Part I: A Conference Overview and What It All Means for Your Training
Welcome to the first in this multi-part series based on CBI’s recent Pharmaceutical Compliance Congress! For obvious reasons, the conference went virtual this year, yet it offered an impressive lineup of industry professionals, vendors, and government officials offering compelling tips and guidelines for building and maintaining an effective compliance program in the life sciences industry. In addition to the live presentations, organizers offered 14 “on-demand” presentations covering an impressive array of topics, so from a content perspective, the virtual format created even more opportunities for learning.
Over the next month, I will touch on some of the thoughts shared by presenters related to topics like speaker programs, patient programs, risk assessments, third-parties, patient advocacy groups, transparency, and strategies for field team compliance, to name a few. And since the mission of this blog, and the PharmaCertify team, is to help you reduce risk and strengthen your compliance culture through training, I will include suggestions for growing and modifying your compliance training practices and curriculum in response to the information shared during the conference.
Kudos to the team at CBI/Informa for their diligent efforts to replicate the learning and networking experience of the live conference. PCC 2020 was a busy conference, with an impressive volume of content scheduled throughout the week and in the on-demand sessions. If you attended and did not have the opportunity to review the on-demand sessions, I have been told these will remain available until September 14th. You will especially want to review the State-of-the-Art Compliance Training session, where my colleague Dan O’Connor and compliance professionals from Sage Therapeutics, Regeneron, and Akebia Therapeutics share creative approaches for increasing training engagement and adoption. You don’t want to miss that one!
While some of the topics were familiar to anyone who has attended the conference in recent years, the “elephant in the room” was not ignored, as a multitude of presenters addressed the overwhelming challenges of keeping an entire organization focused on conducting business in a compliant manner during these unprecedented times. The result was an interesting blend of traditional and familiar compliance conference topics and guidance on navigating the risk associated with conducting business in a highly regulated industry during a pandemic, or at least as much guidance as can be expected at this time.
From a high-level training standpoint, the presentations at the conference affirm the need for a more dynamic and blended curriculum, with microlearning and other components delivered across your learners’ timelines. The method by which life sciences employees conduct their daily activities has suddenly changed, and the level of risk and potential for violations has grown exponentially with that shift.
One of the more compelling presentations was the “Criticality of Compliance” session with John Crowley of Amicus Therapeutics. John shared his family’s moving story and his incredible journey as he pushed for the development of a product to help his two children (did you know his story was the basis for the feature film, Extraordinary Measures?). As he spoke, John reflected on what the commitment means to the patients battling the rare diseases his company’s products treat, “as life sciences professionals, we are an extension of the oath that doctors and nurses have taken, and it is a solemn oath,” he said, “if there is a compliance violation, everything we hoped for in the next several years is threatened.” It is a laudable approach to building a culture of compliance at Amicus and one worthy of emulation.
I look forward to sharing more ideas from the conference, as well as subsequent training suggestions you can utilize to strive toward similar ideals and goals in your organization.
Thanks for reading!
PharmaCertify By NXLevel Solutions
Coming Up: Speaker Programs and Patient Support Programs
As you may have expected, CBI’s Pharmaceutical Compliance Congress is going virtual in 2020. Whether presented live or online, the conference remains one of the few opportunities for those in life science compliance to interact with their peers and learn tips, suggestions, and best practices from industry leaders and government representatives. Live panels and on-demand presentations spread across the agenda represent a wide variety of the topics important to anyone striving to build and maintain a strong and effective compliance program and ethical culture. Here are a few of the presentations I am particularly looking forward to.
To provide an extensive range of content, organizers have made some sessions available on demand. Or, as they say it on the website, “on-demand content is available anytime, to accommodate your needs and schedule.”
On-demand titles range from Strategies for Field Team Compliance, to Best Practices Around the World for Global Compliance Management, and Hub and Specialty Pharmacy Contract Oversight and Risk Assessment, to name just a few. Make sure you watch the State-of-the-Art ComplianceTraining panel discussion being hosted by my colleague from PharmaCertify, Dan O’Connor. Dan will be joined by Alex Ganz of Akebia Therapeutics, Jeffrey Hagy of Regeneron, and Erica Powers of Sage Therapeutics for a deep dive into practical and innovative training approaches that you can apply immediately. I’ve seen the notes on this one, trust me, you don’t want to miss it. The full list of on-demand sessions is on the conference website homepage: https://informaconnect.com/pcc/.
Day 1: Monday August 10
After opening remarks and the video review of the year in compliance, James Stansel, Executive Vice President and General Counsel of PhRMA, will present the organization’s annual address, Healthcare Policy Update – Current State of Regulatory Reform Driving Innovation and Access. Then Gary Cantrell, Deputy Inspector General for Investigations at OIG, will deliver the annual OIG/HHS Update.
The panel presentation from the U.S. Attorneys’ offices typically offers a revealing look into the trends and topics currently in focus for the government. This year, Enforcement Docket Deep Dive – Analysis of Recent CIAs and Settlement Trends features representatives from offices around the country, including New Jersey, Southern New York, Nevada, and Massachusetts. Expect patient assistance programs to be at or near the top of the list this year – and, on this note, PharmaCertify will soon offer a new eLearning module covering patient programs. Send me a note if you’d like to preview the content outline.
From 3:00 pm to 3:45 pm, participants choose between two live Q&A sessions, Boot Camp Q&A, with Perri Pomper from Clinical Genomics, Ed Sleeper from Esperion, and Daniel Kracov and Mahnu Davar, both of Arnold & Porter; and Primer Q&A with Rahul Khara of Acceleron Pharma, and Seth Lundy from King & Spalding.
