NEW MEDICINES, BETTER MEDICINES, BETTER USE OF
NEW MEDICINES,BETTER MEDICINES,BETTER USEOF MEDICINESA Guide to theScience UnderpinningPharmaceutical PracticeMay 2014
THE ROYAL PHARMACEUTICAL SOCIETYABOUT THE ROYALPHARMACEUTICAL SOCIETYThe Royal Pharmaceutical Society is the dedicatedprofessional body for pharmacist, pharmaceutical scientistsand pharmacy in England, Scotland and Wales. We are theonly body which represents all sectors of pharmacy inGreat Britain. We lead and support the development ofthe pharmacy profession, including the advancement ofscience, practice, education and knowledge in pharmacy.We ensure the voice of the profession is heard and activelypromoted in the development and delivery of healthcarepolicy and work to raise the profile of the profession.Our mission is to promote and represent the professionalinterests of our members, supporting the professionto achieve our shared vision for the future. We arecommitted to supporting and empowering our membersto make a real difference to improving health outcomesfor patients.Office details for the Royal Pharmaceutical Society are:HEAD OFFICE1 Lambeth High StreetLondon SE1 7JNTel: 0845 257 2570 or 0207 572 2737Fax: 0207 735 7629Email: support@rpharms.comSCOTTISH OFFICEHolyrood Park House106 Holyrood RoadEdinburgh EH8 8ASTel: 0131 556 4386Fax: 0131 558 8850Email: scotinfo@rpharms.comWELSH OFFICEUnit 2, Ashtree CourtWoodsy CloseCardiff Gate Business ParkCardiff CF23 8RWTel: 0292 073 0310Fax: 0292 073 0311Email: wales@rpharms.com2NEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES
The Society leads and supports the development ofthe pharmacy profession including the advancement ofscience, practice, education and knowledge in pharmacy,as well as promoting public understanding of pharmacyso that its contribution to the health of the nation isunderstood and recognised. In addition, the RoyalPharmaceutical Society promotes the profession’s policiesand views to a wide range of external stakeholders ina number of different forums.New Medicines, Better Medicines, Better Use ofMedicines – A Guide to the Science UnderpinningPharmaceutical Practice represents the views of theRoyal Pharmaceutical Society’s Pharmaceutical ScienceExpert Advisory Panel (PS-EAP). The PS-EAP is anindependent advisory panel of the Royal PharmaceuticalSociety, composed of 17 leading figures in pharmaceuticalscience from academic, industrial, regulatory, hospital andcommunity practice from across Great Britain. Theirremit is to provide strategic direction and assess futuredevelopments in pharmaceutical science to the RoyalPharmaceutical Society on critical issues facing pharmacythat impact on patients and the public.This document is the first to describe, in a single volume,the full spectrum of pharmaceutical science activityand to demonstrate the interdependencies which arecritical to the development of new and better medicinesand ensure the better use of medicines.The Guide is aimed primarily at the pharmacy professionand other interested professionals. More targeted guideswill be produced from this source material for the public,politicians and other groups. The Guide aims to showcasethe important role pharmaceutical science plays in thehealth and wealth of the nation, in particulardemonstrating the breadth of scientific knowledge andunderstanding necessary to underpin the whole scope ofpharmaceutical practice. It also highlights major Challengesand opportunities faced when creating new medicines,improving existing medicines or ensuring the better useof medicines; it makes a series of Recommendations foraction from these Challenges. It is intended that theGuide will be a living document, regularly reviewed andupdated as appropriate.Throughout the Guide, examples are given ofpharmaceutical scientists who have made significantcontributions to their field of work, of medicinesdeveloped by pharmaceutical scientists that havesignificantly improved the lives of patients and newways in which medicines can be used by patients in saferand more effective ways. It is acknowledged, however,that due to space constraints, it is only possible toinclude a representative selection of examples.Jayne Lawrence,Chief Scientist, Royal Pharmaceutical Society.NEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES3FOREWORDFOREWORD
