Tag: medical industry

Categories : Genetics New Compounds and TreatmentsTags :

Embracing Ethnic Genetic Diversity in Drug Design

On By ModernMedia

Although human beings have a great deal of genetic similarity, small genetic differences can nonetheless lead to very different results in drug effects.

Pharmacologist Namandje Bumpus, PhD—who recently became the first African American woman to head a Johns Hopkins University School of Medicine department, and is the only African American woman leading a pharmacology department in the country—explains why certain drugs can have different effects between distinct populations. Warfarin, for example, is known to be less effective in people of African descent.  

As new vaccines and treatments are developed to fight the COVID pandemic, which have disproportionately affected certain ethnic groups. According to APM Research Lab, in the US as of 2 Feb, Pacific Islanders are 2.7 times as likely to die from COVID as whites (adjusted for age), compared to 0.9 times for Asian Americans.

In light of these differences, Bumpus laid out a four-part plan to improve the equity of drug development.

Merely increasing the representation of races in drug trials is insufficient. Her plan includes: laboratory research to study genetic variability; diversifying the scientific workforce; diversity requirements for funding agencies; and diversity reporting requirements on clinical trial demographics in published articles.

Bumpus said that with genetic technology, animals can be engineered to “bolster predictability of drug outcomes and provide a mechanistic foundation for understanding disparities.”

Genetic variations linked to drug response are often associated with a family of enzymes, cytochromes P450. In humans this enzyme family processes about 75% of clinically available drugs. Subtle genetic differences can however lead to altered enzymes in humans, and these are more common in certain ethnic groups. 

This framework, Bumpus said, could compel the drug development field to move toward a future where “treatments are most likely to work for all people” and “existing health disparities are not further exacerbated.”

Source: Medical Xpress

Journal information: Namandjé N. Bumpus, “For better drugs, diversify clinical trials,” Science  05 Feb 2021: Vol. 371, Issue 6529, pp. 570-571. DOI: 10.1126/science.abe2565

Categories : Expert Opinion Medical IndustryTags :

Like 60s Cars, Brand Drugs Have no Price Competition

On By ModernMedia

Brand name drugs, like American cars in the 1960s, are subject to broadly rising prices with little evidence of competing on cost.

Before the oil embargo by Arab countries in 1973 allowed competition from more affordable, fuel efficient cars that we take for granted today, the Big Three car manufacturers, Ford, Chrysler and General Motors, would annually announce price increases at about the same time. Any adjustment by one manufacturer, for example, in size, was quickly matched by competitors.New research analysed the prices for five classes of drugs, and found them to be increasing in lock-step from 2015 to 2020. These classes are direct-acting oral anticoagulants (DOACs), P2Y12 inhibitors, glucagon-like peptide-1 (GLP-1) agonists, dipeptidyl dipeptidase-4 (DPP-4) inhibitors, and sodium-glucose transport protein-2 (SGLT-2) inhibitors.

The study had limitations due to not taking into account measures such as rebates, which would affect the price for the patient. However, even if these were taken into consideration, the researchers believe the overall prices would still increase and have to be borne by some patients who would not benefit from certain rebates. “Rebates, list prices, and net prices have been growing for brand-name medications, and rebate growth has been shown to positively correlate with list price growth, thereby impacting costs faced by patients paying a percentage of (or the full) list price,” the researchers noted. “Therefore, the lock-step price increases of brand-name medications, without evidence of price competition, raise concerns and would be expected to adversely affect patient adherence to medications and thus clinical outcomes.”

Unlike the oil crisis which broke open the automobile market to foreign competitors, the solution with “Big Pharma” is less clear. The researchers recommend policies which would limit such lock-step price increases, reduced patent exclusivity periods, and quicker introduction of generic equivalents.

Source: MedPage Today

Journal information: Liu P, et al “Trends in Within-Class Changes in US Average Wholesale Prices for Brand-Name Medications for Common Conditions From 2015 to 2020” JAMA Netw Open 2021; DOI: 10.1001/jamanetworkopen.2020.35064.

Categories : COVID UncategorizedTags :

SA Government Aims for a Corruption-free Vaccine Programme

On By ModernMedia

In the past week, President Cyril Ramaphosa and health minister Zweli Mkhize have undertaken a publicity drive to demonstrate how the government is working to ensure a tightly controlled vaccine drive that is not plagued by corruption. This is to avoid a repeat of the corruption in PPE acquisition last year, with some R10.5 billion being investigated for looting, with an Auditor-General report finding some items being purchased at five times the going price.

These efforts include centralised transactions which involve the auditor-general looking out for any discrepancies. Vaccine acquisition and roll-out planning will be handled by the government, with the private sector being tapped for storage and distribution. “What we have done is to get the Treasury and the Department of Health’s office of the chief procurement officer to oversee any form of transaction that is going to happen.