The Opening Night Networking Happy Hour follows the Q&A sessions, and when I preview the live conferences, this is where I typically suggest attendees not miss this great opportunity to interact with peers in one-to-one conversations. There is no reason to believe the virtual networking won’t be as valuable, as attendees and presenters clearly look forward to these rare chances to exchange experiences “face-to-face.” My colleagues and I will be there!
Day 2: Tuesday August 11
The opening session on Day 2 is compelling for its title, When Drug Research is Personal: Fireside Chat with Amicus Therapeutics’ CEO and CRO on the Criticality of Compliance in Advancing Lifesaving Therapies. For those of us who work in compliance training, making that training more meaningful to the individual learner is one of our persistent goals. If our clients can communicate the importance of the training to the careers of the learners, and the lives of the patients, learning is enhanced. I am looking forward to hearing John Crowley and Patrik Florencio describe how the “criticality of compliance in advancing lifesaving therapies” is put into practice at Amicus Therapeutics.
Scanning the agenda for the rest of Day 2, anytime the words “digital revolution” appear in a session title, I am intrigued. So, I will be curious to hear Chad Morin of bluebird bio. and Brian Berry of Vertex Pharmaceuticals describe that revolution in the Patient Centricity and Compliance in the Digital Revolution session.
From 3:00 pm to 3:45 pm, attendees choose from one of four hot topic roundtables. The roundtables are diverse and compelling, depending on your objectives. As always, I recommend dividing with colleagues, or even sharing notes with a new friend you meet in the networking session, to conquer and gather as much information as possible.
Two of the roundtables jump off the screen for me. The word “checklist” in any title always catches my eye. Calling All Emerging Biotechs – Pre-commercial Compliance Considerations and Checklist with Tiago Garrido of Verastem Oncology, Rupa Cornell of Takeda, and Trish Dring of MacroGenics looks to be an interesting primer for anyone in the unique position of preparing a product launch. And, since our training is so often targeted to field teams and the risks they encounter in interactions with HCPs, the Strategies for Field Team Compliance, with Erica Powers of Sage Therapeutics, Patrick Mooty of Sumitomo Dainippon Pharma America, and Julianne Brierley of Novartis will be on my list.
Day 3, Wednesday August 12
Wednesday’s agenda begins with the CCO Showcase: Cutting-Edge and Proactive Models Driving Compliance and Transcending Silos Across the Business. Kudos to conference organizers for scheduling such an impressive lineup of chief compliance officers: Daryl Kreml from Sage Therapeutics, Beth Levine from Regeneron, Jill Macaluso from Novo Nordisk, Bryant Aaron from Novartis, Tina Beamon from Karyopharm Therapeutics, and Joshua Marks from Boehringer Ingelheim. Dedicating time for follow up Q&A after the presentation is a great idea since the interaction with the audience usually offers some of the most interesting exchanges of ideas.
Following the DOJ and SEC Insights session from 2:00 pm – 2:45 pm (e.g., the U.S Attorneys session is always worthwhile) attendees are encouraged to participate in “peer-to-peer networking time.” Each attendee will have his or her own virtual meeting room for what is described as a “streamlined networking opportunity.” It’s another attempt by organizers to provide for personal interaction, and regardless of the outcome, they should be applauded for the effort. Think speed dating without the detail about long walks on the beach and pina coladas.
Day 3 closes with additional roundtable discussions intended to foster small group discussions. Rather than dedicate Wednesday’s roundtables to specific topics, I have been informed the focus will be on “thoughts from the day and conference so far.” I like it!
Day 4, Thursday August 13
Thursday’s agenda kicks off with what should be a worthwhile discussion about navigating the sea of life sciences compliance challenges in the crazy year that is 2020 with a session titled, A Look at How In-House Legal and Compliance Departments are Evolving in 2020 to Help Address Business Challenges. John Oroho from Porzio will moderate the panel joined by Tara D’Orsi of Kyowa Kirin, Michael Clarke of ConvaTec, and Michael Hercz of Sentynl Therapeutics.
Following a late morning session focused on emerging risk areas from industry advisors (hey, how come I wasn’t invited?!) and a lunch break, the day continues with a Small Group Interaction Hosted by Track Presenters, then into the series of live hot topic roundtables from 3:45 pm to 4:30 pm.
Two roundtables stand out for me based on the hot topics in compliance training: Speaker Programs – Current Enforcement Trends, Best Practice Benchmarks and Future Fate with Peter Agnoletto from Sanofi, John Knighton from TherapeuticsMD, Jennifer DeVincenzo of Sobi, and Charlene Davis of Aerie Pharmaceuticals; and Zero-In on Compliant Patient Interactions, with Terra Buckley of Mesoblast, Rahul Khara of Acceleron Pharma, Laurie Durousseau of Rigel Pharmaceuticla, and Christie Camelio from TG Therapeutics.
Day 4, Thursday August 13
The conference closes with two sessions sure to draw a large audience of attendees. First up is, Anti-Kickback Accusations and the Aftermath — An Inside Look at Sales and Marketing Practices Under Fire with Jonathan Roper, a former district sales manager for Insys Therapeutics. The Insys case obviously holds a deep cauldron of lessons learned in every aspect of compliance, and its impact continues to reverberate across the industry.
