectal Cancer? Colorectal Cancer (“CRC”) is the collective term for cancer of the large intestine (colon cancer) and cancer that begins in the rectum (rectal cancer). Most cases of CRC begin as small, noncancerous (benign) clumps of cells called adenomatous polyps that over time become abnormal and grow into cancerous tumors. Over time, the cancerous cells will invade and destroy normal tissue nearby and may also travel to other parts of the body to form deposits there (metastasis). In most cases, it’s not clear what causes CRC. Inherited gene mutations such as HNPCC and FAP increase the risk of CRC being passed through families, but these inherited genes are linked to only a small percentage of incidents. Recent studies, however, suggest that diet and lifestyle are contributing factors. Studies of large groups of people have shown an association between a typical Western diet and an increased risk of CRC. A typical Western diet is high in fat and low in fiber. Furthermore, cancer physician and researcher Kimmie Ng of Harvard-affiliated Dana-Farber Cancer Institute recently published a study linking a low-insulin- load diet – consisting of fruits, vegetables, whole grains, and healthy protein and fats – to a dramatic drop in CRC recurrence. Symptoms Many people with CRC experience no symptoms in the early stages of the disease. When symptoms appear, they’ll likely vary, depending on the cancer’s size and location. These can include: • A change in your bowel habits lasting longer than four weeks (including diarrhea, constipation and consistency of your stool). • Rectal bleeding or blood in your stool. • Persistent abdominal discomfort (such as bloating, cramps, gas or pain). • A feeling that your bowel doesn’t empty completely. • Unexplained fatigue, loss of appetite and weight loss. Detection & Screening Patients are advised to make an appointment with their GP as soon as possible if they notice any symptoms. The American Cancer Society recommends those with an average risk of CRC should consider screening from the age of 45. CRC is the fourth most common cancer and second cause of cancer-related death, accounting for about nine percent of all diagnosed U.S. cancers. However, substantial evidence supports the benefits of early detection as it’s linked to five-year survival rates as high as 90%. How Epi proColon® is making a difference In the United States, CRC screening rates remain sub-optimal with one in every three age-eligible Americans non-compliant with screening guidelines. As about 43% of new, later stage CRC diagnoses and 76% of deaths are attributable to people who are not up-to-date with screening. As a result, Epigenomics developed the Epi proColon® blood test for those age-eligible who are unwilling or unable to be screened by colonoscopy or take home stool tests. The test provides a simple and effective alternative to other screening tests and can be performed as a first step in the early detection and prevention of CRC. Available globally, Epi proColon® is an easy and convenient blood test to get. It is the first cell-free DNA (cfDNA) test to be approved by the FDA in the United States. There are no medications or nutritional changes, pre-testing, bowel preparation or stool collection requirements before having your blood drawn for this cancer screening. For more information, please visit: www.epiprocolon.com CRC Tumor Cells with Methylated Septin 9 DNA Cell-Free Methylated Septin 9 DNA and Other DNA in Plasma Methylated Septin 9 DNA Released into Blood Vessels Blood Vessel Apoptosis Necrosis Secretion Methylated Septin 9 DNA Other DNA Lumen Unmethylated DNA Methylated DNA (cytosine) A A A T G G G C T T T A 5' 5' 5' 3' 3' 3' 3' 5' C U T A C U T A A A A T G G G C T T T A 5' 5' 5' 3' 3' 3' 3' 5' C U T A C C C G Untreated DNA Bisulfite Treatment First PCR Cycle Septin 9 DNA-BloodChart DNA Methylation Expert Guide | Litigation & Dispute Resolution 2018 16 What are the consequences of continued spiralling costs in health insurance premiums for clients? We see more cost-shifting of insurance premiums from the employer to the employee. Some employees merely opt-out due to affordability. High deductible plans with out of pocket maximums exceeding $8,000 are not uncommon these days. Even if the employer covers most of the cost for the employee, many employees will go without care because they can’t afford to go to the doctor. Even with insurance, people can’t afford to use it. That is the most significant consequence. What challenges does the diminishing pool of insurance companies and plans pose? With fewer choices, there is not much competition. Also, people in rural areas are faced with limited options resulting in travelling far to seek care. Insurance companies who dropped out of the individual market due to the Affordable Care Act must wait five years before entering back into that space. We slowly see some come back, but not enough. Given the challenging landscape, how can you utilise your knowledge and experience to ensure clients get the most suitable and cost-effective solutions