Continuity of Health

Hypercholesterolemia Awareness Raising Activities 
Hypercholesterolemia is a condition that threatens public health and the leading cause of deaths worldwide. Hypercholesterolemia awareness raising activities are carried out to raise the awareness of physicians and subsequently patients about this issue.  

Diabetes, which is one of the most prevalent diseases today, is a chronic disease that lasts for life. Diabetes, which affects over 400 million people worldwide and over 7 million people in Turkey, is a growing health problem across the globe. Practices that make life with diabetes easier are of utmost importance for patients' lives. To support solutions within that frame, Sanofi conducts several activities. 

Lighten Diabetes Patient’s Life (‘Sen Bul Diyabet Kolaylaşsın’)
This project aims to bring to light the innovative ideas or inventions of university students that could facilitate the lives of individuals with diabetes. The call for the project was made on the  www.senbuldiyabetkolaylassin.com website and during face-to-face activities at universities. More than 100 project applications were made to this competition organized for the 5th time in 2018. Fifteen projects selected as finalists found the opportunity to collaborate with Kworks (Koç University's Acceleration and Incubation Center for Entrepreneurs) and implement their projects under the “Entrepreneur Acceleration Program” in six categories of need. In this context, students have had the opportunity to meet with expert mentors and attended entrepreneurship trainings.  

Diabetes at School Program
The "Diabetes at School Program," which is one of the projects launched to raise disease awareness for diabetes, is carried out since 2010 within the framework of Ministry of Health’s National Diabetes Control Program. The Diabetes at School Program, in cooperation with the Ministry of National Education, Ministry of Health and the Society for Pediatric Endocrinology and Diabetes and supported unconditionally by Sanofi, aims to raise awareness about diabetes among students, parents and teachers and improve diabetic children’s quality of life at school. To date, the program has reached 585 thousand teachers, 580 thousand parents and 7.5 million students in 25 thousand schools. The experience gathered through Diabetes at School Program, was used to co-create the KiDS program with the International Diabetes Federation. In 2017, trainings were held in Adana and Samsun with the participation of 750 people to raise awareness of Type 1 diabetes. In 2018, another training was organized in Eskişehir with the participation of 350 people.

The Fight against Diabetes Program
Within the context of Diabetes Support Program, we signed a protocol with the Public Health Institution. It aims to prevent healthy individuals from developing diabetes through “Prevention of Diabetes Trainings,” to train people with Type 2 diabetes through “In-class and Individual trainings and services” and to raise awareness of all diabetes patients and the healthy population at large through a “website”. As part of “In-class and Individual trainings and services,” we aim to deliver diabetes trainings in the cities, where we provide nursing services for diabetic patients once a week, at locations determined by the Public Health Institution. We aim to reach healthy individuals, in addition to diabetes patients, to explain what diabetes is, what needs to be done for prevention and what the complications would be if not treated properly. A public announcement was made and a comprehensive dedicated website developed to support the program. To date, public trainings were organized in twelve cities. The number of people trained reached 150,000. 

Rare diseases are defined as diseases that affect one out of 2,500 people. There are approximately 7,000 different types of rare diseases and disorders that are estimated to affect a total of more than 300 million people worldwide. 80% of rare diseases are genetic in origin, often chronic and life-threatening and present throughout a person’s life, even if symptoms do not immediately appear. 

At Sanofi Genzyme, we believe that everyone living with a rare disease should be able to receive high-quality services, treatment and support. Thus, we have an integrated approach for our physicians, nurses and patients in order to fulfill the unmet medical needs in the rare disease area.

High Risk Testing - HRT Survey 
The objective of High Risk Testing (HRT) survey is to conduct tests in order to understand the prevalence of rare diseases and their diagnoses in Turkey. Sanofi Genzyme unconditionally supports screening tests for Gaucher, Fabry, MPS I and Pompe diseases for which it offers treatment through its Global Diagnostic Support Program. Regular screening tests are carried out every year as part of the ongoing efforts since 2001. Over 10,000 patients with risk factors have been screened for diseases in the past three years. The survey helps to identify prevalence and provides epidemiological data for Turkey, and enables an early diagnosis before the disease reaches life-threatening dimensions. 