ACKNOWLEDGEMENTSACKNOWLEDGEMENTSNew Medicines, Better Medicines, Better Use ofMedicines – A Guide to the Science UnderpinningPharmaceutical Practice was produced by thePharmaceutical Science Expert Advisory Panelof the Royal Pharmaceutical Society, the membersof which are listed below.nnChristine Bond, Professor of Primary Care(Pharmacy), Head of Centre of Academic PrimaryCare, University of Aberdeen, AberdeennnDuncan Craig, Professor and Director, UCL Schoolof Pharmacy, University College London, LondonnnStephen Denyer, Professor of Pharmacy, Schoolof Pharmacy and Pharmaceutical Sciences and Deanfor Academic Quality, University of Cardiff, CardiffnnRichard Guy, Professor of Pharmaceutical Sciences,Department of Pharmacy and Pharmacology,University of Bath, BathnnJanet Halliday, PhD, Director of Research andDevelopment, Ferring Controlled Therapeutics,East KilbridennKaren Hassell, Professor of Social Pharmacy, Directorof the Centre for Pharmacy Workforce Studies andHead of Pharmacy Practice Group, School ofPharmacy and Pharmaceutical Sciences, Universityof Manchester, ManchesternnGill Hawksworth, PhD, Community Pharmacistand Senior Lecturer, Department of Pharmacyand Pharmaceutical Sciences, University ofHuddersfield, HuddersfieldnnGed Lee, PhD, Retired, formerly Senior Managerof Laboratories and Pharmacopoeia, MHRA, LondonnnSimon Mackay, Professor of Medicinal Chemistry,Strathclyde Institute of Pharmacy and BiomedicalSciences, University of Strathclyde, Glasgownnnn4Luigi Martini, Professor of Pharmaceutical Innovation,King’s College London, London and Chief ExecutiveOfficer, Rainbow Medical Engineering Ltd, LetchworthGarden CityCatherine McKenzie, PhD, Consultant PharmacistCritical Care, Pharmacy Clinical Department,Guy’s and St Thomas’ Hospital, LondonnnTony Moffat, Emeritus Professor of PharmaceuticalAnalysis, UCL School of Pharmacy, University CollegeLondon, LondonnnTony Nunn, Industry Professor, School of Pharmacyand Biomedical Sciences, Liverpool John MooresUniversity and Honorary Fellow, Department ofWomen’s and Children’s Health, University ofLiverpool, LiverpoolnnTheo Raynor, Professor of Pharmacy Practice,University of Leeds and Co-founder and AcademicAdvisor, Luto Research Ltd, LeedsnnPhil Routledge, Professor and Head of Departmentof Pharmacology, Therapeutics and Toxicology,Institute of Molecular and Experimental Medicine,School of Medicine, University of Cardiff, CardiffnnValerie Sillito, Community Pharmacist,Alliance Boots/NHS Grampian, AberdeennnSteve Wicks, Professor and Director of Researchand Enterprise, Department of Pharmaceutical,Chemical and Environmental Sciences, Schoolof Science, University of Greenwich, Greenwich.The members of the Pharmaceutical Science ExpertAdvisory Panel of the Royal Pharmaceutical Societywere supported in their work by:nnColin Cable, Assistant Chief Scientist,Royal Pharmaceutical SocietynnJayne Lawrence, Chief Scientist,Royal Pharmaceutical Society.Draft versions of this document were sent to a widerange of individuals and organisations for comment.We are grateful for all the feedback received whichhelped to develop and refine the final document.We gratefully acknowledge the following individualsfor their contribution to the document.nnLiz Allen, PhD, Quintiles Drug Research Unit,Guy’s Hospital, LondonnnNina Barnett, Consultant Pharmacist Care of OlderPeople, North West London Hospitals Trust andPharmacy Advisor, East and South East England NHSSpecialist Pharmacy Services, LondonnnNicola Gray, PhD, Independent PharmacistResearcher, Green Line Consulting Ltd, ManchesterNEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES
