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Conference report

The future of self-care: Shaping the new environment

The AESGP 52nd Annual Meeting - the annual gathering of the self-care sector in Europe was held in
Athens, Greece, from 31 May -2 June 2016. Entitled The future of self-care: Shaping the new environment,
the conference looked at this overarching theme from three angles: marketplace, regulation and policy covering non-prescription medicines including herbal medicinal products - food supplements and self-care medical devices. With more than 350 participants, including representatives from industry, and many stakeholder
organisations, the conference was once again very well attended.

Launch of the AESGP

Self-Care Agenda 2020

Self-Care Agenda 2020

As AESGP President, Roger SCARLETT-SMITH introduced the AESGPs new Self-Care Agenda 2020
which primarily addresses unnecessary restrictions
currently placed on developing self-care in Europe.
He outlined that industry had the opportunity to
give millions of people across the European Union
safe and effective access to self-care but for this to
happen there was a need for improving the regulatory system. People want to take responsibility for
their own health and this, combined with demographic changes and the increasing cost of professional healthcare, means more must be done to develop and support self-care.
To achieve greater self-care in Europe by the year
2020, the AESGP Agenda puts forward six
enablers: establishing evidence-based policies, fostering enhanced cooperation between all stakeholders, creating more incentives for innovation in
self-care, reducing administrative burden, using
procedures for market access efficiently and implementing existing rules reasonably.

The Self-Care Agenda 2020 summarises the

objectives of AESGP for the years to come in
the area of non-prescription medicines, food
supplements and medical devices.
It focuses on areas where through a reduction of the regulatory burden, the availability of self-care products can be improved.

Roger Scarlett-Smith

In a fast-changing and global environment, it is imperative that the regulatory system be fit for purpose, efficient and risk-based whilst ensuring optimum public health protection. Any formal evaluation of a regulatory instrument should include the
different actors involved (e.g. regulators, industry,
patient organisations, healthcare professionals). It
should also include feedback loops to ensure that
the instruments continue to operate well and remain fit for purpose.
There is an availability issue with non-prescription
medicines in Europe. It is shocking that only five
ingredients were available as non-prescription medicines in all EU Member States. The routes to market (centralised, mutual recognition, decentralised

and national procedures) need to guarantee timely

market access for non-prescription medicines including reclassification from prescription to nonprescription status (switch). The benefits of nonprescription medicines need to be taken into account in the evaluation process e.g. through the use
of recognised risk-benefit decision making models.
It is now important to put the general political
orientations into real action through switch guidance, transparent criteria and open cooperation. It
is vital that applicants continue to have the ability to
choose for well-established substances which
procedure they wish to use (European or national).
Also, the implementation of the new EU pharmacovigilance legislation must reduce unnecessary administrative burdens and avoid unjustified restrictions
for non-prescription medicines.
Having the host country in mind and quoting, the
Commission at the 2007 EU Pharmaceutical Forum,
Roger Scarlett-Smith said that Price control is not
necessary for non-reimbursed medicines. For these
products, price competition can steer the price evolution sufficiently well. Therefore, Member States
should abstain from price-control. This principle
must be adhered to in all Member States. He added
that AESGP acknowledged the high value of information to consumers to assist them in selecting appropriate treatment, to communicate benefit, quality and promised experience and to establish trust
and confidence. So let's learn, get inspired, get involved and take action early to secure the benefits.

New technologies as a possible cure

for healthcare systems

Nicolas Bouzou

According to Nicolas BOUZOU, founder and director of Asters, the healthcare battle is a great way
to reconcile European citizens with scientific innovation because it can help solving human issues. The
Welfare State has been shaping the life of European
people. But the economic and technological environment has been changing quickly while the Welfare State is difficult to reform. European citizens are
getting older. Health expenses increase because of
the impact of chronic diseases like diabetes or cancer. Health expenditures are rising very quickly in
nearly all rich countries. Health is what economists
call a superior good, namely a good whose weight
in private incomes is rising.

Conference report

The more medicines that are developed, the more

the R&D costs increase and with it the price of new
treatments. This is part of our common value to
make all European people access the most adapted
treatments whatever their revenues are, hence the
necessity to regulate the price.
Bouzou insisted that health systems had to be reformed under two constraints: public expenditures
must be regulated (no more tax increase possible)
and justice as conceptualised by Plato must be
given a prominent place. In the EU, the idea of
justice is embedded in the healthcare systems aiming at allowing people to build up their own life.
With regard to new technologies, the changes we
are experiencing confirm the economists renowned
theory that Joseph Schumpeter defined as creative
destruction in 1940: progress is made by destroying the past. Instead of digitalisation, Nicolas
Bouzou prefers to use the term NBIC which stands
for Nanotechnology, Biology and medicine,

An insight into Bayers strategic

Erica MANN, Worldwide President of the Bayer
Consumer Care Division, calls the self-care industry
to look up and build the infrastructure to meet
consumers needs or risk losing them. Recalling that
this industry is deeply rooted thanks to the support
of generations of family trust, Mann asked if its
relationship with consumers was as good as it
could be, should be. We need to move our relationship from simply providing information to advocacy. Industry has to ask itself whether it supplies
the right information, and whether it has invested to
build the infrastructure that would enable consumers to access all the information needed to choose
the right product. A 2013 quantitative study showed
that only 20% of consumers feel very confident in
managing their own health. This points to a pivotal
role for health literacy to provide the knowledge,
capacities and skills to practice self-care.

Information sciences, and Cognitive Science. This

evolution is a four-step process which started with
digitalisation, i.e. converting information into a
digital format (in the 90s).
The second step is uberisation, i.e. digitalisation of
services (ongoing), followed by the Internet of
Things, i.e. the network of physical objects embedded with electronics, software, sensors, and network
connectivity that enables these objects to collect
and exchange data (starting). The last step that can
already be anticipated is transhumanism, i.e. evolution of the human race beyond its current physical
and mental limitations. Bouzou explained that the
introduction of new technologies and notably the
internet of things in the health field was accompanied by the arrival of new players who contributed
to the development of a new ecosystem. The data
developed by these players can greatly help in
patient monitoring and better prevention so as to
allow a better regulation of health expenditure.

space if it did not invest in the right infrastructure,

noting that high-profile technology companies such
as Nokia, Google and Samsung have already integrated healthcare applications that enabled consumers to see all health data from multiple sources in
one place. Consumer power fused with consumer
knowledge will create a new breed of consumers.
Mann concluded: I urge all of us to look up and
lets get a bit of this rather than being overrun by it.
Lets be the difference.