GenAssist (Diagnostic Support Program)
Sanofi Genzyme provides treatment solutions in the field of rare diseases, Multiple Sclerosis (MS), oncology, hematology and immunology. The rare diseases group includes enzyme replacement therapies for Gaucher, Fabry, Pompe and MPS I. There are many new products under development in this area. Rare diseases are a group of diseases where awareness is low due to the fact their prevalence is low, they mimic many diseases, and require special methods for diagnosis. In order to diagnose these diseases, Sanofi Turkey has put in place a diagnostic support program. In 2018 an important step was taken in the field of local resource utilization and localization when we embarked on a collaboration with Düzen Laboratories.

GenPro (Physician Support Program) 
GenPro is a physician support program that aims to bring together specialists devoted to diagnosis and treatment of lysosomal storage disorders and contribute to their knowhow. The program also brings together specialists in different fields to exchange their knowledge and clinical experiences. The aim is to diagnose lysosomal storage disorders, which require a multidisciplinary treatment approach, as early as possible. 

Sixteen GenPro meetings were held in several cities on Gaucher Disease, Fabry Disease and MPS I Disease in 2018. The meetings rose awareness in the 500 physicians of various specialties who attended these meetings, and patient referral systems have been established across specialties. 39% of physicians who participated in GenPro said that the contribution of these meetings to their daily practice was “very good”, and 61% said “good.”  The results of the surveys show that the expected level of performance was achieved. 

GenPart (Nurse Support Program) 
GenPart is a support program aiming to update nurses’ knowledge and skills about preparation and administration of infusions used in the treatment of lysosomal storage disorders. Since the treatment to be administered in lysosomal storage disorders is prepared as an infusion through a special procedure, it is extremely important for nurses to have superior knowledge in this area to ensure patient’s adequate response to treatment and achieve the best possible results.  

In 2018, 247 nurses attended 56 trainings on GenPart Infusion Techniques organized across Turkey and enhanced their knowledge and skills about preparing and applying infusions used in the treatment of lysosomal storage disorders. In the satisfaction surveys conducted following the GenPart training at their departments, 88% of the 247 nurses who took the training said that its content met their expectations while the other 12% stated that the training exceeded their expectations.  

GenTree (Genetic Support Program)  
GenTree is a project developed to inform physicians about the importance of patient’s diagnosis and Family Screening in lysosomal storage disorders with genetic transition. The GenTree Program consists of two parts; 'Ask the Expert' and 'Train the Trainer.' 
 

• GenTree Ask the Expert: A genetics expert in one of the specialty branches involved in diagnosing the disease explains issues of importance in genetic transition of the disease and family screening, with the aim of increasing survival rates and/or improving quality of life for more patients. 
• GenTree Train the Trainer: In Turkey, the number of Genetics Specialists, who know genetic transition in lysosomal storage disorders in depth, is quite limited. With these trainings, the aim is to raise the knowledge level of Genetics Specialists and enable them impart their genetics know-how to specialist branches diagnosing these diseases.
• Fabryka
  The “Fabryka” project was developed with the aim of raising awareness about Fabry disease among physicians and ensuring adequate response to treatment. Fabry is a rare disease, seen in 1 person in 40,000 on average. Since it’s a very rare disease, awareness among physicians and patients is unfortunately quite low. Furthermore, due to intravenous administration of the medicine in a hospital every two weeks, patient adherence is also low.
  
  With low disease awareness and patient adherence, the patient must undergo a series of tests after diagnosis to fully understand how Fabry disease affects the patient. Close and regular follow-up of these test results by the physician is of utmost importance during the course of treatment.  
  
  With the Fabryka project; 
• Physicians’ awareness and knowledge about Fabry disease is raised.
• Physicians’ knowhow, experience and motivation about diagnosis and treatment of Fabry disease increases.
• Patients, who dropped out of treatment due to lack of follow-up and/or patients, whose analysis values were inconclusive, started with treatment.
• Physicians state that patients, who received more comprehensive and regular information from their physicians, respond better to treatment.

