Tremendous response to APL in US, say organisers

The American Premier League (APL) will go ahead with its inaugural Twenty20 tournament from Oct 6, 2009, even if the ICC refuses to sanction the league, the organisers confirmed on Tuesday.

In an exclusive interview with Dawn, Jay Mir, president of the organising American Sports & Entertainment Group Inc (ASEG), remained optimistic about the ongoing negotiations with the USA Cricket Association (USACA) while confirming that the New York City tournament is ‘good to go’.

“As we move forward with our negotiations, it is worth mentioning that we haven’t received a rebel status as yet,” Mir said. “The ICC has advised players and officials to stay away from the league until a concrete decision has been made and I think it is in the best interest of USACA, APL and for the development of the game in USA that this league gets sanctioned,” he added. “However, since we are not depending on the official go-ahead, the first tournament will be held even if the USACA refuses to approve it.”

The maiden APL Twenty20 tournament has attracted big name players from all over the world, especially the ICL recruits deprived of cricket following the league’s season cancellation due to the economic gloom. According to Mir, APL has succeeded in signing Inzamam-ul-Haq, Imran Nazir, Imran Farhat, Abdul Razzak, Taufeeq Umar and Shabbir Ahmed with Moin Khan acting as Premium Pakistan’s coach. It will be one of the six teams competing in the league.

“We have succeeded in recruiting Richard Hadlee as an executive consultant while also signing Graeme Hick, Nathan Astle and Adam Hollioake,” disclosed Mir.

When asked if the APL — as it seems to be following in the footsteps of ICL — could also be labelled a rebel league, Mir remained hopeful of the USACA’s decision and the fact that both organisations shared similar vision. “The reason behind ICL’s failure [due to financial reasons] was because they didn’t have backing from the national board [the BCCI]. I’m sure the decision-makers at the USACA are smart enough to understand that we also want to promote cricket in the United States and judging by the response we’ve had already, I can only imagine how successful we can be in achieving that goal.”

The tournament, due to played on a round-robin basis on the Staten Island Yankees baseball ground, will feature six teams vying for a semi-final berth that will be followed by best-of-three finals. Apart from Premium Pakistan, the tournament will comprise of an Indian, West Indian, American, Bangladeshi and a World XI.

According to Mir, the long term plan is to stage the tournament twice a year with locations varying across the continent. “Since our aim is to promote cricket, we have planned to stage the tournament across the continent from next year. It is a big event — an unprecedented event in fact in the history of the nation — and we want to ensure we launch is properly.”

The organisers’ keenness to get on with the league can be judged by the fact that, according to Mir, most of the sponsors have been confirmed, all participating teams have been finalised and that ASEG has received bids for television rights from multiple companies.

“The response has been phenomenal. We’ve had people enquiring about tickets already and offering their services to the league. There exists great excitement in the general public with regards to the tournament and what we’ve achieved in one month is just amazing,” said Mir. “We want to kickstart the game of cricket in the region and for that reason, I hope we get the USACA’s approval as players of this calibre do not deserve to be tagged as rebels.”

As the tournament details are released, a feeling of uneasiness has been felt around the cricketing world. Apart from the ICC cautions released last week, New Zealand Cricket (NZC) expressed its disappointment over Hadlees’ affiliation with APL. “’It’s regrettable that Hadlee has aligned with an unsanctioned and unofficial circuit,” Justin Vaughan, NZC chief executive, had told the Sunday Star-Times.

But Mir said the league will only promote the game in the US region through Hadlee’s services. “We will be promoting the game in the country with Hadlee,” Mir said. “Although cricket is being played across the continent, APL is serving as a door for the game to enter the US properly.”

© Faras Ghani 2009
Published in DAWN newspaper Apr 29, 2009

Curse of the counterfeit

It is estimated that business in counterfeits will be worth £75 billion this year. The ‘Combating counterfeiting’ conference held by the RPSGB highlighted major issues and techniques affecting the industry as well as procedures undertaken to fight against it...

