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Commentary on Pharma & Biotech Oncology / Hematology New Product Development

Posts from the ‘Competitive Intelligence’ category

SpringPad is a new free tool I’ve recently been playing with and it has quickly become a way to sort and organise information easily. In the past, I’ve been a big Evernote fan, but while it is useful for collecting abstracts, photos, papers etc, SpringPad has a whole different set of utilities that I find myself using on a daily basis, both in the office and while mobile at conferences.

One of the challenges in my work is sifting through vast amounts of data and generating useful insights, either for posts here on this blog or as a consultant. I’ve tried a lot of different web 2.0 tools over the last 7 years but occasionally one comes along that sticks in my workflow. SpringPad is one of them.

The first thing I did after signing up was download the iPhone app and the web clipper for Chrome, my preferred browser. This makes life a lot easier when you come across anything interesting:

SpringPad Web Clipper

You can also email items such as webpages, links and PDF files to SpringPad.

Once in the SpringPad web app (similar layouts for the iPhone are available in an app too), your top level notebooks appear something like this:

SpringPad Notebooks

You can colour code them for easy visual appeal and finding things. I’ve also hidden the mission critical client projects, but you can see the general gist of what my recent science topics looks like.

The nice thing about this approach is that you can create Notebooks by topics and then once you’ve clipped or emailed relevant information to SpringPad, it can be organised efficiently.

For example, the JP Morgan Healthcare conference is ongoing this week with lots of useful snippets emerging by company, drug and pathway.   I can clip, then tag the information and also assign it to several Notebooks.  Information emerging from the meeting on Keryx’s perifosine might get added to the Keryx, colorectal cancer and myeloma Notebooks, for example.  This makes it easier to find information later when you search for it, or later look at all the information you have collected to date on say, lung cancer or a particular pathway, to look at the big picture trends. I also diligently tag items across a broad range of topics so they will appear later in the database searches.

Another useful feature of SpringPad is that you can collate information around an event.

Once inside a notebook, for example, the recent one I created for the ISGC meeting at MD Anderson to keep me organised with a one stop shop for all the preconference information, to-dos and post conference notes looked like this:

SpringPad Notebook

While travelling to this meeting, I had everything I needed for the event in the iPhone app and could add new notes, to dos, places, contacts etc while on the road for other projects. This worked really well, even on the plane, since SpringPad will sync the notes once internet access is available later.

The iPhone is small so it is not good for rapidly note taking at meetings and wifi was gippy at best, so I made most of the notes on my Mac laptop in Twitter using a hashtag and also in an offline text app, Notational Velocity, which syncs with Simplenote. I’m now looking to see if I can email my notes on each presentation to SpringPad or worst case scenario, cut/paste them into the notes created. Another way to do this efficiently would be to use an iPad, but that’s still on my wish list in the Gear Notebook 🙂

Assigning dates to To-Dos and items is a really useful feature – you can check your Alert box and see what’s immediately due.

Another feature I like is the ability to import Delicious bookmarks (I have 3,000 of them!) as well as the associated tags, so these are now searchable in the context of any other information I might have collated in SpringPad. When a client rings up or sends an email asking about something, this makes the scientific, commercial or clinical answer much easier to find than Googling and getting lots of spammy results, which seems de rigeur in public searches of late.

There’s a lot more functionality in SpringPad not covered in this review, but I will add more updates as it becomes more familiar and a bigger database is built up. Has anyone else tried SpringPad yet? If so, what were your experiences or do you have any cool tips to share?

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Recently, I’ve had a lot of enquiries as to how I manage to write so many blog posts, either in terms of finding the time or staying current.

The answer is simple – I use tools to help simplify and minimise the effort involved.  You could also use this kind of web 2.0 approach for creating a database and tracking data, intelligence, keeping current if you work in the Pharma or Biotech industry, whether a scientist, a marketer or a PR professional.  Of course, you could spend hours Googling stuff or reading a few health sites online, but there are other ways to stay ahead of the pack.

The key parameters at play here can be summarised:

  • Gather data
  • Process and understand information
  • Perform analysis
  • Generate Insights

Far too many people often only do the first two tasks, but without analysis and insights, the data means very little.  So what are the tools of my trade?

 

1. Evernote

I’ve talked about Evernote in the past, which is a nifty data capture tool we use daily here at Icarus Consultants. They have both free and premium versions to suit everyone’s pocket.