Finally, conference organizers could not have picked a better session to close with than Empowerment, Diversity and Inclusion. Sujata Dayal of Medline Industries, Jim Massey, formerly of AstraZeneca, Maggie Feltz of Purdue Pharma, and Veleka Peeples-Dyer from Baker & McKenzie LLP will delve into what is certainly a timely and important topic in today’s world.
See You at the Conference
The logistics involved in the transition to a virtual conference must be daunting. CBI, Informa Connect, and all the speakers, are to be congratulated on their efforts and dedication to bringing so much critical content to the agenda. It looks to be a fantastic five days of learning and I hope this information provides you with more context on some key topics that caught my interest.
If you’re attending the conference, I hope to see you in the virtual PharmaCertify booth, where you can learn more about our training products and services and share thoughts about the conference. If you have not yet registered, we still have $500 sponsor discount registration certificates available. Contact us at firstname.lastname@example.org to take advantage of this opportunity to join us.
Thanks for reading. I will see you online at the conference!
Product & Marketing Manager
PharmaCertify by NXLevel Solutions
Life sciences detailing has changed, even if only temporarily, but the rules and best practices related to good product promotion have not. As field sales teams acclimate themselves to the reality of meeting with healthcare professionals through virtual means, they need to ensure those rules aren’t lost in the milieu of that change.
For example, no matter the means by which promotional speech is delivered, the FDA defines it as “any affirmative statement about a prescription drug or medical device.” Regardless of format, promotional statements made while meeting with healthcare professionals must always be truthful and accurate.
Representatives must never exaggerate or mislead the healthcare professional regarding the use, safety profile, or any other aspects of the product and any statements made about a product must include the benefits and the risks associated with the use of the product. They must never overstate the effectiveness of the product, make efficacy claims not supported by substantial research or misrepresent clinical study data. Fair balance cannot be ignored just because a rep is not meeting with the healthcare professional in person.
Products may only be promoted for uses approved by the FDA. In fact, if a healthcare professional asks a representative about an unapproved or off-label use, the rep needs to refer the question to the medical affairs department and, even during a virtual visit, a rep must never steer a conversation with the intent of prompting the healthcare professional to ask an off-label question.
Now is not the time to let the emphasis on good and compliant product promotion slip through the cracks. Updated training and microlearning covering topics like promotional speech, the Bad Ad Program, the use of social media, off-label marketing, and the dissemination of reprints and scientific publications is more important than ever to keep field sales teams compliant and effective.
Thanks for reading!
Sean Murphy PharmaCertify By NXLevel Solutions
Note: the training content shared in this post is from our Good Product Promotion eLearning module, one of the 26 customizable modules available in our Compliance Foundations suite.
One of the significant events of 2019 affecting life sciences compliance was the April release of a new guidance document, Evaluation of Corporate Compliance Programs, (https://www.justice.gov/criminal-fraud/page/file/937501/download) by the criminal division of the Department of Justice (DOJ). The primary intent of the document is to guide prosecutors and courts as they evaluate corporate compliance programs, but it also serves as an important baseline for life sciences businesses evaluating all areas of their compliance programs, including the training curricula.
The guidance document highlights three questions for prosecutors to consider when evaluating a program:
Is the corporation’s compliance program well designed?
Is the program being applied in good faith?
Does the corporation’s compliance program work in practice?
In this post, I examine the DOJ’s document in more detail, and discuss its implications for your compliance training curriculum.
In reference to a “well-designed compliance program,” the DOJ stresses the need for prosecutors to focus on whether a company’s program is customized for the particular risk profile of that company. According to the guidance, prosecutors should “understand the company’s business from a commercial perspective, how the company has identified, assessed, and defined its risk profile, and the degree to which the program devotes appropriate scrutiny and resources to the spectrum of risk.” The company’s periodic training and certification should include all “directors, officers, relevant employees, and, where appropriate, agents and business partners.” In addition, training should be tailored to “audience size, sophistication, or subject matter expertise.”
In pursuit of these standards, foundational training is an effective method for providing a baseline, but additional risk-focused content continuously delivered to individual business units is one way to address that risk. As an example, scenario-based mini modules covering the topics highlighted in risk assessments and audits of the compliance hotline should follow the more comprehensive foundational training for each business unit to make it more relevant and engaging. In addition, microlearning nuggets in the form of quizzes, assessments, and contests have been proven to drive higher retention rates when delivered strategically across a learner’s calendar. Targeted, continuous learning covering the topics deemed critical to each business unit is the key to truly reducing risk.
On the topic of risk-based training, the DOJ recommends prosecutors ask, “What analysis has the company undertaken to determine who should be trained and on what subjects?” In line with that suggestion, a compliance curriculum analysis is a critical first step for any compliance professional interested in understanding the details of existing organizational training and it’s a necessary starting point for the reconfiguration of that curriculum to effectively address the risks. The categories covered in the analysis should include:
Training Type (eLearning, Live, Webinar)
Level of Training (Awareness, Detailed, General, etc.)
Risk Rating Per Audience (Low, Medium, High)
An instructional design analysis should also be included to determine if the proper learning objectives are established and followed, and the visuals, audio, navigation, and assessment are optimized for learning. The data should then be curated into a spreadsheet with sortable cells and columns to allow for an organized and multi-level review of all training programs and topics. At PharmaCertify, we use our Compliance Curriculum Analysis Tool, or CCAT, to assist our clients with this analysis. Once the CCAT is complete, we summarize to highlight the strengths, gaps, and redundancies in the overall curriculum.