Counterfeit medicines have become a growing global problem. According to the World Health Organisation, sales of counterfeit medicine range from approximately one per cent of sales in developed countries to 10 to 30 per cent in developing countries.

In a recent conference held at the Royal Pharmaceutical Society of Great Britain (RPSGB), industry experts highlighted the intensity of the problem as well as current status of new technologies in order to raise public awareness.

‘The counterfeit drugs are now being made to order and for a range of products instead of a single product,’ Dr John Kerridge, EU regulatory advisor, Eli Lilly & Company, observed at the conference. ‘The trend has gradually moved away from lifestyle drugs a few years ago to life-saving drugs now and that change is of huge concern to everyone.’

Citing examples from raids undertaken frequently, Dr Kerridge emphasised the need for ‘closer look’ as although the ingredients and chemical composition may be far off the mark, the finer details that counterfeiters go through while packaging may make the products hard to identify from the genuine ones.

The same point was illustrated by Dr Tesh Patel, senior director of quality assurance at Astellas Pharma Europe UK, as he displayed striking images comparing genuine and counterfeit packaging. Dr Kerridge also raised the concern surrounding the increase in the number of internet pharmacies that have cropped up in the recent past and although a lot of them carry icons – including VIPPS, RPSGB and Legitscript logos – things may not always be what they seem.

Examples were provided by Jane Nicholson, executive director of the European Industrial Pharmacists Group, of purchases from an online pharmacy that have resulted in deaths. ‘While there exist enforcement problems due to lack of sufficiently trained inspectors and funds for laboratories, we also need to look at legislation governing counterfeit drugs,’ she said while noting that the United Kingdom Medicines Act is now over 40 years old.

Highlighting the Medicines and Healthcare products Regulatory Agency’s (MHRA) battle against counterfeiters and counterfeit products, Nimo Ahmed, head of Intelligence, Enforcement Group at the MHRA, discussed how much importance is being placed on packaging. ‘We have examined computers and found that people from the EU and UK have sent sample packs with details and requested them to be made to order.’ The worrying thing according to Ahmed, however, was the amount of active ingredient in the counterfeit product which depended on the amount of money that was offered.

‘Worryingly, we have seen a lot of professionals, wholesalers, pharmacists, people who have operated in the industry for a number of years and know the system and have observed where the gaps are have then tried to penetrate those gaps.’

Counterfeiters, as Ahmed pointed out, have a great understanding of how the supply chain worked and that has made their task easier. Picking on the same point, Dr Patel highlighted a risky assumption that if a package is secured through the supply chain to the pharmacist, it is assumed that the medication is secure.

Quoting Jim Chrisitan, VP Global Corporate Security at Novartis, Dr Patel said: ‘In almost every case, the technology, be it a hologram, tamper-proof labels, embossing, thermo-reactive ink, RFID tags, DNA markers, and the ikes, enables companies to track cardboard, not product. It is not unsual to find genuine product in counterfeit packaging and counterfeit product in genuine packaging.’

Ahmed also reminded the attendees – as well as wholesalers and pharmacists on the whole – of the MHRA’s 24-hour hotline (020 7084 2701 or by emailing counterfeit@mhra.gsi.gov.uk) where discrepancies and irregularities can be reported.

According to Ahmed, counterfeit products are mostly manufactured in China and can then be dispatched to anywhere in the world. ‘We have had to recall a lot of products targetting the parallel trade market and hence are implementing strategies that also includes speaking to healthcare professionals, doctors and nurses who deal with medicines regularly.’

With a network mapped across the world, Dr Patel admitted it was a difficult task preventing the trafficking of illegal drugs. ‘If we cannot as yet prevent trafficking of illegal drugs why do we think we can prevent counterfeit medicines? However, we may not be able to prevent it, but we can be prepared for it.’

Preparation via vigilance, mass serialisation, and even an international convention, according to the speakers.

