Wednesday, August 12, 2009

More on Working With Women

Further to the post I had written earlier on Women managers, seems like someone in The New York Times also had a similar brainwave and did a survey of Women as Managers.

So here is their article on 'Do “female bosses tend to be better managers, better advisers, mentors, rational thinkers”?'

The answer, as you will find is rather subjective. However, the note it ends up with is:

"In terms of their day-to-day actions, women managers should have advantages. But the answer is really not so simple because managers do well only if people accept their authority. ...In roles that have been held mainly by men, women’s competence is often questioned... They have to be extra-competent to be recognized as effective."

"The best managers, female or male, are those who admit that the corporate structure favors men and who recognize their responsibility to help others follow in their footsteps."

and finally, the last nail on the coffin which I thought I was the only one to notice:

"Many people still see an incongruity between the female gender role and the leader role, which makes it harder for women to attain corner office positions and puts them in an unwelcome spotlight when they do. In 2006, after PepsiCo announced that Indra Nooyi would become its new CEO, the headline of the New York Times story was, “A Woman to Be Chief at PepsiCo.” No headline has ever announced “A Man to Be Chief at Acme Corp.”"

Tuesday, August 4, 2009

Medical Tourism and India

Medical Tourism India (a.k.a. Health Tourism India) is a developing concept whereby people from world over visit India for their medical and relaxation needs. Most common treatments are heart surgery, knee transplant, cosmetic surgery and dental care. The reason India is a favourable destination is because of it's infrastructure and technology in which is in par with those in USA, UK and Europe. Since it is also one of the most favourable tourist destinations in the world, Medication combines with tourism has come into effect, from which the concept of Medical Tourism is derived.

Factors that have led to the increasing popularity of medical travel include the high cost of health care, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries.

Major centers of Medical Tourism

Bangkok and Phuket are two leading medical tourism centers, with six medical facilities in Bangkok boasting hospital accreditation from the United States. India is a relative newcomer to medical tourism, but is quickly catching up with Thailand, and recent estimates indicate that the number of foreign patients is growing there by 30 percent each year.
For North American patients, Costa Rica is the chosen destination for inexpensive, high-quality medical care without a trans-Pacific flight.
South Africa also draws many cosmetic surgery patients, especially from Europe, and many South African clinics offer packages that include personal assistants, visits with trained therapists, trips to top beauty salons, post-operative care in luxury hotels and safaris or other vacation incentives. Because the South African rand has such a long-standing low rate on the foreign-exchange market, medical tourism packages there tend to be perpetual bargains as well.
Additionally, Argentina ranks high for plastic surgery, and Hungary draws large numbers of patients from Western Europe and the U.S. for high-quality cosmetic and dental procedures that cost half of what they would in Germany and America.
Lastly, Dubai--a destination already known as a luxury vacation paradise--is scheduled to open the Dubai Healthcare City by 2010. Situated on the Red Sea, this clinic will be the largest international medical center between Europe and Southeast Asia. Slated to include a new branch of the Harvard Medical School, it also may be the most prestigious foreign clinic on the horizon.
India has emerged as a major medical tourism center with over 450,000 medical tourists in 2007, thanks to its rich history and exceptional scope of tourism apart from capable and well experienced medical staff and stellar facilities.

Type of Medical Travelers
(Source: Mc Kinsey survey)

The largest segment of Medical travelers are those who seek worlds most advanced technology, irrespective of cost of treatment or destination. This segment comprises of 40% of total traveler base, and usually originate from Latin America, Europe, Middle East, Canada and go the United States.

Patients traveling for - % age
Most advanced technology 40
Better quality care for necessary procedures 32
Quicker access for necessary procedures 15
Lower cost care for necessary procedures 9
Lower cost care for discretionary procedures 4

The second largest segment usually comprises of people who want therapy in specialized segments, particularly cardiology, and care about costs, to a certain extent.
The third category of people are those who want quick access to medical care which are delayed in their home countries – for e.g., patients in UK.

The segment which wants lower cost care for medically necessary procedures at the moment only comprise 9% of the total population, however, this shows potential for maximum growth. This segment travel to countries like Asia or Middle East and are the target customers for Indian healthcare providers.

The last segment comprises of travelers who travel to other countries for discretionary procedures like various forms of cosmetic surgery, and usually originate from countries like United States.