Test and Test Again
The document also delves into the measurement of training effectiveness by encouraging prosecutors to ask if employees have been tested on what they learned and how the company has addressed employees who fail all or a portion of the testing. While the inclusion of standard assessments with each course is an assumed necessity, using assessments as learning tools has been shown to strengthen long-term memory.
A study by Jeffrey D. Karpicke and Henry Roediger III, of the Department of Psychology at Washington University revealed that learners are poor judges of what they remember, and when given the choice, they stop studying before they have mastered the subject. So even when they think they know it, they don’t, and assessments spaced repeatedly over time is the best method to increase the retention of critical compliance policies and best practices. When possible, alternative types of tests should also be deployed, including:
Pre- and post-training tests to measure gains scores
Priming assessments to encourage the formation of cognitive schema
Diagnostic assessments to help target remediation
Cumulative exams to encourage information retrieval and re-encoding
Effective Implementation, Review, and Revision
Finally, prosecutors are asked to consider whether a compliance program is a “paper program, or one implemented, reviewed, and revised, as appropriate in an effective manner.” This holds true not just for the program in general, but for the compliance training curriculum. Just as the corporation should “provide for a staff sufficient to audit, document, and analyze the results of the efforts,” the proper resources and time need to be dedicated to the evaluation of the current curriculum, with subsequent modifications conducted accordingly.
The DOJ’s Evaluation of Corporate Compliance Programs document refers to a compliance program’s capacity to evolve as a hallmark of its effectiveness. That evolution is necessary because “a company’s business changes over time, as do the environments in which it operates, the nature of its customers, the laws that govern its actions, and the applicable industry standards.” An effective life sciences compliance training curriculum must align the current business with the environment, customers, and laws, and now is the time to bring all of those components together.
I hope the insights above are helpful as you continue to improve your compliance training effectiveness throughout 2020. Thanks for reading!
The Pharmaceutical Compliance Forum (PCF) is celebrating a milestone this year with the 20th anniversary of its annual Pharmaceutical and Medical Device Compliance Congress. I have attended the past 12 of these conferences (yikes) and I am consistently impressed with PCF’s ability to create a fresh and relevant agenda while still covering the fundamentals.
The conference is just around the corner (November 6-8 at the Mandarin Oriental Hotel in Washington D.C.) so let’s get the celebration started with a preview of this year’s sessions.
Day 1: Wednesday, November 6, 2019
Pre-Conference Symposia, 8:00 a.m.
Although the conference “officially” opens at 1:00 p.m., four pre-conference symposia are scheduled from 8:00 to 12:00 Noon as follows:
Risk Assessment Recommendations Based on DOJ Updated Guidance
Third-party Interactions, Including Distributors and Non-Distributor Third Party Vendor Compliance
Investigations: Interconnectivity of Auditing, Monitoring, Investigations, Including Privilege
Emerging Role of Analytics, Bog Data & AI Opportunities for Life Sciences: Implications for Ethics and Compliance
All the sessions offer valuable and worthwhile content as described in the agenda, and that makes the decision as to which one to attend even more challenging. Pre-conference Sessions 1 and 2 are consecutive so you can attend both, but you still need to decide between Sessions 3 and 4. Session 3, which is focused on investigations, is described as covering “issues for a big company vs. a small company,” so it certainly has broad appeal. My suggestion is to take a “divide, conquer, and share notes” approach if you happen to be attending with co-workers, or can tag-team with friendly colleagues from other companies.
Opening Plenary Session, 1:00 p.m.
The conference officially begins with a welcome and introduction from the five PCF co-chairs (Sujata Dayal of Johnson & Johnson, Jeffrey Kawalek of Jazz Pharmaceuticals, Jennifer McGee of Otsuka America Pharmaceutical, Donna White of Chiesi, and Joe Zimmerman of Ferring Pharmaceuticals), at 1:00 p.m. I would normally skip over the opening 15 minutes when previewing a conference, but since industry luminaries are involved, I would suggest you stay on high alert for any unexpected and bonus pearls of wisdom.
20th Anniversary Dialogue: Lessons Learned from 20 Years of Pharma and Medical Device Investigations, Prosecutions, Ethics and Compliance, 1:15 p.m.
The celebration kicks into high gear for this 1:15 p.m. session that features no less than seven presenters, including industry leaders Douglas Lankler from Pfizer, and Lori Queisser from Teva Pharmaceuticals, as well as government regulators Daniel Levinson, former Inspector General for the U.S. Department of Health and Human Services, and James Sheehan of the Charities Bureau of the New York State Department of Law. It’s an impressive array of experience from both sides of the issues.
Keynotes: OIG Update/ US DOJ Update/FDA Update, 2:15 p.m.
At this point, the government’s perspective will be presented in three consecutive keynotes by Mary Riordan of the Office of Inspector General, Brian Benczkowski of the DOJ, and Thomas Abrams of the FDA. The annual discussions of where the industry has been and what will be next year’s likely focus and workplans, always offer clues as to where compliance professionals should be focusing their efforts and future plans.
After a presentation on pricing cost containment, the Annual Chief Compliance Office Roundtable closes Day 1. Although the agenda does not detail the topics to be covered, expect the seven industry professionals listed, including Charlene Davis of Aerie Pharmaceuticals, Sunitha Ramamurthy of Loxo Oncology, and Adam Dubow of Bristol-Myers Squibb, to cover a wide swath of relevant and important topics. Keith Korenchuk of Danaher Diagnostics and Thomas Schumacher of Medtronic will bring a welcomed medical device angle to the discussion.
