Interview with Dutch founder of Meamedica, drug rating site #health20fr

 

The recent Dutch-origin consumer drug rating website http://www.mijnmedicijn.nl appears in Germany and France as Meamedika.de and Meamedica.fr It was created by a Dutch pharmacist Wendela Wessels.  Publishing a new rating site in healthcare in France, for example, is not easy to succeed. Private rating sites  are not forbidden by French law, but so far, there are no comparative healthcare professional sites, other than for hospitals and of course Yelp, Google directories. No French company is devoted specifically to rating drugs. It is interesting to note that as a result, novelty comes from an entrepreneur in another country, in this case, the Netherlands.  Having heard various rumors in France about Meamedica, its "secret" investor and various problems, I interviewed  Wendela Wessels and found a more or less typical start-up founder trying to bring a solution to a problem. This article will be translated to French shortly.

 

Silber's Blog 1. You said that as a practicing pharmacist, you were struck by the fact that the patient experience was not the same as what you had learned in school or found in product leaflet information. You wanted to give patients a place to express their opinion. So, the purpose of Meamedica is to collect their opinions. Can you elaborate?

Wessels We all know that if a patient visits a doctor (and a pharmacist afterwards) he cannot remember everything he has been told. The patient had several means of information, for example the package insert and a patient leaflet. The package insert is problematic for a patient to understand (which is also common knowledge, I guess) because it also has a legal purpose. Putting all the side-effects in is necessary but confusing for a patient. Liver failure in the use of paracetamol for example, is rare but has to be mentioned. For a lot of patients, such side-effects are scary and prevent them from starting to use or continuing to use the medicine.

Besides that, a majority of the patients go on the internet to check and learn more about what the doctor said. On the internet, there are a lot of useful websites helping out, but the patient perspective isn't that obvious or well-organized.

By asking the patient what he is experiencing you will get a general view of what is to be expected when taking that kind of medicine (for paracetamol only 1 out of  a lot will mention something like liver failure) and you can get a feeling about risks and incidence.

By doing this it will get clear what is happening when it is being used by larger groups of people, outside the settings of the controlled circumstances of phase-IV studies.

Of course, we see positive and negative trends.

Silber 2. How does your site differ from other drug rating sites?

Wessels  That is simple, because our basis is user-generated-content. Other sites make use of pre-existing documents to inform patients. Maybe one wants to make a comparison with a forum, and they are user-generated too, but there are no possibilities to do data-analysis later on. And with us, there are some control-processes to make sure the content will be as pure as possible (meaning concerning experiences with medicines instead of assumptions, etc that are filtered out)

(Editor of Silbers' Blog Note: American sites such as PatientsLikeMe, Mediguard, iGuard, also have consumer-generated content)

Silber 3. Meamedica has a simultaneous multi-country strategy for your Europe ? What are your plans? Did you study each country before launching?

Wessels  Yes and No. We, of course, look into the sites that are already available in the concerning country. The multi-country strategy is chosen because:

- all countries lack the patient perspective to a certain extent (our site in Germany is most active right now)

- the experiences of medicine-users are valuable in general, not only to compare effects between countries, and not limited to language. Paracetamol is paracetamol everywhere and it is interesting to see if the local approach makes differences in experiences by patients.

Our plans are to continue and to make Meamedica available for Spain and Italy too.

Silber 4. You consider that as of 50 opinions about a drug, the result is significant.  What does this mean? Should you therefore not publish until there are 50? People don't necessarily read all 50 opinions. How do we make sense of 50 different opinions?

Wessels I think we agree on the fact that 1 opinion isn't that valuable. But how many should we have to be able to get some information about the products, of course that differs too. From medicines that are being used generally (for example simvastatine) you can collect lots of opinions and it is necessary to do so. For medicines to treat cancer or another more specialized disease, one opinion should be read with a different approach.

Besides the differences per medicine, it is good to ask yourself who is reading the opinions: patients aren't looking for more than 100 opinions, maybe for a general impression, but not to read every single opinion and are maybe already satisfied with 20 or 30 opinions.

In general we say our aim is 50 per medicine, but now you can understand it differs per goal and per medicine.

Silber 5. Meamedica has a pharmacist from each country who reviews the comment before posting. How does she check on the authenticity of the comment?

Wessels This part is still under construction, because the number of opinions first has to develop. The opinions are looked at by a team. Who is in the team depends on the amount of opinions per country (and can differ from time to time accordingly); our goal is to have one pharmacist per country available. But, if you don't speak the language you cannot review of course.

Silber 6. Meamedica has an unnamed investor. This has led to speculation that it's some source of finance that you would be uncomfortable to identify, such as a pharma company. What is your response?

Wessels  Hahahah, it is unbelievable how pre-occupied everybody is. No, it certainly hasn't anything to do with pharmaceuticals nor medical. It is a wealthy family (private investor), that's all. They just don't want their name in the newspapers, as one can imagine. They have, due to their personal experiences, affinity with improvements in medical treatments.

But it is good you mention this, because it keeps coming back. I will discuss this point with them and maybe they will change their point of view on how to communicate this.

Silber 7. In your business model, as I understand, you sell widgets to web sites. Is this your only source of revenue?

Wessels At the moment it is, yes. We are working to broaden our product portfolio of course, but we are aware of the importance of our independence and we won't do things that can threaten that. Our widgets make our tool available to a wide range of patients and give our clients the opportunity to improve their services to patients (for example, pharmacists & health insurance companies).

Silber 8. You must be happy with all the interest you've attracted. Yes, no? Any special plans for 2011?

Wessels  Of course I am happy if Meamedica is being used by patients and if they value what we do. For France we are aware of the delicate situation, started by Mediator.

It is very important for us to communicate our vision combined with our independence.

We want to help all parties improving pharmaceutical care. I am really happy if we can achieve that!