In response to that, Mann said that the self-care

industry needed to be the difference and become
the creative force or the connectors to foster this
digital entrepreneurship. Reminding that Ecommerce is growing in every retail market sectors,
she warned that industry would lose in the digital
Erica Mann

Big becoming bigger:

Mergers and Acquisitions
(M&A) in the consumer
health and pharmaceutical

potentially might decide to get bigger. Technology

players are also looking to be part of the game.
Market leadership is consistently changing and
there are faster regional players engaging in merger
and acquisition activities.

Are the big really becoming

bigger? Global OTC Market Trends
Francine NIETO, Global Offering Director, at IMS
Health, provided an insight into the performance of
the worldwide OTC market. Although the OTC markets steady growth continues and should continue
to do so in the next few years (by an expected rate
of 5%), it remains only 10% of the total global
pharma market. Specialty drugs (in oncology and
hepatitis) notably in US are driving the market. OTC
is still a very attractive 95 billion euro market for
2015. Over 60% of the market growth is generated
by China, Latin America, Turkey, Russia, and Middle
According to Nieto, there is no doubt that the
biggest are definitely getting bigger. The top 3
corporations in the global OTC rankings increased
by 15%, however the gap between the first and 10th
-placed companies continues to grow.
The 10th-placed firm had a 1.7% share in 2005, but
the leading player had only a 4.5% share, a factor of
2.6. In 2016, the 10th-placed firm has a 1.3% share
but the leading player has a 5.2% share, a factor of 4
-times more.
While the small ones are also still growing (notably
in the developing regions), middle players are getting squeezed in-between. Nieto explained the
growth in the Australian market as mainly resulting
from export to China using the good image of
Australian consumers. The top 10 players need to
look for mergers and acquisitions to grow. Among
200 companies, there are not so many global corporations. The average growth rate of global companies has only been 3.6%. Local/regional players have
grown faster at 4.3%; while multi-regional firms
have achieved an average increase of 3.8%. Overall
global OTC growth has been 6.1% in 2015, demonstrating the strength of smaller players.
Nieto concluded that players coming from outside
the OTC market were looking to join in and

Francine Nieto

Making bigger mean better

Presenting the new GSK Consumer Health created
in March 2015 from consumer health care joint
venture GlaxoSmithKline (GSK) and Novartis, Brian
McNAMARA, Head of Europe & Americas at GSK
Consumer Healthcare, believes speed and culture
are critical when tackling a merger.
Referring to a KPMG study which indicated that
83% of mergers could be regarded as failures to
enhance shareholder value, he described the most
important driver of success for a deal. First and
foremost, for GSK, the strategic rationale for deal
was clear and had four major areas of focus:

Strengthen 3 core businesses for GSK

1) GSK acquired the Novartis vaccines business
2) GSK sold some oncology assets to Novartis
3) GSK and Novartis created Consumer
Healthcare joint venture

Create a business with key category leadership

positions based on highly complementary

Conference report

Brian McNamara

Give more competitive geographic footprint by

scaling in OTC at country level going from #1
position in only 13 markets to 30. Emerging
markets now account for 40% of GSKS portfolio.
huge synergy potential including both revenue
and cost synergies (400 million of cost synergies by 2017)

McNamara stressed that the initial focus in any deal

was integration the first few steps in a long journey. Starting with setting the strategy (Where to
Play and How to Win), the team needs then to be
built up regrouping talents from both sides. The
systems integration is next for achieving one order, one invoice across markets (in over 100 markets). He was happy to say that no major disruptions had occurred yet. Last but not least, according
to McNamara, culture is critical. Quoting Peter
Drucker who said culture eats strategy for breakfast, he insisted that building right culture for new
company was a key enabler of GSK CHs success.
But integration is only the beginning; real challenge
is creating sustainable long-term value: for consumers, customers and shareholders. For consumers,
this means getting the right product, to the right
consumer at right time notably by accelerating
innovation, expanding access to self-care and build
trust in their brands. He concluded that the overarching critical factor in merger success was speed. In
doing so, GlaxoSmithKline (GSK) has achieved 6%
top-line growth and a 180 basis-point improvement in its operating margin. Noting the strong
Year 1 financial results and performance in the
market, McNamara acknowledged that there was
still a long road ahead.

Vincent Warnery

Sanofis journey in an ever more

exciting environment
According to Vincent WARNERY, Senior Vice
President, Global Consumer Health Care Division,
Sanofi, it is crucial not to give an acquired company a "cultural shock". Sanofi Consumer
Healthcare used a smart integration model when
it acquired Chattem in the US in 2010, and will do
the same later this year when it will merge with
Boehringer Ingelheims OTC business. This approach was behind the decision to maintain Chattem as a separate operating unit in its existing
Chattanooga, Tennessee headquarters. Warnery
insisted that Sanofi learnt from its failures notably
from past acquisition of the wrong targets. In that
regard, Oenobiol is a good example of failure (key
talent loss, erosion of the fast-cycle innovation
culture, agile marketing, regulatory and medical
CHC capabilities loss etc). Having now sold Oenobiol to Vemedia, Warnery appeared confident that
it would be a greater success.
(fexofenadine) in the US has been provided by
Sanofi but no staff had been lost from Chattem,
and in some respects the Chattem integration
represented a reverse takeover. He indicated
that the same approach would apply to Boehringers OTC operations in Germany.
The merger as a whole with Boehringers OTC
represents a natural cultural fit as both companies have a similar market approach.

Boehringer has a perfect portfolio, 15 brands in four of Sanofis six priority categories and the merged entity
would be in the top five in the worlds 11 leading markets, including Japan and Greece. Warnery recognised
the great achievement of Boehringer.
Warnery highlighted two key factors of Sanofis future business model for growth. First, striking strategic
partnerships with prescription brand firms to fuel OTC switches is vital, noting Sanofis deal with Eli Lilly over
the erectile dysfunction drug Cialis (tadalafil). Secondly, "swap transactions" for brands or even whole portfolios will be key to create a win-win situation and to address 2 in 1 strategic objective. In conclusion, Warnery
confirmed Sanofi is highly motivated by the OTC market.