Advantage India

Technical Advantage
India has top-notch centers for open-heart surgery, pediatric heart surgery, hip and knee replacement, cosmetic surgery, dentistry, bone marrow transplants and cancer therapy, and virtually all of India’s clinics are equipped with the latest electronic and medical diagnostic equipment.
Unlike many of its competitors in medical tourism, India also has the technological sophistication and infrastructure to maintain its market niche, and Indian pharmaceuticals meet the stringent requirements of the U.S. Food and Drug Administration.
India has some of the best hospitals and treatment centers in the world with the best facilities. India’s quality of care is up to American standards, and some Indian medical centers even provide services that are uncommon elsewhere. For example, hip surgery patients in India can opt for a hip-resurfacing procedure, in which damaged bone is scraped away and replaced with chrome alloy--an operation that costs less and causes less post-operative trauma than the traditional replacement procedure performed in the U.S.
Apart from the above, patients in country like UK and Canada would want to trabvel to a country like India to escape the long waiting queue for procedures in their home countries.

Monetary Advantage
The US is one of the primary sources of medical tourists. This is mainly because of the high cost of surgery as well as the insurance system for healthcare.

As per a Mc Kinsey survey, an aortic valve replacement in the United States costs more than $1,00,000 while it costs only $12,000 in a country in Asia.

Country of Procedure Cost of Aortic Valve replacement Savings for customer from United States
United States $ 100,000 -
Latin America $ 38,000 62%
Asia $ 12,000 88%

The United States has an estimated 43 million people are without health insurance and 120 million without dental coverage--numbers that are both likely to grow. This population would be interested in conducting their necessary procedures for cheaper in countries like India.

Deterrents to Growth of Medical Tourism

1. Continuity of care: For a patient with a chronic disease, care spanning over different countries would not be adequate. Also, post operative follow up treatment would have to take place in the country of residence for the patient, which may exclude the patient from insurance benefits in the home country
2. Quantum of benefit: patients might not like to benefit of services of medical travel in case they are marginally higher than those in domestic country
3. Re-imbursement of costs: in some cases the re-imbursement by payors may not cover procedures conducted outside domestic country of patient.
4. Willingness to travel abroad
5. Political environment of the country

With recession, there is a direct effect on medical tourism. Since most tourists are interested in non-acute therapies, the downturn has adversely affected the industry to a large extent, especially in Bankgkok. US President Barack Obama has also made public his plans on reducing healthcare costs and improving public healthcare. If implemented, this would mean many of the medical tourists priorly not covered under US healthcare insurance would now receive affordable medicare in their home country.

Thursday, July 9, 2009

Working with Women

'How many of you would like to have a lady boss? Raise your hands'
Less than ten hands were raised, uncertainly, in my MBA class and I instantly felt ashamed. Because I had not raised my arm. Neither had anyone from my bench.
My strategy professor then pointed out the obvious. None of the raised arms were of women, and in a class of 160 students only 10 were enthusiastic about working with a woman.

I don't remember the discussion, the reason as to why it had come to the point where he needed to ask this question and demonstrate it so absolutely to us. But I remember that result. It was truthful - as truthful as people can get, from unsuspecting students about to leap into the corporate world, replying to their admired professor under the cloak of mass-anonymity - they didn't lie. Perhaps some did - the real number of hands might have been much lesser.

I have been working for years now, inching towards a decade. I have not yet worked with a lady and my women friends who have, are not too happy. Some of my male friends did not care much while one was happy enough - as happy as one can be with a boss.

When applying for a new job, it is not unusual for a woman to be questioned about her plans in personal life. And I mean in the way it is not usually questioned of men. It is not a general chit chat about life and where you see yourself five years from now. I mean personal questions like when do you plan to get married, do you plan to have a baby in the near future (if yes, when) and so on. It grates. Yet, on another level its valid. To an interviewer it does not guarantee a truthful answer but it does strengthen their position.

Nobody wants to hire someone who is about to quit within a year of joining work. Yet, so many women I know have done that (for above mentioned reasons). There are very valid reasons for them having done it. However, the fact is, they have quit citing reasons like having to move to the city where the to-be husband or fiancee resides and works.- reasons peculiar more to women, than men. When joining work the woman probably never thought that she will trade her career for family life, yet that's what she is doing in less than a year. However as far as the interviewer is concerned, s/he was duped. Humanitarian reasons be darned, that boss just spent company time and money on training a person who upped and quit.

