Cancer drug fund ‘uncertain future’

Cancer drug fund future ‘uncertain’ as new scheme ‘ill-defined’

In England the cancer drug fund has helped greater than 25,000 patients

Many cancer patients could face an uncertain future over funding for his or her drugs, a parliamentary report says.

A government initiative increasing access to cancer drugs ends this year, however the system promised to switch it’s “nebulous” and ill-defined, say MPs.

The Department of Health insists sooner or later patients won’t fail to spot drugs that they currently receive.

But the report criticises the federal government for delays in explaining its new plans to value all drugs.

The new pricing system is determined to begin in 2014 and will affect many medicines utilized by the NHS, not only cancer drugs.

But a giant concern is that it replaces the temporary Cancer Drug Fund, which was introduced in 2011 to assist people access cancer drugs currently not approved by the health regulator the National Institute for Health and Clinical Excellence (NICE).

The Health Select Committee says the inability of clarity at the way forward for the scheme puts cancer patients and doctors at midnight.

Committee chairman Stephen Dorrell said: “Where a person patient is on a process treatment it can be crucial there is no such thing as a cliff edge, that the patient has continuity of care.”

The Department of Health said it should “ensure arrangements are in place to offer protection to individual patients who’re receiving treatment with drugs funded by the Cancer Drugs Fund because the end of the fund approaches.”

The new drug pricing system because of the are available in is called value-based pricing.

This aims to present NHS patients better access to effective and innovative medicines.

It means the clinical worth of a drug could be taken under consideration when setting a value tag.

But the health select committee says the govt has done little to provide an explanation for how the system will work in practice, despite the plans being under discussion since 2010.

Mr Dorrell said: “What we were told during our inquiry indicates that the move to price-based pricing of medication should be a more modest change than have been suggested, but there’s a loss of clarity across the whole issue which has persisted too long.”

The committee wants the govt to crystallise its plans by March this year.

A Department of Health spokesman said: “We’re engaging various groups including patients, the NHS and industry as we develop plans for value-based pricing.

“However, as negotiations between the dept of Health and the Association of the British Pharmaceutical Industry are under way, it might be inappropriate to comment further at this stage.”

Sarah Woolnough, Cancer Research UK’s executive director of policy and knowledge, said: “The dept of Health should urgently publish details of its plans for value-based pricing – as recommended today by the health committee.

“It’s vital that the recent system works for cancer patients and we wish to see proposals that guarantee this.”

Extra heart check for over-65s

Extra heart check for over-65s ‘advisable’

The check could be achieved while doctors are monitoring blood pressure

A new blood pressure measuring device that may also detect a deadly heart condition was backed by the NHS watchdog.

The National Institute for Health and Clinical Excellence says GPs could use it routinely to identify more patients with atrial fibrillation (AF).

AF is an erratic and frequently fast heartbeat affecting 800,000 people inside the UK and is a tremendous explanation for stroke.

The device NICE is recommending in England is named WatchBP Home A.

It seems like a regular blood pressure monitor, with an inflatable cuff that goes round the patient’s arm.

At an identical time as measuring blood pressure, it could possibly check a patient’s pulse.

Hidden cases

NICE says GPs should think about using it for anyone who they think has hypertension or anyone who’s having a check for prime blood pressure.

In this manner, more cases of undiagnosed AF might be picked up and treated, which might ultimately save lives.

People with suspected AF, either due to their test result or symptoms desire to dizziness, shortness of breath and palpitations, may still be sent for a heart trace called an ECG to make sure the diagnosis.

If people over 65 were to be checked with the WatchBP Home a tool, it can save the NHS about £26m and benefit about 400,000 people, says NICE.

Prof Carole Longson from NICE said: “The guidance is just not about screening for atrial fibrillation, but concerning the benefits that the device offers in helping to pick out up atrial fibrillation unintentionally in individuals with suspected hypertension or those being screened for prime blood pressure, in primary care.”

