Laurie Kelley

Standing on the Shoulders of Giants

Dr. Olaf Walter reviews Octapharma’s history
I
was privileged this week to be invited to a special scientific symposium in
Heidelberg, Germany, sponsored by Octapharma. Octapharma is the largest
privately owned plasma manufacturer in the world. It recently launched  the first and only fourth generation recombinant factor VIII (FVIII)  produced in a human cell line without any chemical modification or protein fusion, NUWIQ®, now available in the
US. This unique product is important as it is hoped that a recombinant product
that originates from a human cell line might have low immunogenicity—in other
words, it might not trigger an inhibitor, which is the greatest complication of
hemophilia.
Octapharma
was founded in 1983 by Wolfgang Marguerre; the name comes from the Greek
for the word “eight.” Octapharma manufactured the world’s first plasma-derived FVIII that employed a viral inactivation step using solvent-detergent. I cannot overestimate how important this process is. My own son used product
initially that had no SD or pasteurization and miraculously escaped HIV and
hepatitis C infection.
 
Octapharma
now serves patients in 105 countries with 6,200 employees in 32
countries, of which half are in the US, the largest market for hemophilia
products.
Laurie Kelley with Marcia Boyle,
executive director of the IDF
The
Saturday symposium featured speakers from the US, Denmark, Canada, and Germany,
including our own Dr. Craig Kessler from Georgetown University. While all the speakers
were excellent, I learned a tremendous amount from Dr. Roger Kobayashi, of UCLA
School of Medicine, who is an immunologist. Patients with immune deficiency
share so many of the same concerns as those with hemophilia. Our need for
constant products, safe products, easy to administer and affordable. Dr.
Kobayashi reminded us that physicians like him, and companies like Octapharma, “stand on the shoulders of giants”–those researchers who have come before us. He told us that the very first Nobel Prize was awarded to a doctor who
discovered gamma globulins, proteins that can be used commercially to treat
infections in those with malfunctioning immune systems. He described the pain patients
felt years ago when intramuscular injection were given; the poor children! They
could not walk for days. Finally, intravenous infusions were manufactured and
successfully treated patients with immune deficiency. While he spoke, I had the honor
to be sitting next to Marcia Boyle, the executive director of the Immune Deficiency
Foundation, an exceptional leader who for 32 years has provided education,
advocacy and help to those with immune deficiency in the US. Indeed, Dr.
Kobayashi mentioned her three times in his speech!
We
learned about Alzheimer’s (discovered here in Germany), and Octapharma’s research into treating this
insidious disease, the fifth leading cause of the death in the US. There is
currently no treatment and after hearing Dr. Shawn Kile’s excellent presentation,
I pray that this company discovers a treatment soon. I recently witnessed the devastating
effects of this disease in a dear elderly friend. It strips a person of their
very identify and almost of their humanity. How long will we wait for a
treatment to slow it or stop its progression? Companies like Octapharma work
daily to answer this.
But
I was most interested in Dr. Craig Kessler’s speech on personalized
prophylaxis. Dr. Kessler described how half-lives differ dramatically among
patients and only a pharmacokinetic (PK) test can determine each person’s half-life. That’s the number one place to start with a proper treatment regimen. In
the “old” days, like when we were raising a child with hemophilia, we dosed
by weight and bleed severity only. Now we realize this is not enough. Each person
will have a different half-life. He displayed one slide that showed 66 patients
with half-lives varying up almost 5 hours. Once you know your half-life, you
can find the proper prophylaxis treatment. This might include looking through the vast
array of factor products. Dr. Kessler reminded us that patients want 1) reduced
number of infusions, 2) reduced inhibitor development and 3) to adopt prophy to
their own lifestyle.
Dr.
Kessler reported that NUWIQ® is Octapharma’s new fourth generation recombinant FVIII from a human cell line—the
first such product. Because it is entirely from humans, and not animal cell
lines, this could potentially reduce the rate of inhibitor development and avoid possible
allergic reactions, and allow personalized prophylaxis with fewer
infusions.  He described several
clinical studies with NUWIQ®, including one with 135 previously treated patients,
none of whom developed an inhibitor. We also know that inhibitors can develop
in about 30% of previously untreated patients with factor VIII deficiency, usually
within 20 exposure days. Octapharma designed NUWIQ® to be less immunogenic by using a human cell line. I will want to follow clinical studies closely on the
product to see what else they uncover regarding this.
Laurie Kelley with Octapharma friends