possible? I think the reason our pipeline is always full is due to our out of the box thinking and passion for helping others. When you face this with empathy you will find a way. I make it my mission to never stop learning different strategies. It starts with identifying each business and individuals’ unique needs. Since no one is the same, there are many ways to teach consumers. But this approach takes time, patience, tenacity, and willingness from the consumer. I’m happy to say that most of the time I end a first time call with the prospect saying, “wow, you just made me feel so much better.” The knowledge and experience I’ve gained over the years does give me a way to simplify the complicated and alleviate unnecessary stress. How frequently should individuals and companies assess their existing coverage? Businesses should look regularly. Things are always changing, whether in their business or the evolving plan choices. So anytime is a good time for a ‘check-up’. Individuals are a little different due to the open enrolment periods. With marketplace plans that include tax credits and cost-sharing they are usually in the best place, especially if they have pre-existing conditions. However, if they pay full price and do not have pre-existing conditions, they should invest some time to learn about all their options now and watch for changes. The sky is the limit if you are a moderately healthy person/family. Continued education and research are powerful. I would encourage businesses and individuals to have an open mind and be attentive to the current events taking place. In recent years, we have seen health insurance premiums in the United States rise to eye-watering levels whilst the range of plan options has diminished significantly. In 2019, the average annual premium for employer-based family coverage rose five per cent to $20,576 and for single coverage, premiums rose four per cent to $7,188. This follows an upward trajectory that has seen a healthcare insurance price hike of 54% since 2009 and 22% since 2014. 1 Founded in 2006, Texas-based independent boutique insurance agency Tanya Boyd & Associates are specialists in finding solutions to meet the unique needs of every business owner and individual they speak with, concerning their health plan options. Over the years they have changed and adapted to the evolving market conditions and found new and innovative ways to ensure the best end result. We spoke to President and CEO Tanya Boyd to find out more. Getting the best deal in the U.S. healthcare insurance market An interview with Tanya Boyd (Tanya Boyd & Associates) www.tanyaboydassociates.com | tanya@tanyaboydassociates.com | +1 972 203 8180 17 Who can benefit from getting in touch with Tanya Boyd & Associates? Oh my, anyone who is in charge of buying health insurance benefits for their employees or themselves. CEO’s who care about their employees, HR professionals, etc. Those who believe there must be something different, a better way, something that gives more access to care. Someone who wants a true partnership in their benefits advisor. Someone who wants the best support an agency and team can provide for themselves and or their employees. Is there anything else you would like to add? When I think about the award, Innovation & Excellence, it makes me proud. Being innovative does not come without pain. It takes courage to do what is right. It is not always easy when you know change is involved. Change is hard. It is hard on me, my team, and the clients who take a chance on our recommendations. There will always be something that goes wrong, no matter what. But if we can see the bigger picture together, it still proves to be the right decision. When I think about Excellence, I think about the many emails and messages I get stating how amazing our agency is, our team is, how pleasant and professional we are. I think about the fact that we have built our business by 100% referrals. 13 years of growing without buying one lead or paying for advertising just based on our brand and reputation – that is excellence. 1. Source: KFF Employer Health Benefits Survey, 2019 Expert Guide | Litigation & Dispute Resolution 2018 18 2018 was a momentous year for British cancer care with the arrival of high energy proton beam therapy in the UK. Leading the charge was Proton Partners International, which is now recognised as the world’s largest developer of high energy proton beam therapy centres through its Rutherford Cancer Centres, now operating across the UK. The first of these, the Rutherford Cancer Centre South Wales in Newport, announced the commencement of proton beam therapy treatment in April 2018 – a landmark moment for cancer patients in this country, who no longer need to travel abroad to mainland Europe or the United States for treatment. The first patient, Simon Hardacre, received treatment for prostate cancer and has spoken about his experience. Innovation in Cancer Care As Proton Beam Therapy Arrives in the UK “It will take some time before I know that the therapy has been a complete success