Conference Report AESGP Annual Meeting 2016 Athens

7/25/2019 Conference Report AESGP Annual Meeting 2016 Athens

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Launch of the AESGP

Self-Care Agenda 2020

As AESGP President, Roger SCARLETT-SMITH in-troduced the AESGPs new Self-Care Agenda 2020

which primarily addresses unnecessary restrictions

currently placed on developing self-care in Europe.

He outlined that industry had the opportunity to

give millions of people across the European Union

safe and effective access to self-care but for this to

happen there was a need for improving the regula-

tory system. People want to take responsibility for

their own health and this, combined with demogra-phic changes and the increasing cost of professio-

nal healthcare, means more must be done to deve-

lop and support self-care.

To achieve greater self-care in Europe by the year

2020, the AESGP Agenda puts forward six

enablers: establishing evidence-based policies, fos-

tering enhanced cooperation between all stake-

holders, creating more incentives for innovation in

self-care, reducing administrative burden, using

procedures for market access efficiently and imple-menting existing rules reasonably.

Self-Care Agenda 2020

The Self-Care Agenda 2020 summarises the

objectives of AESGP for the years to come in

the area of non-prescription medicines, food

supplements and medical devices.

It focuses on areas where through a re-

duction of the regulatory burden, the availa-

bility of self-care products can be improved.

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Conference report

The future of self-care:Shaping the new environment

The AESGP 52nd Annual Meeting - the annual gathering of the self-care sector in Europe was held in

Athens, Greece, from 31 May -2 June 2016. Entitled The future of self-care: Shaping the new environment,

the conference looked at this overarching theme from three angles: marketplace, regulation and policy cove-

ring non-prescription medicines including herbal medicinal products - food supplements and self-care me-

dical devices. With more than 350 participants, including representatives from industry, and many stakeholder

organisations, the conference was once again very well attended.
http://www.aesgp.eu/media/cms_page_media/68/AESGP%20Self-Care%20Agenda%202020.pdfhttp://www.aesgp.eu/media/cms_page_media/68/AESGP%20Self-Care%20Agenda%202020.pdfhttp://www.aesgp.eu/media/cms_page_media/68/AESGP%20Self-Care%20Agenda%202020.pdfhttp://www.aesgp.eu/media/cms_page_media/68/AESGP%20Self-Care%20Agenda%202020.pdfhttp://www.aesgp.eu/media/cms_page_media/68/AESGP%20Self-Care%20Agenda%202020.pdfhttp://www.aesgp.eu/media/cms_page_media/68/AESGP%20Self-Care%20Agenda%202020.pdfhttp://www.aesgp.eu/media/cms_page_media/68/AESGP%20Self-Care%20Agenda%202020.pdf


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Nicolas Bouzou

Roger Scarlett-Smith

In a fast-changing and global environment, it is im-perative that the regulatory system be fit for pur-

pose, efficient and risk-based whilst ensuring opti-

mum public health protection. Any formal evalua-

tion of a regulatory instrument should include the

different actors involved (e.g. regulators, industry,

patient organisations, healthcare professionals). It

should also include feedback loops to ensure that

the instruments continue to operate well and re-

main fit for purpose.

There is an availability issue with non-prescriptionmedicines in Europe. It is shocking that only five

ingredients were available as non-prescription me-

dicines in all EU Member States. The routes to mar-

ket (centralised, mutual recognition, decentralised

and national procedures) need to guarantee timely

market access for non-prescription medicines inclu-

ding reclassification from prescription to non-

prescription status (switch). The benefits of non-

prescription medicines need to be taken into ac-

count in the evaluation process e.g. through the use

of recognised risk-benefit decision making models.It is now important to put the general political

orientations into real action through switch gui-

dance, transparent criteria and open cooperation. It

is vital that applicants continue to have the ability to

choose for well-established substances which

procedure they wish to use (European or national).

Also, the implementation of the new EU pharmaco-

vigilance legislation must reduce unnecessary admi-

nistrative burdens and avoid unjustified restrictions

for non-prescription medicines.

Having the host country in mind and quoting, the

Commission at the 2007 EU Pharmaceutical Forum,

Roger Scarlett-Smith said that Price control is not

necessary for non-reimbursed medicines. For these

products, price competition can steer the price evo-

lution sufficiently well. Therefore, Member States

should abstain from price-control. This principle

must be adhered to in all Member States. He added

that AESGP acknowledged the high value of infor-

mation to consumers to assist them in selecting ap-

propriate treatment, to communicate benefit, quali-ty and promised experience and to establish trust

and confidence. So let's learn, get inspired, get in-

volved and take action early to secure the benefits.

New technologies as a possible curefor healthcare systems

According to Nicolas BOUZOU, founder and direc-tor of Asters, the healthcare battle is a great way

to reconcile European citizens with scientific innova-

tion because it can help solving human issues. The

Welfare State has been shaping the life of European

people. But the economic and technological envi-

ronment has been changing quickly while the Wel-

fare State is difficult to reform. European citizens are

getting older. Health expenses increase because of

the impact of chronic diseases like diabetes or can-

cer. Health expenditures are rising very quickly in

nearly all rich countries. Health is what economists

call a superior good, namely a good whose weight

in private incomes is rising.

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Erica Mann

The more medicines that are developed, the more

the R&D costs increase and with it the price of new

treatments. This is part of our common value to

make all European people access the most adapted

treatments whatever their revenues are, hence the

necessity to regulate the price.

Bouzou insisted that health systems had to be re-

formed under two constraints: public expenditures

must be regulated (no more tax increase possible)

and justice as conceptualised by Plato must be

given a prominent place. In the EU, the idea of

justice is embedded in the healthcare systems ai-

ming at allowing people to build up their own life.

With regard to new technologies, the changes we

are experiencing confirm the economists renowned

theory that Joseph Schumpeter defined as creative

destruction in 1940: progress is made by des-troying the past. Instead of digitalisation, Nicolas

Bouzou prefers to use the term NBIC which stands

for Nanotechnology, Biology and medicine,

Information sciences, and Cognitive Science. This

evolution is a four-step process which started with

digitalisation, i.e. converting information into a

digital format (in the 90s).

The second step is uberisation, i.e. digitalisation of

services (ongoing), followed by the Internet ofThings, i.e. the network of physical objects embed-

ded with electronics, software, sensors, and network

connectivity that enables these objects to collect

and exchange data (starting). The last step that can

already be anticipated is transhumanism, i.e. evo-

lution of the human race beyond its current physical

and mental limitations. Bouzou explained that the

introduction of new technologies and notably the

internet of things in the health field was accompa-

nied by the arrival of new players who contributed

to the development of a new ecosystem. The datadeveloped by these players can greatly help in

patient monitoring and better prevention so as to

allow a better regulation of health expenditure.