When starting projects, we clip relevant information from the internet into a new Evernote Notebook and gather it all in one place. You can use a desktop or a smart phone for this task and dump as much information as you like into it for later searching. This makes it easier to digest when looking at the big picture and gathering ideas and seeing trends.  You can also search your own database for existing information, which is very useful for blog posts or writing reports around a topic.

I often create and write blog posts in Evernote too.  The research information is already there and it’s straightforward to use the editor as well, as backing up and synchronising the information across multiple platforms.  We’ve all written something in Word or a Blog Editor and lost the content >.< but l have found Evernote more reliable for saving information, which can then be cut/paste with minimal editing into the Blog platform or Office for reports. I also have a bunch of articles, reports and blog posts that get part drafted and finished later, acting as a useful repository for gathering ideas.

Other good uses? Need some information on the road while talking to someone? A quick search in the app my iPhone will usually bring it up.

The other side of the coin is generating and gathering data. I’ve mentioned that you can clip research to an app such as Evernote on the go, but I also have a LOT of information in RSS, whether it be news items, feeds for the latest articles in tens of cancer and science journals, blogs from a variety of sources, rss alerts by topic or keyword etc. Keeping track of this huge volume of information used to be unwieldy.

2. My 6 Sense

One tool I really love and have been using for a while is My 6 Sense.  This cool app takes all the rss feeds from my Google Reader, which is clumsy and awkward to read, and processes them into a more manageable fashion.

Several times a day I can check the app on my iPhone and see what’s new or relevant.  Over time the app algorithms learn what your particular interests are and creates a page of what it considers to be useful items of interest in your RSS feeds via the Relevance tab or as they come in (the Time tab) as shown below (left photo).

Data is social, though; it cries out to be shared with others. The M6S app allows you to add social media sites such as Twitter, Facebook etc and share any interesting items with your friends or colleagues too. Here, you can also see the items from my shared stream as an example of what I found interesting and streamed to others to read:

Over time, as you use the app more, it gets much better at predicting what you like or may find interesting. One thing I miss from the M6S app is a Search button – what happens if I want to find a bunch of interesting articles in my RSS database on a given topic, eg PI3K or something similar? At the moment, there’s no obvious way to do that as far as I can tell, but it would certainly be really useful to me.

3. SimpleNote

I confess that after years of losing data unexpectedly, I’ve become a bot of a plain text geek. On my Macs, TextEdit was something I use daily, especially when taking notes from market research interviews on the fly. Then one day, someone mentioned SimpleNote, which is a beautifully simple yet flexible tool for gathering text notes.

For some months now, I’ve been using the App on my iPhone, which allows me to jot down ideas, tasks, notes to self etc on the fly… essentially simple notes.

Then recently, I realised that the free iPhone app also gave me access to the desktop app, which opens up a whole new world of utility and practicality.  Here was something that could help me do multiple things efficiently:

  • Research and find interesting journal articles or news about say, PI3-kinase in My 6 Sense
  • Email article links to self via iPhone
  • On desktop, cut/paste multiple snippets of information to SimpleNote
  • Search SimpleNote for older articles
  • Write blog post in SimpleNote
  • Cut/paste blog post to TypePad for posting
  • Sync selected information with DropBox and read from any computer later

Take a look at the snapshot below for the basic SimpleNote concept:

You can see how neat and intuitive this is at first glance and how easy it is to find information, whether it be data or contact information or even the reference link months after clipping it by scrolling down in an individual note:

The DOI is really useful because when I blog about journal articles, I only have to cut/paste the DOI into the Research Blogging site and it generates a nifty bit of code that provides easy access to the article via a link for anyone interested in it.

Over time, I diligently put in tonnes of stuff into these tools, whether Evernote or SimpleNote and they come in very handy for research for blog posts and consulting reports. Essentially, I find that I tend to use Evernote for web clipping and SimpleNote for text processing.

Of course, the short answer to the blogging question is you either get more efficient and smarter at gathering, processing, analysing and generating insights or you work longer hours.  Being a good European, I’d rather work smarter and hope that people appreciate the insights generated either in the blog posts here or in client report :-).

What are your favourite tools and apps that make a difference to your daily workflow?