Kieran Hand, PhD Consultant Pharmacist,Anti-infectives, University Hospital SouthamptonNHS Foundation Trust, SouthamptonnnAnne Hinchliffe, Consultant in Pharmaceutical PublicHealth, Public Health Wales NHS, CardiffnnCaroline Hind, PhD, Deputy Director of Pharmacyand Medicines Management, NHS Grampian,AberdeenWe also gratefully acknowledge the followingorganisations for their comments on the document.nnAcademy of Pharmaceutical SciencesnnAssociation of the British Pharmaceutical IndustrynnBoard of Pharmaceutical Sciences of the InternationalPharmaceutical FederationnnBritish Pharmacological SocietynnBritish Science AssociationnnBUPAnnPhilip Howard, Antimicrobial Pharmacist, LeedsTeaching Hospitals NHS Trust, LeedsnnCarmel Hughes, Professor of Primary Care Pharmacy,Queen’s University Belfast, BelfastnnDirectors of Pharmacy (Scotland)nnJoint Pharmaceutical Analysis GroupCatriona Matheson, PhD, Senior Research Fellow,Centre of Academic Primary Care, Universityof Aberdeen, AberdeennnMedical Research CouncilnnMedicines and Healthcare ProductsRegulatory AgencynnNational Institute for Health ResearchnnPharmacy VoicennRoyal Society of ChemistrynnRoyal Pharmaceutical Society English and ScottishPharmacy BoardsnnnnDavid Taylor, Professor of Psychopharmacology,King’s College London and Director of Pharmacyand Pathology, Maudsley Hospital, LondonnnStephen Tomlin, Consultant Pharmacist, Children’sServices, Evelina London Children’s Hospital, Guy’sand St Thomas’ NHS Foundation Trust, LondonnnMargaret Watson, PhD, Senior Research Fellow,Centre of Academic Primary Care, Universityof Aberdeen, AberdeennnRoyal Pharmaceutical Society IndustrialPharmacy ForumnnScottish Government Chief Pharmaceutical OfficerGreg Webber, PhD, Product Development,GlaxoSmithKline, Ware.nnScottish Patients AssociationnnSociety for BiologynnUnited Kingdom Clinical Pharmacy AssociationnnWelsh Government Chief Pharmaceutical Officer.nnNEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINESACKNOWLEDGEMENTSnn5
EXECUTIVE SUMMARYEXECUTIVE SUMMARYMedicines are one of the most important interventionsin modern healthcare. They improve quality of life, reducethe number of life years lost and can avoid prematuredeath. In spite of the ubiquitous nature of medicines,however, the complexity of the medicines developmentprocess is often not fully understood.This Guide summarises the important role pharmaceuticalscience has played and continues to play in thedevelopment and use of medicines and demonstratesthe breadth of scientific knowledge and understandingnecessary to underpin the full spectrum of pharmaceuticalpractice. The Guide also highlights the major challengesand opportunities faced when creating new medicines,improving existing medicines or ensuring the better,safer use of medicines, and makes recommendationsand calls for action.Pharmaceutical SciencePharmaceutical science encompasses the basic, applied andsocial sciences and plays a part in all stages of the journeyof a medicine, from its discovery as a new molecule andformulation as a medicine to its manufacture, approval bythe regulatory agencies and ultimate use. Pharmaceuticalscience in the UK has a long and excellent record ofmedicines research and development, being at theforefront of many major advances in modern medicines.The ever-changing climate of medicines development anduse requires a highly educated, multidisciplinary, flexible andwell-trained workforce. UK pharmaceutical science hasalready made huge contributions to improving the healthand wealth of the nation, being a net earner for Britain formore than 30 years. It is an important employer and aleading investor, with 4.85 billion spent on UK researchand development in 2011. There are challenges ahead forthe industry and it is vital to maintain the UK’s position tofurther advance patient health.New Medicines, Better MedicinesDeveloping a new medicine is a costly and lengthy process.It is currently estimated that taking a drug from concept tomarket requires an average of 12 years with costs in therange of 50 million to over 1 billion being widely reported.6The vast majority of potential drugs never reach market,with most discarded during initial screening. The costassociated with drug failure increases as the drug movesthrough the development process, with failure in clinicaltrials frequently