The British Heart Foundation said: “Atrial fibrillation is a potentially dangerous condition that has effects on roughly one in 100 people within the UK and may increase four-fold the danger of a stroke.

“With appropriate treatment that risk may be substantially reduced so early diagnosis is important.”

AF may be treated with medicines to thin the blood and control the abnormal heartbeat.

Children ‘may grow out of autism’

Children ‘may grow out of autism’

Is a label of autism lifelong?

Some small children accurately diagnosed as autistic lose their symptoms and their diagnosis as they grow older, say US researchers.

The findings of the National Institutes of Health study of 112 children appears to challenge the generally held belief that autism is a lifelong condition.

While not conclusive, the study, within the Journal of kid Psychology and Psychiatry, suggests some children might possibly outgrow autism.

But experts urge caution.

Much more work is wanted to determine what might explain the findings.

Dr Deborah Fein and her team on the University of Connecticut studied 34 children who have been diagnosed with autism in early childhood but went directly to function in addition to 34 other children of their classes in school.

On tests – cognitive and observational, in addition to reports from the children’s parents and faculty – they were indistinguishable from their classroom peers. They now showed no sign of issues of language, face recognition, communication or social interaction.

For comparison, the researchers also studied another 44 children of a similar age, sex and non-verbal IQ level who had had a diagnosis of “high-functioning” autism – meaning they were deemed to be less severely suffering from their condition.

It became clear that the kids within the optimal outcome group – those who not had recognisable signs of autism – had had milder social deficits than the high-functioning autism group in early childhood, although they did produce other autism symptoms, like repetitive behaviours and communication problems, that were as severe.

The researchers went back and checked the accuracy of the children’s original diagnosis, but found no reason to suspect they had been inaccurate.

Symptoms can be masked as they how you can adapt to their condition

Label for all times?

The researchers say there are various possible explanations for his or her findings.

It can be that some children genuinely outgrow their condition. Or even some can catch up on autism-related difficulties.

Dr Thomas Insel, director of the National Institute of Mental Health, said: “Although the diagnosis of autism seriously is not usually lost over the years, the findings suggest that there’s a very big selection of possible outcomes.

“Subsequent reports from this study should let us know more concerning the nature of autism and the role of therapy and other factors inside the long run outcome for these children.”

It should be that autism cannot always be accurately defined or diagnosed, particularly because the condition affects people in numerous ways.

Indeed, experts have disagreed about what autism is.

The American Psychiatric Association is currently revising its diagnostic manual – the “bible” for doctors that lists every psychiatric disorder and their symptoms.

Its new edition proposes changes he UK’s National Autistic Society says could affect the way in which diagnoses would be given to people at the autism spectrum.

Instead of using the present terms of autistic disorder, Asperger’s disorder, childhood disintegrative disorder and PDD-NOS (pervasive developmental disorder not otherwise specified), people might be given an umbrella diagnosis of “autism spectrum disorder”.

And their impairments shall be reduced to 2 main areas – social communication/interaction and restricted, repetitive patterns of behaviour, interests, or activities.

Most diagnoses within the UK are in keeping with the International Classification of Diseases (ICD), published by the arena Health Organization, that’s up for revision in 2015.

According to the National Autistic Society, multiple in every 100 people, greater than 500,000 people in all, inside the UK have autism.

About a fifth, an estimated 106,000, are school-aged children.

Dr Judith Gould, director of the National Autistic Society’s Lorna Wing Centre for Autism, said: “Autism is a lifelong disability affecting the way in which that folk communicate and have interaction with others.

“This study is calling at a small sample of high functioning individuals with autism and we might urge people to not jump to conclusions in regards to the nature and complexity of autism, besides its longevity.

“With intensive therapy and support, it’s possible for a small sub-group of high functioning people with autism to benefit coping behaviours and techniques which might ‘mask’ their underlying condition and alter their scoring within the diagnostic tests used to see their condition on this research.