The same thing happens for maternity leaves. And for leaving office by 6pm sharp. And, lets face it, for being difficult to deal with on certain days of the month. The reasons are many, extraneous, and if you want to, one can call it Force Majure. Having a baby or leaving for home to be in time to cook dinner and attend to in-laws and so on are not willful pre-decided decisions made to harm the company. They are the balancing act that women live through on a daily basis. The company, however, doesn't see it that way. Be it men, or women. To them, one of their 'resources' is MIA (missing in action).

What am I coming to? Well, in work life and personal life, women face a lot of choices, a lot of prioritisation requirements and because of all this a lot of 'unfairness'. Unfairness percolated to them due to behaviour of their predecessors. And unjust as it may be, it is an undeniable fact that women continue to hold the same decisions against other women.

When a male boss mentions how work is more important than a mother in law to him as a boss, a woman who has experienced the same might be expected to be a little lenient. However, that is where the 'club membership' (so to speak) falters.

You see, men form a club. They talk to each other, bosses and their reportees about how awful it is that they have to take care of the repairs at home. They gripe about how they need to be rich to get married and hence need a promotion. They talk about 'If I don't have a car how can I expect to have a meaningful position in society?'. And their male bosses agree. So they get the day off to tend to that carpenter, they get a raise so that the car can be bought and they get a promotion so they can suitably impress the girl. Meanwhile the reportee works till midnight if need be, and says 'yes sir!' to the boss. The 'club' is formed. Discussions about buying jewelery for the wife/ girlfriend and the right car will ensue over coffee.

It does not work that way with women. The woman boss will not talk about all this with her repportees and neither do the men divulge this to her - they know it wont work. And then with other women, somehow the expectation bar is set higher. The club is formed very rarely, if at all. Talk about impending marriage? The boss will worry about whether you are planning to leave town. Talk about planning a baby - she will think about getting a replacement in your stead. Talk about an irate mother-in-law, and she will think - Ive managed it, high time you grew up!

Men are not going to change, and neither are women. Yet, an office is like another social network. Perhaps the woes women feel need to be shared and empathised with. Perhaps the questions that women face, are due to this.

Most men will not understand the problems of balancing family and work - they will understand there is a problem but very rarely do they face it. Women do not empathise. Perhaps if a woman empathises, her reportee will also reciprocate. When that happens, slowly the system changes. The team becomes stronger and slowly it does not become imperative to ask whether one is getting married (and therefore quitting or moving) but important to ask whether they are willing to give substantial notice and shoulder responsibility to pass on the baton to the next person before moving, if at all.

So does this mean that the onus lies only on women bosses? No. Because there are pitifully few of them around for this generation. The men too have to understand and appreciate - and that can come from committed women workers. From women willing to say - I have to leave for home dot on time, but I'm willing to work through lunch hour to finish the work. From women willing to say I am getting moving town, but I will pass on all my knowledge to the next person and I am willing to work till then. From women, who have to be truthful about how long a maternity leave they plan to take, and not take a 3 month leave, extend it to 6 months and eventually quit, leaving the company in the lurch. Not all women do this, but enough do so that the system does not trust anyone.

I hope the system will soften. I hope some of the women become more serious about the repercussions of their actions. But most of all, I hope sometime in the future, there is equality in the work place and there is no need for 'clubs' to further ones cause - small or big.

Thursday, June 4, 2009

Google Sqaured!

So I heard about it, and its comparisons to Wolfram Alpha. Guess what? Apparently its more raw than WA.
So I tried a common search - India Prime Ministers. WA yielded results ONLY for Manmohan Singh while GS mentioned everyone except him.

Your viewpoint?

Saturday, May 23, 2009

Wolfram Alpha is Fun!

The name of a new 'search engine' is becoming pretty prevalent all over the Net. It however, is not a search engine. They call themselves a 'Computational Knowledge Engine'. Yup, I'm talking about Wolfram Alpha.


WA is not Google. It does not yield results by some keywords thrown in at random with no semblance to want, requirement or meaning. It is not an indexing site which goes through the Net and all its web pages and spits out results according to which has the information. In fact, it is nothing like Google at all.

Wolfram thinks. When I need information on specific results, when I want to know distances, the time anywhere in world, a short note on any two companies, WA fits in perfectly. I do not have to now scour the Net to check Wikipedia, Timeanddate, Yahoo finance or Google finance, conversion sites, etc. WA is a one-point stop for all this.

WA analyses and gives results for values put in, in correlation to each other.

