Coming Together

I’ll admit it—I’m a sucker for convergence. Whenever something far out in right field can magically connect with something else over in the left-field corner, I’m intrigued. As a concept, convergence melts the separation of distance, of time (sometimes), and more than anything else, the separation in information. The right fielder might know that the next pitch to the batter, if hit to the outfield, is most likely to go to the left fielder. He waves a signal to that fielder, and when the ball shoots out in that direction and is caught, the fans applaud. (With this “battered” analogy, you can tell that I’m anxiously awaiting the start of baseball!)

Convergence is something few people object to in a business context; the mantra is always to connect—with trading partners, customers, patients, researchers. But then reality intrudes. Convergence is often had only at a price, in investing in training (those outfielders’ hand signals!), in communications technology and, perhaps most difficult of all, in changed habits of thought about how a business should be run.

Over the past couple years, we’ve had an instance of the difficulties of convergence with the e-pedigree/track-and-trace effort, which ran aground partly by technological problems (hello, RFID!), cost problems and, more than anything else (I believe), institutional obstacles. States and federal regulators attempted to bludgeon the industry into acceptance of the idea of tracking a drug from point of manufacture to point of consumption, but there were too many hurdles to overcome.

As a concept, though, rather than a regulation, convergence is very much a happening thing. This issue is particularly rich in examples: how the reimbursement for a therapy is being tied to patient outcomes; how the institution of Risk Evaluation and Mitigation Strategies (REMS) are enabled by this connectedness; how better data management stop revenue “leakage” in the supply chain. Two surprising new examples are also presented: used syringes as a means of monitoring patient compliance (p. 8), from Sharps Compliance; and a brand-authentication technology as a means of establishing a manufacturer-patient connection (p. 26), from Catalent Pharma Solutions.

Meanwhile, although the “pedigree wars” of 2008 have receded into the past, significant parts of the industry are still moving forward with drug-tracking efforts—see the EFPIA news on p. 8. It can be argued that the eventual convergence of all these efforts is advancing more slowly than they would have without a regulatory mandate—but they are progressing.