Helping Asthma Patients around the World to Breathe Better
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Tell us about yourself/your team.
Deborah and Olivier head up a cross-functional team of dedicated people drawn from many different disciplines (Commercial, R&D, Medical, Regulatory, CMC, Supply Chain, and Procurement) and geographies. Many of the team has elected to work on the project on a voluntary basis which has added significantly to their personal workloads. Our passion and dedication has enabled us to complete the development phase of the project in record time (12 months vs 24 months), whilst maintaining all regulatory and internal GSK standards. In doing this we have achieved many ‘firsts’ for GSK which can be utilized by future projects.
What makes you an intrapreneur? What are the skills, capabilities, and personality traits that make you an intrapreneur?
Deborah had worked in sales and marketing roles in a number of different industries (aggregates, distribution, and retail) before joining GSK's Consumer Division in 2003. She moved into her current role in Pharmaceuticals in 2011 and is responsible for creating new business solutions which improve the quality of medicines that are available to patients whilst delivering a sustainable return for GSK.
Olivier has been working for GSK for 21 years, starting in supply chain and manufacturing. In 2001 he moved to a global role in CMC (chemistry, manufacturing and control). Two years ago, Olivier's love of a challenge caused him to take the opportunity of a secondment in Emerging Market R&D to lead development of respiratory projects, on top of his main CMC responsibilities.
About Your Organization
United Kingdom, HNS, Brentford
Primary country where this project is creating social impact
Indonesia, XX, Nationwide
Additional countries or regions
We hope that this project will benefit over 9 million asthma patients in more than 50 countries in the next 4-5 years
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Select the stage that best applies to your solution
Start-Up (a pilot that has just begun operating)
The Need: What social or environmental problem are you trying to solve?
Global prevalence of diagnosed asthma is approximately 6%. However, anecdotal evidence across many countries suggests that the prevalence amongst patients in the middle of the income pyramid can be 2 to 3 times higher.
The first treatment option for these patients outside clinics and hospitals is typically older oral medications which provide slower relief and may produce more systemic side effects than inhaled versions of the same medications.
Multi Dose Inhalers (MDIs) in aerosals are less commonly used by this group of “middle income” patients. Price is a barrier to inhaler purchase because the patient needs to purchase between 60-200 puffs in one go instead of a single tablet of oral medication.
The Solution: What is your solution? Be specific!
Ventolin Rotacaps/Rotahaler is a low cost inhaler that uses single dose capsules of salbutamol (a fast acting bronchodilator) which will be sold in a small pack of capsules. This device and capsule system has been designed to suit the cash flow of these patients and will provide them with fast acting rescue medicine that can be used to relieve the symptoms of uncontrolled asthma. The device is a re-engineered version of an old technology that preceded MDI and is still sold in the Philippines. By re-engineering the device we have been able to significantly reduce our manufacturing costs.
The Ventolin Rotacaps/Rotahaler solution offers a number of advantages over MDI inhalers:
- Unit (or multi-unit) dose dispensing removes the barrier of high outlay cost by allowing patients to buy their medication on a daily/weekly basis
- Capsule manufacturing costs allow a price to patient cost that is competitive (against oral and inhaled options)
The Solution: Why is this solution innovative for your company and industry?
This project brings a very different set of patient needs to the heart of the thinking and product design. A collective belief in the project's benefit to millions of patients, shared by the internal team and our external suppliers, has motivated us to continually innovate both the product and the development process. As a result the development cycle has been reduced from 24 months to 12 months and radically reduced the cost of the device.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities.
Although huge strides have been made in the treatment of asthma, it remains a major health burden, affecting over 300 million people worldwide. Under-diagnosis and under-treatment of asthma remain high, particularly in Emerging Markets and Asia Pacific (EMAP) regions. Worldwide, asthma accounts for 250,000 deaths annually.
GSK is committed to improving knowledge of respiratory disease and addressing this significant unmet medical need. Part of our long term vision is to enable patients from middle to low income households in EMAP regions to breathe better. The “Ventolin Rotahaler/Rotacap” is an important step towards this goal.
In addition to its affordable price, the device comes in a carry case with usage instructions in local language and also with guidance pictures embossed on the case. The small pack of capsules will also use local language so that patients will have access to information that is usually removed when larger packs are split during dispensing.