but what I know is, that my body has been spared damage to healthy tissue and I have been able to go about my daily life during treatment. I was told to expect that my body would show signs of improvement in terms of how I was feeling within three months and that happened in even less time. I realise that protons are not the answer in every case – and I still have to wait to see how things finally work out, but I genuinely believe we are in a new era of cancer care in this country now that proton beam therapy is finally available.” Dr Jason Lester, the senior consultant oncologist who treated Mr Hardacre at the Rutherford Cancer Centre South Wales, said: “Treating the first person in the UK with high energy proton beam therapy is a significant event, and it opens up a new frontier for treatment in the UK. In the case of Mr Hardacre, we feel really positive about the way he coped with treatment. He will need regular check-ups in order to monitor his progress, and it was great to see him benefit from having treatment so close to home with minimal disruption to his daily life. We hope Mr Hardacre is the first of many to see the benefits from high energy proton beam therapy treatment here in the UK.” The First Patient to Receive High Energy Proton Therapy Treatment in the UK Mr Hardacre said: “When I was diagnosed with prostate cancer, I wanted to research the best possible form of treatment for me, which is how I came across proton beam therapy. I am delighted to say the treatment has gone exceptionally well in that I have been given intensive cancer care without suffering any gruelling side effects. 19 Next Steps for the Rutherford Cancer Centres The company opened two further centres at the end of last year – the Rutherford Cancer Centre North East in Northumberland which is taking patient referrals for chemotherapy, radiotherapy and immunotherapy, and the Rutherford Cancer Centre Thames Valley in Reading. Proton beam therapy suites at both centres are due to open over the next few months. Proton Partners International is building eight Rutherford Cancer Centres across the country over the next few years, in order to provide a treatment centre within 90 minutes of 75% of the UK population. A centre in Liverpool is also underway and due to open in 2019. Mike Moran, chief executive of Proton Partners International, said: “I am hugely proud of all that Proton Partners has achieved since its founding four years ago. We envisioned a centre which felt welcoming and relaxing to patients and their families, while offering the absolute best available oncology treatments across the board. “Seeing the initial response from patients within the proton therapy suite at the centre in Newport has been brilliant for myself and all of the staff to see – it really shows that we are doing the right thing by bringing this innovative treatment to the UK and making it easier for patients to access this without having to travel abroad. I look forward to seeing what the next three years brings, and know that we will continue to champion patient care and wellbeing alongside our commitment to constant innovation within oncology treatment and research.” The Lowdown: Proton Beam Therapy There are more than 90,000 cancer patients in the UK every year who are treated with radical radiotherapy. Proton Partners International believes around 10% of patients treated with radical radiotherapy – the figure accepted at European level – could be better treatment with proton therapy. Proton beam therapy is a type of radiotherapy used in cancer treatment, delivering heavily charged protons in a more targeted manner to reduce damage to peripheral tissue and organs. It can also help to reduce side effects. Protons deliver the same damage to cancer cells as radiotherapy; however, they can be controlled to stop at a defined point in the body. Due to its precision and accuracy, research has highlighted that proton beam therapy is particularly good for treating cancers in children and can effectively treat hard-to-reach cancers in the brain or near the spinal cord. Cancer Centres Mike Moran - CEO of Proton Partners International For more information, please visit: www.therutherford.com Expert Guide | Litigation & Dispute Resolution 2018 20 Bringing the classroom to the internet with topical webinars Industry professionals such as scientists and professors are also providing LabRoots with webinars, allowing anyone with an interest on a certain topic the ability to learn more about it from the topic experts themselves. The webinars have brought the classroom to the internet; scientific information is now available to you anywhere without having to enrol in classes or pass exams. Most topics presented are chosen due to either being new to the industry, on trend in the science and medical profession, or of significant consequence. Cancer and other tumours, for example, is a topic that weighs heavily in the science and medical industry and so LabRoots offers multiple webinars on important talking points around the topic. ‘Dissecting the Tumour’ is