The exhibitor's hall is a major component of any medical society's annual conference. Exhibitors and sponsors make it possible to bring thousands of society members together to share research, take part in educational programs and network.

The exhibit hall draws conference attendees who wander the aisles of sometimes hundreds of booths between workshops. Some of the booths can be quite elaborate. At a medical physics conference I saw the latest linear accelerator used for image-guided radiation therapy, complete with lovely young models who demonstrated how a patient would lie inside them.

On Friday, at the Academy of Managed Care Pharmacy's 23rd Annual Meeting & Showcase in Minneapolis, I decided to check out the hall and peruse the booths for story ideas.

I had just picked up some literature on Shionogi Pharma's development pipeline and was thanking the rep when out of the blue a 6-foot robot rolls right up to me and says, "Kathlyn, thank you for stopping by." My jaw may have dropped a little but I recovered quickly. (A 6-foot robot addressing me by name wasn't near as shocking as when I was 5 or 6 and the 35-foot seated Paul Bunyan greeted me by my full name and mentioned the town from whence I came.)

The robot, called SICO (for Super Intelligent Computerized Object), soon drew a small audience. A petite woman accepted SICO's invitation to stand on his passenger-carrying platform, and as soon as she did, he gently wrapped his metal arms around her and twirled her around the exhibit floor to blaring techno music. While slightly embarrassed, she appeared to be having a lot of fun.

Henry Mandell, SICO's handler, works for New York-based International Robotics, the firm that created SICO. The robot is programmed to talk, move, dance, scan attendee's registration tags and probably other things as well. It is controlled by wireless remote from up to 200 feet away. SICO's been a big hit at children's hospitals where International Robotics has sent him when he isn't booked at trade shows and corporate functions, Mandell said.

When the dance was over I glanced over at the Shionogi rep. She just smiled and said, "In a land of pens it's nice to have something different."

But some things never change.

Pharmaceutical companies have been known for having a penchant for hiring young, attractive women to work as drug sales representatives. Now that drug companies face greater scrutiny over marketing strategies and sales reps have fewer opportunities to meet with physicians, the trend has been to hire highly skilled "medical communication specialists" who are more likely to possess a medical degree than a business degree. The emerging view is that physicians are more open to meeting with someone who will provide credible medical information rather than a sales job. Indeed, over the past couple years I've noticed a lot more former clinicians -- who happen to be older and male -- working the booths at medical conferences.

Apparently a certain medical publisher hasn't been following the trend. When I stopped by a booth to pick up some free magazines I chatted a while with the pleasant and pretty woman tending the booth. I asked how long she'd been with the company and she said she was just hired to work the show. Curious, I asked if she worked for a temporary job placement agency. "No, they hired me through my modeling agency," she said.

A federal court of appeals in Washington, D.C. ruled 2 to 1 on Friday, April 29, to overturn U.S. District Judge Royce Lamberth order of last August that called for an injunction on taxpayer funding for stem cell research.

Lamberth's ruling -- that National Institute's of Health guidelines allowing use of embryos were illegal and that researchers using taxpayer funds for embryonic stem cell research enjoyed an unfair business advantage -- was put on hold pending appeal.

In March 2009 President Barack Obama lifted the ban his predecessor had placed on federal funding for research on new embryonic stem cell lines in 2001.

Federal law has prohibited the use of public funds on research involving human embryos since 1996, but private funders have been allowed to reproduce embryonic cells from existing cell lines.

The issue will continue to face White House and court reversals until Congress passes definitive legislation on embryonic stem cell research -- something it has avoided doing for decades.

USA Today's Dan Vergano collected responses to the ruling from the academic research community.

Detailed coverage of the ruling:

Court Lets U.S. Resume Paying for Embryo Study, New York Times, April 29, 2011

Appeals Court Vacates Research Funding Ban Courthouse News Service, April 29, 2011

Patient adherence to their prescribed treatments remains an important health care challenge, especially for patients with chronic illness. It's estimated that on average, about 50 percent of patients fail to follow their treatment, which in turn leads to lower quality of life, greater numbers of hospital admissions, higher costs for public health programs, and preventable deaths.

Pharmacists and health benefit managers are among the specialists looking for greater understanding of the rates of adherence, the causes of low adherence, and solutions that lead to greater adherence.

Several health outcome researchers presented adherence study results at the Academy of Managed Care Pharmacy annual meeting held in Minneapolis, Minn., this week.

Wenjia Chen, fellow of global outcomes research, Merck Sharp and Dohme Corp. in West Point, Penn., presented an analysis of bipolar disorder patients' adherence to six commonly prescribed mood stabilizers, typical antipsychotics and atypical antipsychotics at a Friday, April 28, poster session.

Data was drawn from the pharmacy claims of 16,807 new users (a year or less of treatment) of antipsychotic medications and 22,131 existing users (those who had been filling their prescriptions for a year or longer). All patients had health care insurance.

