Pfizers miljö- och ansvarsblogg

Year-end is coming up…

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Snow in my back yard...

It is December, and we are having a very snowy winter here in Sweden. The year-end is approaching and you cannot avoid looking back on the year that has passed and the year that will come.

Professionally for me, 2010 has been dominated by discussions about the MPA report on “stricter environmental standards” from December 2009. I have discussed the report here on the blog several times during 2010, e.g. May 31, May 5, April 27, Feb 8, and Jan 28. And as you may recall, the topic became more widely discussed, i.e. outside the community of “stakeholders in the pharma and health care sector”, through the articles in Forskning och Framsteg and Veckans Affärer in August and September. As you understand if you read my blog posts regarding these articles (Aug 16 and Sept 10 respectively) I was very happy to see that those articles did not take the “easy way out” just blaming the industry, but actually clearly pointed to what I believe is a major root cause, namely the never-ending increased pressure on price…

We have from the industry been very clear that we like to participate in all discussions with MPA and other relevant stakeholders regarding legislative initiatives as propsed by MPA in their report from Dec 2009 (e.g. environmental requirements in GMP). However, we do strongly believe that market driven measures are more efficient and much faster to implement. Hence, an overview of the reimbursement system and the generic reform, is high on our list. I am sure that 2011 will include a lot of discussions on this topic. I know that industry will discuss it with MPA as a follow up on their report, but also as an important part of the Swedish National Pharmaceutical Strategy, which will be developed during spring 2011. You can read more about the Pharmaceutical Strategy on my blog post from Dec 12 and via this link.

It will be an interesting process to work with all different stakeholders in Swedish health care on Sustainable Development, one of 5 focus areas in the Pharmaceutical Strategy. We will look into not only the environmental perspective on sustainability, but also the social perspective. One part of the social dimension is health promotion and illness prevention, topics that I have discussed at the blog during 2010, e.g. Nov 16, Aug 24, June 9, and March 29. The discussion will be intensified during 2011.

What more to remember from 2010? Well, of course what probably can be seen as a life changing experience for me. In October, I spent a week in Uganda looking into three of our global core CSR-programs, namely Infectious Diseases Institute, International Trachoma Initiative, and the Diflucan Partnership.

Infectious Diseases Institute

It was extremely interesting and I was deeply touched by the people we met and the things we saw. I hope that you followed my trip via the blog. If you didn’t, or if you want to recall what happened, read the blog posts from Oct 19, Oct 20, Oct 21, and Oct 24. I have to admit that I was very proud of the difference that Pfizer makes for the people in Uganda and other third world countries that do not have a functioning health care systems in place. It is literally the difference between life and death.

Another thing that made me proud during 2010 was the award presented to me by Pharma Network, “Pharma Person of the Year“.

Proud award winner

The nomination read as follows:

“Bengt Mattson receives the award due to his work during several years to put the environmental issue as a more and more important topic on the pharmaceutical industry’s agenda”

Of course, that makes me proud. And 2010 became even more satisfying when I in addition to the Pharma Network award also bacame the “Bengt Danielsson lecturer 2010“. An award established by the Swedish Academy of Pharmacutical Sciences (in Swedish: Apotekarsocieteten) in 1989 to recall Professor Bengt Danielsson’s long commitment to pharmaceutical education.

Being proud again...

I cannot summarize the year 2010 without mentioning Dizza Tobak. The tobacco prevention project, that we run together with our partners SAMBA and A Non Smoking Generation is fun and so rewarding. To work with kids, and being infected by their energy and enthusiasm is a privilege. Their task is to produce the best anti-tobacco campaign ever, and looking into some of the uploaded contributions from 2010, they are definitely on their way. Do not forget to view our flash-mob from the central station… It will be so fun to see what they come up with during 2011.

Obviously 2010 was a year when a lot of things happened. I have probably forgot several things worth mentioning, but I just have to stop sometime… 2011 will probably be as interesting. But before entering into 2011, let me close 2010 by showing two drawing from two kids in Solletuna, taking part in the traffic safety program we sponsor (in Swedish: Skolbarnens Trafikkalender). I ended my blogging in 2008 and 2009 in a similar way. So with the experiences and wisdom of Viktor Oroug and

Watch out for cars...

Kajsa Alexandersson I wish you all a good ending of 2010 and a Happy New Year 2011.

30 km per hour, fast enough

And as always,

…För övrigt anser jag att hälsa bör finnas med på schemat…

Empowered patients

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Stakeholder dialogues are an important part of all CSR programs (Corporate Social Responsibility). To discuss with stakeholders helps forming programs and initiatives in order to reach the objectives set up.

Today and yesterday I have had very interesting discussions with our peer companies within LIF (The Swedish Association of the Pharmaceutical Industry) and others stakeholders regarding patient empowerment. The empowered patient has been discussed for some years, and several trends in Swedish as well as in other markets underlines the importance of empowerment, e.g.:

- more and more information is available on-line, information that may change the “power balance” in the relation between a physician and his/her patient,

- the ability for EU-citizens to seek health-care in other EU-countries, and

- the “patient choice reform” in Sweden, where patients can chose the supplier of their health-care (regardless whether it is privately or publicly operated).