Some examples:

1. Mumbai, India. This yeilds results about Mumbai, a city in India. Pretty helpful for a working individual who wants the basics - temperature, time, place location etc.

However, Mumbai to Kolkata gives me results on travel between the cities, a map, time for travel etc. But its all theoretical. None of the air travel results are on the basis of a certain airline.

2. Conversions. The 'enter' button on WA corresponds to '=' and not to 'search'. This means, it acts a mini calculator. And it gives results of computations in all formats you want. Its fun!

3. Company results. WA gives me stock quotes, financial health etc of a single company, or compares two of them.

And so on. The main website gives a lot of details.


However, it still has a long way to go. Most of the information is US-centric. There is a lot of work to be done. It is very useful for someone on the go, who wants instant results on any topic without having to scour many websites. However, it does lack sophistication. The results are not always useful. I mean, sure, I know about the city and its distance from where I am but how about making it a little...
relevant? Say, include travel modes, carriers, a couple of pictures etc. - something which makes it real analysis, and not just a bunch of information. Speed is not something WA seems to be aiming at.

Overall, I think it is a fun site as of now. Its great for students perhaps, who would like instant information and just skim the surface, or executives who want a certain simple bit of information,
stat. It is little like a Wikipedia where searching for required data is not needed. I think it will take a little time to catch on, though it seems to be doing beautifully at the moment. Many people it seems are confusing it with Google Search. That can only take a little time.

But I feel WA needs to index a lot more pages to get information and it needs to add a little more analysis (apart from making its name a little simpler perhaps?). A little more coherence to the raw information it gives me now. The biggest benefit of Wolfram Alpha? It does not give a lot of words. Just the information.

Eventually, if I want the internet to do the basic thinking for me, I would like it to be a little more smart about it.

[Image courtesy India Business Blog]

Monday, May 18, 2009

Stem Cell Research: Policies in US, Europe and India

This is an essay on Stem Cells, Stem Cell Research, and the policies for (Embryonic) Stem Cell Research around the world. Though I personally feel that work on adult stem cells should be stepped up and media hype around embryonic stem cell research lessened, it seems media is winning and authorities influenced by Media are leaning towards more stress on ES cell research. Which is not a bad thing in itself. Scientists need to study Embryonic Stem Cells for science to progress. My point is, they have been doing so for decades with no outcome. Meanwhile therapies using Adult Stem Cells have reached and transformed life of patients around the world!
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Stem Cell Research:
Stem cells are undifferentiated cells that can be moulded into almost any kind of cell of the adult body. Scientists have identified stem cells as a source of cells that can be used in many therapies, for eg., in the treatment of cancer cells destroyed by radiation or chemotherapy can be replaced with new healthy stem cells that adapt to the affected area. Stem Cell Research is thus an international, developing field of research.


Source of Stem Cells: Stem cells can be sourced from adults as well as from embryos. Adult stem cells that can differentiate into any type of cell (pluripotent cells) are small in number, and can be collected from specific tissue sites. Usually, adult stem cells are lineage-restricted (multipotent). Collection of adult stem cells from organs is painful and difficult though not under debate. Also, in such cases the chances of rejection of the final tissue is much lower as there is an exact DNA match with patient.

Umbilical cord cells are extracted during pregnancy and stored in cryogenic cell banks (similar to blood banks) for future use on behalf of the newborn. Cord cells can also be used by the mother, the father and can be donated as well. Even though there is not an exact DNA match in cases where cord cell is used in relations/ other patients, scientists have developed methods to increase transferability and reduce risk.

Embryonic Stem (ES) cells are collected from the embryo four to five days after its formation and they are pluripotent, capable of giving rise to more than 200 types of cell types of the adult body. Also, ES cells are grown and multiplied to form Embryonic Stem Cell Lines, which can be further used for research. However, due to the removal of these cells, the embryo is destroyed. This has led to controversy regarding ES cell research, as this has been viewed as ‘killing of life for research’.

International Stem Cell Research
Stem cell research has been an on-going research field since 1908, when Stem Cells were first identified. The first successful bone marrow transplant to treat a disorder was done in 1968. Presently Leukemia and bone marrow transplants to treat various cancers are successfully performed using stem cell therapy.
Due to their unique characteristics, researchers believe that stem cells can be used to treat a wide variety of disorders and diseases like cancer, Parkinson's disease, spinal cord injuries, Amyotrophic lateral sclerosis, multiple sclerosis, muscle damage, etc. At present, the research using stem cells investigate not only treatment options, but also study the nature and behavior of the cells to enable optimal use of such cells for therapy.