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One of the things about oncology or any other therapeutic are new product development and marketing is that you get to spend a LOT of time at scientific congresses like AACR in DC the other week, which means early to rise and late to sleep:

Photo
Source: Personal iPhone – view of over the Potamac and Georgetown, DC from Arlington, VA. 

Anyone who thinks these meetings are junkets or jollies should join me on my schedule next trip;sometimes there isn't time to eat or by the time you do have a free slot it's too late.  Often, it means 18 hour days and a day back in the office is a relative rest.  There's always thought leaders to talk to, sessions to attend, media briefings, poster sessions (you can walk miles at those alone), plenaries etc, not to mention clients as well.  Fitting it all in makes for jam packed days.

The interesting thing about new data though, is that while trends may be obvious to those following the specific disease area, they are not to others.  I always find it amusing watching the teams of young things running around with their crib sheets frantically collecting poster handouts, rudely barging past people and trying to discreetly snap the posters without security catching them.  

In DC, I asked one what they did with all the data they amassed.  It turns out they just dump it all in a report for their client by whatever category seems apt.  No strategic analysis, what it all means or even trend spotting, just a data dump.  Ugh.

Sometimes less really is more.

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Here at Icarus, we get a lot of interesting, varied and strategic projects but imagine getting a request from a client to come up with a big picture analysis of the global pharmaceutical market and also the oncology area with no budget for commercially available reports.

This is fun and meaty stuff, and in any case, most of the run of the mill reports are not particularly helpful despite being hundreds of pages long and costing several thousand dollars apiece.  They sadly suffer from analysis by paralysis syndrome without offering any real insights.

A lot of the legwork into answering a landscape question like this comes down to common sense.  Let's take a look at the US market, which is the largest single region and one of the most profitable, until recently. What's happening there?

Here's a basic snapshot of what we all know:

  • Increased mergers and acquisitions (with Roche-Genentech, Pfizer-Wyeth, Merck-Schering etc)
  • Increased focus on cost containment (see the Obama administration stand)
  • Loss of major blockbuster patents in the next 2 years (too many to mention)
  • Increase in the number of generic Rx's and hence share of the market
  • Reduced pipeline success (several drugs have failed spectacularly in phase III recently)
  • Increased focus on personalised medicine (target the right drug to the right patient)

All of these factors essentially combine to produce a near perfect storm in the US (and EU) markets, with the result of this being:

  • Increased layoffs
  • Reduction in the number of sales reps
  • Hospitals are reducing access to doctors
  • Reduction in profits as branded Rx share and value declines

However, baby boomers are getting older and retiring, placing an increased focus on:

  • Chronic health conditions eg hypertension, diabetes, dementia
  • Cancer (largely a disease of aging)
  • Cost containment
  • Health and lifestyle

All of these factors force the pharma companies to regroup and either re-trench as a specialty player in niche markets (eg BMS) or expand more aggressively in emerging markets (eg sanofi-aventis, Pfizer, Novartis, GSK and Merck). 

The BRIC countries (Brazil, Russia, India and China) are all becoming more industrialised and as the middle class grows, so does demand for quality healthcare.  That presents new opportunities for smart companies with resources and infrastructure.  These trends are seen across the board, not just in sales and marketing, but also in R&D as companies seek to reduce development costs and speed time to market by going to emerging markets where there is a much larger, untapped pool of newly diagnosed patients available.  This is especially true in the oncology market, where even registration trials in various cancers are now being undertaken in China, India, Eastern Europe and the Latam region.  An increased focus on partnerships and open science is also beginning to emerge.

All in all, what we are seeing here is slow adaptive change to the external environment, but the trends are already showing clear signs of these shifts, which also mirror the economic change in direction in general.

My suspicion is that the more nimble and diversified a company is, the better they will be able to weather the extended downturn over the next 5-10 years.  Change is sometimes a good thing.

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One of the most useful things I gathered, intelligence-wise, for a client project this week was from following some cancer patients stories via their their blogs.  This is social media monitoring at is best.

Why?

Autumn1

Because they tell it as it really is, no strings attached…  

What the treatment involves, the practicalities, the side effects, the tests, and everything else in between, including the weather and how the medications affect things like taste, for example. 

I learned that the 3 infusions needed for their particular protocol took seven hours.  Ouch! Imagine how tiring that would be for the patient and caregiver who was with them shepherding them around , the nursing staff monitoring it and everyone else involved?