An insight into Johnson & Johnsons

strategic thinking
Birgit SCHUHBAUER, Global Vice President, Strategic Marketing OTC at Johnson & Johnson, made
clear that in all integrations the people question is
the tough one. Each company leads its merger and
acquisitions differently but it is all about clarity and
speed. Organisational charts need to be in place
soon after an acquisition is agreed and the new
structure needs to be quickly communicated to
employees, informing them of their job status.
When people dont know what their future is, they
are blocked. Although there is a lot of understandable fear amongst staff during the merger
process, such activities create larger companies and
offer more cross-category opportunities. Mergers
do not fail because the assumptions and the strategy are wrong; they fail for culture and changemanagement reasons.

Birgit Schuhbauer

Smaller acquisitions must not be underestimated

because they can also create more value with existing assets. Referring to Johnson & Johnsons acquisition of Indian Orsl, an electrolyte drink that is
Schuhbauer demonstrated that smaller acquisitions
might allow developing the relationship with
healthcare practitioners, which was of primary importance in emerging countries. External growth is
definitely Johnson & Johnsons big strategy as
merger and acquisition are in the companys DNA
but it has to be the right fit.
Session Chair Babis PAPADIMITRIOU, a wellknown journalist in Greece, concluded that M&A
activities do not seem to have reached its end point
and wondered how the market will look like in a
decade from now.

Babis Papadimitriou

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Key elements to make progress for self-care in reality

Chair Suneet VARMA, President and General Manager at Pfizer Consumer Healthcare, introduced the
session in which speakers presented case studies in
three different countries on how to really improve
the availability of non-prescription medicines.

Manifest for the development of

self-care in France
Pascal BROSSARD, President of the French industry
association (AFIPA), presented AFIPAs recommendations to promote the development of self-care and in particular, self-medication in France and
promoted the inclusion of the health care reform in
the political debate ahead of the 2017 national
elections. France lags behind in the use of selfmedication, which represents 15.4% of the volume
of the French medicine market versus 32.3% on
average in Europe. Afipas objective is to demonstrate that the French people are ready to practice
self-medication and that the GPs are willing to
support them in this practice. A recent study conducted on both patients and doctors has shown that
nearly all French people questioned (91%) feel they
are able to deal by themselves with minor health
issues. 80% of them have practiced responsible selfmedication to treat benign symptoms over the past
year. 92% of the people questioned indicate that
their symptoms disappeared without their having to
consult a doctor. According to the GPs themselves,
16% of the patients they see in consultations could
be treated by responsible self-medication. The GPs
also state that the development of responsible selfmedication could de-saturate their offices (59%),
reduce health spendings (53%) and enable them to
re-focus on more severe health issues (63%).

Suneet Varma

proach, self-medication will become the first

step of the health care process, based on wellinformed, autonomous patients and perfectly
trained health care professionals.
Facilitate self-medication and ensure it is financially accessible in order to obtain patient support:

In France, everything is ready to increase the development of self-care rapidly: the patients, the health
care professionals, the distribution and control networks The only missing factor is a strong political
will to place self-care at the heart of a new health
care strategy. The lack of political anticipation on
these issues is difficult to understand. According to
Brossard, we must react and adopt an approach
which works everywhere else in the world. He concluded that Afipa was ready to support any political
action aiming to develop self-care.

Afipas manifest recommends an action plan to

develop self-care in France to benefit all actors of
the health care system:

Reform the financial coverage and develop the

self-medication medicine offer: The reduction of
the public financing for 201 molecules, corresponding to 66 self-medicatable indications,
would provide savings exceeding 1.5 billion
euros during the very first year.
Associate health care professionals and patients
to this new health care strategy. With this apPascal Brossard

Addressing the sustainability

challenge of Healthcare Systems
The vital role of Self-Care
An example from Germany
Dirk OSSENBERG-ENGELS, Head Region EU South,
CEE & ME at Bayer Consumer Health, said with
conviction that self-care is the right thing to do.
To accomplish self-cares full potential a joint discussion of all policy-makers and stakeholders is
needed which looks at both public health and longterm sustainability of health care systems. Self-care
can help consumers to get well and stay well
through fostering self-care literacy and enabling
consumer empowerment if appropriate access and
availability of current and future OTC medicine are
guaranteed. Self-medication is an important pillar
of the German healthcare system.
Focusing on the importance of headache, he mentioned the 2010 consumption data of OTCanalgesics per capita that showed a rather minor
consumption of OTC-analgesics in Germany compared to other countries such as France. Bayer
Consumer Health Division has undertaken a study
on how much self-care treatment of migraines with
OTC analgesics had saved the German healthcare
system annually. The study based on a representative, independent survey of persons insured by a
Statutory Health Insurance investigated the value of
self-medication and found that switch to self-care
for this one indication saved 1 billion a year."
Ossenberg-Engels concluded: That is one indication in one country; think about the saving if it was

Dirk Ossenberg-Engels

Key Elements to Make Progress for

Self-Care in Reality
According to Karen PROUD, President of Consumer Health Products Canada, building the evidence base is key to prevent a slow-down in reforms to consumer healthcare rules in Canada. In
June 2014, Health Canada announced a consultation on a Framework for Consumer Health Products,
which proposed to modernise the oversight of
health products, intended for consumer use. Using
concrete examples of borderline products, Proud
explained that consumer health products covered a
broad range of products including cosmetics (e.g.
make-up, deodorants), disinfectants (e.g. for use on
nonprescription drugs (e.g. pain relievers, cold and allergy remedies) and natural health products (e.g.
vitamin and mineral supplements, traditional and
homeopathic products, toothpastes). The 2015 Canadian election gave a strong majority to the liberals who swept into power and changed the game
players. While the reform of consumer healthcare
rules remains a priority of the new government, this
government contains numerous rookie politicians
who have no knowledge of the consumer
healthcare space. In response to that, Proud promoted three key elements: raising awareness, educating the willing and driving for change. The Association is developing a study, similar to Bayers study in Germany, outlining the benefits to consumers
and the Canadian healthcare system of supporting
prescription to over-the-counter switch initiatives.

Karen Proud

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CHP Canada is working with pharmacy regulators to ensure that self-care remains the first response to
health care and has launched communication campaigns to the public. CHP Canada has been spreading
the word self-care and is working with Canadian politicians to increase awareness among Canadian officials of the value of formally recognising self-care as a primary component of the healthcare system and
providing the resources necessary to support the efforts of its citizens to practice responsible self-care.
Concluding on the session, Chair Suneet VARMA reminded that the true value of self-care needs to be
shown to policymakers, health insurances, consumers and the like, and while we say this every year, the
time is now to demonstrate the benefits.