Status of Stem Cell Research
Nearly all research to date has taken place using Mouse ES (mES) or Human ES (hES). After nearly ten years of research, there are no approved treatments using embryonic stem cells. One of the main reasons for failure of successful therapies using ES is their tendency to be teratomic (a type of cancer). Differentiating ES cells into usable cells while avoiding transplant rejection is also a competitive problem. Many nations currently have moratoria on either ES cell research or the production of new ES cell lines.
The first case of clinical trial for a therapy derived from human embryonic stem cell was reported in January 2009. The trial is for a treatment of spinal cord injury by Geron, the biotechnology company that first applied to the Food and Drug Administration to conduct the trial in March ‘08. The study is in Phase-I trials.
Globally, the market size for stem cell therapy in 2006 was estimated at $26 billion and is expected to touch the $96 billion level by 2015.

International Regulations on SCR

USA
Ex-US President G.W. Bush authorized federal funding for research on the stem cell lines available in August 2001, and blocked money to fund research on human embryonic stem cell lines created after 9 August 2001. Other stem cell lines were available for research, but could not avail federal funding. U.S. officials identified 64 eligible stem cell lines in 10 U.S., Israeli, Indian, Swedish, and Australian labs, of which 21 were ready for use to scientists. However, scientists found this too restrictive as they considered older stem cell lines lose their potency after a number of iterations.
US President B. Obama changed the said legislation in March 2009, when he signed a memorandum allowing federal funding to embryonic stem cell research to more than the hitherto approved lines, as long as it did not open “the door to the use of cloning for human reproduction”.
Some scientists argue against ES cell research on medical grounds. Mice treated for Parkinson's with embryonic stem cells have died from brain tumors in as much as 20% of cases. Embryonic stem cells stored over time have been shown to create the type of chromosomal anomalies that create cancer cells. As per some groups, funds devoted to embryonic stem cell research can be better employed to developing therapies from adult and cord blood stem cell research.

Europe
The EU is divided in its opinion for stem cell research. While some countries like Belgium, Spain, Sweden and the UK are enthusiastic about stem cell research, none of them have shown interest in embryonic stem cell research. The European Union ministers after a collaborative voting had decided not to finance the procurement of embryonic stem cells, however are open to funding ‘further research’ on already procured lines. A very small part of the total EU research fund (EUR54bn) has been earmarked for Stem Cell research till 2013. The decision was also made keeping in mind the intent of researchers, and there were no projects till 2007 which requisitioned funding for Stem Cell research in EU.
Funding for research in the EU happens at the national level as well, and to that extent The UK Stem Cell Foundation (UKSCF) was founded in 2005. It has dedicated £100m towards stem cell research where there is potential of direct benefit to patients in the short term (2-5 yrs). Other countries which have shown interest in some SC research are Belgium, Finland, France, Portugal, Spain and Sweden. The driving factor however is to ensure that talented researchers do not emigrate to other countries to seek funds. However, research activity has been very low in any of the countries.
Work on Stem Cells in the EU
In 2002, the Human Fertilisation and Embryology Authority of UK issued two licenses to create stem cell lines from embryos discarded after IVF treatment. However, progress on ES cells for treatment has been slow. The UKSCF has however seen progress in research directed towards use of adult stem cells. There are five promising projects for which they are now seeking funding.

Japan
In 2003, Japanese government panel recommended allowing limited cell research on human embryos, but only if a regulatory body is appointed. Although Japan permits embryonic stem research, it imposes the heaviest regulatory conditions of any country that does so.
In 2008, there was seen some progress on SC research in Japan, where a research team developed induced pluripotent stems from mice cells. However, the research was yet to find further funding.

India and Stem Cell Research
India has a number of organizations which act as stem cell banks, storing stem cells from cord blood for future use. Institutions like Stem Cell Voice of India, Cord Life India Pvt. Ltd etc. are actively involved in the promotion of Stem Cell therapeutic potential. However, research is still a developing field, with much need for funding. As per Dr. Geeta Jotwani, assistant director general, Indian Council of Medical Research (ICMR), the number of public-private partnership funds to take forward stem cell research is on the rise, a promising future for SC research.
Leading institutions active in research in India are the All India Institute of Medical Sciences, Centre for Cellular and Molecular Biology (CCMB), Reliance Life Science, Indian Institute of Science and LV Prasad Eye Institute.
The draft guidelines for stem cell research in India had been founded by Indian Council of Medical Research (ICMR) and the Department of Biotechnology (DBT), in November 2007.
With US federal funding now open to embryonic research on newer ES Cell lines, research is expected to pick up pace throughout the world, including India.