Adjournment and Networking Reception and 20th Anniversary Party, 6:00 p.m.
I typically highlight the conference networking reception as a can’t-miss opportunity to share information and experiences with other compliance professionals, and to form valuable relationships with industry peers. This year’s compliance congress brings the bonus of an anniversary party so let the noisemakers ring and the champagne flow!
Day 2: Thursday, November 7, 2019
Morning Plenary Session, 8:45 a.m.
Following a series of concurrent breakfast roundtables from 7:15 to 8:15 a.m., and the Co-chair’s Welcome and Introductions, Day 2 kicks off with an interview of the Countess of Frederiksborg, Alexandra Christina. In addition to being a Countess, she is the Chairperson of the Ethics and Compliance Board Committee for Ferring Pharmaceutics and co-author of The Sincerity Edge: How Ethical Leaders Build Dynamic Businesses.
U.S. DOJ and U.S. SEC Update on FCPA Enforcement, 9:15 a.m.
The FCPA is back! Or, at least the topic is back on conference agendas after what seems like an extended absence (or at least from the conferences I attended). Presenters include Robert Dodge of the SEC, David Last of the DOJ’s FCPA Unit, and Gary Giampetruzzi, partner at Paul Hastings and former Head of Government Investigations at Pfizer.
AUSA Roundtable, 10:00 a.m.
John Bentivoglio, Partner at Skadden, keeps the enforcement topics going as he moderates the discussion from the AUSA angle with Rachel Honig of the District of New Jersey, Amanda Massenlam Strachan of the District of Massachusetts, and John Claud, from the Consumer Protection Branch of the DOJ.
Mini Summits Block A, 11:15 a.m.
This is where the agenda gets challenging but potentially rewarding. PCF has scheduled four “blocks” of mini summits (A, B, C, and D) right up to the closing plenary session at 4:45 p.m. As with the pre-conference symposia, a “divide and conquer” approach with your colleagues is recommended. Even if those colleagues aren’t from the same company, make friends, then share notes over dinner or via email the following week. For the sake of brevity, I will highlight one mini summit per block, but please review all options in the agenda to determine your best fit based on your interests, compliance challenges, and company risks.
Mini Summit II: Reduce Compliance Risk Using a Portfolio Approach to Training! (Microlearning Alone is Not the Answer)
I may be a bit biased since I have spent the last 12 years building compliance training and my colleague, Dan O’Connor, is moderating this session. But, with microlearning being all the rage, this promises to be a compelling look at what that term really means, and as importantly, why it is not the one and only panacea for making training stick.
If you work in medical device, please consider Mini Summit VII: Annual Medical Device Roundtable. Kudos to PCF for integrating medical device sessions into the agenda.
Mini Summits Block B, 12:45 p.m.
Mini Summit VIII: Lessons Learned from Enforcement Actions
This session stands out as an opportunity to hear an impressive array of industry leaders, including Tom Glavin from Olympus, William Hrubes of ACell, Puja Leekha of Lundbeck, and Kathleen Boozang, Dean of the Seton Hall University School of Law. Legal actions and settlements have long been the guideposts for where and how regulators focus their efforts and they should be an integral component in the planning of a yearly compliance plan and training curriculum.
Note: attendees dealing with the risk that combination (med device/pharma) products bring should alternatively consider, Mini Summit XIV: Issues with Medical Device/Combination Products.
Mini Summits Block C, 2:00 p.m.
Mini Summit XIX: Compliance – Board Communications: Effective Measurement and Reporting Strategies
Expect a deep dive into a topic that has risen to the forefront of industry concern with this look at the most effective methods for integrating the Board of Directors into the compliance program. Expect Katherine Norris of Berkeley Research Group to lead an informative panel that pleasantly includes a current member of the U.S. Board of Directors for Sanofi, Thomas Costa.
Mini Summits Block D, 3:30 p.m.
Mini Summit XXIII: Social Media Engagement by Manufacturers
Social media seems to be such a moving target for the life sciences industry. Hopefully, this team of industry professionals, including Joanne Kwan of Exelixis and Jessica Sergi of EMD Serono, can offer insight and guidance to an audience sure to be hungry for answers to vexing and evolving questions.
Again, the mini summits listed above are only a few of the sessions offered during this year’s conference. Visit the agenda section of the conference website to review the full list and decide which presentations best meet your needs.
After completion of the mini summits, the Day 2 adjourns with an important and sure to be sobering plenary session on “what pharmaceutical/medical device industries can learn from the opioid cases,” followed by a discussion on the “changing face of the qui tam.”
Day 3: Friday, November 8, 2019
Day 3 features an “industry only best practices think tank,” with Sujata Dayal from Johnson & Johnson and Jacob Elberg, Associate Professor of Law at Seton Hall, followed by a benchmarking survey and table discussion breakouts before the conference closes at 12:00 Noon.
It’s Not to Late to Attend!
The Pharmaceutical and Medical Device Compliance Congress offers compliance professionals the rare opportunity, along with CBI’s conference in the Spring, to interact face-to-face with their peers and learn from leaders in the industry and regulators. From a compliance training standpoint, our organization considers it an invaluable opportunity to hear about the challenges facing pharmaceutical and medical device companies directly from those who matter the most, our clients, colleagues, and friends.
If you’re interested in attending, contact me at email@example.com to take advantage of our conference sponsor registration discount.