An insight into Bayers strategicthinking

Erica MANN, Worldwide President of the Bayer

Consumer Care Division, calls the self-care industryto look up and build the infrastructure to meet

consumers needs or risk losing them. Recalling that

this industry is deeply rooted thanks to the support

of generations of family trust, Mann asked if its

relationship with consumers was as good as it

could be, should be. We need to move our rela-

tionship from simply providing information to advo-

cacy. Industry has to ask itself whether it supplies

the right information, and whether it has invested to

build the infrastructure that would enable consu-

mers to access all the information needed to choosethe right product. A 2013 quantitative study showed

that only 20% of consumers feel very confident in

managing their own health. This points to a pivotal

role for health literacy to provide the knowledge,

capacities and skills to practice self-care.

In response to that, Mann said that the self-care

industry needed to be the difference and become

the creative force or the connectors to foster this

digital entrepreneurship. Reminding that E-

commerce is growing in every retail market sectors,she warned that industry would lose in the digital

space if it did not invest in the right infrastructure,

noting that high-profile technology companies such

as Nokia, Google and Samsung have already inte-

grated healthcare applications that enabled consu-

mers to see all health data from multiple sources inone place. Consumer power fused with consumer

knowledge will create a new breed of consumers.

Mann concluded: I urge all of us to look up and

lets get a bit of this rather than being overrun by it.

Lets be the difference.

Conference report

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Big becoming bigger:Mergers and Acquisitions(M&A) in the consumer

health and pharmaceuticalindustry

Are the big really becomingbigger? Global OTC Market Trends

Francine NIETO, Global Offering Director, at IMSHealth,

provided an insight into the performance of

the worldwide OTC market. Although the OTC mar-

kets steady growth continues and should continue

to do so in the next few years (by an expected rate

of 5%), it remains only 10% of the total global

pharma market. Specialty drugs (in oncology and

hepatitis) notably in US are driving the market. OTC

is still a very attractive 95 billion euro market for

2015. Over 60% of the market growth is generated

by China, Latin America, Turkey, Russia, and Middle

East.

According to Nieto, there is no doubt that the

biggest are definitely getting bigger. The top 3

corporations in the global OTC rankings increased

by 15%, however the gap between the first and 10th

-placed companies continues to grow.

The 10th-placed firm had a 1.7% share in 2005, but

the leading player had only a 4.5% share, a factor of

2.6. In 2016, the 10th-placed firm has a 1.3% share

but the leading player has a 5.2% share, a factor of 4

-times more.

While the small ones are also still growing (notably

in the developing regions), middle players are get-

ting squeezed in-between. Nieto explained the

growth in the Australian market as mainly resulting

from export to China using the good image ofAustralian consumers. The top 10 players need to

look for mergers and acquisitions to grow. Among

200 companies, there are not so many global corpo-

rations. The average growth rate of global compa-

nies has only been 3.6%. Local/regional players have

grown faster at 4.3%; while multi-regional firms

have achieved an average increase of 3.8%. Overall

global OTC growth has been 6.1% in 2015, demons-

trating the strength of smaller players.

Nieto concluded that players coming from outsidethe OTC market were looking to join in and

potentially might decide to get bigger. Technology

players are also looking to be part of the game.

Market leadership is consistently changing and

there are faster regional players engaging in merger

and acquisition activities.

Francine Nieto

Making bigger mean better

Presenting the new GSK Consumer Health created

in March 2015 from consumer health care joint

venture GlaxoSmithKline (GSK) and Novartis, BrianMcNAMARA, Head of Europe & Americas at GSKConsumer Healthcare, believes speed and culture

are critical when tackling a merger.

Referring to a KPMG study which indicated that

83% of mergers could be regarded as failures to

enhance shareholder value, he described the most

important driver of success for a deal. First and

foremost, for GSK, the strategic rationale for deal

was clear and had four major areas of focus:

Strengthen 3 core businesses for GSK

1) GSK acquired the Novartis vaccines business

2) GSK sold some oncology assets to Novartis

3) GSK and Novartis created Consumer

Healthcare joint venture

Create a business with key category leadership

positions based on highly complementaryportfolios

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Brian McNamara

Give more competitive geographic footprint by

scaling in OTC at country level going from #1

position in only 13 markets to 30. Emerging

markets now account for 40% of GSKS portfo-

lio.

huge synergy potential including both revenue

and cost synergies (400 million of cost syner-

gies by 2017)

McNamara stressed that the initial focus in any deal

was integration the first few steps in a long jour-ney. Starting with setting the strategy (Where to

Play and How to Win), the team needs then to be

built up regrouping talents from both sides. The

systems integration is next for achieving one or-

der, one invoice across markets (in over 100 mar-

kets). He was happy to say that no major disrup-

tions had occurred yet. Last but not least, according

to McNamara, culture is critical. Quoting Peter

Drucker who said culture eats strategy for break-

fast, he insisted that building right culture for new

company was a key enabler of GSK CHs success.

But integration is only the beginning; real challenge

is creating sustainable long-term value: for consu-

mers, customers and shareholders. For consumers,

this means getting the right product, to the right

consumer at right time notably by accelerating

innovation, expanding access to self-care and build

trust in their brands. He concluded that the overar-

ching critical factor in merger success was speed. In

doing so, GlaxoSmithKline (GSK) has achieved 6%

top-line growth and a 180 basis-point impro-

vement in its operating margin. Noting the strong

Year 1 financial results and performance in the

market, McNamara acknowledged that there was

still a long road ahead.

Sanofis journey in an ever moreexciting environment

According to Vincent WARNERY, Senior VicePresident, Global Consumer Health Care Division,

Sanofi, it is crucial not to give an acquired com-

pany a "cultural shock". Sanofi Consumer

Healthcare used a smart integration model when

it acquired Chattem in the US in 2010, and will do

the same later this year when it will merge withBoehringer Ingelheims OTC business. This ap-

proach was behind the decision to maintain Chat-

tem as a separate operating unit in its existing

Chattanooga, Tennessee headquarters. Warnery

insisted that Sanofi learnt from its failures notably

from past acquisition of the wrong targets. In that

regard, Oenobiol is a good example of failure (key

talent loss, erosion of the fast-cycle innovation

culture, agile marketing, regulatory and medical

CHC capabilities loss etc).Having now sold Oeno-biol to Vemedia, Warnery appeared confident that

it would be a greater success.

Regulatory expertise to switch Allegra

(fexofenadine) in the US has been provided by

Sanofi but no staff had been lost from Chattem,

and in some respects the Chattem integration

represented a reverse takeover. He indicated

that the same approach would apply to Boehrin-

gers OTC operations in Germany.

The merger as a whole with Boehringers OTC

represents a natural cultural fit as both compa-

nies have a similar market approach.

Vincent Warnery

Conference report

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An insight into Johnson & Johnsonsstrategic thinking

Birgit SCHUHBAUER, Global Vice President, Strate-

gic Marketing OTC at Johnson & Johnson, madeclear that in all integrations the people question is

the tough one. Each company leads its merger and

acquisitions differently but it is all about clarity and

speed. Organisational charts need to be in place

soon after an acquisition is agreed and the new

structure needs to be quickly communicated to

employees, informing them of their job status.