costing hundreds of millions of pounds.Both the cost and time taken to bring a medicine to marketneed to be reduced to ensure the development of newand innovative medicines remains an attractive proposition.New funding mechanisms are needed to incentivise drugdevelopment, while at the same time ensuring patientsreceive the best treatments as early as possible.This need for new incentives is particularly true forantibiotics as the last new class of drug was discoveredin 1987. The incentive for pharmaceutical companies todevelop new antibiotics is low due to the poor returnon investment they provide. This is because antibiotics areusually taken for a short period of time, are frequentlycurative and newer drugs will need to be reserved to treatpatients with infections which are resistant to treatmentby other antibiotics.Scientific advances are providing exciting new opportunitiesfor drug development. For example, sequencing of thehuman genome has allowed the development of medicinesfor specific groups of patients. This approach, known asstratified (or personalised) medicine, has led to thedevelopment of treatments such as Herceptin for patientswith breast cancer. Advances in systems biology areimproving our understanding of how a patient’s genesand lifestyle, environmental factors, and the interactionbetween them, influence both the disease process andits response to a medicine.These scientific advances allow medicines to be developedfor small numbers of patients based on their particulargenetic make-up, extend the life of other drugs previouslydiscarded because of poor efficacy and identify newindications for well-established medicines. Increasingly, testsare being developed to measure biomarkers that identifysusceptibility to a disease and a patient’s likely response toa medicine. Such developments are, however, at a relativelyearly stage and further research is required if the fullpotential of these advances is to be exploited.NEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES
Special formulation issues arise from the complex natureof biologics, for example vaccines, whole cells and evenbody tissues. Their limited stability means cold storageis needed. This is particularly relevant to vaccinations,where the need for cold storage can account for up to80% of the price and can prohibit their use in many partsof the world. Another new and exciting treatment area isregenerative medicine where damaged human cells, tissuesand even organs are stimulated to repair themselves,thus holding out the promise of a cure for some diseases.One example of this is the use of stem cells to treat failingorgans or joints. Further progress in this field will requiremuch research and there are also many ethical issuesto be resolved.While the majority of medicines treat the symptoms ofdisease, gene therapy offers the possibility of furthercurative treatments. Although there has been muchinterest in this field there has only been very limited successand the promise of this form of therapy remains to berealised. To date, the European Medicines Agency has onlyapproved one gene-therapy medicine, Glybera, to treathigh levels of lipids in the blood.Better Use of MedicinesMedicines account for over 12% of the total yearly NHSbudget, about 123 billion across Britain in 2011/2012.Once marketed, it is important that medicine use isclinically and cost effective. Between 30-50% of patients,however, taking medicines for chronic conditions do nottake them as directed, leading to avoidable ill health andeconomic loss to the healthcare system and society ingeneral. Research has shown that 6% of UK hospitaladmissions are related to adverse drug reactions equatingto 4% of hospital bed capacity. Patient non-adherenceto medication regimens is a complex problem, althoughreviewing a patient’s medicine(s) and identifying strategiesto help them to take their medicine(s) as intended can helpimprove adherence.Pharmacists provide evidence-based advice and guidanceon medicines to prescribers and patients and contributeto improving health literacy by supplying information