I
was also interested to hear from Dr. Olaf Walter, senior vice president, and MC for the day, that Octapharma is conducting research for a  subcutaneous (under the skin) delivery of factor. I know of two other companies
that are also working on this, and it will again be interesting to watch
developments. As we write in our May issue of PEN, this is the most exciting
time in hemophilia!

The symposium
closed with a delicious lunch and then a black tie gala that evening at the
Heidelberg Castle. It was not only the 33rd anniversary of
Octapharma, but also the 75th birthday of founder and chairman Wolfgang
Marguerre. I have a special indebtedness to Wolfgang, as he is Save One Life’s
largest supporter and also sponsor the largest number of children, 120.

Laurie Kelley with Octapharma Founder and Chairman
and Save One Life’s leading donor Wolfgang Marguerre



The evening was
dazzling, with over 40,000 flowers, 500 guests including Octapharma employees from around the world, 150 wait staff, at least two high quality bands, delicious food and drink. This was a wonderful way to celebrate
the accomplishments of this company and its indefatigable and brilliant
founder. I met up with my hemophilia colleagues, including three of our
top sponsors for Save One Life: Wolfgang, and also Patrick Schmidt, CEO of FFF
Enterprises, Neil Herson, president of ASD Healthcare, and Paolo Marcucci of Kedrion S.p.A.

Together, all three sponsor
about 280 children with hemophilia in poverty annually. Many of the other
attendees also sponsor children, including hemo-mom and Octapharma employee
Sherri Rojhani, who just sponsored a child in honor of Wolfgang Marguerre’s
birthday.

The evening
ended with spectacular fireworks, accompanied by songs representing many
countries, but the final song was a favorite of mine, the Irish pub-song The
Wild Rover.

When I thanked
Wolfgang for such a lovely evening, I told him he needed to manufacture a new
product—his energy! I want an infusion of whatever he has to keep me going strong
at 75 to do the humanitarian work I love to do. If only!
Thanks to Octapharma for a fascinating
symposium, such amazing festivities, and for all its support for Save One Life.

Pulse on the Road in Sunny California

Speakers Michelle Rice, Kelly Lynn Gonzalez, Laurie Kelley

Warmer than the
California sunshine was the greeting the Pulse on the Road speakers received
when visiting Buena Park on May 13. Executive Director of the Hemophilia
Foundation of Southern California Michelle Kim opened the Friday night event by
welcoming the large audience, who had just finished a delicious meal, and
introducing me, Michelle Rice (vice president public policy and stakeholder
relations, NHF), Paul Clement (science editor, PEN), and Kelly Gonzalez, person
with von Willebrand disease and mother of a child with the same.

See all photos from the event here.
Volunteers Patti Huerta, Linda Clement and
Randi DeSantis
Intro by Michelle Kim

The focus this time was
on access to product choice. Michelle Rice opened the event by speaking about
the many ways payers might choose to block choice of product—and why. Skyrocketing
drug costs combined with a plethora of new biological drugs, and not just in
hemophilia, are breaking the budgets of states and insurers. To contain costs,
payers are looking for ways to streamline contracts with the various
pharmaceutical companies. Payers might attempt to restrict brands under their
formulary. This means you must read your formulary to see if your brand is
covered. They also might attempt “step therapy,” which allows you to keep your
brand, even if it is not on formulary, but only after you “fail” at the
approved brand. What does fail mean? The drop fails to stop your bleeding. This
approach seems quite risky for those with bleeding disorders.

