A pharma guy speaks – P. Reed Maurer, Part One

TOKYO (majirox news) – P. Reed Maurer is a veteran Japanese pharmaceutical industry watcher. He is President of International Alliances Limited and Chairman of aRigen Pharmaceuticals.

Maurer has been a prominent figure in Japan’s pharmaceutical industry for more than 35 years. He worked first with Eli Lilly and Company, then with Merck & Company. He served on the board of seven joint-venture companies in Japan since 1970, and founded International Alliances Limited in 1989 to facilitate international collaboration with Japan in the area of innovative life science technology. In addition, he served for seven years as the first representative in Japan for Pharmaceutical Research and Manufacturers of America.

A native of Pennsylvania, Maurer earned a Master of Science degree from the University of Pennsylvania and subsequently served as an associate professor of embryology and genetics at Bucknell University.

His new book titled It’s Worth Doing was published this month by The Japan Times.

Majirox News recently sat down with the still youthful-looking and energetic Maurer in Tokyo.

Q: How did the earthquake and tsunami of March 11 affect the Pharmaceutical Industry?

In terms of drugs, not much. Of course, in the beginning there was some shortage, but not now. Entire hospitals were wiped out in the tsunami so there is a great need for facilities, which they are now building.

Q: What are the biggest growth areas in Japan in the health industry?

The aging of this population is driving this industry, including assisted living quarters and nursing homes, which will increase because momma doesn’t stay with the children anymore. The nuclear family no longer exists.

Q: You mean the custom of having generations living together is more unusual these days?

Having two and three generations living in the same house is gone. Also, many houses are too small to care for someone who is chronically ill. The acute care hospitals in the 1970s were important because this was a young population and those with acute diseases got better. Today people are older and they will not get better, but yet are being treated.

For doctors in hospitals it is hard work, so more and more doctors are setting up clinics without beds. These doctors have a day practice, which means they don’t have to work all night and they can set their own hours. This means the number of clinics and extended care facility beds are going up and acute care hospital beds are coming down.

Veteran Japanese pharmaceutical industry watcher P. Reed Maurer

Q: What is the other segment that is growing in Japan?

Devices such as stents used for coronary hearts. (A stent is an artificial tube inserted into a natural passage/conduit in the body to prevent, or counteract a disease-induced localized flow constriction. The term may also refer to a tube used to temporarily hold such a natural conduit open to allow access for surgery.)

Q: You personally had an experience of having a stent put in.

Last December at Tokyo’s Jikei Hospital I had a stent put in my abdominal aorta because of an aneurysm, which Lucille Ball and Albert Einstein died of. If it bursts you’re dead and bleed out very quickly.

First, I went to Hiroo Hospital in Tokyo where they wanted to cut out my artery and replace it. It’s scary to doctors because they know if it breaks, you’re dead. The surgeon at Hiroo said a stent wouldn’t work, then reached in his desk drawer and pulled out an artificial artery.

I got a second opinion from Doctor Oki at Jikei University Hospital, who spent 12 years at Albert Einstein Hospital in New York and is recognized by his peers as being world-class. He spends four weeks in Tokyo and one week in New York operating. I said, ”Why don’t you spend four weeks in NY where you would make 10 times more money?” And Oki said, “Mr. Maurer, there’s more to life than money and I need to teach those guys in Hiroo hospital who wanted to cut you open, because they are butchers.”

Q: He actually called them “butchers”?

Yes.

Q: What else did he tell you?

He said I needed to stop smoking. He prescribed a medicine called Champix, which acts on the same receptor that nicotine does in the brain. When you take this medicine tobacco smells and tastes terrible. However, Pfizer is now being sued because some people committed suicide while taking the drug. As a result, some practitioners have gotten scared about prescribing it, so the sales are not very high.

At first I didn’t take the drug. I was still smoking and Oki knew it. The next time I saw him, he said, “Mr. Maurer, is smoking your highest priority, greater than your wife, children and grandchildren? Because if it is, the people who need my services are so numerous that if I worked 24/7 I couldn’t satisfy or treat them all, and Mr. Maurer, you are wasting my time.” That did it. I started taking the medicine and after only a week I couldn’t stand the taste or smell of tobacco.

Q: Are there many doctors in Japan who put stents in?

No, there are not many doctors that do it. There are a lot more in the States. In fact, there was a man in my room at Jikei Hospital from Shikoku, far away from Tokyo, who was told they couldn’t fix the aneurysm that was near his heart. However, when he came to Tokyo on business, he walked into Jikei Hospital and they later fixed it.

Q: How was the service that you got at Jikei? Was it comparable to the States and Europe?

I had outstanding nursing care every day and service from the doctors, drugs, IV fluids, etcetera, and the bill was 174,000 yen (about $2,000) out of pocket costs. I would have had to mortgage my house if I had it done in the States. It would have been between 150,000 and 200,000 dollars

Q: Going back to these medical devices, does Japan make them?

The Americans are bringing them in. The Americans have been behind the innovation of stents and Japan is a little behind the curve in approving the stents — Japan is trying to overcome their lag. But it’s shifting to Japan in terms of the very small catheters used to put in stents. But innovation in Japan and the regulatory process is a lot easier than approval of drugs.

Q: Stents are used a lot these days.

Coronary stenting is big. As people get older they are in danger of having heart attacks. The doctors have to go in and unclog arteries

Q: How about drugs? They seem to be over-prescribed in Japan.

The largest selling drugs are for lifestyle diseases such as diabetes, high blood pressure and high cholesterol.

Q: Same as in the States?

Exactly. First of all, you have to look at the therapeutic category like psychotropic drugs such as tranquilizers and antidepressants. The amount prescribed here is very low. However, many people in the U.S. are on tranquilizers. If you think about pain medication it is very low here as well. It’s much higher in the U.S. In Japan it’s “gambatte” (try your best) put up with the pain.

Q: Do you think that is good?

Well, they certainly are not over-prescribing those medications now.

This is Part One of our interview. In Part Two Maurer talks about drug myths, more growth areas and patient power through networking.

Part two: http://www.majiroxnews.com/2011/06/01/a-pharma-guy-speaks-p-reed-maurer-part-two/

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3 Responses to A pharma guy speaks – P. Reed Maurer, Part One

  1. TJ medical insurance user on 06/01/2011 at 7:49 pm

    Although Japan’s social security pension has had many problems and has yet to be solved, our medical care system is working.
    Also, Japanese doctors skills are world class, if you look for them. Many of those medicines cure people but at the same time kill them, too. We need more disclosure.
    It is a great article, thanks for P. Reed Maurer.

  2. mr bond on 06/02/2011 at 8:05 am

    Bravo Reed! Not only does this man get to publish a new book this month, drawing on his wisdom in the pharma field, but he has this two part double-header to tell us more about the author, a veteran in these parts since heaven knows when (approx. 1970). Given all the stew over medicare in the US, for at least a decade, here is how Japan has shown up the US in this field, showing us how it could have been done in America… by inference.

  3. Peter on 06/06/2011 at 7:22 am

    Stents have become overused in the states. They are indicated
    in many cases but research shows drug therapy in some cases works
    as well as stents.
    I personally had stents put in. My last procedure was stopped
    because the needle nicked my abdominal aoerta and I started to bleed
    to death.
    —Peter

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