When people dont know what their future is, they

are blocked. Although there is a lot of under-

standable fear amongst staff during the merger

process, such activities create larger companies and

offer more cross-category opportunities. Mergers

do not fail because the assumptions and the strate-

gy are wrong; they fail for culture and change-

management reasons.

Smaller acquisitions must not be underestimated

because they can also create more value with exist-

ing assets. Referring to Johnson & Johnsons acqui-

sition of Indian Orsl, an electrolyte drink that is

recommended by healthcare practitioners,Schuhbauer demonstrated that smaller acquisitions

might allow developing the relationship with

healthcare practitioners, which was of primary im-

portance in emerging countries. External growth is

definitely Johnson & Johnsons big strategy as

merger and acquisition are in the companys DNA

but it has to be the right fit.

Session Chair Babis PAPADIMITRIOU, a well-known journalist in Greece, concluded that M&A

activities do not seem to have reached its end point

and wondered how the market will look like in a

decade from now.

Birgit Schuhbauer

Babis Papadimitriou

Boehringer has a perfect portfolio, 15 brands in four of Sanofis six priority categories and the merged entity

would be in the top five in the worlds 11 leading markets, including Japan and Greece. Warnery recognised

the great achievement of Boehringer.

Warnery highlighted two key factors of Sanofis future business model for growth. First, striking strategic

partnerships with prescription brand firms to fuel OTC switches is vital, noting Sanofis deal with Eli Lilly over

the erectile dysfunction drug Cialis (tadalafil). Secondly, "swap transactions" for brands or even whole portfo-

lios will be key to create a win-win situation and to address 2 in 1 strategic objective. In conclusion, Warnery

confirmed Sanofi is highly motivated by the OTC market.

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Key elements to make pro-gress for self-care in reality

Chair Suneet VARMA, President and General Mana-ger at Pfizer Consumer Healthcare, introduced the

session in which speakers presented case studies in

three different countries on how to really improvethe availability of non-prescription medicines.

Manifest for the development ofself-care in France

Pascal BROSSARD, President of the French industryassociation (AFIPA), presented AFIPAs recommen-

dations to promote the development of self-care -

and in particular, self-medication in France and

promoted the inclusion of the health care reform inthe political debate ahead of the 2017 national

elections. France lags behind in the use of self-

medication, which represents 15.4% of the volume

of the French medicine market versus 32.3% on

average in Europe. Afipas objective is to demons-

trate that the French people are ready to practice

self-medication and that the GPs are willing to

support them in this practice. A recent study con-

ducted on both patients and doctors has shown that

nearly all French people questioned (91%) feel they

are able to deal by themselves with minor healthissues. 80% of them have practiced responsible self-

medication to treat benign symptoms over the past

year. 92% of the people questioned indicate that

their symptoms disappeared without their having to

consult a doctor. According to the GPs themselves,

16% of the patients they see in consultations could

be treated by responsible self-medication. The GPs

also state that the development of responsible self-

medication could de-saturate their offices (59%),

reduce health spendings (53%) and enable them to

re-focus on more severe health issues (63%).

Afipas manifest recommends an action plan to

develop self-care in France to benefit all actors of

the health care system:

Reform the financial coverage and develop the

self-medication medicine offer: The reduction of

the public financing for 201 molecules, corres-

ponding to 66 self-medicatable indications,

would provide savings exceeding 1.5 billion

euros during the very first year.

Associate health care professionals and patients

to this new health care strategy. With this ap-

proach, self-medication will become the firststep of the health care process, based on well-

informed, autonomous patients and perfectly

trained health care professionals.

Facilitate self-medication and ensure it is finan-

cially accessible in order to obtain patient sup-

port:

In France, everything is ready to increase the deve-

lopment of self-care rapidly: the patients, the health

care professionals, the distribution and control net-

works The only missing factor is a strong politicalwill to place self-care at the heart of a new health

care strategy. The lack of political anticipation on

these issues is difficult to understand. According to

Brossard, we must react and adopt an approach

which works everywhere else in the world. He con-

cluded that Afipa was ready to support any political

action aiming to develop self-care.

Suneet Varma

Pascal Brossard

Conference report

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Addressing the sustainabilitychallenge of Healthcare SystemsThe vital role of Self-Care An example from Germany

Dirk OSSENBERG-ENGELS, Head Region EU South,

CEE & ME at Bayer Consumer Health, said withconviction that self-care is the right thing to do.

To accomplish self-cares full potential a joint dis-

cussion of all policy-makers and stakeholders is

needed which looks at both public health and long-

term sustainability of health care systems. Self-care

can help consumers to get well and stay well

through fostering self-care literacy and enabling

consumer empowerment if appropriate access and

availability of current and future OTC medicine are

guaranteed. Self-medication is an important pillar

of the German healthcare system.

Focusing on the importance of headache, he men-

tioned the 2010 consumption data of OTC-

analgesics per capita that showed a rather minor

consumption of OTC-analgesics in Germany com-

pared to other countries such as France. Bayer

Consumer Health Division has undertaken a study

on how much self-care treatment of migraines with

OTC analgesics had saved the German healthcare

system annually. The study based on a representa-

tive, independent survey of persons insured by aStatutory Health Insurance investigated the value of

self-medication and found that switch to self-care

for this one indication saved 1 billion a year."

Ossenberg-Engels concluded: That is one indica-

tion in one country; think about the saving if it was

Europe-wide.

Dirk Ossenberg-Engels

Key Elements to Make Progress forSelf-Care in Reality

According to Karen PROUD, President of Consu-mer Health Products Canada, building the evi-

dence base is key to prevent a slow-down in re-

forms to consumer healthcare rules in Canada. InJune 2014, Health Canada announced a consulta-

tion on a Framework for Consumer Health Products,

which proposed to modernise the oversight of

health products, intended for consumer use. Using

concrete examples of borderline products, Proud

explained that consumer health products covered a

broad range of products including cosmetics (e.g.

make-up, deodorants), disinfectants (e.g. for use on

countertops, contact lens solution), non-

prescription drugs (e.g. pain relievers, cold and al-

lergy remedies) and natural health products (e.g.vitamin and mineral supplements, traditional and

homeopathic products, toothpastes). The 2015 Ca-

nadian election gave a strong majority to the libe-

rals who swept into power and changed the game

players. While the reform of consumer healthcare

rules remains a priority of the new government, this

government contains numerous rookie politicians

who have no knowledge of the consumer

healthcare space. In response to that, Proud pro-

moted three key elements: raising awareness, edu-

cating the willing and driving for change. The Asso-ciation is developing a study, similar to Bayers stu-

dy in Germany, outlining the benefits to consumers

and the Canadian healthcare system of supporting

prescription to over-the-counter switch initiatives.

Karen Proud

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CHP Canada is working with pharmacy regulators to ensure that self-care remains the first response to

health care and has launched communication campaigns to the public. CHP Canada has been spreading

the word self-care and is working with Canadian politicians to increase awareness among Canadian offi-

cials of the value of formally recognising self-care as a primary component of the healthcare system and

providing the resources necessary to support the efforts of its citizens to practice responsible self-care.