Getting full support for self-care from stakeholders

In his introduction, the session Chair George DOKIOS, Director General, EFEX, stressed that stakeholders
in many parts of Europe needed to recognise the benefits of self-care. While stakeholders in markets like
the UK have already embraced the self-care concept, others in countries like Greece have only just started
to grasp the benefits. Self-care needs a coordinated support by all stakeholders. Noting that new laws in
Greece are bringing radical changes to the Greek pharmaceutical market, he said that any process of
change following major economic difficulties had implications on healthcare in general as well as on
healthcare professionals, including in particular community pharmacists.

Portugal Self-Care Program Take

care of myself
According to Mafalda ARAJO, Vice President of
APIFARMA / OTC, Portugal, developing Portugals
self-care publicity campaign has brought all of the
stakeholders together for the first time. She explained that the key objectives for this campaign
had emerged from stakeholders consultation
aiming at: empowering the Portuguese population to manage minor health problems, promoting healthy behaviours and the responsible use
of OTC medicines, actively contributing to health
literacy in Portugal and ensuring the involvement
of health professionals and educators in a national program. Choosing an accessible language for
the consumers, the association went for the brand
Tratar de mim meaning I take care of myself.

distributed to pharmacies & health centers. Facebook was a key tool in this campaign as it allows
for speed and flexibility by contrast with leaflets
and factsheets. Since its launch, the programme
has been extended with a childrens game called
Learning about health is fun and a self-care
conference is also planned for the autumn 2016.

Arajo highlighted that the whole process started

in Lisbon 2013 at the AESGP conference which
raised awareness and interest from stakeholders.
Although bringing together doctors and pharmacists in partnership around self-care was a challenge, the program was officially launched in July
2015 with a poster and two leaflets published and
Mafalda Arajo

Efficient OTC Self-Care in German

Michael BECKER, Deputy Chairman of the German Medicines Manufacturers Association (BAH)
put forward that combination of OTC and strong
pharmacies were key factors for an efficient public
healthcare-system. Having presented the product
classification and distribution channels in Germany, Becker indicated that 4 million German consumers went in pharmacies every day, 70% of them
going to their local pharmacy. There are more
pharmacies in Germany than bakeries and gas
station, i.e. more than 20,000 pharmacies. Looking
at the number of pharmacy per inhabitants, Germany has 4.000 inhabitants per pharmacy which,
compared to Greece, does not appear so high
(1.000 inhabitants per pharmacy in Greece). Noting that 95% of internet enquiries refer to diseases and symptoms, Becker insisted on the
need to have fast, reliable and local expertise at
In many cases, the pharmacist appears as the first
point of contact to provide trust and advice.
Sale of OTC in pharmacies enables more efficient
patient care and will lead to change in behaviour
and awareness of all involved stakeholders in the
healthcare environment. Becker concluded that
OTC and pharmacies were strongly interconnected: Strong OTC products & brands strengthen pharmacies and vice versa. Strong pharmacies enable higher self-care and, as such contribute to efficient public healthcare-system.

Michael Becker

The pharmacists perspective:

The biggest and the most complex
merger in self-care
Jan SMITS, President of the European independent pharmacists association, PGEU, emphasised
that getting stakeholders including healthcare
professionals, regulators and consumers in
every country to come on board was like performing the biggest and most complex merger
imaginable. Stakeholders are fragmented and we
must not underestimate the differences in cultures across the European Union (EU), and It is
difficult to get everyone in line. Recalling that 46
million European citizens visit pharmacies every
day, he said that it was 46 million unique opportunities to improve their health and well-being.
Pharmacists are trusted medication expert enjoying a key touch point throughout continuum
of care. They also are the last health care professional seen by patient before medications are
taken. Noting that pharmaceutical care is much
cheaper than secondary/tertiary care (hospital
costs) and primary care (GP/medical-professional
related costs), Smits underlined the critical role of
community pharmacists to provide hygiene advice (general and personal), nutrition advice and
counselling (type and quality of food eaten, etc.),
lifestyle advice and counselling (sporting activities, leisure, etc.), self-medication support in treating minor ailments, and support for patients with
chronic conditions to care of themselves.

Jan Smits

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priate non-prescription medicine for their patients. Last, she informed the audience about the
EPSA Training Project aiming at raising awareness
among students through webinars and fostering
the development of their soft-skills.
Following the same approach and promoting a
better interprofessional collaboration and education (with dentistry, psychology and medicine
students), Swiderek informed the audience that
EPSA collaborated with the other European health
care students associations.

OTC medicinal products, public

health and pharmacies
Katarzyna Swiderek

Bringing pharmacy knowledge

and students together
Katarzyna SWIDEREK, President of the European
Pharmaceutical Students Association (EPSA)
presented the approach of pharmacy students
towards self-care. A study conducted in 32 countries showed that Pharmaceutical care, defined
as the pharmacists contribution to the care of
individuals in order to optimise medicines use and
improve health outcomes, is covered by the
university degree in all countries either as a separated subject or in the overall program.
Looking at the example of Austria, practiceoriented seminars are organised for students
involving analysis of patient cases. In Belgium,
series of classes are devoted to self-care with
practical exercises in virtual pharmacy (with volunteers playing the role of patients), recorded sessions (feedback can be provided in small groups
of students). In the UK, OTCs are tackled in dispending classes in every year study including role
plays with lecturers as patients. It allows to test
knowledge of interaction between OTC products
and prescription medicines.

Dagres GIANNIS, Pharmacist, Vice-President of

Panhellenic & Attica Pharmaceutical Association
(PFS & FSA NPDD) highlighted that a proper
access to OTC Medicine required an independent
pharmacist, at least, to interfere first. So far, 100%
of OTCs are dispensed exclusively in Community
Pharmacies. While misuse of OTC medicines can
be of safety concern, Greece guarantees so far a
high level of safety by restricting the use of most
medicines to pharmacies. Average Hellenic Pharmacies retail profit margin is below European
average. Advocating for the sale of OTC medicines in pharmacies, Giannis listed the main advantages of these products among which accessibility in purchase, safety in use, efficiency in use
(giving an advantage compared to other easy-toaccess everyday health treatments), beneficial and
trustworthy cooperation (Higher Profit Margins
and Lower Risks in Deals) and prestige.

Overall, Swiderek concluded that there was a

positive change in pharmaceutical studies offering
opportunities to future pharmacists to play a
more complementary role in primary healthcare
and a more active advisory role to the patient in
the pharmacy, notably in selecting the approGiannis Dagres

Legislation, passed in May 2016, is expected to allow the sale of 216 out of 1582 non-prescription medicines outside Community Pharmacies. The average price of an OTC product being the lowest in Europe,
there is room for higher prices, still keeping in mind the sensitive economic and social situation of the
country. Although in theory competition in pricing should benefit the consumers, it may also give the
opposite results, leading to more expensive products and bigger risks for public health. He concluded by
warning the industry that if the situation gets worse, state-fixed prices and sales restrictions could easily
be re-established.