Chen said the analysis showed that about 85 percent of new users discontinued, augmented or switched their medications and about 60 percent of existing users discontinued, augmented or switched their medications during the one-year study period.

Pam Pawlowski, PharmD, a research associate with HealthPartners Research Foundation, in Bloomington, Minn., assessed the demographics and adherence rates of 31,636 patients across eight different types of diseases, in a study titled "Participant Characteristics Associated with Medication Adherence."

Not surprisingly, Pawlowski found the highest rates of adherence were among patients with multiple sclerosis, hypertension, hypercholesterolemia, osteoporosis, and cancer. These patients had a greater than 75 percent adherence rate.

Patients with asthma/COPD had the lowest adherence rates at 33 percent. Patients with depression and diabetes had 63 and 60 percent adherence rates, respectively.

Pawlowski said HealthPartners undertook the study to gain a better understanding of adherence patterns as the HMO expands intervention efforts to improve adherence. HealthPartners is also planning to launch outcome studies of various interventional strategies.

References:

Chen W, DeVeaugh-Geiss AM, Palmer L, Barnes J, Princic N, Chen Y, Rutgers, The State University of New Jersey. Patterns of Atypical Antipsychotic Therapy Use in Adults with Bipolar I Disorder. JMCP Vol. 17, No. 3 April 2011.

Rolnick S, Bruzek RJ, Pawloski P, Hedblom B, Asche S, Meier D, Fustgaard M, HealthPartners Research Foundation. Participant Characteristics Associated with Medication Adherence. JMCP Vol. 17, No. 3 April 2011.

More news from the AMCP 2011 annual meeting:
Managed Care Pharmacists Keep Ahead of the Curve

What's on the minds of managed care pharmacists these days? Many of the same issues that consume executives and managers in the pharmaceutical industry.

The Academy of Managed Care Pharmacy is holding its annual meeting in Minneapolis this week for about 3,500 people working in managed care and benefit management. Among the topics drawing large attendance are comparative effectiveness research, a pathway for FDA approval of biosimilars, the rise of generics, the drug pipeline, and the impact of the staged roll-out of health care reform.

The business of managed care pharmacists is to work through a maze of regulations and with numerous stakeholders: payers, companies, drug manufacturers, physicians, hospital directors, and politicians, while managing pharmacy benefit programs for patients.

Doug Long, vice president of industry relations for IMS Health, Inc., a global pharmaceutical information company, breezed through a fact-packed session on emerging issues and trends that affect managed care and drug companies alike.

Among my takeaways from his presentation:

• Generics now own 75 percent of the pharmaceutical market and by 2015, 86 percent of prescription drugs sales will generics.

• The retail pharmacy market has also shifted. In 2010 pharmacy chains took the major share (54 percent) of the retail market from independents.

• Market leaders are turning to faster-growing emerging markets for pharmaceuticals in China, Brazil and Russia as they face the U.S. 2012 "patent cliff."

• Innovations will come in the form of new therapy options, such as injectables for more common diseases and the oral multiple sclerosis option.

• Government will become the largest managed care provider in terms of people enrolled, but not until 2014.

Earlier in the day, Iris Tam, director of Genentech, a member of the Roche Group, and T. Jeffrey White, director of strategic analysis at WellPoint, talked about the good, the bad and the uncertain aspects of comparative effectiveness research (CER).

There are many arguments for how cost savings can be achieved through greater use of CER, which often means tried and true (and off-patent) therapies, rather than the latest novel treatment on the market.

One foreseeable drawback to CER is implementation, according to Tam. Practice parameters (those clinical guidelines generally issued by a medical specialty based on decades of published research) are the closest model we have for CER. Tam said studies have imparted that it takes 15 to 17 years before practice guidelines come into widespread use by physicians, and that guidelines are followed only 50 percent of the time.

Another drawback seen by the presenters is the inability of pharmaceutical companies to freely impart data, a key aspect of CER, to consumers. Currently, any information drug companies direct at consumers is tightly regulated.

Both speakers said it is important that lines of communication between policy-makers and drug manufacturers remain open so that manufacturers' information about different therapies, the so-called "real world" evidence, can be part of a patient's decision-making.

"Drug information from manufacturers may be a valuable resource to customers, if customers understand the available mechanisms to obtain such evidence and the limitations under which we operate," said Tam.

Leaving the Minneapolis Convention Center this afternoon I was again struck by the overwhelming complexity of the system and the changes to come over the next five to 10 years.

There will be winners and losers as the country lumbers toward the goals of lowered costs and a more inclusive health care system. Managed care pharmacists get that. They seem a pragmatic bunch (given that their roles will change, too) and focused on finding the right balance of cost and quality for the greatest number of patients.