But was does it really mean with an “empowered patient”. In my opinion the patient needs both the ability to make the choices and the information needed to make those choices correctly. And how do patients get hold of the needed information? What responsibility does the pharmaceutical industry have, and what are the responsibilities of PAGs (Patient Advocacy Groups) and government respectively?

We also discussed the potential difference between strong individual empowered patients and strong PAGs. Strong individual empowered patients probably rest on strong patient right regulations whereas a strong position for the Patent Advocacy Groups could more rely on clear and transparent processes for how decisons are made within agencies, County Councils and in other parts of the health-care sector.

I look forward to continuing discussions on Patient Empowerment, which in my view is closely linked to a lot of other areas in our CSR programs. Examples of such programs are:

- health promotion and different types of prevention initiatives,

- a wider usage of patient support programs, and

- consumer preference for “green branded pharmaceuticals”.

Dizza Tobak and A Non Smoking Generation

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We have had a Dizza Tobak-meeting today, with our partners from SAMBA and from A Non Smoking Generation.

Dizza Tobak meeting

As you know, Dizza Tobak is a tobacco-prevention project supported by Pfizer Foundation, run by SAMBA in collaboration with A Non Smoking Generation. We work with kids and have given them the challenge to produce the best anti-tobacco campaign ever. We have run the project for two years now, and will reach the final year of the Pfizer sponsored part of the program in 2011. Hence, a very important part of the project this year will be to transfer the “ownership” of the Dizza Tobak platform to A Non Smoking Generation. They will take the concept and platform into their regular operations.

The transfer of “ownership” to A Non Smoking Generation will happen during fall 2011, according to the project plan:

Project plan Dizza Tobak

But before the transfer and all activities in the fall of 2011, the focus will be on this year’s competetion. View last year’s uploaded anti-tobacco campagin contributions on dizzatobak.se. Get inspired and start working on your contribution for this year!

Dizza Tobak Flyer

Who to blame?

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The UN Conference on Climate Change (COP16) in Cancun, Mexico, has now ended. And the discussions regarding the achievements of the conference (or the lack thereof) has begun. The comments by Andreas Carlgren, the Swedish Environmental Minister, are relatively positive. Although he thinks that the commitments made to lower CO2 emissions are not satisfactory, he thinks that the Cancun meeting gave confidence back to the UN-process after the great disappointment in Copenhagen last year. Several other organizations, as exemplified by DN this weekend, are more reluctant to use strong positive words, but everyone seems to be happy that the process survived at all…

To develop your own understanding of the outcome of the conference I could recommend you to read Daily Telegraph’s article “what it all means” and their analysis of the agreement text.

In a lot of the comments I have seen during the last two weeks there has been a tendency to find someone to blame. Sometimes it is “the developed world” or often more specifically US, sometimes it is the “developing world” or at least China and India. But where are the large releases of CO2, and how to handle those releases? One thing that I have not seen to much discussions about is ”who actually owns the releases”. Is it the country who manufactures products and goods who should be blamed for the release, or is it the country where consumption takes place? See the huge volumes of embedded CO2 in products exported and imported on this slide that I have borrowed from Björn Stigson of WBCSD (read the blog post from Dec 2), based on data from Stephen Davis:

So, who to blame? According to Björn Stigson, half of the import to Germany from China actually comes from German owned factories in China. I guess that makes it even more difficult “to blame China” for those releases…

It will be interesting to follow the discussions on climate change in the coming year until the next meeting, COP17, in Durban, South Africa. But as I have said many times before, we cannot just wait with actions until a strong global agreement has been signed. Actions are needed already today. So, in both your private life, and in your professional life, let’s contribute to decreasing releases. As you know if you have followed my blog over the years, I am proud of Pfizer’s contributions. A 43% decrease (as indexed by sales) in green house gas releases from 2000 to 2007 and an objective to decrease the releases with additional 20% (in absolute numbers) until 2012.

Pfizer Climate Change Goal

Landstingens nätverk för läkemedel och miljö

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This blog post is in Swedish. It is a summary from a seminar on Pharmaceuticals and the Environment on Dec 9, organized by the County Councils’ network for pharmaceuticals and the environment. Issues discussed were e.g. the national pharmaceutical strategy (including Sustainable Development), MPA’s on-going activities on environmental issues, the de-regulated pharmacy market in Sweden and environmental consequences of that, and the view of the industry (a presentation given by me).

I torsdags anordnade Landstingens nätverk för läkemedel och miljö ett seminarium kring hållbar läkemedelsanvändning - nu och i framtiden - på Citykonferensen i Stockholm. Seminariet var välbesökt och vi fick en bra blandning av såväl socialdepartementets och Läkemedelsverkets perspektiv på frågan, som av Sveriges Apoteksförenings, landstingens och akademins olika perspektiv. Jag hade själv förmånen att få presentera industrins syn.