© Faras Ghani 2009
Published in Pharmacy Business April 2009

Plan young, aim high

Kishor Ragha’s successful journey as a pharmacist started at a young age. From the days of playing around with chemistry sets to leaving his native country to obtain pharmacy qualifications, Ragha has remained committed and confident. Winner of the Pharmacy Business Clinical Excellence Award 2008, Ragha shares his success trail with Faras Ghani...

In the life of many pharmacists across the country, these are the days of regret. Long working hours, low pay, pressure to provide increasing number of services, and stagnant OTC sales. As a result, many pharmacists are reported to be fed up of the profession, planning a career switch and a rethinking.

With Kishor Ragha, who left his native Zambia in order to pursue a pharmacy career, life is smooth at his Vantage Pharmacy. Growing business, lust for knowledge, striving for improvement, complementing accolades, and a prevailing sense of satisfaction. Developing an interest in pharmacy from a very young age, Ragha’s commitment to what he wanted to achieve has been a driving force behind his success and his achievements.

‘Pharmacy is something I’ve been deeply interested in from a young age,’ he said. ‘Even as a child I had my own experimental sets at home that I would spend time with. Therefore, it is a gradual progression.

‘Although my family wanted me to become a doctor, more so due to the status symbol than anything else, my interest in chemistry and pharmacy was stronger than becoming a doc. And for precisely that reason, I left Zambia to come study in the UK as the University of Zambia did not cater for a pharmacy degree. That is how strong my commitment was towards pharmacy.’

Although Ragha did go back to Zambia after his qualifications to start a pharmaceutical industry, conditions proved adverse for the plans and prompted a swift return to the UK. An interest in industrial pharmacy was what gave birth to those plans initially, but as he realised his zest lies in the business side of things, it was not long before he realised what he was cut out for.

‘It was the clinical side of pharmacy that interested me in the beginning but obviously as you get older and once you have your qualifications, the focus changes slightly. It still remains towards pharmacy but you then narrow down your options.

‘In my case, I narrowed it down to community pharmacy. Following the abandonment of my industry plans in Zambia, I realised I wanted to work in community pharmacy the most and that is the reason I came back.’

It was due to Ragha’s desire to be his own boss that he decided to go into community pharmacy. Signing up with a franchise scheme that AAH had in the early 90s, Ragha developed this interest further and opted to buy out the business as the franchise contract came to an end.

‘Looking after a business is what I’m interested in besides the pharmacist aspect of it. I’d always wanted to be my own boss. I did get offered fantastic salary at the places I worked at in the past but the fact that they were able to offer me that made me think that I’m capable to making much more by just having my own business.

‘I did locum work in central London and worked as a manager for two years following my return from Zambia. While I was still working as a locum, the AAH offer came up and I became one of the few lucky ones to get on board. And when, at the end, I had the option to buy out the business, I didn’t think twice. It was an excellent decision I made and I’ve never looked back since.’

Apart from being the pharmacy owner and the pharmacist at Vantage, Ragha is also a qualified Independent Prescriber and sits on various local committees as well as the LPC. A respect individual among customers and local surgeries, Ragha is contacted by nurses, GPs and patients alike for advice and guidance.

‘I do help out patients in my batch but it does not stop there. The GPs and the nurses would phone me up for advice if they are not 100 per cent sure on something and need a a second opinion. We have that rapport with local GPs that we are quite proud of and we respect each other for that.’

Ragha won the Pharmacy Business Clinical Excellence Award 2008 for his specialisation in the treatment of diabetes. He undertakes the full range of tests for diabetes and also advises patients on how to improve their lifestyle. But how did the interest in diabetes develop?

‘Around five years ago, we had a diabetes improvement scheme is Hillingdon where we undertook basic tests and advised patients over a period of six months. It was so successful that we, as a group, won a care award for that. Working with diabetes then was what got me interested.