“This research acknowledges that a diagnosis of autism is simply not usually lost through the years and it’s important to recognise the support that individuals with autism need so that they can live the lives in their choosing.”

She said getting a diagnosis may be a critical milestone for kids with autism and their families, often helping parents to know their children better and helping them to support their children in reaching their full potential.

Doctors join debate over drug policy

Doctors say UK drug policy should focus more on health

Drug-related deaths have remained static, despite fewer people using illicit drugs

UK drugs policy needs an improved health focus as criminalisation is deterring users from seeking help, say doctors.

Although illicit drug use was declining within the UK, long-term problem drug use and drug-related deaths are usually not decreasing, says the British Medical Association.

Its Board of Science says evidence shows the present prohibitive way to drug use isn’t working.

It says doctors should inform drugs policy to position patients’ needs first.

Prof Averil Mansfield, chairman of the BMA’s Board of Science, said: “While the medical profession would never condone illegal drug-taking, we believe that we must always show understanding of the illness of drug addiction and respond inside the way that we might with some other medical problem.

“The BMA believes that drug users are patients first.”

Problem drug use affects about 10% of all UK drug users, with the top levels within the 25 to 34 age group.

Cannabis is essentially the mostsome of the most customary drug, followed by cocaine powder, ecstasy and amphetamines.

Last month, Prime Minister David Cameron ruled out a royal commission to think about the decriminalisation and legalisation of banned drugs, considering that the government’s approach was working.

He was responding to a house affairs committee report that argued there has been a case for a fundamental review of all UK drug policy “now, greater than ever”.

Official figures show that drug use in England and Wales is at its lowest rate under current measurements since 1996.

Uneven dementia care ‘disgraceful’

Uneven dementia care ‘disgraceful’

Uneven pattern of dementia diagnosis across UK – says charity

There is a “disgraceful” variation inside the collection of proportion with dementia being diagnosed around the UK, in keeping with the Alzheimer’s Society.

About 800,000 people inside the UK have some type of dementia, but most haven’t been diagnosed.

Estimates by the charity suggest 32% were diagnosed within the East Riding of Yorkshire compared with 76% in Belfast.

The government said the difference was “unacceptable” and caused “unnecessary suffering”.

Predicted levels of dementia around the UK were compared with data from GPs at the actual choice of patients being diagnosed.

The map suggests a north-south divide, with the best rates of diagnosis in Scotland (average 64%) and northerly Ireland (average 63%).

Rates dropped to 50% within the north-east of britain, 41% within the south-west of britain and 39% in Wales.

Across the total of the united kingdom, the share of folks with dementia who’ve been diagnosed has gone from 43% in 2011 to 46% in 2012.

Jeremy Hughes, the manager executive of the Alzheimer’s Society, said: “It’s disgraceful that greater than half all of us with dementia are usually not receiving a diagnosis, and disappointing to peer one of these disparity in diagnosis rates in several regions of the united kingdom.

“This goes against best clinical practice and is preventing individuals with dementia from accessing the support, benefits and the medical treatments which can help them live well with the condition.”

The charity said one explanation was variation in “stigma”, which ended in people not visiting their GP. The upper figures in Scotland were put right down to an improved relationship between social services and the healthcare system.

Health Secretary Jeremy Hunt said: “The small improvement in dementia diagnosis is excellent news, however the extreme variation around the country is unacceptable.

“It is time for the worst performing areas to awaken to the dementia time bomb.”

He said failing to diagnose dementia was delaying treatment and “causing unnecessary suffering”.

Generic HIV drugs ‘less effective’

Generic HIV drugs ‘cheaper but less effective’

HIV drug costs had been driven down over the years

Any rise inside the use of cheaper, non-branded HIV drugs could see more patients with treatment failure, doctors warn.

Soon-to-be available generic medicines could save the usa health care system nearly $1bn a year, they are saying inside the journal Annals of Internal Medicine.

But trial data suggests generic drugs possibly slightly less effective.