Concluding on the session, Chair Suneet VARMA reminded that the true value of self-care needs to be

shown to policymakers, health insurances, consumers and the like, and while we say this every year, the

time is now to demonstrate the benefits.

Getting full support for self-care from stakeholders

In his introduction, the session Chair George DOKIOS, Director General, EFEX, stressed that stakeholdersin many parts of Europe needed to recognise the benefits of self-care. While stakeholders in markets like

the UK have already embraced the self-care concept, others in countries like Greece have only just started

to grasp the benefits. Self-care needs a coordinated support by all stakeholders. Noting that new laws in

Greece are bringing radical changes to the Greek pharmaceutical market, he said that any process of

change following major economic difficulties had implications on healthcare in general as well as on

healthcare professionals, including in particular community pharmacists.

Portugal Self-Care Program Takecare of myself

According to Mafalda ARAJO, Vice President ofAPIFARMA / OTC, Portugal, developing Portugalsself-care publicity campaign has brought all of the

stakeholders together for the first time. She ex-

plained that the key objectives for this campaign

had emerged from stakeholders consultation

aiming at: empowering the Portuguese popula-

tion to manage minor health problems, promo-

ting healthy behaviours and the responsible use

of OTC medicines, actively contributing to health

literacy in Portugal and ensuring the involvement

of health professionals and educators in a natio-

nal program. Choosing an accessible language for

the consumers, the association went for the brand

Tratar de mim meaning I take care of myself.

Arajo highlighted that the whole process started

in Lisbon 2013 at the AESGP conference which

raised awareness and interest from stakeholders.

Although bringing together doctors and pharma-

cists in partnership around self-care was a chal-

lenge, the program was officially launched in July

2015 with a poster and two leaflets published and

distributed to pharmacies & health centers. Face-

book was a key tool in this campaign as it allows

for speed and flexibility by contrast with leaflets

and factsheets. Since its launch, the programme

has been extended with a childrens game called

Learning about health is fun and a self-care

conference is also planned for the autumn 2016.

Mafalda Arajo

Conference report

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Efficient OTC Self-Care in GermanPharmacies

Michael BECKER, Deputy Chairman of the Ger-man Medicines Manufacturers Association (BAH)

put forward that combination of OTC and strong

pharmacies were key factors for an efficient publichealthcare-system. Having presented the product

classification and distribution channels in Germa-

ny, Becker indicated that 4 million German consu-

mers went in pharmacies every day, 70% of them

going to their local pharmacy. There are more

pharmacies in Germany than bakeries and gas

station, i.e. more than 20,000 pharmacies. Looking

at the number of pharmacy per inhabitants, Ger-

many has 4.000 inhabitants per pharmacy which,

compared to Greece, does not appear so high

(1.000 inhabitants per pharmacy in Greece). No-ting that 95% of internet enquiries refer to di-

seases and symptoms, Becker insisted on the

need to have fast, reliable and local expertise at

hand.

In many cases, the pharmacist appears as the first

point of contact to provide trust and advice.

Sale of OTC in pharmacies enables more efficient

patient care and will lead to change in behaviour

and awareness of all involved stakeholders in the

healthcare environment. Becker concluded that

OTC and pharmacies were strongly intercon-

nected: Strong OTC products & brands streng-

then pharmacies and vice versa. Strong pharma-

cies enable higher self-care and, as such contri-

bute to efficient public healthcare-system.

The pharmacists perspective:The biggest and the most complexmerger in self-care

Jan SMITS, President of the European indepen-dent pharmacists association, PGEU,

emphasised

that getting stakeholders including healthcareprofessionals, regulators and consumers in

every country to come on board was like perfor-

ming the biggest and most complex merger

imaginable. Stakeholders are fragmented and we

must not underestimate the differences in cul-

tures across the European Union (EU), and It is

difficult to get everyone in line. Recalling that 46

million European citizens visit pharmacies every

day, he said that it was 46 million unique oppor-

tunities to improve their health and well-being.

Pharmacists are trusted medication expert en-joying a key touch point throughout continuum

of care. They also are the last health care profes-

sional seen by patient before medications are

taken. Noting that pharmaceutical care is much

cheaper than secondary/tertiary care (hospital

costs) and primary care (GP/medical-professional

related costs), Smits underlined the critical role of

community pharmacists to provide hygiene ad-

vice (general and personal), nutrition advice and

counselling (type and quality of food eaten, etc.),

lifestyle advice and counselling (sporting activi-

ties, leisure, etc.), self-medication support in trea-

ting minor ailments, and support for patients with

chronic conditions to care of themselves.

Michael Becker

Jan Smits

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Bringing pharmacy knowledgeand students together

Katarzyna SWIDEREK, President of the EuropeanPharmaceutical Students Association (EPSA)

presented the approach of pharmacy students

towards self-care. A study conducted in 32 coun-

tries showed that Pharmaceutical care, defined

as the pharmacists contribution to the care of

individuals in order to optimise medicines use and

improve health outcomes, is covered by the

university degree in all countries either as a sepa-

rated subject or in the overall program.

Looking at the example of Austria, practice-

oriented seminars are organised for students

involving analysis of patient cases. In Belgium,

series of classes are devoted to self-care with

practical exercises in virtual pharmacy (with volun-

teers playing the role of patients), recorded ses-

sions (feedback can be provided in small groupsof students). In the UK, OTCs are tackled in dis-

pending classes in every year study including role

plays with lecturers as patients. It allows to test

students on their communication skills,

knowledge of interaction between OTC products

and prescription medicines.

Overall, Swiderek concluded that there was a

positive change in pharmaceutical studies offering

opportunities to future pharmacists to play a

more complementary role in primary healthcareand a more active advisory role to the patient in

the pharmacy, notably in selecting the appro-

priate non-prescription medicine for their pa-

tients. Last, she informed the audience about the

EPSA Training Project aiming at raising awareness

among students through webinars and fostering

the development of their soft-skills.

Following the same approach and promoting abetter interprofessional collaboration and educa-

tion (with dentistry, psychology and medicine

students), Swiderek informed the audience that

EPSA collaborated with the other European health

care students associations.

OTC medicinal products, publichealth and pharmacies

Dagres GIANNIS, Pharmacist, Vice-President ofPanhellenic & Attica Pharmaceutical Association

(PFS & FSA NPDD) highlighted that a proper

access to OTC Medicine required an independent

pharmacist, at least, to interfere first. So far, 100%

of OTCs are dispensed exclusively in Community

Pharmacies. While misuse of OTC medicines can

be of safety concern, Greece guarantees so far a

high level of safety by restricting the use of most

medicines to pharmacies. Average Hellenic Phar-

macies retail profit margin is below European

average. Advocating for the sale of OTC medi-cines in pharmacies, Giannis listed the main ad-

vantages of these products among which accessi-

bility in purchase, safety in use, efficiency in use

(giving an advantage compared to other easy-to-

access everyday health treatments), beneficial and

trustworthy cooperation (Higher Profit Margins

and Lower Risks in Deals) and prestige.