Cerbest
The Cerbest project has been designed for a 360-degree evaluation of the Gaucher disease. The Cerbest project aims to interpret the bone results of Gaucher patients using DEXA, MRI and bone biomarkers, prevent irreversible bone damage in patients, and demonstrate Cerezyme's unique bone data by the effective use of multiple channels. 

Physicians who treat Gaucher Disease are now evaluating DEXA, MRI, and other bone biomarkers after the Cerbest Project has shown to the selected specialists of pediatric metabolic diseases, pediatric gastroenterology, gastroenterology, and endocrinology that it is a disease of the bones. This marks the beginning of a holistic management of Gaucher's disease, which involves observing improvements in the bone as well as in the visceral organs and blood parameters. Six regional treatment management meetings were held in 2018 within the scope of the Cerbest project. The meetings reached 35 treating physicians.  

In order to raise public awareness on multiple sclerosis, several activities have been conducted including meetings, forums and congresses.

MS – Lego Projesi: The MS– Lego is a year-round project organized periodically. The aim is to increase the level of practical and theoretical knowledge on MS in the health facilities in Istanbul through meetings moderated by two physicians with plenty of patient experience.

MS Forum: MS Forum is held three times a year in designated regions. The main aim of the forum moderated by Taşkın Duman, Professor at Mustafa Kemal University, is to raise awareness and share with participants two different aspects of a given topic determined jointly with the lecturing physicians. The meetings are broadcast live over the Internet.

Global Impressions: The ’Global Impressions' event takes place every year in January. These events aim to share with the participants a summary of all the issues discussed at the important congresses of the previous year by the MS KOLs in Turkey. The attendance is very high to these meetings, which are broadcast live on the Internet.

With its experience and expertise in oncology, Sanofi Turkey focuses on improving the quality of life for millions of people affected by the disease. Through its Global Business Unit, Sanofi Genzyme, Sanofi Turkey continues to develop innovative treatments and approaches to fight cancer and empower life.

Oncology Clinics share Experience over Facetime
A series of experience sharing meetings among departments over Facetime were held in April 2018. The aim of the project was to create a new and interactive digital platform where disease-related experience could be exchanged, as meetings broadcast live offered very limited interaction and information flow between the speakers and participants. 

In this context, two inpatient units (i.e. Izmir Ege University and Ankara Dışkapı Training and Research Hospital Oncology units) have been identified. These inpatient units were then connected via the digital platform to hold a video-conference. A large amount of time was devoted to the question-answer and discussion sessions following real-life case presentations at the meeting, which only required the use of an iPad, computer and loudspeakers, thus bringing increased efficiency with low costs. In this way, the exchange of ideas between the two inpatient units has effectively been achieved. 

Health Ambassadors at Home
The ‘Health Ambassadors at Home’ program, launched in 2017 in partnership with ÇABA Association (Contemporary and Independent Solidarity Association), aims at improving health literacy and reinforcing the value of vaccines for public health. The goals of the program include informing participants in trainings organized in different provinces and contributing to the community by creating health awareness, starting with families. The ‘Health Ambassadors at Home’ program is carried on with face-to-face meetings and presentations of physicians and public figures. Participants of the program are presented with ‘Health Ambassador at Home’ certificates. These ambassadors continue to receive regular information to raise awareness in their circles, while awareness-raising activities are also supported through social media and website. (http://www.evimizinsaglikelcileri.com) The ’Health Ambassadors at Home' Program reached out to a total of 3,000 people with two launch meetings and nine training sessions organized between September 2017 to November 2018.

Others
Compassionate use program with Alemtuzumab
Sanofi is providing alemtuzumab free of charge to patients, whose physicians specifically express their need for the medicine since April 2013. The product was pulled from the market to be developed for another indication. With this program patients, whose physicians express their need for the medicine, can obtain it for free.