Myth #2: It’s Not Really Targeted to the Life Sciences Industry
In this installment of our series on the myths and realities associated with off-the-shelf compliance training, I cover the common concern that off-the-shelf compliance and ethics training is not effective because it is so rarely focused on the life sciences and the only way to get targeted training is to build from the ground up.
All too often, life sciences companies purchase off-the-compliance training designed with generic content that is somehow intended to be applicable to any industry. This especially holds true when training is sold under the banner of ethics training. After all, ethics is ethics, no matter the industry…at least that is the sales pitch from companies who sell generic compliance training.
Unfortunately, the aggressive marketing and sales efforts of those companies perpetuate the myth among many life science companies that custom-development is the only training option that will meet their needs. Unknowing compliance professionals think they have only two bad options: 1) purchase generic training, or 2) hire a generalist training developer to build expensive modules from scratch, with the added burden of having to provide subject matter expertise to the training developer (As if they don’t have enough to do already!). There is a better approach, one that can be both efficient and cost-effective.
Those pedaling generic compliance training may insist otherwise, but effective life sciences compliance training absolutely requires content targeted to the pharmaceutical or medical device industries. The intricacies and details of the risks in our industry are far too unique to expect learners to find real value in generic training. But that doesn’t mean the only path to quality training is through custom development. Off-the-shelf training, with content developed by industry experts and vetted by your peers in the industry, is readily available for customization and launch.
Our Compliance Foundations™ eLearning modules cover the topics those working in the life sciences industry need to effectively reduce the risk inherent to their job responsibilities. Off-the-shelf courses include Good Promotional Practices; Interactions with Healthcare Professionals; Healthcare Compliance Overview; On-label Promotion; and Managing Speaker Program Risk to name a few. The modules are designed for easy customization, so your language, policies, and practices are easily woven into the content. And our modules can be launched on any SCORM-compliance learning management system…either the one you have in place or our cost-effective LMS.
The Bottom Line
There is a better way. You don’t deserve to have to settle for generic compliance training. You can have off-the-shelf content that is specifically targeted to the risks in our industry and the ability to further customize the training specifically to your company. You also don’t need to always build from scratch to ensure the content is relevant and optimized for the risks your learners face every day as they interact with healthcare professionals and conduct their work-related activities.
But don’t just take my word for it when you can see for yourself. Follow the four steps below to access demos of the Compliance Foundations™, and see first-hand, the level of industry focus we bring to our modules.
Myth #1: Off-the-Shelf Training Doesn’t Align with My Content Requirements
Welcome to the first installment of our series on the myths and realities associated with off-the-shelf compliance training. In each post, we will dive into one commonly heard myth concerning the pros and cons of using off-the-shelf eLearning to reduce compliance risk in the life sciences industry. We begin this week with the frequent lament, “off-the-shelf training doesn’t align with my content requirements.”
Multiple presenters at the 2019 Pharmaceutical Compliance Congress emphasized the importance of targeting training to the audience. As one speaker said, “scientists are not going find value in training that features scenarios with sales representatives.” He ended his comments by saying that is why he only uses custom-developed training.
In addition, in its recently updated guidance on the evaluation of corporate compliance programs, the Department of Justice emphasizes the need for “appropriately tailored training and communications.” When describing what prosecutors should take into consideration when evaluating a company’s program, the DOJ asks, “has the company provided tailored training for high-risk and control employees, including training that addresses risk in the area where the misconduct occurred?”
Clearly, government regulators and industry leaders recognize the importance of targeting training to the roles and risks associated with individual learner groups. And the belief that only fully-custom training can meet those requirements is predictable and understandable.
But is it reality?
The Case for Off-the-Shelf
While I agree wholeheartedly about the need to target the audience and use role-appropriate content, well-designed off-the-shelf training allows for extensive customization, in a streamlined, cost-efficient manner.
Consider Healthcare Compliance Overview, a module from our library of Compliance Foundations eLearning courses. The module covers a broad range of commercial compliance topics, including the False Claims Act, off-label promotion, HIPAA, good product promotion, and the Anti-Kickback Statute so our clients typically launch it to their full staffs. Most of our clients customize the content to reflect the needs of specific learner groups, e.g. sales, medical, clinical, and corporate. Since the modules are built in a “templated” format, the process is simplified and the cost is less than custom-developed training.
Healthcare Compliance Overview features knowledge checks instructionally designed to reinforce key objectives throughout the module. The knowledge checks are often written in the form of scenarios that reflect “real-life” experiences some learner groups are likely to face in their daily activities. Since the modules are so easy to customize, our clients roll out multiple “versions” of the module, each one tailored to the appropriate audience. The result: highly professional and engaging customized compliance training at less cost than custom training.
The Bottom Line
Custom development certainly offers the opportunity to tailor compliance training to various learner groups within a life sciences company, but it comes with a steep price and lengthy development timeline. Delivering appropriately targeted off-the-shelf compliance training throughout the company is not only possible, but it is often the optimal solution based on budget and time frame. Just be sure the off-the-shelf training offers the right level of flexibility.
Launching off-the-shelf compliance training, customized for your learners, is a simple four-step process with PharmaCertify:
Review your risks and goals with our team.
Select from our Compliance Foundations curriculum.
Make our content your content through the customization process.
“There is only one rule for being a good talker – learn to listen.”
The importance of effective communication and more specifically, listening, wasn’t lost on the speakers at the 19th Annual Pharmaceutical and Medical Device Compliance Congress. The consequences of poor listening were summarized by one panelist on the Qui Tam Roundtable when she said, “the vast majority of whistleblowers who contact me have tried to report their concerns to the company, but the company didn’t want to hear it.” In an era when the nuances of an effective compliance program are discussed and debated in detail, the simple yet often lost art of effective listening needs to be a priority.