one such webinar presented by speaker Olaf Hardt, PhD, Manager of R&D Oncology at Miltenyi Biotec. Due to the breadth of this topic, LabRoots has, like with many other of its webinars, developed it into a dedicated series to give you the in-depth coverage needed to understand the topic as well as possible. Virtual Events with industry leading speakers and expert panellists As a global scientific online platform, LabRoots’ user network is worldwide. By hosting interactive virtual events, all of its users are able to participate and attend as time and place restrictions are eliminated, giving everyone the opportunity to attend from all around the world. These events cover some of the leading global topics in science in a conversational and interactive setting. Industry experts from all sectors and backgrounds are on hand to engage with you and share their knowledge and expertise. In the ‘24 Hours of Stem Cells’ event for example, the panel of experts includes public speakers, scientists, professors and doctors who will lead activities such as discussion groups, conference calls and talks. The benefit of this is to give you opportunity to engage in beneficial one-to-one and group dialogues to gain a wide range of knowledge, advice and opinion, as well as gain those all-important contacts in the field. What’s more, as these virtual events are completely unconstrained; you only need to partake in the areas of the event that most interest you. LabRoots is a leading scientific social networking website, offering top trending news articles, premier educational virtual events and stimulating, informative webinars conducted by leading field experts. They greatly contribute to the advancement of science through these exceptional content sharing capabilities, both individually and combined as a platform. Some of the latest discoveries in the world of science are explored in this virtual space and are shared through networks and communities spanning the globe. Topics covered are broad, spanning everything from the stars to the sea. However, a particular focus is put on health and medicine, an ever changing and developing industry, which requires those within it to be constantly informed. The nature of this site is educational and interactive; a platform that encourages you to learn and develop an understanding of current hot topics in science and medicine collaboratively. Learning through LabRoots The Leading Global Scientific Social Network 21 Current affairs & breaking news stories LabRoots is also a leading source of science news. To keep you up- to-date with current affairs in the science and medical industries, they publish regular news articles that have been authored by scientists themselves and other industry experts too. These articles span across all areas of science and medicine, with a focus on the topics that are most on trend and relevant to the industry. As well as those previously mentioned, news articles currently focus on topics such as ‘microbiology’, ‘cannabis science’, ‘technology’ and ‘drug discovery’. These are all topics that have a particularly heavy influence within the industry today. Many of the LabRoots articles have in fact trended online from the sheer amount of readers that they have had. This is due to them being written by experts at the forefront of the science and medical industries who can offer breaking news stories of new discoveries and new technology in science and medicine. For example, there has been huge talk in the news recently about the possibility of nuclear war. Therefore, when the article ‘ Here’s What’d Happen if We Detonated a Nuclear Bomb in Space ’ was published, it became one of the top trending scientific articles online. Points and prizes for participation If that wasn’t enough to keep you engaged in the world of science though, LabRoots recently launched its Leadership gamification platform. This allows you to collect points for engagement with others on the site, for watching seminars and for event participation – the more you engage the more points you gain! The site even runs a monthly competition where the 10 users with the most points for that month will win a LabRoots gift card to get one of their fun (and kind of nerdy) scientific themed t-shirts. So, what will you choose when you win – the ‘Cell-ebrate’ t-shirt or the ‘Trust me, I’m a scientist’ t-shirt? To keep you up-to-date with current affairs in the science and medical industries, they publish regular news articles that have been authored by scientists themselves and other industry experts Corporate LiveWire Expert Guides are available on all platforms. Access everything from our latest publication to our archived collection through your computer, laptop, tablet or smart phone. It’s as easy as one click of the button or a tap of the screen. Medical LiveWire Expert Guides are available on all platforms. Access everything from our latest publication to our archived collection through your computer, laptop, tablet or smart phone. It’s as easy as one click of the button or a tap of the screen.