Digital strategies to
provide support to the
European citizens
Session chair Sophia FILAKTOU, Business & Industry Solutions at SAP, expressed her pleasure to
chair this session in her home country and introduced the speakers who would give insights into
the changes of consumer behaviour e.g. through
social media. What are the concrete implications
for the manufacturers of self-care products? How
to best develop a digital strategy which corresponds to market expectations?

An insight into RBs digital

strategic thinking
Laurent FARACCI, Senior Vice President, Global
Marketing and Digital Excellence, RB, underlined
that the digital transformation of the firm's marketing involved no longer just talking to consumers but engaging with them; the questions
being where, how and when to engage.

Laurent Faracci

Sophia Filaktou

This has led the company growth by 14% last

year. With the character of Mr Mucus who personifies since 2002 RBs Mucinex decongestant the
number one OTC brand in the US Faracci demonstrated how RB had gone from speaking to
people to engaging with people in 2016. The character was digitally transformed over the years
from a simple picture of broadcasting, conversations and pharmacy into a complex model that
leveraged what digital brings to you. Mr. Mucus
personalises the sickness and can engage with the
consumers. Mucinex 2.0 moved from advertising
to a cultural formula. While not digital at first it
set progressively the scene to start being digital.
Progressively Mr Mucus has been active on Facebook and Twitter, as well as interactive out-ofhome, to get as close to sick as possible using
detailed data, on illness prevalence and distribution for example. According to Faracci, digital media allow to bring brand purpose to life. Consumers must remain be at the heart of everything
and communications should be channel deliberate. Last, Faracci advised the audience to
embrace creativity as a multiplier.

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@susitravel used as a platform for weekly conversation between pharmacists aiming at improving
advice to patients and increasing product sales.
Torrens concluded that pharmacist could offer
health and independent trustable advice online
and created a community around their brand.
Social media can be used to boost the community vitality.

How to best develop a digital

strategy, which correspond
to market expectations?

Inma Riu Torrens

Digital strategies from Spanish

pharmacists to provide support
to the citizens
Inma RIU TORRENS, Pharmacist and Director of
Saludability, showed how individual pharmacists
in Spain were educating consumers online and
the key factors of their success. She presented
five examples of ways individual Spanish pharmacists had gone online to reach Spanish-speaking
consumers and develop huge communities of
followers. She noted that 80% of Spanish internet
users searched for online health information but
that the overall levels of general health literacy
was much lower. In response to most frequently
asked question relating to urine infections or the
difference between paracetamol and ibuprofen
and to fight against Dr Google, the blog has won awards for
best blog. Its founder has since become a published author, magazine contributor and television
personality. Focusing first on questions asked by
consumers mainly around babies needs and
website delivering video messages to
consumers following purchase in the pharmacy
on how to use medication was another example
presented by Torrens. By contrast, the site uses infographics to
make the difference and answer typical posology
related questions such as: How much ibuprofen
shall I give to my children? The last example of
pharmacists community was the Twitter account

Laurent CORAZZA, founder of DIGILITYX, explained that speed is key for a successful digital
business strategy. The development of the ehealth market shows that health care is becoming
digital. Instead of talking about a digital strategy,
Corazza preferred to talk about a digital roadmap
to achieve a sustainable and competitive advantage with digital capabilities. Sharing his own
experience, he listed four main factors that the
health industry should take into account to develop a digital strategy:

digital health path: understand how patients

and all the healthcare actors will interact
tomorrow in a digital word

Explore data: data being tomorrows petroleum, collecting and processing data is essential to understand the needs of the actors
and to integrate the new technological capabilities
Think deep digital: Make sure that your internal processes are aligned with your digital
objectives (full dematerialisation).

Collaborate: both internally (to make working

together R&D and marketing) and externally
(with start-ups, software companies, digital

In other words, Corazza advised the audience to

switch from molecule to service (from products
to services), to use digital services to enforce
molecule power and justify a better price. Switching from cure to care allows to focus on
disease prevention through patient monitoring,
and from sell to rent to engage in a long term
relationship rather than a one shot sale.


According to Corazza, this approach allows to

commit on results, and accept to be paid only if the
patient is cured while making profits with the monitoring services. To succeed, the strategy must be
consumer centric (what will be your role in the
healthcare value chain?), open-minded (explore
your eco-system to create innovative services) and
digital ready (encourage initiative and collaboration between business and IT teams, make sure to
learn something from your external providers)
taking into account the digital maturity of the
company. Reminding the audience that speed is
key, Corazza concluded that a good strategy required adaptation in real time of the roadmap, to
competitor, to new technologies and to new uses.
Echoing Corazza, Faracci said that the industry
must be humble and must be aware of its weaknesses and strengths to better adapt to the environment in order to put itself in the driving seat as
new digital platforms emerge. We have strengths
as an industry in product development and regulatory affairs, but companies like Google are building

platforms and investing at a level that is orders of

magnitude greater than we can. As an industry,
we must steer developments and be seen as a
force for good as digital channels develop in future.

Laurent Corazza

Branding self-care
Roger SCARLETT-SMITH, AESGP President, introduced the session recalling brands are the major asset of
the self-care industry; 80% of consumers choose their OTC products based on their brand name in Europe.
He reiterated industry support for umbrella branding, noting that it was clear that consumers were used to
interpreting and reading the label" and using brands as navigation. In line with its self-care Agenda 2020,
AESGP will continue to work with regulators to support umbrella branding, Introducing the speakers, Scarlett-Smith asked them how brand communication can evolve in the age of new technologies.

As brands are a major asset of the

self-care industry what needs to
be done to strengthen their role?

Briain de Buitleir

Briain DE BUITLEIR, CEO of PGT Healthcare, presented the joint-venture combining the two companies Procter&Gamble and Teva to allow a better
growth by synergy of the two parent companies
and of the culture dedicated to brands. To be successful, brands must put consumer at the centre.
To create a brand, there must be a belief that have
an important social purpose (referring to ratiopharm and Swisse), a distinctive proposition, a
product that delivers (repeat rate number on the
market like Swisse) and capabilities to make it real
(investments and commitments).