thatis tailored to an individual patient’s needs. Ensuring the bestuse of medicines, minimising a patient’s risk of experiencingadverse events such as side effects, reducing medicationerrors and contributing to medicines safety are coreactivities of all pharmacy services. Some pharmacistsare now prescribing medicines for patients, with earlyindications of benefits to patients with chronic conditions.The nationwide network of community pharmacies, socrucial for the prescribing, supply and use of medicines,could in the future be a place where non-invasive tests forbiomarkers are used to aid the early detection of diseaseand optimise medicine selection.Children and older people present particular challengesas they require medicines at age appropriate doses andin acceptable formulations. Furthermore, in older people,a balance must be struck between taking many medicinesfor several conditions and minimising side effects andunwanted drug interactions. In both patient groups thereis often insufficient evidence to make informed medicineschoices, which is a deficiency that must be addressed.Pharmaceutical science research has also underpinnedpharmacy public health and health protection activitiesand informed pharmacy policy. Evidence supports therole of community pharmacy in smoking cessation,providing emergency hormonal contraception servicesand antibiotic stewardship. Further evidence is needed tooptimise the sector’s contribution to, for example, weightmanagement, alcohol consumption and cancer detection.In developing countries, much remains to be done to tacklediseases such as HIV-related disease, malaria, andtuberculosis and to control zoonoses. Simple and affordabletreatments for diseases endemic in the developing worldare urgently required, together with the development ofinnovative vaccines against these diseases that do notrequire refrigerated storage.At a global level, the falsified and counterfeit medicinesmarket must be tackled to ensure such medicines do notenter the legitimate medicines supply chain, potentiallycausing harm to those who take them.NEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES7EXECUTIVE SUMMARYMany drugs pose significant formulation challenges,including how to selectively deliver drugs to their intendedsite(s) of action in the body to maximise efficacy andreduce side effects. At present, the vast majority ofmedicines are given orally. New methods of drug delivery,such as microneedles (small patches consisting of thousandsof small needles that pierce the upper layer of the skin),provide examples of where the pharmaceutical andbioengineering sciences have come together and producedpractical and economically viable innovations, which shouldfind wide exploitation in the future.
RECOMMENDATIONSRECOMMENDATIONSThroughout this Guide, 71 Challenges are presentedwhich highlight issues faced in creating new medicines,improving existing medicines or ensuring the betteruse of medicines. Outlined below are the sevenRecommendations identified for action, which arise fromthe Challenges highlighted in the Guide. The Challengesassociated with each of the Recommendations areidentified by their number in the document. For easeof reference, the full list of all the Challenges is givenin section 8.1 of the appendix.Of the Recommendations given below, onlyRecommendation 2 deals with a specific group ofmedicines used to treat disease. This reflects the growinginternational concerns around the use of antimicrobialsin human and veterinary medicines, as well as their usein animals intended for the human food chain, and theimpact that a lack of efficacious antimicrobial agentsin the future will have on health.Recommendation 1 – Ensuringthe Safe Use of MedicinesnnPromote further research into the causes ofmedication errors in patients and research intointerventions to reduce those errors (31, 32, 34, 36,37, 40, 41, 42, 69)nnEnsure consideration is given to the safe use ofmedicines at all stages from the discovery of a drug toits administration to a patient as a medicine. (4, 32, 40)nnImprove patient understanding of the risks