 
My talk followed
Michelle’s and I focused on what you need to know about product choice in order
to challenge your payer to keep the drug you want. Kind of like a Hemophilia
Products 101. We started with the basics: plasma-derived versus recombinant. Safety
versus purity. First, second and third generation drugs. Prolonged half-life
products. And what’s in the pipeline… and that was at once exciting and scary!
You can see that if you are a payer, you will soon be deluged with new
products. I asked the audience to guess how many factor VIII and IX drugs there
are currently on the market. They replied, six? Ten? How about 24! And more to
come.
The evening finished up
with Kelly Gonzalez’s riveting take of how she took control of her own health care
in the face of apathetic payers who did not understand VWD or her needs or that
of her daughter. Kelly’s story is a model for anyone looking to achieve success
in securing products and services. It’s dramatic, gut-wrenching and
inspirational!
When we finished, we had
the audience choose by applause where they’d like a donation from Pulse on the
Road to go, and the Emergency Fund won. POTR gave $1,000 to the HFSC in recognition
of its advocacy and great work for families. Michelle Kim has turned heads with
her new leadership and we look forward to more great things from this vibrant
chapter!
I recalled I first visited
this chapter in 1992, where I first met Paul Clement and wife Linda, who are
now my long-term dear friends, and also colleagues. Paul, as you may know, is
an extraordinary writer and researcher for us at LA Kelley Communications. And
I saw so many others I met here long ago. It was great to see everyone.

Thanks to Michelle and
her team for hosting us; and thanks to Baxalta for supporting this event!

Pfizer Hemophilia Connect: New Resources, Better Accessibility


Part of my work providing educational resources for the last 25 years to the bleeding disorder community is to remind families from time to time of the many great offerings that help us cope with a chronic disorder. I encourage you to read the below to learn more about what Pfizer has to offer the hemophilia community.

New Resources – For over 19 years, Pfizer has been a part of the hemophilia community. Pfizer understands the challenges that come with living with a bleeding disorder, and we are committed to helping improve patient lives and the lives of their caregivers. Now, a group of Pfizer Hemophilia employees is dedicated solely to providing support to the community: the Pfizer Patient Affairs Liaison. Your Pfizer Patient Affairs Liaison is available to help patients and caregivers access the support and information they need from Pfizer. 
Better Accessibility – Pfizer Hemophilia Connect, a one-stop destination designed to provide easy access to all of Pfizer’s hemophilia tools and programs. The Pfizer Hemophilia Connect support team is dedicated to working with patients, their caregivers, and healthcare providers or pharmacies to connect them to helpful Pfizer tools and programs based on their individual needs. 

Pfizer Hemophilia Connect can be reached Monday through Friday from 8:00 AM to 8:00 PM ET.
The content of this post is provided and sponsored by Pfizer.
PP-HEM-USA-0438

Mental Health Challenges in the Bleeding Disorders Community

Mental Health Awareness Week begins May 15, so it’s a perfect time to think about mental health challenges that individuals with bleeding disorders and their families may often face.

People with chronic illness experience difficulties that can contribute to the development of depression, and people with bleeding disorders such as hemophilia are no exception. As early as childhood, people with hemophilia may have difficulty forming and maintaining friendships due to frequent surgeries and hospital stays, or because they need to avoid activities that other children are free to enjoy. They may appear “different” from their peers because of bruises, needle marks, or swollen joints, which can make them targets for teasing or bullying. As a result, they may struggle with social isolation, body image issues, and chronic pain, which can contribute to depression.

Social isolation and its role in depression can be a problem for people with a bleeding disorder into adulthood. Indeed, lack of social support has been noted as an important risk factor for depression in a study of adult men with hemophilia. In the same study, lack of employment emerged as another important risk factor. With a bleeding disorder, there are additional challenges to finding and keeping a job, such as the need for flexibility, adequate medical insurance benefits, and an employer who supports the rights of someone living with a chronic disorder.

Another mental health challenge for people with a bleeding disorder relates to the use of opioid medications to manage pain associated with joint bleeds and surgeries. Because patients often need effective pain relief, opioids have a distinct place in their treatment. Some individuals may be concerned about addiction. For this reason, it’s important to work with a health care professional with an expertise in pain management when considering opioid treatment.