Katarzyna Swiderek

Conference report

11Giannis Dagres


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Digital strategies toprovide support to theEuropean citizens

Session chair Sophia FILAKTOU, Business & In-dustry Solutions at SAP, expressed her pleasure to

chair this session in her home country and intro-

duced the speakers who would give insights intothe changes of consumer behaviour e.g. through

social media. What are the concrete implications

for the manufacturers of self-care products? How

to best develop a digital strategy which corres-

ponds to market expectations?

An insight into RBs digitalstrategic thinking

Laurent FARACCI, Senior Vice President, GlobalMarketing and Digital Excellence, RB, underlined

that the digital transformation of the firm's mar-

keting involved no longer just talking to consu-

mers but engaging with them; the questions

being where, how and when to engage.

This has led the company growth by 14% lastyear. With the character of Mr Mucus who perso-

nifies since 2002 RBs Mucinex decongestant the

number one OTC brand in the US Faracci de-

monstrated how RB had gone from speaking to

people to engaging with people in 2016. The cha-

racter was digitally transformed over the years

from a simple picture of broadcasting, conversa-

tions and pharmacy into a complex model that

leveraged what digital brings to you. Mr. Mucus

personalises the sickness and can engage with the

consumers. Mucinex 2.0 moved from advertising

to a cultural formula. While not digital at first it

set progressively the scene to start being digital.

Progressively Mr Mucus has been active on Face-

book and Twitter, as well as interactive out-of-

home, to get as close to sick as possible

using

detailed data, on illness prevalence and distribu-

tion for example. According to Faracci, digital me-

dia allow to bring brand purpose to life. Consu-

mers must remain be at the heart of everything

and communications should be channel delibe-

rate. Last, Faracci advised the audience to

embrace creativity as a multiplier.

Sophia Filaktou

Laurent Faracci

Legislation, passed in May 2016, is expected to allow the sale of 216 out of 1582 non-prescription medi-

cines outside Community Pharmacies.The average price of an OTC product being the lowest in Europe,

there is room for higher prices, still keeping in mind the sensitive economic and social situation of the

country. Although in theory competition in pricing should benefit the consumers, it may also give the

opposite results, leading to more expensive products and bigger risks for public health. He concluded by

warning the industry that if the situation gets worse, state-fixed prices and sales restrictions could easily

be re-established.

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Digital strategies from Spanishpharmacists to provide supportto the citizens

Inma RIU TORRENS, Pharmacist and Director ofSaludability, showed how individual pharmacists

in Spain were educating consumers online and

the key factors of their success. She presented

five examples of ways individual Spanish pharma-cists had gone online to reach Spanish-speaking

consumers and develop huge communities of

followers. She noted that 80% of Spanish internet

users searched for online health information but

that the overall levels of general health literacy

was much lower. In response to most frequently

asked question relating to urine infections or the

difference between paracetamol and ibuprofen

and to fight against Dr Google, the blog

www.boticariagarcia.com has won awards for

best blog. Its founder has since become a publis-

hed author, magazine contributor and television

personality. Focusing first on questions asked by

consumers mainly around babies needs and

breastfeeding issues, the website

www.pharma20.es delivering video messages to

consumers following purchase in the pharmacy

on how to use medication was another example

presented by Torrens. By contrast, the

www.medicadoo.es site uses infographics to

make the difference and answer typical posology

related questions such as: How much ibuprofen

shall I give to my children? The last example of

pharmacists community was the Twitter account

@susitravel used as a platform for weekly conver-

sation between pharmacists aiming at improving

advice to patients and increasing product sales.

Torrens concluded that pharmacist could offer

health and independent trustable advice online

and created a community around their brand.

Social media can be used to boost the communi-

ty vitality.

How to best develop a digitalstrategy, which correspondto market expectations?

Laurent CORAZZA, founder of DIGILITYX, explai-ned that speed is key for a successful digital

business strategy. The development of the e-

health market shows that health care is becoming

digital. Instead of talking about a digital strategy,

Corazza preferred to talk about a digital roadmap

to achieve a sustainable and competitive advan-

tage with digital capabilities. Sharing his own

experience, he listed four main factors that the

health industry should take into account to deve-

lop a digital strategy:

digital health path: understand how patients

and all the healthcare actors will interact

tomorrow in a digital word

Explore data: data being tomorrows petro-

leum, collecting and processing data is es-

sential to understand the needs of the actors

and to integrate the new technological capa-

bilities

Think deep digital: Make sure that your inter-

nal processes are aligned with your digital

objectives (full dematerialisation).

Collaborate: both internally (to make workingtogether R&D and marketing) and externally

(with start-ups, software companies, digital

experts)

In other words, Corazza advised the audience to

switch from molecule to service (from products

to services), to use digital services to enforce

molecule power and justify a better price. Swit-

ching from cure to care allows to focus on

disease prevention through patient monitoring,

and from sell to rent to engage in a long termrelationship rather than a one shot sale.

Inma Riu Torrens

Conference report

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According to Corazza, this approach allows to

commit on results, and accept to be paid only if the

patient is cured while making profits with the mo-

nitoring services. To succeed, the strategy must be

consumer centric (what will be your role in the

healthcare value chain?), open-minded (explore

your eco-system to create innovative services) anddigital ready (encourage initiative and collabora-

tion between business and IT teams, make sure to

learn something from your external providers)

taking into account the digital maturity of the

company. Reminding the audience that speed is

key, Corazza concluded that a good strategy requi-

red adaptation in real time of the roadmap, to

competitor, to new technologies and to new uses.

Echoing Corazza, Faracci said that the industry

must be humble and must be aware of its weak-nesses and strengths to better adapt to the envi-

ronment in order to put itself in the driving seat as

new digital platforms emerge. We have strengths

as an industry in product development and regula-

tory affairs, but companies like Google are building

platforms and investing at a level that is orders of

magnitude greater than we can. As an industry,

we must steer developments and be seen as a

force for good as digital channels develop in fu-

ture.

Laurent Corazza

As brands are a major asset of theself-care industry what needs tobe done to strengthen their role?

Briain DE BUITLEIR, CEO of PGT Healthcare, pre-sented the joint-venture combining the two com-

panies Procter&Gamble and Teva to allow a better

growth by synergy of the two parent companies

and of the culture dedicated to brands. To be suc-

cessful, brands must put consumer at the centre.

To create a brand, there must be a belief that have

an important social purpose (referring to ratio-

pharm and Swisse), a distinctive proposition, a

product that delivers (repeat rate number on the

market like Swisse) and capabilities to make it real(investments and commitments).

Briain de Buitleir

Branding self-care

Roger SCARLETT-SMITH, AESGP President, introduced the session recalling brands are the major asset ofthe self-care industry; 80% of consumers choose their OTC products based on their brand name in Europe.

He reiterated industry support for umbrella branding, noting that it was clear that consumers were used to

interpreting and reading the label" and using brands as navigation. In line with its self-care Agenda 2020,

AESGP will continue to work with regulators to support umbrella branding, Introducing the speakers, Scar-

lett-Smith asked them how brand communication can evolve in the age of new technologies.