Conference report

PGTs vitamins and supplements brand Swisse was

built around the belief that you celebrate life every day and this had driven everything the company had done with the brand, he pointed out, and
despite a premium price, it had been incredibly
Then for building a brand, trial and awareness are
needed and must be repeated; the brand must be
mentally and physically available to the consumers.
Showing a chart of the Vicks brand development
since 1918, de Buitleir highlighted that the fastest
growing product in PGT portfolio was the unchanged original products. Alluding to fashion
brands like Louis Vuitton or Hermes which do not
use broadcasting or social media but still continues
expanding, he provocatively concluded that there
was no need for more consolidation or new brand
to grow. While the regulatory environment could
make things easier it does not prevent the industry
to build great brands. De Buitleir concluded that
the obligation of this industry was to serve the
consumer to the very best of its availability but to
play that role, the brand had to have a belief.

An insight into Bionoricas

branding strategy
Michael POPP, Owner of Bionorica, put forward
the different approach of his company created in
1933. The company does not invest in advertising
so much but this year 17% of the total turnover
was invested in research to create phytopharmaceutical products that were backed by clinical
research that had been peer-reviewed. As a result
the company is the worlds leader in the evidencebased proof of efficacy of herbal medicines. In order to guarantee the quality, safety and efficacy of
its extracts, Bionorica has its own cultivation, percolation-methods, patented extract concentration
and patented extract drying process. The company
established the concept of phytosimilar which is
more than biosimilar because the raw material and
the process define the phytopharmaceutical and
therefore are not suitable for generics. Presenting
the example of Sinupret extract, Popp highlighted
the challenges in marketing herbal medicines in
the EU resulting from the divergence in national
procedures and approaches for these products.
Nonetheless academic, alternative, top quality and

evidence based medicines bring results; Bionoricas

products are the top products on the German, Russian and Ukrainian phytomarket. In these countries,
the market is driven by physician prescriptions,
then pharmacists and, when the products are well
known, the products enter the self-medication
market. Doctors are Bionoricas authentic brand
ambassador since they use the products for
themselves and recommend them in their private
environment. Same situations with pharmacists,
99% of the German pharmacists use Sinupret and
that is how Bionorica builds trust. Physicians and
healthcare practitioners are more able to explain to
patients the differences between plant-based medicines and other natural products according to
Popp. In order to enable pharmacists to properly
counsel consumers and patients on herbal medicines, Bionorica developed Phytotek, a competence
center for phytomedicines. In conclusion, Popp
called EU regulators and national authorities to
implement the Traditional Herbal Medicines legislation in a consistent manner, to grant 10 year
protection for preclinical/clinical data and to introduce the term phytosimilar. With regard to food
supplements, Popp asked the EU regulators why
approved Herbal Medicinal Products are still undermined by botanical food supplements with
unauthorised health claims on the market although
the European Food Safety Authority has rejected
most of the submitted health claims for botanicals.

Michael Popp


Strengthening the Role of Brands

Some Lessons from Cosmetics
John CHAVE, Director General of Cosmetics Europe, started his presentation by presenting key
features of the cosmetic market which is strongly
driven by EU regulation (since 1976). Highlighting that the absence of risk assessment agency
was problematic as well as the ban on animal
testing, he indicated that the rates of innovation/
reformulation were very high (on average 25% of
product portfolio annually). Regarding claims
and advertising in the cosmetics sector, Chave
explained that they are underpinned by Commission Guidance and a soon to come Commission
report on the effectiveness of the system was
awaited. The industry strongly rejects positive
list approaches to claims and favours the current
system which gives reasonable flexibility. Turning
to branding, Chave indicated that there was very
high brand equity, in general. Diverse brand strategies, with some companies focused on distinct
brand development/acquisition (e.g. LOreal)
others with single or limited brand approach
(Chanel). Luxury market sees brand extension
into fashion and other sectors. Both brand extension and maintenance of brand value are supported by flexibility given by in market control,
and absence of strongly restrictive claims environment (i.e. claims supported innovation is key).
While the cosmetic industry as a whole is concerned by difficult innovation environment in the

EU, brand strength is bolstered by relatively high

emotional engagement with cosmetics and personal care brands, particularly in some categories
(although there is some evidence that this is declining in importance). Overall, the cosmetic sector is traditionally very strong in point of sale/
retail environment/consumer experience factors.
Chave concluded that the cosmetic industry fully
embraced the digital revolution and was even
promoted in some cases - by industry, in
others by social media phenomena such as
cosmetics blogging.

John Chave

What is needed for

innovation in self-care

Hubertus Cranz


Chair Hubertus CRANZ, Director General at

AESGP, introduced the session by highlighting
the strong influence of the legislative and regulatory framework on the future of self-care in
the areas of self-care medical devices, food
supplements and non-prescription medicines.
Before turning to the panellists, Cranz informed
the audience on the status of AESGP data bases
on non-prescription medicines and substancebased medical devices recently updated as well
as the one on food supplements, the update of
which is to be completed by the end of June

Conference report

Regarding the OTC ingredients directory, the

2016 version comparing the classification status
(prescription or non-prescription) of a number of
active pharmaceutical ingredients in 39 countries
is now available and a printed copy has been distributed to the conference participants. Besides
the publication of the AESGP self-care Agenda
2020, Cranz reminded the audience of the two
topic specific AESGP conferences which took
place in the past year on substance based medical devices (in October 2015) and on the proportionality of medicines regulation (in February

Status update on the Medical

Devices Regulation
Lars RITTER, Adviser to Gesine Meiner, rapporteur on the proposed legislation for the Liberal
Group in the European Parliament, shared some
fresh news on the status of the negotiations and
said final agreement had been reached on the
long-awaited legislation on 25 May at the 10th
Trialogue between the Parliament, Council and
Commission. This came almost four years after
the publication of the proposed regulations by
the European Commission in September 2012.
Noting the AESGP priorities on the negotiated
text, Ritter indicated that the classification rule 21
now foresees a classification in the highest category of substance-based medical devices, or
their products of metabolism, which are systemically absorbed by the human body in order to
achieve the intended purpose, or which are systemically absorbed by the human body and
achieved their intended purpose in the stomach
or lower gastrointestinal tract. Ritter commented
that a risk-based approach had been applied to
ensure that medical devices would only be in
Class III if they achieved their intended purpose in
the stomach or lower intestinal tract. And if they
were applied in the nasal or oral cavity, and
achieved their intended purpose in those cavities,
they would be in the lower-risk Class IIa. Similarly,
nanomaterials would only be placed in Class III if
there was a high or medium risk of exposure. If
the potential risk was negligible, they would be
put in Class IIa. Assuming the legislation was
enacted in January 2017, it would come into force
three years later in January 2020. In what-isexpected-to-be-the-final text, it is proposed that
certificates issued, after the entry into force of the

AESGP Ingredients Directory

The AESGP OTC Ingredients Directory compares the classification status (prescription or
non-prescription) of key active pharmaceutical ingredients used in self-care in 39 countries (25 European and 14 non-European).
It is based on information provided by WSMI
and AESGP member associations and is
widely recognised as the most comprehensive analysis in this context.

