Posts Tagged ‘2020 selection’

QOF 2012/13 changes summary

March 16, 2012

QOF guidance 2012-2013 (fifth revision)

As part of the 2012-2013 GMS contract changes, the General Practitioners Committee (GPC) and NHS Employers have agreed a number of changes to the quality and outcomes framework (QOF) effective from 1 April 2012.

The key changes are:

  • the retirement of seven indicators (CHD13, AF4, QP1, QP2, QP3, QP4, QP5) releasing 45 points to fund new and replacement indicators
  • the replacement of seven indicators with eight NICE recommended replacement indicators, focusing on six clinical areas namely Diabetes, Mental Health, Asthma, Depression, Atrial Fibrillation and Smoking
  • the introduction of nine new NICE recommended clinical indicators, including two new clinical areas (Atrial Fibrillation, Smoking, PAD and Osteoporosis)
  • the introduction of three new organisational indicators for improving Quality and Productivity which focus on Accident and Emergency attendances
  • amendments to indicator wording for CHD9, CHD10, CHD14, Stroke12, DM26, DM27, DM28 and DEM3
  • inclusion of telephone reviews for Epilepsy 6

Quality and productivity indicators
The six quality and productivity (QP) indicators covering outpatient referrals and emergency admissions have been agreed for a further year. Three new QP indicators on Accident and Emergency (A&E) attendances have been introduced for one year and are aimed at reducing avoidable A&E attendances. These indicators continue to be aimed at securing a more effective use of NHS resources through improvements in the quality of primary care.

Miscellaneous changes
In addition to the above, a number of other changes have been agreed as follows:

Changes to the points values for the following indicators:

  • BP4 – reduced by eight points to eight points
  • BP5 – reduced by two points to 55 points
  • DM2 – reduced by two points to one point
  • DM22 – reduced by two points to one point
  • CKD2 – reduced by two points to four points
  • Smoking3 (now Smoking5) – reduced by five points to 25 points
  • Smoking4 (now Smoking6) – reduced by five points to 25 points

A number of threshold changes as follows:

  1. raising all lower thresholds for indicators currently 40-90% to 50-90%,
  2. raising all lower thresholds for indicators currently with an upper threshold between 70-85%      to 45%,
  3. a number of upper threshold changes for indicators CHD6, CHD10, PP1, PP2, HF4, STROKE6, STROKE8, DM17, DM31, and COPD10
  4. lower and upper threshold changes for BP5, MH10 and DEM2

ASTHMA3 has been renumbered to ASTHMA10 following a change to the business rules to include a new exception cluster.

DEP4 has been renumbered to DEP6 following a change to the prevalence calculation to apply to all new diagnosis of depression from April 2006.

MH14 has been renumbered to MH19 following a change to the business rules to include an exclusion cluster for patients already diagnosed with CVD.

Records23 has moved into the clinical domain and the supporting business rules have been amended. This indicator is renumbered to Smoking7.

Education1 has been renumbered to Education11 due a change to the indicator wording.

Summary of Allocation of Clinical Domain points

CLINICAL DOMAIN  2012/13 QOF  POINTS

Secondary prevention of coronary heart disease   48

Cardiovascular disease – primary prevention  13

Heart failure 29

Stroke and Transient Ischaemic Attack  22

Hypertension 69

Diabetes mellitus  88

Chronic obstructive pulmonary disease 30

Epilepsy  14

Hypothyroidism  7

Cancer 11

Palliative care 6

Mental health 40

Asthma 45

Dementia 26

Depression 31

Chronic kidney disease 36

Atrial fibrillation 27

Obesity 8

Learning disabilities 7

Smoking 73

Peripheral arterial disease 9

Osteoporosis : secondary prevention of fragility fractures 9

If you have found this informative please visit the  2020 Selection website where you will find many other relevant Factsheets in the Candidates Section

Source: http://www.nhsemployers.org The full QOF guidance is available to download from this site

NICE to review local formularies to end post-code prescribing lottery

February 7, 2012

NICE is to produce a best practice guide to help trusts develop local formularies, as part of a move to ensure that all patients in England have access to clinically and cost-effective drugs.