14


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PGTs vitamins and supplements brand Swisse was

built around the belief that you celebrate life eve-

ry day and this had driven everything the com-

pany had done with the brand, he pointed out, and

despite a premium price, it had been incredibly

successful.

Then for building a brand, trial and awareness are

needed and must be repeated; the brand must be

mentally and physically available to the consumers.

Showing a chart of the Vicks brand development

since 1918, de Buitleir highlighted that the fastest

growing product in PGT portfolio was the un-

changed original products. Alluding to fashion

brands like Louis Vuitton or Hermes which do not

use broadcasting or social media but still continues

expanding, he provocatively concluded that there

was no need for more consolidation or new brand

to grow. While the regulatory environment could

make things easier it does not prevent the industry

to build great brands. De Buitleir concluded that

the obligation of this industry was to serve the

consumer to the very best of its availability but to

play that role, the brand had to have a belief.

An insight into Bionoricasbranding strategy

Michael POPP, Owner of Bionorica, put forwardthe different approach of his company created in

1933. The company does not invest in advertising

so much but this year 17% of the total turnover

was invested in research to create phytopharma-

ceutical products that were backed by clinical

research that had been peer-reviewed. As a result

the company is the worlds leader in the evidence -

based proof of efficacy of herbal medicines. In or-

der to guarantee the quality, safety and efficacy ofits extracts, Bionorica has its own cultivation, per-

colation-methods, patented extract concentration

and patented extract drying process. The company

established the concept of phytosimilar which is

more than biosimilar because the raw material and

the process define the phytopharmaceutical and

therefore are not suitable for generics. Presenting

the example of Sinupret extract, Popp highlighted

the challenges in marketing herbal medicines in

the EU resulting from the divergence in national

procedures and approaches for these products.Nonetheless academic, alternative, top quality and

evidence based medicines bring results; Bionoricas

products are the top products on the German, Rus-

sian and Ukrainian phytomarket. In these countries,

the market is driven by physician prescriptions,

then pharmacists and, when the products are well

known, the products enter the self-medicationmarket. Doctors are Bionoricas authentic brand

ambassador since they use the products for

themselves and recommend them in their private

environment. Same situations with pharmacists,

99% of the German pharmacists use Sinupret and

that is how Bionorica builds trust. Physicians and

healthcare practitioners are more able to explain to

patients the differences between plant-based me-

dicines and other natural products according to

Popp. In order to enable pharmacists to properly

counsel consumers and patients on herbal medi-

cines, Bionorica developed Phytotek, a competence

center for phytomedicines. In conclusion, Popp

called EU regulators and national authorities to

implement the Traditional Herbal Medicines le-

gislation in a consistent manner, to grant 10 year

protection for preclinical/clinical data and to intro-

duce the term phytosimilar. With regard to food

supplements, Popp asked the EU regulators why

approved Herbal Medicinal Products are still un-

dermined by botanical food supplements with

unauthorised health claims on the market although

the European Food Safety Authority has rejected

most of the submitted health claims for botanicals.

Michael Popp

Conference report

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16

Strengthening the Role of BrandsSome Lessons from Cosmetics

John CHAVE, Director General of Cosmetics Eu-rope, started his presentation by presenting key

features of the cosmetic market which is stronglydriven by EU regulation (since 1976). Highligh-

ting that the absence of risk assessment agency

was problematic as well as the ban on animal

testing, he indicated that the rates of innovation/

reformulation were very high (on average 25% of

product portfolio annually). Regarding claims

and advertising in the cosmetics sector, Chave

explained that they are underpinned by Commis-

sion Guidance and a soon to come Commission

report on the effectiveness of the system was

awaited. The industry strongly rejects positivelist approaches to claims

and favours the current

system which gives reasonable flexibility. Turning

to branding, Chave indicated that there was very

high brand equity, in general. Diverse brand stra-

tegies, with some companies focused on distinct

brand development/acquisition (e.g. LOreal)

others with single or limited brand approach

(Chanel). Luxury market sees brand extension

into fashion and other sectors. Both brand exten-

sion and maintenance of brand value are sup-

ported by flexibility given by in market control,

and absence of strongly restrictive claims envi-

ronment (i.e. claims supported innovation is key).

While the cosmetic industry as a whole is concer-

ned by difficult innovation environment in the

EU, brand strength is bolstered by relatively high

emotional engagement with cosmetics and per-

sonal care brands, particularly in some categories

(although there is some evidence that this is de-

clining in importance). Overall, the cosmetic sec-

tor is traditionally very strong in point of sale/retail environment/consumer experience factors.

Chave concluded that the cosmetic industry fully

embraced the digital revolution and was even

promoted in some cases - by industry, in

others by social media phenomena such as

cosmetics blogging.

John Chave

What is needed forinnovation in self-care

Chair Hubertus CRANZ, Director General atAESGP, introduced the session by highlighting

the strong influence of the legislative and regu-

latory framework on the future of self-care in

the areas of self-care medical devices, food

supplements and non-prescription medicines.

Before turning to the panellists, Cranz informed

the audience on the status of AESGP data bases

on non-prescription medicines and substance-

based medical devices recently updated as well

as the one on food supplements, the update of

which is to be completed by the end of June2016.Hubertus Cranz


17/22

Conference report

17

Regarding the OTC ingredients directory, the

2016 version comparing the classification status

(prescription or non-prescription) of a number of

active pharmaceutical ingredients in 39 countries

is now available and a printed copy has been dis-

tributed to the conference participants. Besides

the publication of the AESGP self-care Agenda2020, Cranz reminded the audience of the two

topic specific AESGP conferences which took

place in the past year on substance based medi-

cal devices (in October 2015) and on the propor-

tionality of medicines regulation (in February

2016).

Status update on the MedicalDevices Regulation

Lars RITTER, Adviser to Gesine Meiner, rappor-teur on the proposed legislation for the Liberal

Group in the European Parliament, shared some

fresh news on the status of the negotiations and

said final agreement had been reached on the

long-awaited legislation on 25 May at the 10th

Trialogue between the Parliament, Council and

Commission. This came almost four years after

the publication of the proposed regulations by

the European Commission in September 2012.

Noting the AESGP priorities on the negotiatedtext, Ritter indicated that the classification rule 21

now foresees a classification in the highest ca-

tegory of substance-based medical devices, or

their products of metabolism, which are systemi-

cally absorbed by the human body in order to

achieve the intended purpose, or which are syste-

mically absorbed by the human body and

achieved their intended purpose in the stomach

or lower gastrointestinal tract. Ritter commented

that a risk-based approach had been applied to

ensure that medical devices would only be inClass III if they achieved their intended purpose in

the stomach or lower intestinal tract. And if they

were applied in the nasal or oral cavity, and

achieved their intended purpose in those cavities,

they would be in the lower-risk Class IIa. Similarly,

nanomaterials would only be placed in Class III if

there was a high or medium risk of exposure. If

the potential risk was negligible, they would be

put in Class IIa. Assuming the legislation was

enacted in January 2017, it would come into force

three years later in January 2020. In what-is-expected-to-be-the-final text, it is proposed that

certificates issued, after the entry into force of the

regulation, will remain valid until the end of the

period indicated on the certificate, which shall not

exceed five years from its delivery. While no more

negotiation is foreseen, Ritter noted that the next

steps were votes in the Parliaments Environment

Committee on 15 June and Council on 17 June. A

plenary vote in Parliament will follow in Decem-

ber.