India on the Global Map
In March 2009, Centre for Stem Cell Research at the Cristian Medical College, Vellore succeeded in reprogramming adult fibroblast cells (multipotent cells) to pluripotent cells, a first step in overcoming the need for embryonic pluripotent cells.

Conclusion

Research using stem cells investigate not only treatment options, but also explore options where Stem Cell Therapy can be commercialized at the soonest. With high research and development costs and the nascent stage of development of most research, stem cell research has a long way to go. To support and develop this industry, there is rising an adjunct industry catering to the requirements of stem cell research.

With increasing international interest from governments and the private sector, Stem Cell Research and its associated research fields are expected to gain further importance in the near future. India, by virtue of being an international pharma R&D hub as well has having one of the most permissive SC research guidelines, is expected to play a crucial role in the growth and development of the field internationally.
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Monday, May 11, 2009

Northfield, Ardea: Is Pharma R&D too difficult?

Continuing with the story on Pharma R&D and how R&D pipelines are increasing acquisitions in the Pharma space, the pharmaceutical markets are now shaken with two companies reporting losses on the basis of R&D expenses.

Northfield Laboratories Inc. has been working on a single product (as is the want of smaller research based companies) for the past 20 years. The product, as would seem on first look seems fairly impressive. Called PolyHeme, it was being developed as a temporary blood substitute - path breaking indeed for human biology and the medical fraternity. Or so one would think.

However, after a long study conducted by the US FDA, they have not approved the final product. After twenty years of hard work for a single product, raising money, going public, and enough publicity, the company failed. It has laid off most of its operational and staff employees at its manufacturing facilites, and has publicly mentioned its intent of shutting down. Just the present economy which will not frther its venture? Or is it a case where a very good molecule could not face upto the ever changing, stringent requirements of the administration. Though PolyHeme promised many benefits, it caused death in patients about 30 days after use: 13.2 percent of patients receiving PolyHeme died versus 9.6 percent among the control group. A fairly large population group. However, considering the end-stage and emergency conditions in which PolyHeme could be used, the FDA could have approved the drug for specific conditions.

Unfortunately for Northfield, the FDA has rejected the drug, and the company and its employees are now out of a job.

On another note, Ardea Biosciences, a company focused on HIV related and cancer related therapy, recently inked a deal with Bayer, with USD 35mn upfront payment. However, even with this income, they find the R&D expenses too high and have declared a 47% cut in its workforce.

Is the recession increasing the pressure on R&D for smaller pharma? Or was it just a matter of time before companies like this had to fold?

Wednesday, May 6, 2009

Late Hours & Work Life Balance


To most people working in India, working till late in the evening is not uncommon. Thanks to the bureaucratic era seen by most of the generation working today, it is considered sinful to actually work 9 to 5. That luxury is reserved only for the inefficient government workers, who make it 10 to 5.

As a result of this conditioning, in India, most people in the age group of around 40 work late. They regularly reach office by the designated time (say 9am) and leave office a few hours after the designated time (say, 9pm). They have virtually no family life to speak of, since to them, working is of prime importance. Leaving office by 7:30pm or an 'early' 8pm, they are barely home for dinner. Weekends are also spent checking office mail or following up with the underlings they designate to stay in office. This group of individuals have worked hard all their lives - though at what, baffles me. Due to this, the stereotype of working husbands and housekeeping wives was born. After all, while one person spent their life at the office, another had to look after the house.

In today's world, there are efficient means of finishing jobs. There is Microsoft Office, there is the Internet and there is email. Computer and telephone. Each of them have their own characteristics. Sure, the work done by a single individual has also increased manifold, but unless under extraordinary circumstances, one need not stay back an hour or two late daily. Socially also, there is more importance on work-life balance rather than a stress on just working. With increasing number of women working, household responsibilities fall on two shoulders and thus, both individuals have to make it home a while before dinner. This means, people today do not really care to be in office beyond the necessary time. Unless of course, there is urgent work.

However, still, in most organizations in India, people work late. Companies try to cut costs, but the one cost they cannot cut are the electricity expenses of computers, lights and A/Cs running 12 to 14 hours a day, including weekends.