Local formularies provide a list of selected or preferred drugs available to local prescribers and have an important role in underpinning safe and effective use of medicines.

However, there is currently no standard process or advice for putting together a local formulary which has led to variations across the country.

Medicines Management departments within many PCTs currently operate a controversial traffic light sytem of red lists and green lists, which does not necessarily reflect NICE guidance.

A recent report into innovation in healthcare by The Department of Health has highlighted that not all local formularies are including all of NICE’s technology appraisals. This can lead to a postcode lottery where patients miss out on drugs approved by NICE.

In some cases, local formularies are duplicating NICE assessments and challenging appraisal recommendations, acting as a barrier to the uptake of NICE-approved medicines.

The report states that the Department of Health is “committed to ensuring that NHS patients have access to clinically and cost-effective drugs and technologies, and that NICE appraisal guidance is promptly delivered throughout the NHS.

“There should be no local barriers to accessing technologies recommended in NICE appraisals, beyond a clinical decision relating to an individual patient.”

The report recommends that formulary processes should proactively consider the impact of new NICE Technology Appraisals, and all NICE Technology Appraisal recommendations should – where clinically appropriate – be automatically incorporated into local formularies.

This process should take place within 90 days to support compliance with the three month funding direction and the NHS Constitution ensuring that these medicines are available for clinicians to prescribe, should they choose to, in a way that supports safe and clinically appropriate practice.

To help achieve this, NICE will develop a best-practice guide covering the creation and review of local formularies to assist local trusts and clinical commissioning groups.

Dr Gillian Leng, Deputy Chief Executive of NICE said: “NICE will embark on a specific piece of work to look at how local formularies are put together. At the moment there is no standard process for them and there tends to be a lot of variation and inconsistencies across England. This has been flagged up in the recent NHS Innovation report.

“NICE will produce a best-practice guide on how to develop a local formulary. We will be holding a workshop to develop the guide, which will then go out to consultation before being published later this autumn.”

“NICE-approved drugs should not be excluded from local formularies on the grounds of cost. We want all patients to have access to medicines that we consider to be effective,” added Dr Leng.
Elsewhere, the report outlines plans to introduce, within three months, a NICE Compliance Regime for the funding direction attached to NICE technology appraisals to ensure rapid and consistent implementation throughout the NHS.

The Department of Health will also establish a NICE Implementation Collaborative (NIC) to support the implementation of NICE guidance. The NIC will bring together the NHS Commissioning Board, NICE, the Chief Pharmaceutical Officer, the main industry bodies, the NHS Confederation, the Clinical Commissioning Coalition and the Royal Colleges.

Reference: http://www.nice.org.uk/

20:20 Selection is a specialist recruitement agencies which places candidates into roles within the UK pharmaceutical and healthcare/devices sales industries. The agency has been established since 2002. If you are seeking a role within pharmaceutical sales please visit our website to view our live vacancies http://www.2020selection.co.uk

Global Top Ten Pharma Company based in SE England recruiting for a Training Manager

February 1, 2012

This is just one of many live vacancies that are being advertised by 20:20 Selection. Please visit the website to see all these exciting opportunities in the UK Pharmaceutical Industry.

Training Manager, specialist products division within the pharmaceutical business of a global healthcare company.

An opportunity currently exists for a talented training and development manager to be responsible for delivering programmes in line with agreed company training strategy. You will focus on specialist therapy areas such as renal and neurology (Parkinson Disease). Additionally you would also be the point of contact point and coordinator, for the UK implementation of the E-Learning strategy

This is a Head Office based role (Berkshire) requiring you to work cross functionally with marketing, medical and sales management in order to offer the highest quality training solutions, your responsibilities will include:
– Coordinating and running induction/initial training
– Providing ongoing support across the franchise for new campaigns, conference etc.
– Working with brand teams to identify desired training outcomes that will support brand plan execution
– Supporting growth plans within division and working with other Training Managers to develop and deliver training plans
– Annual planning, ensuring adherence to budget and deadlines.
 