During Mental Health Awareness week and beyond, patients, parents, and caregivers should be aware of these mental health challenges. Together, we can support each other—and ourselves—throughout our bleeding disorder communities.


To get support, resources, and more to overcome challenges like mental health in your life, reach out to your local community chapter. Eligible individuals can also sign up for the HeroPath™ program and receive a personal mentor/life coach who can help keep you focused on your goals and what’s ahead. Learn more at www.mynovosecure.com.

This is a sponsored message from Novo Nordisk®.
Learn more at http://www.novonordisk.com.

HeroPath™ is a trademark of Likone Corporation.
Novo Nordisk is a registered trademark of Novo Nordisk A/S.

Uganda Part 2: “Meat is Christmas”

Uganda Visit:  Sunday April 24, 2016
More like 2.5 hours!

“I feel as though the cardboard box of my own
reality has been flattened and blown open. Now I can see the edge of the
world.” ― 
Tom Hiddleston, on an African UNICEF UK mission.

Today we would visit one family in Luweero, only a
two and a half hour drive north from Kampala. This time the
van came at 9:30, giving me a chance to sleep in. The sky was
cast in pewter, heavy and foreboding. Agnes and I again stopped at a roadside store to stock up
on groceries for the family. In the back of the van we still had gift bags brought from home for
the kids. We loaded up on rice, sugar, coffee, tea, lollipops… then I discovered a toy aisle!
Balls, dolls, puzzles, building blocks, crayons and paper: all very inexpensive, and I knew they would be a big hit. 
Agnes Kiskye,
executive secretary of HFU
Herding Ankole Watusi cattle

As we drove away, I absorbed the many sights of Uganda: red, rugged
roads; little boys herding enormous Ankole Watusi cattle—startlingly beautiful animals with
saber-like horns that generally steal all the attention at farm shows; a man
riding a bicycle carrying huge 2x4s sideways; a woman balancing baskets of
vegetables. There are not many cars as we leave the city; only bicycles, as most people get
about on foot.

The rains in Africa

The sky caved in, loud bullets of raindrops assaulting the roof in an ambush. During
the rainy season, the heavens gush water as if from a hose. We
could barely see the road ahead of us–but we could feel it. The pavement once again turned to dirt as we drove
deeper into the countryside. Mud splattered and huge puddles formed in the ruts
in the road. We jostled and bumped, watching the poor pedestrians get soaked.
As we drew close to the home of our next family, the countryside became
desperately rural. Green, lush and rich with minerals,
everything grows in Uganda: bananas, tea, and coffee. Most families engage in
subsistence farming, meaning they farm for themselves and sell whatever they
have left over.

Sseempa home in the rain

At last we find the little brick home of the
Ssempa family, blocks made from the local soil. By now their dirt front yard was
a pond. Whereas yesterday I told the driver to stay away from the house so I
could snap photos without the van in front, this time I asked him to pull up as close as possible. I was
wearing tan Etienne Aigner open-toed sandals, as old as the hills, but still!
Grabbing all our bags, umbrella, briefcase, we plunged our feet into the warm, rusty-colored
water and took two steps into the home, which we quickly saw had no floor. Just
dirt. It only had two rooms in the front, maybe two in the back. And in one of
the rooms was a motorbike, the driver sitting in the adjacent room, safe from the rain. A clothesline
full of laundry hung over the motorbike, and next to the bike, three blue plastic
chairs, where we were to sit. So we all crammed into this tiny, muddy, dusty
room: Agnes, me, the motorbike, the clothes, and nine children. Justine, the
mother, shuffled in, and nodded to us quietly. The children were smiling, as we
all laughed over the rain drenching us. Without room to maneuver, we
surrendered the food, and Justine slowly smiled. The children excitedly
took their lollipops; the ice was broken. We sat down on the chairs. Agnes tried
to help me keep my briefcase from resting on the floor, but we had no choice;
and my briefcase is made for rugged travel.