No one wants to leave a job incomplete. A task completed to self satisfaction is what we have been trained to do since childhood - and this is not just to please the boss. However, this also does not mean that it will take an individual 14 hours on a daily basis to do tasks allocated to him/ her, which as per the company are worth 8 hours per day. To me, this can mean only a few things:
a) The individual is incompetent. S/he takes much longer than is required to finish the work as defined on his/ her job description. In such case the management should take up the issue and deal with it satisfactorily.
b) There is more work given to the individual than designated. The person in this case should point out the lack of sufficient manpower to complete the extensive work required, and if the management is deaf to the requirements, take a stand to improve the situation.
c) There is no work related problem, it is a legacy.

In most cases, I find option (c) the most relevant. Forget the customer. In an office, Boss is King. With most leaders in todays companies coming from the generation of late workers, they cannot fathom not having their team finishing work on or before the day is over. Deadlines are important, but its just as important to stick it in office. Because the Boss says so.

As a result it is not uncommon to see people take it easy after 5pm in an office. They take longer breaks, and eventually sit on a trivial matter till late in the evening, or at least till their supervisor is present. Soon after s/he leaves, they too miraculously finish their work and wrap up.

Sure, sometimes there is an emergency and a spike in the work requirement. Where does that not happen? When working, it is but natural that there be a spike or drop in the amount of work required. However, a continuous spike interspersed by all-nighters on a regular, monthly basis is unnatural.

The legacy has to be addressed. It has to be understood by supervisors as well as workers that it is not beneficial to either party to extend working hours. That hours worked for no extra benefits actually slacken the pace of work, reduce morale and eventually undermine real emergencies.

Organizations in India should address late workings, and not encourage them. If working late were the only response to working hard and well, how is it that so many large organizations have fixed working hours to which individuals stick, as they do to the company. In certain situations people have to work with different countries and time zones. The company in that case should make allowances for different working hours for such employees.
Hard work should not, and cannot be confused with sitting back late in office.

What do you think readers? What are your views on working late in office.

Tuesday, April 28, 2009

Research – How it works for Small & Big Pharma

The Pharmaceutical industry is heavily reliant on Research and Development. The final product is always tied with the research labs, undergoing testing even years after it has hit the market. As a result, there is a lot of importance associated with R&D.

Molecules typically take 10-15 years to be shortlised and eventually declared suitable for curing a disorder/ disease. However, the percentage of molecules that actually make it through this long process are a handful, nay, perhaps one, from a seed lot of over ten thousand.

Research spending happens at various levels. The first and most important stage is identification of the area where research is to be targeted. With over a million diseases, the spectrum to choose ones research from is wide. However, considering the many organizations involved in pharma research, there are very few unexplored areas. Thus, it is incumbent upon the company to select and shortlist areas, and identify where they might have a competitive advantage. Thereafter, the company has to select one particular disorder - in which it will have either lesser competition or else has a considerable advantage in terms of available research.

Armed with a research area and a pinpointed disease, scientists then move on to conjecturing what the ultimate molecule should look like (on a molecular level) for it to be effective. Modern day CADD (Computer Aided Drug Designing) tools are helpful in this respect, though there is considerable human manpower required as well.

Thereafter begins the actual lab work which helps in shortlisting a few possible candidates which the real world will allow to exist and act. These molecules are then tested on tissue cultures and different lab conditions and eventually on small animals to test whether they are really as active as they are expected to be. This research alone can take years and be a drain on resources.

Eventually, if the lab is lucky, one molecule makes it to be marketable for human testing.

Considering this long chain, many Big Pharma take a short-cut. Using their ample resources, Big Pharma over the years has cultivated several smaller research organizations. They keep a track of labs and companies who perform original research and pluck their promising candidates for a fee. This saves them time, and gives them seed molecules at comparable costs. Hence, they do not have to fret about the outcome of their initial researches, or even indulge in primary research.

Most of the times, companies like Novartis, Pfizer etc, do not bring the molecule idea in their labs. Instead, they opt for co-development. Co-development is the means by which two companies collaborate on a project with (equal) rights on its development costs and future revenues. This helps the Big Pharma to cut costs and enhance their appetite for risk. The model, therefore, can be replicated across companies, rather than working on a couple of molecules.