To be considered for this exciting position you are likely to:
– Have healthcare related sales experience having demonstrated achievements in sales & your career to date
– Have some prior training experience with a training qualification being an advantage
– Show potential to be innovative and creative in approach to both the design and delivery of training programmes
– Demonstrate good coaching and counselling skills
– Possess well-developed interpersonal skills with the adaptability to work cross-functionally within the company
– Have excellent planning skills with the drive to see projects through to completion
– Be able to work well under pressure & have a high level of flexibility.
It is likely that you are educated to degree level and are ideally ABPI qualified.

On offer to the successful person will be a highly competitive basic salary and benefits package. This is a superb opportunity to join a forward thinking team in a company who truly believe in investing in people.

Please don’t delay in applying. Email your CV to administrator@2020selection.co.uk and/or call on of our recruitment consultants on 0845 026 2020.

Trainee Recruitment Consultant – A Day In The Life Of Chris

January 26, 2012

Last week I started a training contract within an established Medical Sales recruitment company  As a virgin to the industry I prepared myself as best I could for what I was about to undertake. I did all my reading around the career area and the company itself and eventually it came down to taking the plunge and accepting a 2 week trial in a very unpredictable time period for a recruitment consultant, the 2 weeks preceding the Christmas break. This is obviously an odd time in the industry as our Clients will be in one of 2 camps, the 1st of which being the “lets get the most out of our budget spend before the end of the year before its taken away from us in January”, and the 2nd being, “I’ve done all I can this year, lets start again in 2012”.

My 1st day was, as expected, the birth by fire. This is how we operate, take in as much as you can and see if you can keep up. This gave me a great insight into the speed, efficiency, and accuracy required from a consultant. If you’re not 1st, you’re last. This ethos opens up possibilities for huge success but at the same time great falls. After all we are competing against several other companies with differing approaches to achieving the same goal, luckily for me I’m working on the basis of quality rather than quantity. But that doesn’t mean quantity doesn’t get it right some times.

The harsh reality of the other side of recruitment fast became apparent. You really have to shine to get noticed in the current climate and the vast array of approaches that candidates use to attain this is eye opening. The role itself is very diverse. Admin is air tight, and has to be. It can be the difference between placing and missing out, a point regularly re-enforced during my training thus far. Combine admin with confident selective telephone manner, excellent knowledge of your clients and candidates, and the foresight to combine the two and you may have what it takes to take on the world of recruitment.

The industry requires you to effectively sit on a knife edge, the whole game is in balance, continually changing as both clients and candidates change their ‘requirements’, which can either push you right to the top or plunge you back to square one. This makes for a very exciting work environment as we are challenged with the task of keeping the balance in our favour right until the very last minute and then if all goes to plan, we can tip the scales and reap the benefit.

The team currently have the task of not only managing business but also managing me. As a fresh starter I am as keen and eager as you’d expect. I want to get my hands dirty and dive straight in but my lack of experience leaves me blind to the consequence. I am effectively stood on top of a diving board blindfold, trusting my team for direction and timing so I land on soft success rather than the hard ground of misconception. Time will tell……

Which Recruitment Agency?

January 18, 2012

Despite the global recession and credit crunch, one of the UK’s leading pharmaceutical recruitment agencies , 20:20 Selection Ltd has gone from strength to strength. How have they acheived their organic growth in these difficult times?

The team have over 50 years of combined, actual experience in the pharmaceutical and healthcare sales arenas in the UK.

Managing Director Karen Forshaw formed the company in 2002, after a successful career in medical sales (both primary and secondary care) and medical sales management (at both area and national sales manager level). She is passionate about providing an unirivaled service to both clients and candidates. The 20:20 Selection maxim of “perfect vision: not hindsight” extols the company virtues down to a tee. By carefully selecting their  candidates, 20:20 Selection ensure that when one goes before a client for an interview then they have an excellent chance of actually getting hired.

Using the experience and advice from Karen’s team, 20:20 Selection will ensure that you are only ever put forward for roles which you really understand and want to do. They only send your CV to clients with your full permission. Should you get an interview, then Karen and the team will keep you fully briefed and ‘prepped’ during the entire process. They have an enviable reputation within the industry as a recruitment company that really cares about both clients and candidates. One of the prime motivating factors is that individual consultants are not bonussed on just their own performance, but on the performance of the whole company. As a result you will not find yourself being forced or coerced into going for a role just to make up the sales figures of the consultant that you are dealing with.