As we go about our daily lives we forget how easy it is to take life for granted.  This sort of real information keeps us human and our feet on the ground.

The rival product in development is a pill.  You can pop it at home over breakfast while watching the morning news.  Sometimes we forget that simpler is easier but not always better, though.  

For short term treatments, remembering to take the pills is relatively easy but over the long term, compliance becomes a problem, either because you feel good and forget to take the pills or because chronic therapy can induce its own side effects and symptoms and perhaps you feel the need for a break from the relentless of it.  After all, how many of us forget (or can't be bothered) to take antibiotics in the third week of a course, let along consider daily consumption for a more chronic condition? 

Thus, I wasn't entirely surprised to see an article in the FT this week about the Novartis deal with Proteus, a company who focuses on compliance solutions:

"The company is testing technology that inserts a tiny microchip into each pill swallowed and sends a reminder to patients by text message if they fail to follow their doctors’ prescriptions."

Finanical Times

Now, that may sound a little like Big Brother is watching you and the cynical might think that companies are more interested maintaining their profits by keeping refill prescriptions on schedule, but for some serious diseases it may also affect outcomes.  In my experience, with acute conditions approximately 15-18% of patients forget to take all their pills, but this sadly rises to 25-35% with chronic therapy over time.

Another way companies can track the data from their own products is analyse the data from their Patient Assistance Programs (PAP).  One time when I was working on the industry side as a marketer, we did this and were surprised to find that even with free drug, the compliance rate was about 25% for a cancer therapy taken chronically after about 18 months or so.  We knew this would only get worse over time as patients feel better and think their cancer is in remission.  That was a sobering thought because the risk of the cancer coming back is high unless the oncogenic clone was suppressed.  It also underscores the importance of continuous patient and physician medical education; perhaps this is where patient programs through selective use of social media can be effective in reaching a wide audience.  The message is never ever take anything for granted.

Think about the impact of chronic therapies for life threatening diseases like cancer, for example.  As more companies are developing oral small molecule tyrosine kinase inhibitors (TKIs), so cancer moves from an acute condition to a chronic one.  However, with TKIs their mechanism of action is based on constantly competing with ATP to suppress the oncogenic clone and keep the disease in check.  This means that not taking the drug over time can lead to a return of the disease, new mutations and possibly even major relapse or patients becoming refractory or resistant to their therapy.  That is the last thing an oncologist wants to see.  


There are other ways to improve compliance, including Pharmacies tracking refills over time and phoning you with a friendly when you are overdue or chips in the bottle caps instead of the pills themselves.  The loose pill bottles favoured in the US actually contribute the problem.  Unless you get into an almost religious routine, it is easy to forget sometimes whether you took your daily dose or not and we haven't even considered the effect of patients deliberately self medicating less with to save money or because some side effects were bothering them.  At least the weekly or monthly blister packs common in Europe make it easier to remind oneself to take the prescription on schedule more easily.

Ultimately, though, the goal with these tools is about helping to improve patient outcomes.  This is a trend we are probably likely to be seeing more of in the future.

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One of the biggest challenges in the Pharma world is meshing strategy with execution in a timely and effective manner. 

My experience in big Pharma taught me that the environment is often full of Thinkers, who sit on their 100,000 ft cloud plinking on their harps contemplating ideas, with little regard the practicalities of execution and Doers, who are focused on execution and chopping down trees, without necessarily asking if they are in the right forest or chopping down the right trees.

It's also the classic Global versus Affiliate wars, although not always.

Great teams come together and either have a nice balance between the Thinkers and Doers or have smart people who can do both.  When those scenarios plays out, something magical happens and the organisation reaps the benefit of a well organised and well executed strategy that truly makes a difference to both patient outcomes and market performance.

Is it as rare as it seems though?

Sometimes organisations become bogged down in analysis by paralysis or paralysis by analysis.  The way forward is to shake things up and bring in decisive leaders who break through the consensus thinking to drive goal driven execution based on real customer insights.  They challenge the team to find the nuggets and focus on what's important.

A thoughtful client recently asked me: "What are insights and how can we teach them?"