‘A Warwick diabetes course came along after that which I enrolled in and passed. So, the more I learnt about diabetes the more fascinated I became and the more I wanted to know. As a result, I wanted to do more than that just prescribing and wanted to look after the patients myself. So I went to King’s College and did my course in supplementary prescribing. Following that, I went further and became and IP the following year so now all the decisions will be mine.

‘I was happy, prepared and confident to make changes to the medication and it was this confidence that drove me.’

Despite having his hands full and complaining that ‘there are not enough hours in the day’ to do what he wants to, Ragha has built up a successful business and he attributes a lot of success to the skills of his staff and the training they underwent.

‘You can’t keep an eye on everything that is happening in the pharmacy. I have dispensing duties as well. Therefore, it is essential that you give staff the ownership of particular sections and product range. Delegation is the key to success but for that to work effectively, adequate training must be provided beforehand and constant review must be undertaken to ensure a common goal is being aimed at.

‘We have regular discussions with staff and at times, even I’m not aware of products they order since I have given them full authority following the training. I followed a similar path en route success and I’m all for giving them ownership and letting them little entrepreneurs.’

Apart from providing diabetes services, Vantage Pharmacy also provides chlamydia screening and smoking cessation services as well as offering the morning-after pill together with the required consultation.

Ragha’s workload is ever increasing. ‘I’m busy all the time, the script numbers have shot through the roof and on average we do 8,000 scripts per month. I can’t possible do all this on my own and that’s where backup and well-trained staff come handy.

‘Without backup, you can’t do all these services and it’s dispensing or the paperwork or services. They all take up a lot of time and the only way you can do this is if you have very good staff.

‘I’m quite happy doing the services since I know other parts of the business are in capable hands. I enjoy dispensing, especially when I’m giving out the medication and as the verbal interaction takes place.’

Despite the workload, Ragha’s interest in diabetes and diabetic patients is on the rise and he is coming up with ideas and advice to help patients all the time.

‘The main aim is to change the patient’s attitude towards diabetes. I change the mindset of that person from day one by giving him/her the ownership of the problem. Put restrictions on and list things they should not be doing. Give them all the facts as opposed to just the medication and I find that this works better.’

Although Ragha has his hands full with dispensing, training and offering services, he still has time to ponder over the future of pharmacy. He envisages it to change no doubt but warns of repercussions with the government’s desire to see more and more services being undertaken by pharmacists that increase the workload. ‘We just don’t have the time. For example, I’m giving advice on MURs verbally and not claiming for it as I do not do the paperwork due to not having much time.

‘With Category M and all that, it has become a political issue that will take time to settle down. It will be tough and you can’t reply on income from dispensing alone. The sooner the colleagues of mine realise that the better.’

Doing so much can sometimes affect the quality offered, something that Ragha was quite wary of. However, the Award provided the confidence that he needed to strive towards improvement in patient care.

‘I never realised my work was of a reasonably high standard until another pharmacist asked me to apply for the award. It was a fantastic evening and, as every other award-winner, I never expected to win it.

‘However, it was really funny because everyone told me, after I had won, that they expected that to happen sooner than later. It is nice to be appreciated and is satisfying when your work gets recognised but I never undertook all the additional work for the sake of an award.

‘I just love helping patients.’

© Faras Ghani 2009
Published in Pharmacy Business April 2009

The PSNC Conference

The annual LPC conference brought up topics of discussion ranging from prescription pricing to Category M as well as commissioning issues.

The 2009 LPC Conference, attended by over 280 delegates, discussed issues ranging from PCT issues, PNAs, funding, and supply issues, to CIP and reimbursement. Chris Hodges, Pharmaceutical Services Negotiating Committee’s (PSNC) chairman, opened the conference by reminding attendees of the previous year’s conference where the White Paper was mentioned.

Detailing PSNC’s priorities, Hodges detailed a group of planned activities in order to achieve the goal to ‘bring the new community pharmacy service envisaged in the pharmacy White Paper to fruition, securing fair, reliable and sustainable funding for contractors that incentives and rewards provision of new NHS services.’