So if you are interested in a role in UK pharmaceutical, medical or device sales then please contact us at administrator@2020selection.co.uk or visit our website http://www.2020selection.co.uk to find out more about the company.

Please note that in order to reach our minimum standards you will need to be qualified to work in the UK, have a full UK driving licence with not more than 6 points and be educated to degree level or be of graduate calibre.

Good Luck in your career.

Are you eligible? Having your documents ready for your job search.

July 7, 2011

Embarking on a search for a new job can be daunting however like all things in life it can go more smoothly with forward planning. This short article is aimed at ensuring you have the relevant factual information at hand. This is important as agencies (like20:20 Selection Ltd) and importantly employers do need to check your legal, employment and academic documentation. Hence if you have all this in order, then when it comes to you being made that perfect job offer the contract/job offer letter is likely to be with you more quickly.

 

The following checklist should help you with your preparation:

  • Passport & Visa (if applicable) – an employer can be fined for employing individuals who are not eligible to work in theUK
  • Driving Licence – you will need the paper and photo card parts. For field based positions you will need a validUKdriving licence with no more than 6 penalty points. It is important you make clear declarations about your driving history when asked as employers will check this with the DVLA.

If you have a nonUKlicence holder and need to convert your licence the following link will give you some guidance:

http://www.direct.gov.uk/en/Motoring/DriverLicensing/DrivingInGbOnAForeignLicence/DG_4022562

  • A recent payslip. This will validated your current basic salary and your National Insurance number. If you are in receipt of other monthly benefits such as a car allowance this will also be verified on the payslip.
  • ABPI certificate – if you have sat and passed the examination you will need to produce your certificate if you are offered employment with a pharmaceutical company. If you have misplaced this, the following link may help

https://extranet.abpi.org.uk/web/abpi/exams.nsf/pages/duplicate_certificate_request

  • Highest education certificates (degree, nursing, A levels etc)
  • For nursing roles you will need your current NMC PIN number and date of expiry. Plus you will also be asked about the date of your last CRB check however your new employer will need to undertake a fresh check.
  • For sales positions you should also put together your ‘Brag File’ or portfolio of successes which should include Sales Data, other performance against KPIs, recent appraisal documents; in fact anything that you can use to sell you and differentiate you in the marketplace.

 

If you are not facing redundancy, timing your job search is also something to consider. For example,

  • We do come across people who may be tied in to car schemes. You are advised to carefully calculate the costs involved to you in walking away from your current agreement, as not all employers offer car opt-out schemes.
  • If you are going to jeopardise any bonus/incentive payments pay by leaving before a certain date.
  • If you have significant holiday commitments it is important you flag these. A job offer may be subject to you attending a training course on a specific date for a fixed time, however discussing these with your Recruitment Consultant early in the process may mean this can be negotiated. Also remember that holiday entitlement will be prorated depending at what stage of the leave year you commence work.

 

At 20:20Selection, we are here to help and guide our candidate along the process. Our specialist team can be contacted on 0845 026 2020 from08:30 – 18:00weekdays.

MABS / CYTOKINE MODULATORS / ANIT- TNF AGENTS AND MORE

May 19, 2011

A medication ending with the stem ‘mab’ indicates that it is a monoclonal antibody. This is the internationally recognised nomenclature for the naming of monoclonal antibodies. 

Nomenclature has become somewhat confusing though as the BNF includes ‘mabs’ under the heading of cytokine modulators and anti-lymphocyte monoclonal antibodies in several chapters.

 Monoclonal antibody production for medical use was first discovered by Milstein and Kohler in 1975, but it was confined mainly to diagnostics until Vilcek and Li approached Centacor (now part of Johnson & Johnson) to help them produce ‘mabs’ against TNFα.

Tumour necrosis factor-alpha (TNFα) is a cytokine (an immunomodulating agent) produced by monocytes and macrophages, two types of white blood cells. It mediates the immune response by increasing the transport of white blood cells to sites of inflammation, and through additional molecular mechanisms which initiate and amplify inflammation. Inhibition of its action by ‘mabs’ reduces the inflammatory response which is especially useful for treating autoimmune diseases.