Agnes explained again the Save One Life
sponsorship program, why we were here and how we could help. Now we had to do
our interviews. Nine children: Rose, Florence, Isaac, Daniel, Simon, Annette,
and three with hemophilia—Kato, Vincent and Lawrence. 
Justine is only 30 but must care for nine children,
three with hemophilia, on $1.50 a month

Justine shares her family information with us:
her husband Peter is a lumberjack but must travel far with his employer to
where they can cut trees. He is not home much. He can be gone for up to 30 days
at a time, leaving her with the nine children and hemophilic bleeds to deal
with. And with that, there wasn’t much else to say. I noted the look on her
face: distant, furtive, stressed. She looked to be about 45, and I was stunned
when Agnes said softly, no. She is only 30.

The children with hemophilia still attend school,
which is good. The school is less than a mile away, and sometimes Justine must carry the children on her back when they have
bleeds. She tells us she fears for the children with hemophilia at school. “Caning”—corporal
punishment—is popular here and causes the children to have bleeds.

While she speaks, a weak and wet kitten hobbles
in, sores on its back, and sniffs at my feet. A scrawny chicken pokes his head
in the door then scuttles off. The children wait patiently for their turn to
speak. I feel something at the back of my neck; the oldest daughter, Rose, has leaned
over to touch my blond hair. Then she touches my forearm. They want to feel my
hair and skin, which feels and looks different from their own. I smile and give
her unspoken permission by my playful response, trying to “catch” her in the
act by grabbing her hand. She smiles back.

The home is rustic: there is no running
water, no plumbing, no electricity. They use candles at night. No place to keep
food. How does she feed nine children? I ask about meat: do they get beef,
chicken? Agnes just looked at me oddly. “Meat is Christmas,” she said. “It’s
too expensive; they may have it once a year.”

Kato
Vincent
Lawrence
I learn that Kato, the youngest child with
hemophilia, had a twin brother who died at nine months from a suspected bleed. Kato is a
gem. He is responsive, curious, engaging, and always ready to smile. His two brothers are more studious
and quiet, and very shy. Interviewing them was difficult. But Kato couldn’t
wait to show us what he knew. He can write a bit in English! On the Save One Life new beneficiary form, he carefully wrote “Cow.” This was a
revelation. Together with his winning personality, there is surely hope for him
someday to rise above his origins.
Kato watches Agnes intensely
Kato can write in English!

While
Kato peers intensely into Agnes’s face as she is speaking to Justine, I glance about the home. No light can get in except through the splintered front door,
which is narrow. There are windows but they are boarded up with cloth and
cardboard. Malaria and yellow fever are rampant here, and so this must be some
attempt to protect them. The rain drums the steel roof, making it
hard to follow the conversation and translation.

 We
pinpoint the same problem we have seen with the other families: they live too
far away for immediate treatment. It takes literally hours of rough travel to
get to Kampala for treatment. They can’t afford the transportation costs: motorbike
up to a main road, then public transport. And picture yourself on a 100-250cc motorbike
on these bumpy dirt roads with a bleed, then another two hours on a public bus
crammed with people. It’s pure torture.
They love new York!

The biggest shock of all was when we asked
Justine for her monthly income. $1.50. Surely we heard wrong and we ask again.
No, $1.50. She wants a little money so she can set up a small vegetable stand
and sell whatever vegetables she has left over. Or maybe participate in a craft
to sell goods. She wants to be more independent because she can’t rely on her
husband’s income.

Laurie Kelley and Agnes with Ssempa family, Uganda

When we finish the interview, the rain waned, and the sun was shining. Within minutes, the ground was drying, the water
receding, and we stepped outside for photos. Again I take out my New York City Chapter
t-shirts, the cleanest things around here, and the three hemophilic boys put
them on proudly. We have to leave, and promise to help. Even with the children smiling,
Justine cannot muster a smile. Her eyes gaze to somewhere else and she seems
without hope. Only little Kato carries the energy and dreams of the family. I
feel he is the one who will truly benefit from our attentions, so that he can
one day care for his mother as a man. 

As we return to our world, Kato’s smile would cheer me, and Justine’s face would haunt me for days to come.

Who wouldn’t love this guy?

 Visit www.saveonelife.net for more information on sponsoring children with hemophilia, and to learn how you can help.
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