Ann Einerth

Först ut i talarstolen var Ann Einerth från Socialdepartementet. Ann presenterade förstudien kring den Nationella Läkemedelsstrategin. Visionen i strategin är rätt läkemedelsanvändning till nytta för patient och samhälle. Ett av målen är en minimal negativ miljöpåverkan. Av de fem så kallade fokusområdena valde Ann på detta möte förstås att lyfta upp “Hållbar utveckling”.

Strategin skall vara klar i juni 2011 och alla relevanta intressenter kommer att deltaga i arbetet. Jag själv leder den grupp inom LIF (Läkemedelsindustriföreningen) som ska ta fram industrins underlag för det kommande arbetet. Vi kommer lyfta upp inte bara miljöperspektivet på Hållbar utveckling utan även diskutera socialt ansvarstagande, arbetet med att förebygga ohälsa i samhället samt etiska frågeställningar.

Efter Anns presentation kom Staffan Castensson från Läkemedelsverket upp på scenen.

Staffan Castensson

Staffan presenterade dels det nybildade Centrum för bättre läkemedelsanvändning (CBL) samt Läkemedelsverkets rapport kring ökade miljökrav på läkemedelstillverkning. Denna rapport har jag diskuterat här på bloggen många gånger tidigare (se exempelvis inlägget från 8 februari).

Efter Staffan gav Inger Näsman, Kronans Droghandel och representerande Sveriges Apoteksförening, en presentation om den omreglerade apoteksmarknanden och de ökade förutsättningar som den nya marknaden ger för gröna läkemedel.

Inger Näsman

Ett av Ingers budskap var att införandet av “periodens vara” (den generikaprodukt inom alla olika behandlingar som apoteken måste byta ut de förskrivna läkemedlen till) riskerar att öka kassationen samt att det kan försvåra följdsamheten (vilket i sig också kan öka kassationen…). Hon påtalade också att det måste vara rimligt att inte bara pris beaktas när “periodens vara” beslutas, utan att även miljöaspekter borde vägas in. Apoteken har en stor möjlighet att positionera sig “grönt” genom att de kan agera relativt fritt vad gäller receptfria läkemedel och övriga varor. Det är endast inom det receptbelagda området som de har en strikt tillhandahållandeskyldighet. Vilken av de nya aktörerna på apoteksmarknaden blir “det gröna alternativet”?

Efter att jag sedan hade gett industrins syn på läkemedel och miljöfrågan (och om den kan ni ju läsa på nästan vilket inlägg som helst här på bloggen) intog min gamla spelmanskompis Patrik “Putte” Andersson scenen.

Patrik Andersson

Putte är läkare på internmedicinska kliniken på Södersjukhuset i Stockholm och har bedrivit ett mycket framgångsrikt arbete med att minska användningen av vissa antibiotika, och därigenom minskat miljöbelastningen. Det riktigt intressanta är att Putte sa att det enda som egentligen krävdes var att avdelningen faktiskt följde de vårdprogram och riktlinjer som redan fanns… Ett par “lessons learned” från avdelningens arbete var att den traditionella rondstrukturen inte främjar kontinuerliga förbättringar, samt att man är väldigt duktiga inom många delar av hälso- och sjukvården på att vara emot alla förändringar… Vill ni ta del av hur Avdelning 27 på Södersjukhuset har lyckats så rekommenderar jag er att ta kontakt med Patrik Andersson.

Vi fick ytterligare två exempel på hur miljöarbete bedrivs i vardagen inom landstingen. Dels av Rose-Marie Hallin från Karolinska Universitetssjukhuset

Rose-Marie Hallin

som bland annat pratade om färdigspädda standarddoser av antibiotika samt om läkemedelsautomater, dels av Marie Portström, från Landstinget i Sörmland, som diskuterade kring beaktande av miljöaspekter i förskrivningsögonblicket.

Marie Portström

Efter Marie var det dags för Åke Wennmalm att ge en presentation kring det regulatoriska läget vad gäller läkemedel och miljö. Han tog med oss på en resa in i EU-byråkratins värld. Han påtalade att det är viktigt att komma ihåg att “lagstiftandet idag sker i Bryssel och inte i Stockholm”. Således måste man agera på den europeiska arenan om man vill se regulatoriska förändringar. Åke diskuterade bland annat EU:s så kallade Läkemedelspaket med oss.

Åke Wennmalm

Det sista föredraget innan paneldebatten gavs av Christina Rudén från KTH. Chrsitina är programvärd för MistraPharma, det stora svenska forskningsprojektet inom området Läkemedel och miljö. Läs mer om MistraPharma på projektets hemsida.

Christina Ruden

Ett stort tack till Landstingens nätverk för läkemedel och miljö. Det var en mycket lärorik och spännande dag. Det är uppenbart att området utvecklats starkt under de senaste åren, och att de olika intressenterna idag har väldigt likartade uppfattningar om vad som behöver ske. Och då bör vi ju faktiskt kunna lösa de utmaningar som vi står inför!