The ‘mab’ that Vilcek and Li discovered become known as Infliximab (Remicade) and it became an important treatment for severe Crohn’s disease, including the fistulating variety. It has subsequently been used to treat other auto-immune system  diseases such as psoriasis and rheumatoid arthritis. Infliximab became known as ‘Kwik Fiximab’ in medical circles due to it’s clinical success in treating otherwise unresposive patients.

There are two types of TNF receptors: those found embedded in white blood cells that respond to TNF by releasing other cytokines, and soluble TNF receptors which are used to deactivate TNF and blunt the immune response. In addition, TNF receptors are found on the surface of virtually all nucleated cells. Red blood cells, which are not nucleated, do not contain TNF receptors on their surface.

A ‘mab’ neutralises the biological activity of TNFα by binding with high affinity to the soluble (free floating in the blood) and transmembrane (located on the outer membranes of T cells and similar immune cells) forms of TNFα and inhibits or prevents the effective binding of TNFα with its receptors. Infliximab and adalimumab (another TNF antagonist) are in the subclass of “anti-TNF antibodies” (they are in the form of naturally occurring antibodies), and are capable of neutralising all forms (extracellular, transmembrane, and receptor-bound) of TNFα. Etanercept, a third TNF antagonist, is not a ’mab’ and it is in a different subclass (receptor-construct fusion protein), and, because of its modified form, cannot neutralize receptor-bound TNFα. Etanercept is sometimes referred to as a ‘non-biologial’ agent to distinguish it further from the ‘mabs’ Additionally, the anti-TNF antibodies adalimumab and infliximab have the capability of lysing cells involved in the inflammatory process, whereas the receptor fusion protein apparently lacks this capability. Although the clinical significance of these differences have not been absolutely proven, they may account for the differential actions of these drugs in both efficacy and side effects.

Infliximab has high specificity for TNFα, and does not neutralise TNF beta (TNFβ, also called lymphotoxin α), an unrelated cytokine that uses different receptors from TNFα. Biological activities that are attributed to TNFα include: induction of proinflammatory cytokines such as interleukin (IL) 1 and IL 6, enhancement of leukocyte movement or migration from the blood vessels into the tissues by increasing the permeability of endothelial layer of blood vessels; and increasing the release of adhesion molecules.

A range of newer agents which act against these other cytokines have subsequently been developed.

Tha table below summarises the anti- TNF mabs available in the UK currently. None-mab anti-TNF agents are also included for comparison

MOLECULE BRAND CLASS DERIVATION INDICATION NICEAPPROVED
Adalimumab Humira (Abbott) Anti-TNFα Recombinant human ‘mab’

From hamster ovary

RA

PJIA

PA

AS

CD

P

Yes

No

Yes

Yes

Yes

Yes

Alemtuzumab MabCampath (Genzyme) Anti-lymphocyte Recombinant human ‘mab’ from hamster ovary CLL Yes
Certolizumab Pegol Cimzia (UCB Pharma) Anti-TNFα Recombinant human ‘mab’

From E Coli

RA Yes
Golimumab Simponi (Schering-Plough) Anti-TNFα Recombinant human ‘mab’ from murine cell line RA

PA

AS

No

No

No

Infliximab Remicade (Schering-Plough) Anti-TNFα Recombinant human ‘mab’ RA

CD

UC

AS

PA

P

Yes

Yes

Yes

Yes

Yes

Yes

Ofatumumab Arzerra (GSK) Anti-lymphocyte Recombinant human ‘mab’ from murine cell line CLL No
Rituximab MabThera (Roche) Anti-TNFα Recombinant human ‘mab’ from hamster ovary RA

CLL

NHL

Yes

Yes

Yes

Tocilizumab RoActemra (Roche) Anti-IL-6 Recombinant human ‘mab’ from hamster ovary RA Yes
Ustekinumab Stelara (Janssen-Cilag) Anti-IL-12/23 Recombinant human ‘mab’ from murine cell line P Yes
           
Abatacept Orencia (Bristol-Myers Squibb) T-cell modulator Fused protein formed by recombinantDNAtechnology RA

PJIA

Yes

No

Anakinra Kineret (Swedish Orphan) Anti-IL-1 Recombinant human ‘mab’