andbenefits of their medication (32, 38, 39, 40)nnImprove pharmacovigilance and reporting ofsuspected adverse drug reactions by healthcareprofessionals and patients to identify any safety issuesfollowing launch of a medicine (32, 35, 50)nnEncourage developments in toxicology testing,predictive pharmacokinetics, drug delivery, clinicaltrial design and age-related formulations to aiddevelopment of safer medicines (27, 28, 29, 37).8Recommendation 2 – StimulatingNew Antimicrobial Developmentand Improving AntimicrobialStewardshipnnEducate the public and patients on the use ofantimicrobials and their place in therapy (45, 46)nnEncourage further development of antimicrobialstewardship by healthcare professionals to maintainthe effectiveness of current and any futureantimicrobials (45, 46)nnSupport the discovery and development of newantimicrobials or treatment methods by developingnew financial incentives (2, 13).Recommendation 3 – AdoptingNew TechnologiesnnEducate the public and patients about the ethical andmoral issues surrounding the use of new technologiesand medicines such as gene therapy, regenerativemedicine, therapeutic vaccines and stratified medicine(23, 38, 39)nnEnsure new technologies and medicines fulfil theirpotential (19, 20, 24, 26)nnEncourage the development of appropriate models ofreimbursement to support the use and developmentof new technologies (18, 25, 63, 64).NEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES
nnnnEncourage the adoption of new technologies andinnovative approaches that assist in drug targetidentification, reduce drug attrition, optimise medicinesdevelopment and clinical trials, and improve the safetyprofile of medicines (3, 8, 9, 10, 11, 12, 25, 29)Facilitate the supply of new and innovative medicines,and reduce the cost and time to bring these medicinesto the patient (2, 6, 14, 16, 17, 18, 20, 21, 22)nnStreamline and reduce the regulatory burdenassociated with approval, particularly of new andinnovative medicines, while continuing to ensurepatient safety (15, 25, 58, 63)nnEncourage participation and transparency in clinicaltrials (27, 65, 66).Recommendation 5 – Increasingthe Evidence Base for PharmacynnIncrease the health services research expertise withinthe profession (33, 34, 43, 44, 47, 48, 49, 51, 52, 67)nnDemonstrate the clinical and cost effectiveness ofNHS pharmacy services by means of well-conducted,definitive trials that are appropriately funded toenhance the role of pharmacy in the treatment ofpatients (30, 58, 67, 68).Recommendation 7 – ImprovingAccess to Medicines at aGlobal LevelnnTackle disease in developing countries and ensure theequitable access of quality medicines to all patients.(53, 54, 55)nnSupport the responsible re-use of medicines andimprove access to medicines in developing worldcommunities, thereby improving health. (54, 55)nnPrevent harm to patients by the removal of falsifiedand counterfeit medicines from the legitimatemedicines supply chain and illegal supply throughthe internet. (56, 62).RECOMMENDATIONSRecommendation 4 – Supportingthe Development of New andInnovative MedicinesThe Royal Pharmaceutical Society will lead on theimplementation of several of these Recommendationsand will work with a range of stakeholders to supportthe implementation of others. It is envisaged that someof the Recommendations will be achievable in the nextfew years, while others will require much moresustained effort over many years. An implementationstrategy is detailed in section 5 of the Guide.Recommendation 6 – SupportingPharmaceutical Science in the UKnnEncourage investment in scientific education andtraining to ensure a highly skilled and adaptivepharmaceutical science workforce (1, 7, 68, 70, 71)nnEnsure that the UK remains a major player in thedevelopment of new and innovative medicines byexpanding current Government initiatives aimed atmaking the UK an attractive location for companiesof all sizes (5, 57, 59, 60, 61)nnIncrease support for more academic/NHS/industrialpartnerships (58, 59, 60).NEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES9