Lars Ritter

regulation, will remain valid until the end of the

period indicated on the certificate, which shall not
exceed five years from its delivery. While no more
negotiation is foreseen, Ritter noted that the next
steps were votes in the Parliaments Environment
Committee on 15 June and Council on 17 June. A
plenary vote in Parliament will follow in December.


Jurate SVARCAITE, Secretary General of the Pharmaceutical Group of the European Union (PGEU)
congratulated Ritter for the important legislative
work done on the very challenging and broad category of products covered by the definition of medical devices.
Noting that medical devices had been one of the
most innovative sectors in self-care, she pointed out
that pharmacists were still building trust in these
products as they were still more comfortable with
the regulatory framework applicable to medicinal
products. As healthcare professionals, Svarcaite said
that pharmacists were highly interested in the medical devices requirements regarding pharmacovigilance or any regulated activities allowing detection,
assessment, understanding and prevention of medical devices related issues.

Food Supplements - regulatory

developments on botanicals in
the EU
Alexandra NIKOLAKOPOULOU, Head of Unit at
the European Commissions Directorate General
Health and food safety, explained the regulatory
framework applicable to food supplements and the
state of play of the ongoing so-called REFIT exercise in relation to the Nutrition and Health Claim
This evaluation will besides nutrient profiles examine whether the current rules concerning
health claims on plants and their preparations used

Alexandra Nikolakopoulou

Jurate Svarcaite

in foods are adequate, and how the use of such

claims interacts with the current applicable food
regulatory framework on plants and their preparations. She reminded the audience that more than
500 claims on plants and their preparations received an unfavourable assessment from EFSA in the
context of their scientific assessments, and this
raised concerns. To date, the remaining over 1500
submissions concerning such health claims have
not yet undergone the scientific evaluation by
The Regulation provides for the substantiation of
health claims made on plants and their preparations used in foods by demonstrating the causal
link between consumption of such foods and the
claimed beneficial effect. This precludes any safety
considerations by EFSA on the use of the substance
in foods when assessing the claim. She explained
that this had given rise to increased concerns
amongst the Member States on the authorisation
of health claims on certain substances when no
regard is given to the safety aspects of their use in
foods. In addition, an Overview Report which was
finalised in 2015 based on a series of fact finding
missions carried out by the Food and Veterinary
Office (FVO) in Member States in 2013 and 2014 in
order to gather information regarding the controls
on food supplements highlighted the problems
that Member States face due to differing national
rules for the use of plants and their preparations in

Conference report

Nikolakopoulou warned that the REFIT process

would be lengthy because of the Commissions
new commitment to employ wide consultation,
following its adoption of its Better Regulation
Communication of 19 May 2015. An action plan
would not be presented before the first quarter of
2018, she said, after the final report had been
completed in the fourth quarter of 2017. The results of this evaluation will be used to decide on
the next steps regarding this policy area. Nikolakopoulou indicated that an external contractor
would be performing a study during 2016-2017 to
feed into the final report and that there would be
a 12-week open public consultation as well as an
eight-week stakeholders consultation targeted at
small-and medium-sized enterprises (SMEs) by the
end of 2016.
Svarcaite raised concerns about certain food
supplements which can be of different quality levels and can make claims that are not even possible medicinal products. Pharmacists are worried
that the food supplements market will destroy the
herbal medicines market.
Echoing her comment in relation to the medical
devices legislation, she underlined the absence of
any vigilance system allowing detection and prevention of food safety related issues. Pharmacists
are highly sensitive to the safety of food supplements and the absence of vigilance system to monitor safety issues does not help to build trust in
these products. In addition, she noted that the
level of information required on food being less
exhaustive than on medicines does not allow a
proper information of the consumers with regard
to possible interactions with medicines.

ken to confer Rx status. It is a simple principle but

it is very important to remember it. Being at an
important time juncture, she added that it is important to reflect on fundamental questions:
where we come from first, who is setting the pace
and how can we influence the future of self-care.
The Tajani report on corporate responsibilities in
promoting good governance on non-prescription
medicines was the output of a successful stakeholders initiative at EU level and marked a significant landmark. Amongst others, it acknowledged
that availability was an issue with only 5 actives
being available in all Member States.
Five years later, one could have expected that new
switches would have deluged Europe, but realistically its rather a slow trickle Importance of
stakeholder engagement in reclassification process was identified by the EU Working Group on
Promoting Good Governance of Non-prescription
Medicines as a key factor to successful switch:
stakeholder platforms should be established nationally to share views & develop strategies for
common approach to supporting patient access to
non-prescription medicines and stakeholders
should be involved early in reclassification process
so concerns addressed and training prepared. At
national level, the UK government has always
been committed to increase access to medicines
as soon as it is safe to do so.

Innovation in self-care in
Europe - Update from a Medicines
Regulatory Agency
June RAINE, Chair of the European Medicines
Agency (EMA)s Pharmacovigilance Risk Assessment Committee (PRAC) and Director of Vigilance and Risk Management of Medicines at the
Medicines Healthcare products Regulatory Agency
(MHRA) of the United Kingdom, started her presentation by referring to the definition by default
of the non-prescription legal status; the natural
legal status is pharmacy unless active decision ta-