For patients who have suffered a severe asthma attack, Emergency Rooms provide an opportunity for patients to be prescribed the device and taught how to self administer a fast acting reliever in the future.
For undiagnosed patients, GSK has developed a simple questionnaire that can be completed by patients whilst they wait to see their doctor. The numerical scoring flags whether the patient potentially has uncontrolled asthma symptoms for the doctor to investigate further during the consultation and, if appropriate, prescribe Ventolin Rotahaler/Rotacaps.
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
Whilst there are a few strong local payers who also provide unit dose respiratory solutions, none of them have a global reach that matches GSK. The process to develop a high performing device and formulation to global standards is extremely challenging.
Ventolin, Rotahaler, Rotacaps are each registered trademarks of the GlaxoSmithKline Group of companies
This Entry is about (Issues)
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
The first was when we reviewed some market research commisioned by GSK in the Philippines. This suggested that:
- In addition to a diagnosed population of 6%, potentially a further 11% of “Middle Income” patients were living with the symptoms of undiagnosed asthma.
- Whilst Ventolin Rotahaler/Rotacaps were available in the country, 2/3rds of the diagnosed middle income population did not have access to inhaled respiratory medicines (outside of clinics and hospitals).
The second was when we analyzed further data for the Philippines and realized that the cost of the device was deterring the patients from switching from oral treatments to rotacaps. If we were to successfully launch rotahaler/rotacaps in other countries we would need to radically reduce the cost of the device.
The level of unmet need suggested that the volume opportunity for expanding this solution across EMAP could be large which would help to offset the investment needed to re-engineer the device.
What has been the impact of your solution to date?
Development of the device has been completed and stock has been delivered into the first launch market. Full launch will commence in 2013.
What is your projected impact over the next 1 to 3 years?
Our goal is to bring fast-acting, affordable, gold standard relief from the symptoms of uncontrolled asthma to millions of patients across the EMAP Regions. GSK defines EMAP regions as every country across the globe except Japan, North America and Europe.
What barriers might hinder the success of your project? How do you plan to overcome them?
In many markets with large middle income populations, governments continue to focus healthcare investment and data collection on infectious diseases such as HIV, Malaria and TB. However, the disease burden is already shifting towards non-communicable diseases such as Asthma and Diabetes. We are therefore faced by a chicken and egg situation: data collection on asthma will not be prioritised until the economic impact of this disease is understood and data is needed to demonstrate the impact. We are developing an approach to work in partnership with governments and asthma associations to quantify the impact of the disease and economic benefit of healthcare investment.
What is the benefit or value you're creating for your business?
For GSK to become the leading supplier of gold standard relief from the symptoms of uncontrolled asthma for all patients whilst generating a sustainable return.
How are you leveraging internal resources (funds, time, knowledge, etc.) to support this initiative?
The project was conceived whilst Deborah and Olivier were working in Emerging Markets R&D. From there we secured senior management support from both the chairman of R&D and the President of EMAP; funding to develop the low cost device; and resource from across the business including our Consumer Healthcare Division.
We have also benefitted from strong commercial support from the Area Director in Asia Pacific who has given us strong support in encouraging markets to register and launch the product.
Expand on your answer, explaining the long-term funding and support plan.
Marketing to Middle Income patients requires our local operating companies to develop new capabilities and to employ a high volume:low margin mindset. We are therefore supporting the launch of the product with cross-functional workshops that include spending time with in patient's homes and visiting government health clinics; and utilizes case studies from GSK’s Consumer Division.
Launch of the product needs to be self-funding within 2 years.
Tell us about your partnerships across your company and externally that are key to your project's success.
This project brings a very different set of patient needs to the heart of the thinking and product design. A collective belief, shared by the internal team and our external suppliers, that this project really can make a real difference to millions of patients, has motivated us to continually innovate both the product and the development process. As a result the development cycle has been reduced from 24 months to 12 months
What internal support have you gotten for your project? What kind of push-back have you received?
Initially the project was solely driven by team members in our spare time until we could quantify the patient need. Once this had been done things became easier. However, persuading General Managers to invest limited resources in launching a low margin product remains an on-going challenge. A well communicated, early in-market success storywill be important for us to gain momentum in rolling the project out.