E SUMMARY6RECOMMENDATIONS81. INTRODUCTION121.1 PHARMACEUTICAL SCIENCE121.2 MOLECULES TO MEDICINES131.3 MAKING BRITAIN A SAFER PLACE TO TAKE MEDICINES171.4 MAKING THE UK A WORLD CENTRE FOR PHARMACEUTICAL SCIENCE192. NEW MEDICINES, BETTER MEDICINES2.1 DRUG DISCOVERY, DESIGN AND DEVELOPMENT212.1.1 Drug Discovery and Design2.1.2 Drug Optimisation2.1.3 Biopharmaceutics2.1.4 New Antimicrobials2.1.5 Neglected Diseases2.1.6 ‘New Life’ for Old Drugs2.2 DRUG FORMULATION AND DELIVERY212425272829302.2.1 Biopharmaceutics and Drug Formulation2.2.2 Low Molecular Weight Drugs (‘Small Molecules’)2.2.3 Biologics2.2.4 Nanomedicines2.2.5 New and Enabling Technologies2.3 STRATIFIED MEDICINES3031333435362.4 PHARMACOKINETICS AND PHARMACODYNAMICS2.4.1 The Younger Population (see also section 3.3.3.1 Younger Patient Groups)2.4.2 The Older Population (see also section 3.3.3.2 Older Patient Groups)3. BETTER USE OF MEDICINES394042433.1 INTRODUCTION433.2 OPTIMISING MEDICINES USE AND DECISION MAKING443.2.1 Clinical Roles for Pharmacists3.2.1.1 Developing Guidelines3.2.1.2 Medication Review (see also section 3.3.3.2 Older Patient Groups)3.2.1.3 Prescribing3.2.1.4 Self-care and Over-the-Counter Medicines3.3 MEDICINES USE4546464748493.3.1 Consequences of Inappropriate Medicines Use3.3.1.1 Concordance3.3.1.2 Adherence Issues1021494949NEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES
515253535456573.4.1 Pharmacy and Public Health3.4.2 Health Improvement3.4.2.1 Smoking Cessation, Emergency Hormonal Contraception, Alcohol, Weight Management and Sexual Health3.4.3 Health Protection3.4.3.1 Infection control3.4.3.2 Antibiotics3.4.3.3 Drug Misuse3.4.3.4 Immunisation3.4.3.5 Surveillance of Disease and Medicines3.4.4 Disease Screening3.5 GLOBAL HEALTH57585859595960616162633.5.1 Access to Medicines3.5.2 Reducing the Pervalence and Spread of Disease in the Developing World3.5.3 Managing the Health Consequences of Globalisation3.5.4 Effects of Climate Change on Health4. DEVELOPING THE UK AS A WORLD CENTRE FOR PHARMACEUTICAL SCIENCE63636565674.1 INTRODUCTION674.1.1 UK as the Preferred Location for Pharmaceutical Research, Development and Manufacture4.1.2 UK as the Preferred Location for Clinical Research4.1.3 UK as the Preferred Location for Pharmacy-Focused Health Service Research4.1.4 Funding4.2 WORKFORCE INTELLIGENCE: PLANNING FOR A HIGH QUALITY WORKFORCE67717273744.2.1 Introduction4.2.2 Causes of Workplace Pressures4.2.3 Identifying Future Global Demand for Pharmaceutical Services and Expertise4.2.4 Measurement of the Effectiveness of the Pharmacy Workforce5. IMPLEMENTING NEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES74757578795.1 INTRODUCTION795.1.1 World-Leading Pharmaceutical Science5.1.2 Excellent Pharmaceutical Scientists5.1.3 Implementation of the Recommendations5.2 PROPOSED IMPLEMENTATION PLAN798080806. REFERENCES887. GLOSSARY988. APPENDIX1068.1 LIST OF CHALLENGES1068.2 LIST OF VIGNETTES110NEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES11CONTENTS3.3.2 Patient Information3.3.2.1 Health Literacy3.3.3 Special Patient Groups3.3.3.1 Younger Patient Groups (see also section 2.4.1 The Younger Population)3.3.3.2 Older Patient Groups (see also section 2.4.2 The Older Population)3.3.3.3 Other Patient Groups3.4 PUBLIC HEALTH
1. INTRODUCTIONINTRODUCTION1.1 Pharmaceutical SciencePharmaceutical science is the science of medicinesdiscovery, development and use. It is truly multidisciplinary,drawing on many of the basic, applied and social sciences.These skills and knowledge are applied to the discovery,design, formulation, manufacture, regulation and optimaluse of medicines, to the ultimate benefit of the patient.By its very nature, pharmaceutical science involves allsubject areas that contribute to the study of drugsand medicines and brings together components ofmany of the sciences, including the chemical, physicaland biological sciences, computation, mathematics,statistics and engineering as well as the social andbehavioural sciences.PHARMACEUTICAL SCIENTISTS’ KNOWLEDGEOver the years, pharmaceutical scientists, with theirunique blend of knowledge, have played a