And they require users to take three daily pills rather then one, increasing the chance some patients may miss doses.

The doctors calculate reduced treatment efficacy could lead to 4.4 months of life lost per patient lifetime.

At an identical time the lifetime savings could be $42,500 (£26,500) per patient, say the Massachusetts General Hospital investigators.

The currently recommended treatment for newly diagnosed patients is a single pill (Atripla) taken daily that mixes three brand-name antiretrovirals – tenofovir (Viread), emtricitabine (Emtriva) and efavirenz (Sustiva).

A generic kind of a drug that has an analogous mechanism of action to emtricitabine became available in January 2012, and a generic version of efavirenz is anticipated within the relatively near future.

Patients could soon take these two much cheaper generic drugs alongside the logo drug tenofovir.

Lead researcher Dr Rochelle Walensky said: “It is a trade-off that many folks will find emotionally difficult, and maybe even ethically impossible, to recommend.”

For patients who took their medications well and adhered to the medical regimen, the generic option can be a piece more complex but can be as effective because the standard regimen, she said.

But people who missed a dose faced treatment failure.

She said this trade-off will be more acceptable if the savings were redirected to other aspects of HIV medicine.

The researchers calculate that for each 15 patients switched to the generic-based regimen, one that is likewise infected with hepatitis C can be treated and potentially cured of that infection.

Jason Warriner, of the Terrence Higgins Trust, a UK HIV charity, said: “We welcome this research, which couldn’t be more timely.

“There are around 7,000 people diagnosed annually within the UK, meaning the price of anti-HIV drugs is rising year on year.

“With the NHS under unprecedented financial pressure, the spread of the epidemic is a challenge not only for public health but for the general public purse.

“Introducing generic medications will be a technique for the health service to attenuate expenditure, but this must never be on the expense of patient health.

“Anything that compromises the effectiveness of anti-HIV drugs, or makes people less prone to keep on with treatments, will be a false economy.

“Currently, ensuring those with HIV are diagnosed and on treatment is a cornerstone of HIV prevention efforts.

“Effective medications not just keep those living with the virus fit and well, additionally they help to maintain down new infections.”

Drop in winter vomiting bug cases

Drop in level of norovirus winter vomiting bug cases

The virus could cause vomiting and diarrhoea

Levels of the winter vomiting bug norovirus have gone down for a second week, latest figures show.

But experts say the 32% drop seen within the rate of confirmed new cases during the last week alone in England and Wales doesn’t mean the issue has gone away.

Infection rates always fluctuate and cases could easily rise again, says the Health Protection Agency (HPA).

This season, a brand new strain called Sydney 2012, is answerable for most cases.

This strain of the virus was first seen in Australia, where the norovirus season is lasting longer than usual as outbreaks continue into their summer.

Experts are watching international patterns closely but can’t be sure what’s going to happen next within the UK.

The variety of new cases are up 56% at the number reported this time last year, and the entire lab-confirmed toll now stands at 4,407.

For each confirmed new case experts estimate an additional 288 cases tend to go unreported.

Hospital outbreaks

John Harris, a professional in norovirus on the HPA, said: “Norovirus activity always varies from year to year and although we’d have expected cases to rise again we have passed the hot year period this hasn’t been the case.

“We won’t read anything into q4 and do not know the way busy the remainder of the season might be.

“The busiest months are normally from December to April, so further cases will occur but we won’t say if there’ll be further significant increases within the variety of laboratory reports.”

During the 2 weeks as much as 13 January 2013 there have been 39 hospital outbreaks reported, in comparison to 33 within the previous fortnight, bringing the complete of outbreaks for the season to 728.

The highly contagious virus may be spread by contact with contaminated surfaces or objects, contact with someone who has the infection or through contaminated food and water.

Experts advise anyone who thinks they might have the virus to remain faraway from hospitals, GP surgeries and care homes to bypass spreading it to those that could be vulnerable.

The illness usually resolves in several days without a long-term effects.