From E Coli

RA No
Etanercept Enbrel (Wyeth) Anti-TNFα

(soluble receptor specific)

Fused protein formed by recombinantDNAtechnology from hamster ovary RA

PJIA

PA

AS

P

Yes

Yes

Yes

Yes

Yes

 

KEY

RA = Rheumatoid arthritis

PJIA = Polyarticular juvenile idiopathic arthritis

PA = Psoriatic arthritis

AS = Ankylosing spondylitis

CD = Crohn’s disease

P = Psoriasis

CLL= Chronic lymphocytic leukaemia

NHL= Non-Hodgkin’s lymphoma

NICEapproval status correct as of May 2011. Please refer to NICEwebsite for latest guidance http://www.nice.org.uk/

Sources:NICE, manufacturers Summaries of Product Characteristics, and BNF vol 61

VALUE BASED PRICING (VBP) – How the NHS will purchase drugs

February 15, 2011

 The government intends to reform the way in which drugs purchased by the NHS are priced by the end of 2013. It aims to ensure that drug costs more fully reflect clinical benefit and to improve patient access to new treatments. At present the prices are determined by the Pharmaceutical Price Regulatory Scheme (PPRS). These prices are usually reviewed at 5 yearly intervals. Pharmaceutical companies are relatively free to set the price of a newly launched product (assuming it is accepted for use by NICE, the Scottich Medicines Consortium or the All Wales Medicines Strategy Group in the first instance). The PPRS then reviews these prices so that the profits that are made from the sale of drugs to the NHS are not considered to be excessive.

The Office of Fair Trading argues that drug prices should reflect their clinical benefits and current policy wastes NHS resources. The pharmaceutical industry welcomes the concept of value-based pricing, but is concerned about the impact on profits which are needed to make research viable. The Office of Fair Trading (OFT) estimates that up to 25% of world pharmaceuticals sales reference UK prices to some extent. Companies are thus particularly sensitive about any agreement that reduces the UK list price of a drug as this can have a knock-on effect on the profits made on sales elsewhere in the world.

Successive price cuts and exchange rate movements mean that UK prices are currently amongst the lowest in Europe. This has led to parallel-exporting (the opposite of the practice of parallel-importing cheaper non-English language versions of the same branded product from the EEU to the UK) of UK branded medicines to the EEU, by wholesalers, pharmacies and NHS trusts for commercial gain which has led to severe shortages of many popularly prescribed medicines in the UK.

Under the new system of value-based pricing, the Government would apply weightings to the benefits provided by new branded medicines, which would imply a range of price thresholds reflecting the maximum they are prepared to pay for medicines. These thresholds or maximum prices would be adjusted to reflect a broader range of relevant factors that are not fully taken into account by the current sytem of using Quality Adjusted Life Years (QALYs) by NICE so they could be used to calculate the full value of a new product.

The Government proposes that the price threshold structure is determined as follows:

  • there would be a basic threshold, reflecting the benefits displaced elsewhere in the NHS when funds are allocated to new medicines
  • there would be higher thresholds for medicines that tackle diseases where there is greater “burden of illness”: the more the medicine is focused on diseases with unmet need or which are particularly severe, the higher the threshold
  • there would be higher thresholds for medicines that can demonstrate greater therapeutic innovation and improvements compared with other products
  •  there would be higher thresholds for medicines that can demonstrate wider societal benefits.

 

Designing the new system to be both stable and transparent would allow companies to predict well in advance how prospective products may fare, and to focus their research efforts on the treatments that society values most. Companies would be informed of these weightings – allowing them to orient their research and development investments appropriately. This may well draw to a close the ‘me too’ concept of launching ‘newer versions’ of drugs which treat similar conditions with little demonstrable benefit over the original.

Thus, a new product would be launched, then reviewed by the Government to access its impact on patient health and the others factors discussed above, and the price to the NHS adjusted accordingly over a period of time.

The work of NICE as a provider authoritative advice and information would continue, but the decision as to whether a new medicine will be used in clinical practice will ultimately be made by the clinicians themselves.

VBP models are already implemented in many European countries including Germany, Sweden, France, Spain and Italy.