The value of listening extends across all departments and business units and it starts with field-based employees. A presenter in the Compliance Considerations for Small to Mid-Size Companies session echoed that sentiment, saying, “the stream of questions from the field is not going to stop, but those questions tell a story and you need to monitor them carefully and build your plan from there.” The data from those responsible for interacting with healthcare professionals is critical as you evolve your program and look for gaps and redundancies that need to be addressed in personal interactions and in your continuous training curriculum. And listening for that data begins with open, non-judgmental relationships across the company. Or, as another presenter in the Compliance Considerations for Small to Mid-Size Companies session stated it, “when employees interact with the compliance department, they should not feel like they are being judged.”
The need for open lines of communication doesn’t stop with the field. The industry trend toward “building a culture of ethics and compliance,” and frankly, the regulatory focus on the culpability of those in the C-Suite and boards of directors, more than ever, dictates the need for open and regular communication with company leadership. The proverbial “seat at the table” for Compliance extends upward in the organization. As was stated during the AUSA Roundtable, “Compliance should have a good relationship with the Chief Executive Officer, and the officers of the company. The two departments need to communicate openly and honestly.” He continued, “when issues do arise, the Department of Justice needs to see that you are being proactive and responding to those issues.” In other words, listening to one and another.
During the Chief Compliance Officer Roundtable, the risks associated with the use of third-party vendors was discussed in detail and the need for open lines of communication beyond the walls of the company was stressed. “Work with the stakeholders in the third party and make them feel like you are partnering with them,” one participant said, “be transparent, if you hear that people aren’t disclosing information, that’s a warning sign. If there is any confusion, ask questions.” And listen carefully to the answers.
The key takeaway: to build a truly effective and modern compliance program that proactively addresses the risks across the organization, a policy of open communication must be established from the top down. The concept of an ethics-based approach to compliance may seem nebulous and difficult to quantify, but it begins with fostering a level of respect across the company. And respect begins with real listening. When employee questions, feedback, concern, and complaints are welcomed, appreciated and nurtured in a respectful manner by Compliance and the C-Suite, all aspects of the compliance program, including the training, are enhanced.
The French journalist and novelist, Jean-Baptiste Alphonse Karr, is credited with coining the phrase, “the more things change, the more they stay the same.” For anyone who has attended multiple compliance conferences in the last five years, his words certainly ring true. Terms like “partnering with the business,” “tone from the top,” and “third-party risks” are still staples during conference presentations and this year’s Pharmaceutical and Medical Device Compliance Congress was no exception. For good reason.
As an example, the Compliance 3.0 presentation on Day 2 of the conference began with one panelist expressing his concern that “we still have to fight for a seat at the table.” In other words, while the concept has been bandied about for years now, the reality is that raising compliance to the organizational level of respect it requires to affect true behavior change is still a struggle. He and his co-presenters emphasized the need to not only find that seat alongside the businesses but truly understand their business policies as well as what they do and who they are. As another presenter put it, “bring value to the business as a compliance representative, educate them every step of the way, and help them educate their people.” She added, “when they get to the point where they are doing it themselves, that’s nirvana.”
Not surprisingly, the need to train and manage third-party vendors continues to be stressed. In the session covering the Foreign Corrupt Practices Act, one government representative even delved into the need to extend the corporation’s culture to the vendors. She added “you really need to know your third-party vendors and they need to understand you. You need to know who it is that is making payments on your behalf.” The presenters in the Third-Party Lifecycle Management session agreed, citing the need to “have vendors take the same training that is rolled out for your employees. Treat them as partners and make sure they understand the risks involved. They are more likely to care about being compliant if they feel like a partner and if they will be held responsible.”
As with the conversation and debate over an “ethics-based approach to compliance,” concepts like “tone from the top,” “partnering with the business,” and “third-party risks” warrant our focus and consideration simply because they are that relevant and critical. Industry conferences offer the valuable opportunity to hear our peers share their latest insights and success stories around the themes that seem to drive the conversation. While the world of life sciences compliance is evolving, in some cases, the more things change, the more they stay the same…at least at the compliance conferences.
Thanks for reading!
Compliance Training Intelligence Blog
To say the audience at the 19th Life Sciences Compliance Congress West was energized and engaged is an understatement. The size and scope of the two-day conference led to unusually interactive discussions, with the audience eagerly sharing their experiences along with the presenters and panelists. For someone relatively new to the field of life sciences compliance training, I found the exchange of ideas and advice quite educational and enlightening.
PharmaCertify was there as a conference sponsor and we found an agenda filled with information designed to help attendees strengthen their compliance cultures and reduce risk, which of course is a mission close to our hearts from a compliance training standpoint. Here are my takeaways, with a focus on training of course (it’s what we do):
1. Build an ethical culture, not just a compliant one.
This was a recurring theme, and it’s a compelling one. On the surface, the line between ethics and compliance may appear inconsequential and not significant enough to be worthy of consideration. But more companies are evolving away from a rules-based approach to compliance to one that stresses ethical decision making as the foundation for their principle-based policies. It begins with a question: are people doing the right thing when no one is looking?
For us, the answer begins with a new approach to training. Modern life sciences companies need to teach the value of ethical decision making, and not just recite the rules and regulations. Training needs to instill in learners the understanding that the company trusts and expects them to do just that.