“Right now the procurement of the vaccines is within government. It makes it easier because it’s a tight-knit set of people, the prices are known, the manufacturers are known, the deviation is specific and it’s not the same as what we had in PPE where there were so many vendors, suppliers and so many different prices,” he said.

Furthermore, there will be consultation with the Attorney General. “We are going to say [to the AG]… these are the risks we have identified and ask them to analyse our plans and see if there are further risks we must be aware of and how we can work together to prevent any risk of looting,” Mkhize said.

Medical aid schemes have voiced concerns over the process, having sourced vaccines for their members as well as contributing to the vaccination costs of those not covered by any medical aid scheme.

President Ramaphosa said that South Africa would have pre-paid like other countries to secure vaccines, even given the risks of them failing, if it had the funds to do so.

However, he affirmed that there are funds available to buy the vaccination scheme, saying: “we are going to have the money, it will come from Treasury. There is just no way we can say, when it comes to saving the lives of South Africans, that we don’t have the money. The money will be there. It has to be there to save the lives of South Africans. That one will be my bottom line.”

The Covax programme will provide a vaccine for 10% of the population in the second quarter of 2021, for which a deposit of R283 million has been paid. A further 1.5-million vaccine doses have been secured from AstraZeneca and 9-million from Johnson & Johnson (J&J). The J&J vaccine only requires a single dose to confer immunity, so should be able to cover 9 million people.

“J&J will be producing through Aspen here at home, and we are hoping to get the bulk of our supply from there, once the production starts,” said Ramaphosa.

Source: Times Live

Categories : COVID Medical IndustryTags :

Netcare CEO Recounts Challenges and Lessons of 2020

On By ModernMedia

In an interview posted on Moneyweb, the CEO of Netcare, Dr Richard Friedland, related how the company had weathered a very hard financial year.

“We have certainly felt the effects financially and we haven’t been able to pay a dividend to shareholders. But, as I’ve said to all of our frontline workers, we paid a dividend to South Africa in terms of looking after so many thousands – more than 28 000 Covid patients. That is far more significant than anything we could have done in monetary terms,” said Friedland.

The company learned valuable lessons, being at “the tip of the spear” of the COVID pandemic. Following their first cases on March 9, a large outbreak occurred at St Augustine’s, followed by a much smaller one at Kingsway. 

Friedland spoke of the sacrifices the staff had made over the past months, saying “This is not a time to abandon them. It’s a time to stand with them. It does mean our recovery will be longer, but we’ll do that together. And I think it’s critically important, given the headwinds we’re facing in South Africa.”

The company made much of its profit from asset disposal, but Friedland said that they were seeing a return to demands for elective surgery, excepting their two hospitals in the Nelson Mandela Bay area. He noted that there was a noticeable uptick in cases, similar to what they had experienced in the first wave, and that their hospitals were relatively full. However, they were putting their lessons learned into practice by having readied adequate stores of PPE and oxygen, for example. The length of stay has been reduced from 22 days to seven. He remarked on how stressful the pandemic had been for all concerned, but he said that continued efforts must be made.

“[…]Covid nearly robbed us of our humanity, and we need to be very careful about that going forward, particularly as healthcare workers, when patients cannot see their loved ones, when they’ve got to communicate with us through masks and spaces. We’ve managed to find other ways, through Facetime and mobiles, to communicate with their loved ones; but there’s no excuse for [not] improving communication all the time. I think Covid exposed that and there’s been a lot of anxiety as a result that we still need to manage,” concluded Friedland.

Categories : UncategorizedTags :

Dis-Chem Continues to Grow, Eyes Medical Insurance Sector

On By ModernMedia

According to Moneyweb, the JSE-listed Dis-Chem group has announced that it is seeking to acquire an as yet unnamed medical insurance group, withholding the payout of dividends to pay for the expansion.

Earlier this year, it also announced plans to acquire Baby City for R430 million. It is also apparently “investigating” the acquisition of a community-based pharmacy group. In justifying the motivation for the deal, the group said: “Covid-19 has highlighted that individuals and companies are more prepared than ever to spend on healthcare and has also led to a deeper understanding of the importance of mental health, accelerating the need for companies to provide support to employees and their families.

“Through this transaction, the group will benefit from vertical integration into the health value chain, with access to a unique set of assets, in a sector of the healthcare market that is experiencing rapid and sustainable growth,” the group continued.

“All this at margins that are significantly higher than those in the core retail business. This investment also provides access to segments of the population who have historically not been covered by the private healthcare sector. In so doing it will assist in providing deeper access to healthcare to a wider and under-served community,” Dis-Chem concluded.