The goals consist of PSNC:

• Supporting development and adoption of pharmacy services

• Agreeing relevant and manageable quality frameworks for provision of
NHS services

• Ensuring full and fair costing and funding for pharmacy services

• Agreeing effective frameworks for local service commissioning

• Supporting local contracting and provision of services from pharmacy

Lauding community pharmacy’s contribution to public health, Hodges termed it as a benefit not only for the public but the NHS as well. ‘Community pharmacy can help manage the big public health challenges of modern times – obesity, smoking, alcohol, sexual health. We can help manage long-term conditions – diabetes, asthma and heart disease. We can deal with minor ailments, and help people stay out of A&E or the GP’s surgery when they don’t need to go there. We can help deliver the government’s targets for vascular risk assessment of everyone in this country aged between 44 and 75. And we can help the healthy stay healthy.’

Hodges also spoke of how MURs have demonstrated the power of community pharmacy to extend its role in patient care. ‘In the last financial year, 73 per cent of all pharmacies in England provided MURs. In the financial year to the end of March 2009, we are on target for 1.3 million MURs.

‘The next piece is how to ensure that MURs are properly integrated into primary care services and how to ensure consistent quality, targeting of the service, and that the value of the MUR to patients is understood.’

Sue Sharpe, PSNC chief executive, highlighted some of the core issues affecting community pharmacy. ‘Most of you have stories to tell of poor commissioning or administration by PCTs,’ she said. ‘Sometimes the PCT responds with claims of poor delivery by pharmacies. We all need to move on from this – understand what has gone wrong and make progress for the future.

It is vital to get over negativity wherever it lies. Whilst the nationally agreed services and funding will continue to be the foundation for the community pharmacy business, local services contracting will become increasingly important as a source of revenue. Local contractors and LPCs will have greater responsibility than before for identifying and negotiating their role as service providers.

With an increasing focus on local service commissioning we need to ensure that the workload burden for independent pharmacy contractors remains manageable. It is already very heavy, and the independent today does not have the time and capacity to deal with large and complex documentation. We are committed to support independent contractors, all contractors. Manageability is vital.’

Following the conference, over 400 guests attended the annual PSNC annual where members of both houses of Parliament, PCT and SHA managers, LPCs and other health organisations were amongst the guests. Phil Hope, pharmacy minister, gave enthusiastic support for community pharmacy.

‘We do see and we do value your hard work, the way you’re driving the agenda forward,’ Hope said. ‘In Corby, we will be developing a new public strategy to tackle obesity and a strategy to reduce cardio-vascular disease and I have no doubt that pharmacies will play a key role.’

Hope also stressed the importance of MURs in community pharmacy and lauded the efforts that have been undertaken. ‘MURs are making their mark,’ he said. ‘But its not just about how many are being undertaken. The outcomes are what really matter and recent research shows that they are reducing drug therapy problems by more than 60 per cent.’

Quoting a Portsmouth University study, Hopes said that 87 per cent of asthma patients who had received an MUR felt more knowledgeable about their condition and over 90 per cent felt more knowledgeable about their medication. MUR, according to the minister, are cutting hospital admissions and emergency admissions due to asthma have dropped by over 50 per cent according to research on the Isle of Wight with the associated deaths have fallen by a remarkable 75 per cent.

Sharpe ended her speech by stating that despite that grim economic conditions, funding for contractors has improved. ‘Community pharmacies are doing a great job for their patients, and between the LPC and PSNC, we have great opportunities to grasp as we implement the White Paper.’

© Faras Ghani 2009
Published in Pharmacy Business April 2009.

Ahmed Shehzad - Young, ambitious, lucky

Terribly lucky are the ones who have their dreams come true as teenagers. You stroll out amid deafening support, making your debut as a youthful 17-year-old ready to show your class against the mighty Australians. The track is flat and you think you're on top of the world.