Taking a look at the Princeton Dictionary we find:

  • insight – penetration: clear or deep perception of a situation
  • insight – a feeling of understanding
  • insight – grasping the inner nature of things intuitively

If we relate this back to Pharma, insights ultimately come from the customer and consumer:

– How do they feel about your brand, their disease, your competitors? 

– What do they really want and need?

– How can you help them meet those needs?

Sometimes you may need to be more creative and find new ways of looking at data in order to see things differently, much like the facets of a diamond and how they reflect different patterns in the light.  Insights are the same; they help you see what really matters at the heart of something more clearly. 

Other times getting out of your dreary corporate office environment can also help.  Personally, I used to love impromptu small team meetings in a coffee shop or on the terrace of a hotel overlooking a golf course.  Being out and about in a more relaxed environment seems to shake out the cobwebs and get people chatting more informally about the topic and issues at hand.  Several heads are always better than one for such a think tank session.

Perhaps also it is the lack of Powerpoint replaced by sketches on napkins or scraps of paper that brings out the childhood creativity in people to simply be free that makes the difference sometimes.  Certainly, I've seen more creative and effective ideas come out of those loose relaxed meetings when someone said a seemingly isolated and random thought that focused and stimulated the team on a whole new idea. 

That's insight right there – often buried deep inside us and all we need to do is find ways of letting them bubble up or the key to unlocking them.  The challenge is to close off the left brain logical control and let the right brain loose on concepts, creativity and connections between the team members.

Those A-ha! moments are priceless.

Ultimately, social media is more about right brain thinking than left brain logic.  It's about communication, empathy, interaction and engagement, all things that make logical, scientific-driven Pharma extremely uncomfortable.  The key to achieving balance is to use both sides of the brain to create a whole brain strategy.

What does this mean?

Well, it is possible to use the left brain analytical side to evaluate and monitor your market or competitors for useful data driven intelligence to enable the team to develop actionable insights.  Then utilise the right brain to create new ways of engaging and interacting with doctors and patients that improve the all round experience for all concerned.

It doesn't have to be scary if you Think and Do, but in the long run the Pharma companies that crack this dilemma will be bold winners in the race to superior customer engagement.  The losers will still be focused on dying out traditional methods of selling in a brave new conceptual and digital age.

Do you want to be a winner or loser?

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This morning I checked into my database intending to search for some information on lung cancer relating to the SATURN data in maintenance therapy that is being updated at the World Lung Congress in San Francisco.

Instead, the first dozen items were on the FDA approval of Onglyza (saxagliptin).  Oooh.  It seems that the FDA just approved BMS/AZ's joint development in diabetes, talk about a wealth of signalling data all at once.  This product is a me-too, very similar to Merck's Januvia, a billion dollar therapy already on the market.  On checking my emails and Twitter alerts, there was a bunch of information pertaining to Onglyza, Januvia and also Lantus (insulin glargine), sanofi-aventis' novel insulin product recently in the news for potential (but not proven) cancer adverse events.

The amusing thing is that sometimes you forget that you even set these alerts up, but they are very handy when major news or events in the market happen and you have a nice set of warnings and data with which to make a handy assessment of what's going on without having to search for it. 

Even better, 5 mins later a frantic client called asking,

"Help, I'm travelling and need to know the price of Onglyza!  You wouldn't happen to know it would you, please?" 

It took all of 10 seconds to find the intelligence they were looking for in the database – price parity with Merck's Januvia at an average wholesale price of $5.72 per pill for both the 2.5 and 5 mg doses, which seemed to surprise them.  Novartis also have a similar DPP-4 therapy on the market, Galvus, although it not yet approved in the US. 

This market segment is now set for some very serious competition between some heavyweight players, especially as many of the older therapies cause weight gain or do not control blood sugar levels optimally.  Merck's product has done reasonably well, but a wake up call has happened and it will be interesting to see how they respond to competition.

What I'm wondering though, is what patients switching to Onglyza or receiving the therapy de novo will be posting via blogs and social media over the next few months.  It would be an interesting exercise to track if anyone is interested, because these sentiments may help redefine messaging and positioning of the brand against the competition and vice versa for other existing diabetes therapies.  The neat thing is that some web2.0 tools can even enable you to do this in real time.

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Recently, I was talking with a Pharma client about signalling (or signaling as our American cousins call it) and how it can be extremely useful for marketing strategy purposes.