Lars Ritter

AESGP Ingredients Directory

The AESGP OTC Ingredients Directory com-

pares the classification status (prescription or

non-prescription) of key active pharmaceuti-cal ingredients used in self-care in 39 coun-

tries (25 European and 14 non-European).

It is based on information provided by WSMI

and AESGP member associations and is

widely recognised as the most comprehen-

sive analysis in this context.
http://www.aesgp.eu/media/cms_page_media/68/AESGP%202016%20Ingredients%20Directory_FINAL.PDFhttp://www.aesgp.eu/media/cms_page_media/68/AESGP%202016%20Ingredients%20Directory_FINAL.PDFhttp://www.aesgp.eu/media/cms_page_media/68/AESGP%202016%20Ingredients%20Directory_FINAL.PDFhttp://www.aesgp.eu/media/cms_page_media/68/AESGP%202016%20Ingredients%20Directory_FINAL.PDF


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Jurate Svarcaite

Jurate SVARCAITE, Secretary General of the Phar-maceutical Group of the European Union (PGEU)

congratulated Ritter for the important legislative

work done on the very challenging and broad ca-

tegory of products covered by the definition of me-

dical devices.

Noting that medical devices had been one of the

most innovative sectors in self-care, she pointed out

that pharmacists were still building trust in these

products as they were still more comfortable with

the regulatory framework applicable to medicinal

products. As healthcare professionals, Svarcaite said

that pharmacists were highly interested in the medi-

cal devices requirements regarding pharmacovigi-

lance or any regulated activities allowing detection,

assessment, understanding and prevention of medi-

cal devices related issues.

Food Supplements - regulatorydevelopments on botanicals inthe EU

Alexandra NIKOLAKOPOULOU, Head of Unit atthe European Commissions Directorate General

Health and food safety, explained the regulatory

framework applicable to food supplements and the

state of play of the ongoing so-called REFIT exer-cise in relation to the Nutrition and Health Claim

Regulation.

This evaluation will besides nutrient profiles -

examine whether the current rules concerning

health claims on plants and their preparations used

in foods are adequate, and how the use of such

claims interacts with the current applicable food

regulatory framework on plants and their prepara-

tions. She reminded the audience that more than

500 claims on plants and their preparations recei-

ved an unfavourable assessment from EFSA in the

context of their scientific assessments, and this

raised concerns. To date, the remaining over 1500

submissions concerning such health claims havenot yet undergone the scientific evaluation by

EFSA.

The Regulation provides for the substantiation of

health claims made on plants and their prepara-

tions used in foods by demonstrating the causal

link between consumption of such foods and the

claimed beneficial effect. This precludes any safety

considerations by EFSA on the use of the substance

in foods when assessing the claim. She explained

that this had given rise to increased concernsamongst the Member States on the authorisation

of health claims on certain substances when no

regard is given to the safety aspects of their use in

foods. In addition, an Overview Report which was

finalised in 2015 based on a series of fact finding

missions carried out by the Food and Veterinary

Office (FVO) in Member States in 2013 and 2014 in

order to gather information regarding the controls

on food supplements highlighted the problems

that Member States face due to differing national

rules for the use of plants and their preparations infoods.

Alexandra Nikolakopoulou

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Nikolakopoulou warned that the REFIT process

would be lengthy because of the Commissions

new commitment to employ wide consultation,

following its adoption of its Better Regulation

Communication of 19 May 2015. An action plan

would not be presented before the first quarter of2018, she said, after the final report had been

completed in the fourth quarter of 2017. The re-

sults of this evaluation will be used to decide on

the next steps regarding this policy area. Nikola-

kopoulou indicated that an external contractor

would be performing a study during 2016-2017 to

feed into the final report and that there would be

a 12-week open public consultation as well as an

eight-week stakeholders consultation targeted at

small-and medium-sized enterprises (SMEs) by the

end of 2016.

Svarcaite raised concerns about certain food

supplements which can be of different quality le-

vels and can make claims that are not even pos-

sible medicinal products. Pharmacists are worried

that the food supplements market will destroy the

herbal medicines market.

Echoing her comment in relation to the medical

devices legislation, she underlined the absence of

any vigilance system allowing detection and pre-

vention of food safety related issues. Pharmacists

are highly sensitive to the safety of food supple-

ments and the absence of vigilance system to mo-

nitor safety issues does not help to build trust in

these products. In addition, she noted that the

level of information required on food being less

exhaustive than on medicines does not allow a

proper information of the consumers with regard

to possible interactions with medicines.

Innovation in self-care inEurope - Update from a MedicinesRegulatory Agency

June RAINE, Chair of the European MedicinesAgency (EMA)s Pharmacovigilance Risk As-

sessment Committee (PRAC) and Director of Vigi-

lance and Risk Management of Medicines at the

Medicines Healthcare products Regulatory Agency

(MHRA) of the United Kingdom, started her pre-

sentation by referring to the definition by default

of the non-prescription legal status; the naturallegal status is pharmacy unless active decision ta-

ken to confer Rx status. It is a simple principle but

it is very important to remember it. Being at an

important time juncture, she added that it is im-

portant to reflect on fundamental questions:

where we come from first, who is setting the pace

and how can we influence the future of self-care.The Tajani report on corporate responsibilities in

promoting good governance on non-prescription

medicines was the output of a successful stake-

holders initiative at EU level and marked a signifi-

cant landmark. Amongst others, it acknowledged

that availability was an issue with only 5 actives

being available in all Member States.

Five years later, one could have expected that new

switches would have deluged Europe, but realisti-

cally its rather a slow trickle Importance of

stakeholder engagement in reclassification pro-

cess was identified by the EU Working Group on

Promoting Good Governance of Non-prescription

Medicines as a key factor to successful switch:

stakeholder platforms should be established na-

tionally to share views & develop strategies for

common approach to supporting patient access to

non-prescription medicines and stakeholders

should be involved early in reclassification process

so concerns addressed and training prepared. At

national level, the UK government has always

been committed to increase access to medicines

as soon as it is safe to do so.

June Raine

Conference report

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20

George Dokios

Recently a UK stakeholders platform on reclassifi-

cation to non-prescription medicines was launched

and the interim report was published in February

2016. Part of this initiative a dedicated webpage

and an assessor guide on evaluation of a switch

application will be launched. In 2015, esomepra-

zole was the first proton pump inhibitor on theGeneral Sales List (GSL). Heart burn can be an im-

pedance on everyday life and easier access makes

a real difference.