Add in ballyhoo that this very day the master, the great Sachin Tendulkar, was unveiled to the world and you plan a fame-filled journey ahead of you.

But Ahmed Shehzad found himself dumped by his senior partner halfway down the pitch – ironically his captain as he made his first-class debut just over two years ago – floored further by a recent change in the ICC laws. At that point, the Dubai cricket stadium did not seem big enough to contain the reek of disappointment, and realisation that cricket indeed is a cruel, cruel game.

Little would Shehzad have known about the cruelty of the game as he made an impactful entry to first-class cricket, aged only 16. Three 40-plus scores in his first two matches, and the world was his oyster, that too despite his mediocre performances against Indian U-19s in a home Test series.

Following this brief yet successful cameo at first-class level, Shehzad was part of the touring Pakistan U-19 side that played two Youth Test matches against England. Following an innings-and-58-run humiliation in the opening Test, in which Shehzad could only muster a nought and 40, it was time he truly announced his potential. Chasing a tricky 342 in the final innings of the tour, Pakistan needed an anchor. They not only found that, but also a match-winning innings from Shehzad who stroked a majestic 167, off only 260 deliveries, thus ensuring a series-levelling win.

Not looking back since, Shehzad smashed another century against Bangladesh U-19 later that year, but his youth and academy commitments resulted in him being deprived of first-class experience. But as the love-affair rekindled, he ensured authority: scoring almost 600 runs in the latest edition of Quaid-e-Azam Trophy for Habib Bank Limited.

Already gone through his share of scandals – a ritual that most Pakistani cricketers have followed at will – Shehzad was determined to let the talent count. Told by the coach of a visiting team that he will 'definitely represent Pakistan no matter how poor his performance was at that point', Shehzad – heavily disappointed by his poor show, remained adamant that the heroics against England would be the turning point of his career.

Not content with the low tier of international cricket, Shehzad soon had his chance against the menacing combination of Shaun Pollock, Makhaya Ntini and Andre Nel in a tour match as South Africa visited Pakistan. Although he could only score 35 (off 44 balls), it was the six hits to the boundary – four along the ground and two over the rope – that gave him the confidence to climb up the ladder of success.

“It was a great experience,' Shehzad told Cricdb. “It was hard to play against bowlers the calibre of Pollock and Ntini but as I stroked a few boundaries, I felt the confidence inside me and the assurance that I can play at the top level.”

Taking up to international opposition, conforming to his knack of scoring centuries at will, Shehzad eased to 146 against the Sri Lankans in another tour match prior to the ODI series at home. The bowling attack comprised Chaminda Vaas, Ajantha Mendis, Muttiah Muralitharan, Dilhara Fernando and Farveez Maharoof.

Terming Imran Khan and Ricky Ponting as his all-time favourites due to their fighter instincts, Shehzad assures that he has not faced any problems ever since he started playing cricket. However, even that fighting instinct that he seems to have possessed from his idols was not enough to take Pakistan U-19 to a third successive World Cup crown. A disappointing individual show overall – bar the eight wickets he captured in the tournament – was somewhat rectified in the semi-final mauling against South Africa with an aggressive 60.

Failing to live up to the pre-tournament favourites tag, however, is something Shehzad will rue for eternity. And the fact that his father was not able to witness him in Pakistan's colours as he passed away when Shehzad was only eight months old. Shahzad devotes his career-building to his brother Khurrum Shahzad – older brother - who encouraged Shahzad in every part of his life, including cricket

While poor judgement on his senior partner's part may have cost Shehzad an ideal start to his international career, he is sure to get another chance. However, a country that is more cruel than the game itself and one that has banished success to the wilderness, Shehzad will need to ensure he grasps any given opportunity with both hands. Both for his sake and for the nation still mourning the loss of Saeed Anwar and Aamir Sohail as the last prolific set of openers ever seen in green.

© Faras Ghani 2009.
Published on Cricdb Apr 25, 2009.