2. Hubs are in, so get that training out!
Patient support hubs are trending, and since they serve as the “connection point” for so many stakeholders (patients, providers, and physicians), they come with a high level of risk. With the influence of commercialized companies, and the lack of guidance from the Office of Inspector General and Department of Justice, patient support hubs are a hot bed of kickback and false claims risks.
Job aids, clear business rules and program guidance, and a robust training curriculum are necessary to mitigate that risk. All parties involved, including vendors, must be continuously trained on how to interact with patients and understand what they can or cannot say and do.
3. If you think PSPs and PAPs are in the regulatory spotlight, you’re right.
The scrutiny on Patient Support Programs (PSPs) and Patient Assistance Programs (PAPs) is intensifying, with a growing number of settlements (Jazz Pharmaceuticals, United Therapeutics) raising questions over the idea of companies donating to independent charities. In addition to causing potential false claims and HIPAA violations, the donations raise concerns that they may be intended to induce patients to purchase certain products and implicate the Anti-Kickback Statute.
As was highlighted during the conference, PSPs and PAPs can be beneficial to patients, but commercial organizations cannot have any influence on the support being provided. Training needs to emphasize that sales representatives are not permitted to discuss specific PAPs or disease state funds with patients or healthcare professionals. And as prescription costs climb, the scrutiny and risks will continue to grow.
4. Nurse Educators: Are they here to stay?
The jury is still out. As defined during the presentation on nurse educators, “white coat marketing” refers to the use of healthcare professionals in marketing or sales activity, and therein lies the risk with the use of nurse educators. According to the Office of Inspector General (OIG), the practice is scrutinized under the Anti-Kickback Statute because patients rely on the advice of physicians, they may “have difficulty distinguishing between medical advice and a commercial sales pitch.”
Recently unsealed qui tam cases highlight the risks and cause for concern, with one company deploying “nurse ambassadors” directly to patients’ homes and another implementing nurse-led adherence programs designed to increase product refills. Patients tend to trust the opinion and advice of their physician, and by extension, their nurse educator. However, it can be confusing for a patient to decipher advice from marketing, and exposure points emerge when nurse educators are trained similarly to sales representatives and conducting calls with those representatives. Asking yourself key questions about the training:
What materials do the nurse educators use (disease state, promotional, fair, balanced, etc.)?
Does the training focus on adherence and education instead of sales and marketing?
Does the training resemble sales training (e.g., overcoming objections, cold calling)?
5. Speaker Programs: How is this still happening?
The idea that speaker programs bring high levels of risk is not a secret, so much so that one audience member even asked, “how is this (insert expletive) still happening?” Good question. Selling in the life sciences industry is a relationship-based activity, and back in the “good old days,” there was little monitoring around meals, vacations, golf outings, etc. Now, the risks are rampant and include speaker selection (make sure they are credible), payments, receipts, the amount of money spent, spouses or guests in attendance, and analytics. The panelists also used Insys as a case study for the importance of communication, particularly email. Multiple documented emails within the company revealed how they were trying to utilize speakers. Training needs to emphasize the need for open, honest and communication, with no hidden agendas because as was quoted about the Insys case, “it takes a very long time to turn your ship around.”
6. Calibrate Your Compliance Training for Greater Impact
There’s plenty of guidance available from the DOJ and OIG to assist ethics and compliance professionals with determining their training priorities. The OIG guidance alone offers 49 distinct metrics for communication, education, and training. It can be a bit overwhelming, so what’s a compliance officer to do?
A presentation by Dan O’Connor of NXLevel and Jeremy Lutsky of Theravance offered attendees a practical framework for designing, developing, and implementing compliance training, beginning with the questions, “Is there a training need?” In other words, is there actually a knowledge and/or skill deficit or is there a problem with incentives, motivation, unclear expectations, etc.?
Assuming there is a training need, ethics and compliance officers can use the long-established ADDIE (Analysis-Design-Development-Implementation-Evaluation) process to efficiently attack the problem, beginning with analyzing risk by role in the organization. Several pragmatic approaches were shared by Dan and Jeremy, including use of the “3F” Curriculum Framework, Bloom’s Taxonomy, and a structured process for evaluating existing training.
7. The food choices in San Francisco are, well, pretty good.
The restaurant choices are clearly bountiful in the City by the Bay and we leave you today with a brief note on two that we enjoyed during our stay:
The Hog Island Oyster Company is nestled in the Ferry Building Marketplace, where you can watch the ferries come and go as you enjoy freshly-shucked oysters on the half shell. Choose oysters from various locations or order a dozen or two to try them all! They all come with a fresh vinaigrette or cocktail sauce if you so desire. While their main stake is oysters, the rest of the menu is not neglected. The chowder comes stacked with clams in a nice cream base with veggies, potatoes, bacon and cheese! And the fish sliders are perfectly crispy paired with a tangy coleslaw that compliments the fish nicely. From the bar, the Chardonnay from Napa was crisp and light, and the Wolfback Ridge IPA was a perfect pairing for the fish sliders.
The Douglas Room is a quaint restaurant located adjacent to the Tilden Hotel that offers a boutique gastropub vibe to transport diners to another time (think speakeasy era). The talented mixologists curate creative spins on classic martinis behind the bar to help authenticate the experience. For dinner or late-night snacks, the innovative menu features locally sourced and seasonal ingredients. We enjoyed the shishito peppers, duck confit wings, wedge salad, and Tilden burger. The portions were perfect for sharing, and the presentation was stunning. We’ll be back when the conference returns to San Francisco!