Who should be setting the pace? She mentioned

the PRAC which current focus is on simplifying the

pharmacovigilance legislation and the EU strategy

2020 arising from the alignment of the Heads of

Medicines Agencies (HMA) and the EMA around 4

main pillars. Availability of medicines is one of

them, including availability of well-established me-dicines and non-prescription medicines. The

CMDh has a very consistent strategy with the EU

strategy 2020 and its Multi Annual Work Pro-

gramme: easier access to non-Rx, explore decen-

tralised (DCP) and mutual recognition procedures

for OTCs and particularly in procedures where

legal status is different between Member States.

The first step is to update the Best Practice Guide

on DCPs for non-prescription medicines.

Key to success of the self-care sector are innova-tion, simplification, flexibility and stakeholder col-

laboration. In 2014, ulipristal an emergency contra-

ceptive was switched centrally. She gave tribute to

companies that put a lot of efforts and resources

into switches which set the success (although

maybe not always the case from a commercial

point of view). Maintaining success involves

keeping the product information up to date and

constantly improving the benefit- risk of a product.

Success needs to be monitored too and for

example the easy access to emergency contracep-

tion has played a role in the decrease in the num-ber of pregnancies in teenage girls. It is also crucial

to seek opportunities to simplify and it is what the

MHRA is doing when looking at its switch process

with fresh eyes. Flexibility in interpretation is also

important; the recent switch of sildenafil in Poland

is substantially different from the product with the

same substance authorised through the centra-

lised procedure. Lastly, collaboration between

committees, external cooperation with pharma-

cists, doctors and patients is key. Hearing the voice

of patients and what risks they are ready to accept,what risk management plans mean for stake-

holders is one of the direct goal of the EMA public

hearings.

Thanking Raine for her speech, the Chair

highlighted the importance of stakeholders

cooperation to promote innovation in self-care.

Scarvaite said that, within the Committee for Me-

dicinal Products for Human Use (CHMP) at the

EMA, there was some mistrust and criticism to-

wards pharmacists that prevented a pragmaticapproach towards the classification of medicinal

products. She called for a better integration and

consideration of the healthcare professionals re-

presentative notably pharmacists within these re-

gulatory platforms.

Challenges for tomorrow

Self-Care in Greece

The session Chair George DOKIOS, Director Ge-neral of the Greek industry association, EFEX,

described in detail the difficulties that the Greek

healthcare system had been facing in the past

years due to the economic crisis. Showing fi-

gures about the unpreceded decrease of the

total pharmaceutical market (by 60% between

2009 and 2015), he highlighted that this trend

was in contrast with the development of the OTC

market for the same period (increase by 31%between 2010 and 2015).


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Conference report

21

According to Dokios, the good situation of the

OTC market is multifactorial but results from two

key milestones: the 2010 decision to de-

reimburse OTC Medicines and the 2014 decision

to lift price barriers (applicable as of January

2017). EFEX works in further promoting the OTCmarket as part of health-care notably because of

its economic benefits for the healthcare expendi-

ture: savings up to 160mm in pharmaceutical

expenditure, productive allocation of doctors

time, less patient visits at health centers and less

working hours lost due to doctors visits. To sup-

port the development of self-care, Dokios called

for a simplified and more predictable OTC regis-

tration process coupled with better self-care in-

formation for consumers and educational pro-

gram for pharmacists. The industry will commit indeveloping healthy competitiveness. Dokios con-

cluded that if all Social Partners engaged actively

in promoting the effectiveness of self-care and

the role of the pharmacist was upgraded to that

of the Primary Care Consultant, self-care would

be fully established in Greece.

Challenges for tomorrow: theGreek economy and the health

care sector

Nikos VETTAS, Professor of Economics and Ma-naging Director of the Foundation for Economic

and Industrial Research (IOBE) presented the ove-

rall economic situation in Greece. Since 2010,

Greece is in an adjustment program meaning it

cannot control its monetary and fiscal policy.

How can you change the country and increase

the competitiveness with no means outside hu-

mans will? Noting that the Eurozone crisis

stopped the growth for all Europeans and pushed

all investors out of Greece, he listed the two typesof measures comprised in an adjustment pro-

gram: structural reforms requiring to become

better and austerity. In accordance with this pro-

gram, between 2009 and 2014, Greece traded its

public deficit for a huge recession and made the

economic much smaller. According to Vettas, the

economy could be growing again after the sum-

mer 2016. However, due to a lack of competi-

tiveness and competition in the economy, it can-

not go back on its feet unless it doubles the in-

vestment rate. Public finances have been fixedbut since the economy has been shrinking a lot

of new troubles are emerging such as pensions

which become a larger percentage of the GDP

and requires an additional cut in the expenses.

Turning to healthcare, he indicated that it was the

spending category that had been shrinking the

most in GDP. Noting a negative trend in every-

thing, Vettas highlighted that the public health

expenditure growth showed an unpreceded

shrink. As a result, during the economic crisis pe-

riod there was a shift of household expenditure

towards pharmaceuticals and hospital care.

Looking at the OTC market, Vettas noted that

OTC share in Greece was among the lowest com-

pared with the rest of Europe. However, the res-

pective market shares depend crucially on the

range of non-prescription medicines included in

each country. Among the various OTC categories,

vitamins and minerals had the greatest share of

the market, followed by analgesics and cold re-

medies.

According to Vettas the Greek economy is a labo-

ratory that could happen elsewhere since Euro-

zone economies are gradually evolving in scena-

rios where public spendings have to be discipli-

ned. Warning about the growing pressure on pu-

blic finances, he urged the audience to redefine

how we guarantee the economic and social wel-

fare of citizens (social security, education,

healthcare etc). To succeed, Vettas strongly be-

lieves that we need to boost innovation.

Nikos Vettas


22/22

Laurent Alexandre

The death of self-care

Laurent ALEXANDRE, President of NBIC Finance and a familiar of TED shows, closed the conference by aprovocative and thought-provoking talk: the self-care sector will die!

The traditional self-care and healthcare in general

are at the heart of an important mutation. The new

technologies in the hands of the GAFA (Google,Apple, Facebook, Amazone), neuro-cognitive

sciences, nanotechnologies, IT and biotechnology

will radically transform the future of healthcare and

self-care. He warned participants that the e-health

will become a reality in no time: genes will become

editable within 10 to 20 years and the genome will

be sequenced by 2030 with as consequence possi-

bility to enhance humans, solve many diseases,

stop or radically delay the aging processes. Lead

thinkers in the GAFA predict that artificial intelli-

gence will become more powerful than humanintelligence, and that human brains will be con-

nected to robots which have the size of nano

(nanobots).

It will be a complex and at least for some frigh-

tening world and new issues such as data privacy,

technophobia, and regulatory issues will rise. He

urged the assistance not to ignore the mutation

but rather to get prepared for it.

Vienna

30 May - 1 June 2017

53rd AESGP

Annual Meeting

Alfred Grn & Gerhard Ltsch

Invitation to Vienna 2017

At the end of the conference Gerhard LTSCH and Alfred GRN, from the Austrian Self-CareAssociation (IGEPHA) invited all participants as well as all those interested in the latest developments on

self-care around the world to the 53rd AESGP Annual Meeting, which will take place in Vienna from

30 May 1 June 2017.

Documents

Conference Report AESGP Annual Meeting 2016 Athens