We are all signalling our intent, ideas and thoughts everyday in our daily lives, but imagine if you can aggregate information about a company or brands strategic intent around future business events?  This might take the form of numerous sources including press releases, analyst presentations, discussions with company employees or physicians involved with clinical studies, news articles, RSS feeds, web2.0 tools, online search, social media monitoring etc. 

In fact, you could look at the building of a picture about brand X or topic Y in a simple hub and spoke fashion like this:

Picture 30  

Now imagine monitoring those sources over time and clearer, focused, sharper picture emerges about the strategic intent of the competition and if you're aware of this intelligence, you can use it to your advantage by pre-empting defensive or offensive strategies as appropriate.

Of course, it gets even more fun when you factor in multiple products and companies around a particular topic or disease, with numerous hub and spokes and different sizes of systems depending upon how much information is available or collected and this simplified without intertwined links, which can make the whole picture more akin to solving an evil sudoku puzzle:

 

Picture 40

The beauty of seeing the big picture is that out of the chaos emerges patterns and trends that can be very useful to a marketing team wondering what to do next.  Playmaking and strategy aren't limited to NFL teams, but the smart Pharma marketers can use intelligence and customer driven data insights wisely to better position their brand either now or in the future.

We get a to spend a lot of time on these activities as consultants and thus over time we also get to see general disease area or industry trends emerging ahead of the mainstream.  Ultimately, helping our clients stay one step ahead of the competition can be a very interesting and fun experience indeed.

On the hot subject of biomarkers and predicting response to therapy, Scottish scientists at the Edinburgh Breakthrough Cancer Centre have made an important finding.  They have confirmed that PTEN loss can  pred a patient’s response to Herceptin.  Although trastuzumab targets HER-2, it does not benefit every woman who has HER-2+ breast cancer.  The puzzling question has long been why does resistance develop and how can it be overcome?

The research group reported that they:

“… Examined 122 samples of metastatic breast cancer tumours treated with Herceptin. They demonstrated that the amount of PTEN was related to overall survival and patients whose breast cancer tumours had high levels of PTEN survived on average 22 months longer than those with low levels.”

In addition, using mathematical modeling techniques, the loss of PTEN was more predictive than could be determined using standard multivariate or laboratory analysis.

PTEN is a protein that acts as a tumor suppressor gene and has recently been shown to be associated with resistance in some patients to EGFR therapy in colorectal cancer.  Given it's apparent role in the development of drug resistance in cancer, this should be a very interesting biomarker to watch. 

Pintex, a small biotechnology company that was developing compounds around PTEN appear to have gone out our business and sold their scientific and IP rights to Vernalis, a UK biotechnology company earlier this year.

{UPDATE:   Sincere thanks to Dr Wafik El-Deiry at Univ. of Pennsylvania for gently reminding me that the discovery was initially made in 2004 by MD Anderson Cancer Center in Houston, TX.  You can download their groundbreaking paper from Cancer Cell freely HERE}.

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Someone raised an interesting question at a conference hosted by the Business Development Institute (#BDI) that I went to last week.  They asked how anyone could possibly keep up with all the Pharma news and information, never mind follow thousands of people and interact via social media?

The answer is I don't. 

Obviously, we all dip in and snack sometimes, but for me, most of the time I aggregate my information sources and use it for intelligence purposes on demand, ie search.

It's faster, more user-friendly and ultimately, faster.

It also means I'm a lot more efficient and less overwhelmed this way.  Just in the same way people find information on this blog through Google searches, I can do the same thing with my personalised Pharma database.  If a drug is in the news for not being approved by the European CHMP in indication X, then I can search for relevant information in the database, as appropriate.  Certainly, I don't have time (or the inclination) to read lots of news articles on the topic every day or my brain would simply fry with information overload.

What is interesting is that once you have a database then there is the ability to see and detect strategic trends more clearly, rather than isolated individual items or snippets of data.  The more data you have, the more useful those pictures of the trends in real time will be.

None of us can truly predict the future, but getting some sense of change before everyone else is often very useful business intelligence that can give you or your client a competitive advantage if you can grasp the broader landscape better and faster than anyone else.

These days, I see a big craving by senior Pharma executives for better intelligence and smarter strategic decision making based on data and deeper expertise, rather than a growing shopping list of uncoordinated tactics.

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