Another model used by Big Pharma is one where they give it away for contract research. Rather than incur the costs and responsibilities associated with taking a molecule to ‘medicine’, many companies either give it away to cheaper labs with pre-fixed milestone achievement payments, or else, license it out to smaller companies. The smaller company then works on the molecule in a bid to make it achieve its pre-planned medicinal objectives, and on completion of every successful stage of its experiments, it is given a special pre-fixed payment by Big Pharma. In the latter case though the smaller company can keep ownership rights of the molecule in certain territories, Big Pharma can buy those rights subsequently. However, if they feel the project is not going as planned, they can abandon it without much capital loss.

Hence, when Big Pharma acquires molecules, it can cut costs by either buying out a finished product, replete with all patent rights, or, it can collaborate on a semi-finished product and see it through its development by sharing costs. Sometimes, of course, Big Pharma does come up with its own researched molecules.

Friday, April 24, 2009

Why are Pharmaceutical Companies doing Big Acquisitions?

Or, The Giants are Rampaging

Big Pharma's world is spinning. And they are reacting. It's not the recession that's causing it.

So, allow me to track what has been happening in the Pharma world in the recent past, to get an answer to the latest mergers and acquisitions taking place in the World Pharma Market

Usually when talking about Pharma, Indians tend to focus more on the US market; and as a beginning point I too will do that, keeping India in focus. This of course does not mean that Pharma World means only the North American market while Europe and Japan, Asia and Africa, South America and Australia are not worth talking about. Its just that when we talk about regulation changes and amount of money raked in, as well as the top Pharma Companies in the world (by value), US ranks at the top and most influential.

Some years ago in 1984, came the Hatch-Waxman Act. This ensured that Big Pharma, while sitting on high profits of patented drugs in the US, could no longer enjoy the same benefits indeterminately after patent expiry. With enforced usage of generics, branded drugs lost their sheen. So the originators started tightening their belts, and in some cases, even discontinuing the patented brand after patent expiry. This caused a serious dent in their bottomlines.

An originator company incurs a lot of expenses in the initial years, but by the time it is year 17 of selling the brand, expenses whittle down to mostly just cost of production - i.e. a lot of profit*. So, these big companies, with their big virtual bottomlines, spent part of it on R & D, while ensuring a good PAT, which kept shareholders happy.

Then came Mr. Hatch and Mr. Waxman, who spoiled the party somewhat. They came up with the bill which ensured that generic drugs were given special preference and were not only approved earlier, but were given preference when it came to prescribing medicines - somewhat akin to what happens in Europe. This meant, the market share of high-priced, low-cost off-patent drugs reduced. So much so, that in some cases they discontinued these drugs, or reduced the prices, or sold them off to their newly formed generic arms. Almost every Big Pharma started spouting their own generic companies. This party too, did not last very long as patients started preferring the cheaper medication available from lesser known companies, usually Indian. The Giants did not like this and started all sort of fights on legal fronts (meanwhile the puny unknown companies started getting bigger with their larger profits)
^.

So then the giants had a hard job balancing between the shareholders and their research requirements. Typically, the Big Pharma just buys the smaller companies with promising research molecules and takes them to fruition
#. However, in this scenario, the smaller companies too, did not have any money to devote to develop astonishing new molecules. And the bigger companies felt the heat. They no longer had molecules which would probably develop into promising medicines a few years down the line, earning them the type of profit which allowed for indiscriminate R&D spends while allowing for happy shareholders. The cycle was breaking. It was almost twenty years since Hatch-Waxman's bill was passed and finally the Big Pharma was feeling the heat. The was Now.

As an immediate step therefore, they did the next possible thing - looked at their competitors. With research molecule pipelines drying up, pharma companies in the world are trying hard to make up the possibility of revenue loss in the future. So, Pfizer merged with Wyeth. There will be layoffs, but at least when Lipitor expires, Pfizer will have some other possible products to look forward to.
Merck and Schering-Plough too merged. They had tried to compliment one another earlier, and though that was not a success story, this time round they are trying a merger of companies and not molecules.
Glaxo SmithKline, already a few mergers old, acquired a skin-product company, Steifel, in abid to increase its cash.

So as the world changes, it seems the Big Pharma has finally realised the need for future planning, rather than just saving their turf
^. With the economic downturn, things couldn't have been timed better. With valuations touching lows they haven't for some years, the large pharmaceutical companies of the world seem to have a good time shopping.

Note: I will be elaborating on the following topics in subsequent posts
* Expenses of Big Pharma companies
^ Steps taken by Big Pharma to reduce generic impact
# How R &D really works