pivotal rolein bringing new medicines to the market: medicines whichhave improved both the quality of life and reduced thenumber of life years lost or avoided premature death.It is this distinctive knowledge and understanding thatadds considerable value to the development and optimaluse of medicines.As science and medicine have evolved, the requiredknowledge and skills of pharmaceutical scientists haverapidly expanded in order to keep pace with the latestdiscoveries and developments. This expansion in thepharmaceutical scientist’s knowledge base is expectedto continue apace following rapid developments inmedical science, particularly in fields such as stratified(or personalised) medicine, regenerative medicine(comprising stem cell therapy and tissue engineering)and nanomedicine.1–712THE ROLE OF PHARMACEUTICALSCIENTISTSMedicines have revolutionised the treatmentof disease, reduced the need forhospitalisation and surgery, and improvedthe quality of life of patients. Pharmaceuticalscientists have been instrumental in thediscovery of new drugs and the developmentof novel medicines for the treatment of manyconditions, including asthma, peptic ulcers,migraines and cancer and in developing newand improved vaccinations.PHARMA
NEW MEDICINES, BETTER MEDICINES, BETTER USE OF MEDICINES 3 FOREWORD FOREWORD The Society leads and supports the development of the pharmacy profession including the advancement of science, practice, education and knowledge in pharmacy, as well as promoting public understanding of pharmacy
Before we get into the detail there are some commonalities of all stop smoking medicines that you need to know. Stop smoking medicines increase quit rates All stop smoking medicines increase the chances of stopping smoking for good. Smokers should be encouraged to use one of the licensed stop smoking medicines to aid them in stopping smoking.
Chapter 1. Biological medicines have revolutionized the treatment . 6 Since their first use in the 1980s, biological medicines have grown to become an indispensable tool . Chemically synthesized medicine Growth hormone Antibody. Producing biological medicines tends to be more
Yes. Some medicines used by older people can make it easy to get hypothermia. These include medicines you get from your doctor and those you buy over-the-counter, such as some cold medicines. Ask your doctor if the medicines you take may affect body heat. Always
certain medicines you put yourself at even greater risk. Combining alcohol with some medicines can lead to falls and serious injuries, especially among older people. MEDICINES MAY HAVE MANY INGREDIENTS Some medications—including many popular painkillers and cough, cold, and allergy remedies—contain
Drug Interactions with Enteral Nutrition (general use) Guidance regarding enteral administration of medicines and interactions between medicines and enteral feeds, including feeding breaks General points: This list is not exhaustive - contact ward pharmacist, practice pharmacist or Medicines Information (01355 584879 or medicines.information .
medicine. Name the two sources of all drugs. Identify four different types of medicines and their effects on the body. Identify five different ways that drugs can enter the body. Describe why some drugs are considered drugs of abuse. Differentiate between prescription medicines and over-the-counter medicines.
3. Human medicines — five strategic goals for regulatory science 10 3.1 Goal 1: Catalysing the integration of science and technology in medicines development 10 3.2 Goal 2: Driving collaborative evidence generation improving the scientific quality of evaluations 19 3.3 Goal 3: Advancing patient-centred access to medicines in partnership
for use in animal nutrition. Regulation (EC) No 178/2002 laying down the general principles and requirements of food law. Directive 2002/32/EC on undesirable substances in animal feed. Directive 82/475/EEC laying down the categories of feed materials which may be used for the purposes of labelling feedingstuffs for pet animals The Animal Feed (Hygiene, Sampling etc and Enforcement) (England .