June Raine


Recently a UK stakeholders platform on reclassification to non-prescription medicines was launched

and the interim report was published in February
2016. Part of this initiative a dedicated webpage
and an assessor guide on evaluation of a switch
application will be launched. In 2015, esomeprazole was the first proton pump inhibitor on the
General Sales List (GSL). Heart burn can be an impedance on everyday life and easier access makes
a real difference.
Who should be setting the pace? She mentioned
the PRAC which current focus is on simplifying the
pharmacovigilance legislation and the EU strategy
2020 arising from the alignment of the Heads of
Medicines Agencies (HMA) and the EMA around 4
main pillars. Availability of medicines is one of
them, including availability of well-established medicines and non-prescription medicines. The
CMDh has a very consistent strategy with the EU
strategy 2020 and its Multi Annual Work Programme: easier access to non-Rx, explore decentralised (DCP) and mutual recognition procedures
for OTCs and particularly in procedures where
legal status is different between Member States.
The first step is to update the Best Practice Guide
on DCPs for non-prescription medicines.
Key to success of the self-care sector are innovation, simplification, flexibility and stakeholder collaboration. In 2014, ulipristal an emergency contraceptive was switched centrally. She gave tribute to
companies that put a lot of efforts and resources
into switches which set the success (although

maybe not always the case from a commercial

point of view). Maintaining success involves
keeping the product information up to date and
constantly improving the benefit- risk of a product.
Success needs to be monitored too and for
example the easy access to emergency contraception has played a role in the decrease in the number of pregnancies in teenage girls. It is also crucial
to seek opportunities to simplify and it is what the
MHRA is doing when looking at its switch process
with fresh eyes. Flexibility in interpretation is also
important; the recent switch of sildenafil in Poland
is substantially different from the product with the
same substance authorised through the centralised procedure. Lastly, collaboration between
committees, external cooperation with pharmacists, doctors and patients is key. Hearing the voice
of patients and what risks they are ready to accept,
what risk management plans mean for stakeholders is one of the direct goal of the EMA public
Thanking Raine for her speech, the Chair
highlighted the importance of stakeholders
cooperation to promote innovation in self-care.
Scarvaite said that, within the Committee for Medicinal Products for Human Use (CHMP) at the
EMA, there was some mistrust and criticism towards pharmacists that prevented a pragmatic
approach towards the classification of medicinal
products. She called for a better integration and
consideration of the healthcare professionals representative notably pharmacists within these regulatory platforms.

Challenges for tomorrow

Self-Care in Greece
The session Chair George DOKIOS, Director General of the Greek industry association, EFEX,
described in detail the difficulties that the Greek
healthcare system had been facing in the past
years due to the economic crisis. Showing figures about the unpreceded decrease of the
total pharmaceutical market (by 60% between
2009 and 2015), he highlighted that this trend
was in contrast with the development of the OTC
market for the same period (increase by 31%
between 2010 and 2015).
George Dokios

Conference report

According to Dokios, the good situation of the

OTC market is multifactorial but results from two
key milestones: the 2010 decision to dereimburse OTC Medicines and the 2014 decision
to lift price barriers (applicable as of January
2017). EFEX works in further promoting the OTC
market as part of health-care notably because of
its economic benefits for the healthcare expenditure: savings up to 160mm in pharmaceutical
expenditure, productive allocation of doctors
time, less patient visits at health centers and less
working hours lost due to doctors visits. To support the development of self-care, Dokios called
for a simplified and more predictable OTC registration process coupled with better self-care information for consumers and educational program for pharmacists. The industry will commit in
developing healthy competitiveness. Dokios concluded that if all Social Partners engaged actively
in promoting the effectiveness of self-care and
the role of the pharmacist was upgraded to that
of the Primary Care Consultant, self-care would
be fully established in Greece.

Challenges for tomorrow: the

Greek economy and the health
care sector
Nikos VETTAS, Professor of Economics and Managing Director of the Foundation for Economic
and Industrial Research (IOBE) presented the overall economic situation in Greece. Since 2010,
Greece is in an adjustment program meaning it

cannot control its monetary and fiscal policy.

How can you change the country and increase
the competitiveness with no means outside humans will? Noting that the Eurozone crisis
stopped the growth for all Europeans and pushed
all investors out of Greece, he listed the two types
of measures comprised in an adjustment program: structural reforms requiring to become
better and austerity. In accordance with this program, between 2009 and 2014, Greece traded its
public deficit for a huge recession and made the
economic much smaller. According to Vettas, the
economy could be growing again after the summer 2016. However, due to a lack of competitiveness and competition in the economy, it cannot go back on its feet unless it doubles the investment rate. Public finances have been fixed
but since the economy has been shrinking a lot
of new troubles are emerging such as pensions
which become a larger percentage of the GDP
and requires an additional cut in the expenses.
Turning to healthcare, he indicated that it was the
spending category that had been shrinking the
most in GDP. Noting a negative trend in everything, Vettas highlighted that the public health
expenditure growth showed an unpreceded
shrink. As a result, during the economic crisis period there was a shift of household expenditure
towards pharmaceuticals and hospital care.
Looking at the OTC market, Vettas noted that
OTC share in Greece was among the lowest compared with the rest of Europe. However, the respective market shares depend crucially on the
range of non-prescription medicines included in
each country. Among the various OTC categories,
vitamins and minerals had the greatest share of
the market, followed by analgesics and cold remedies.
According to Vettas the Greek economy is a laboratory that could happen elsewhere since Eurozone economies are gradually evolving in scenarios where public spendings have to be disciplined. Warning about the growing pressure on public finances, he urged the audience to redefine
how we guarantee the economic and social welfare of citizens (social security, education,
healthcare etc). To succeed, Vettas strongly believes that we need to boost innovation.

Nikos Vettas

The death of self-care

Laurent ALEXANDRE, President of NBIC Finance and a familiar of TED shows, closed the conference by a
provocative and thought-provoking talk: the self-care sector will die!
The traditional self-care and healthcare in general
are at the heart of an important mutation. The new
technologies in the hands of the GAFA (Google,
Apple, Facebook, Amazone), neuro-cognitive
sciences, nanotechnologies, IT and biotechnology
will radically transform the future of healthcare and
self-care. He warned participants that the e-health
will become a reality in no time: genes will become
editable within 10 to 20 years and the genome will
be sequenced by 2030 with as consequence possibility to enhance humans, solve many diseases,
stop or radically delay the aging processes. Lead
thinkers in the GAFA predict that artificial intelligence will become more powerful than human
intelligence, and that human brains will be connected to robots which have the size of nano
It will be a complex and at least for some frightening world and new issues such as data privacy,
technophobia, and regulatory issues will rise. He
urged the assistance not to ignore the mutation
but rather to get prepared for it.

Laurent Alexandre

Invitation to Vienna 2017

At the end of the conference Gerhard LTSCH and Alfred GRN, from the Austrian Self-Care
Association (IGEPHA) invited all participants as well as all those interested in the latest developments on
self-care around the world to the 53rd AESGP Annual Meeting, which will take place in Vienna from
30 May 1 June 2017.

53rd AESGP
Annual Meeting

30 May - 1 June 2017

Alfred Grn & Gerhard Ltsch