Greek hospitals and pharmacies are running short of around 300 medicines because drug companies are refusing to supply them.

Hospitals failing to pay drug bills and parallel trading by wholesalers and pharmacists are the main reasons for supplies being withheld.

Major pharmaceutical companies that have admitted halting shipments of some products include Pfizer, Roche and Sanofi.

Medicines for arthritis, hepatitis C and hypertension, statins, antibiotics, anaesthetics, antipsychotics and antidepressants are all affected.

Dimitris Karageorgiou, Secretary General of the Panhellenic Pharmaceutical Association, said: “I would say supplies are down by 90%. The companies are ensuring that they come in dribs and drabs to avoid prosecution. Everyone is really frightened.

“The government is panic-stricken and the multinationals only think about themselves and the issue of parallel trade because wholesalers can legally sell them to other European nations at a higher price.”

According to the Greek government, more than 50 companies are holding back products or planning to do so. The Ministry of Health is intending to fine eight major drug companies, which have not been named.

There are reports of widespread panic and anger among patients who are going from one pharmacy to another with prescriptions. “We have reached a tragic point,” commented Karageorgiou.

With austerity tightening in Greece, the debts owed to pharma companies by hospitals and social insurance funds has reached €1.9bn (£1.6bn).

Pfizer has admitted withdrawing four medicines “because alternatives were available and because of the parallel trade situation”: leukaemia drugs Zavedos and Aracytin, the analgesic Neurontin and the epilepsy treatment Epanutin.

Roche said it was withholding supplies to Greek public hospitals, apart from “critical medicines” such as HIV drugs, but was still supplying pharmacies.

Sanofi claimed it was still supplying public hospitals with life-saving and unique products (for which no generic version or recommended alternative exists).

GSK, AstraZeneca, Novartis and Boehringer Ingelheim denied they had stopped supply of any products to Greece.

The pharmaceutical industry has urged the Greek government to set its drug prices in accordance with a eurozone standard. Greek drug prices are 20% lower than the next lowest in the EU, giving rise to widespread parallel trading.

Greek regulator the National Organisation for Medicines has banned the export of 60 medicines and is considering another 300. It will fine wholesalers and pharmacists who have broken the export ban.

AbbVie’s Humira (adalimumab) is now available in the UK for treatment of paediatric Crohn’s disease (CD), a painful bowel disorder that can inhibit children’s growth.

The drug is licensed for treatment of patients aged six to 17 years with severe active CD who do not respond well to conventional therapies.

This new indication for a drug already used to treat arthritis and psoriasis offers the first new biological therapy for paediatric CD to gain EU approval in five years.

It also represents AbbVie’s first UK drug launch since its split from Abbott to form a stand-alone research-based biopharmaceutical company.

CD, which affects 90,000 people in the UK, is an inflammatory bowel disorder that causes severe pain and diarrhoea. In young patients, it can inhibit growth and the onset of puberty.

Conventional treatments include hospital-based injection of corticosteroids and immunomodulator drugs. Humira can be injected by children and their families outside the hospital, allowing for more flexible treatment with less disruption.

“Paediatric Crohn’s disease is a chronic bowel disease that may have a significant impact on a child or young person,” said Dr Richard Russell, Consultant Paediatric Gastroenterologist, Royal Hospital for Sick Children, Glasgow. “For patients who do not respond to standard therapies, this new treatment option addresses a significant unmet need.”

Richard Driscoll, Chief Executive of the charity Crohn’s and Colitis UK, commented: “Paediatric Crohn’s disease is known to be increasing in frequency among children and young adults of all ages. We welcome this new treatment that is being made available in the UK, as the symptoms can be very severe and have a significant debilitating effect on the child and their family.”

AbbVie separated from Abbott in early January as a manufacturer of research-based biological medicines.

Advanced physiotherapists and podiatrists are set to become prescribers by 2014.

New legislation will enable these clinic-based practitioners to prescribe drugs such as painkillers, asthma inhalers, steroid creams and antibiotics.

The relevant professional associations have welcomed the changes, which will significantly bridge the gap between primary and outpatient care.

Physiotherapists and podiatrists in the UK will be the first worldwide to prescribe medicines for their patients.

People with neuromuscular and foot disorders are often shuttled back and forth between specialist practitioners and GPs.

The new arrangements promise to simplify patient pathways and accelerate treatment of conditions such as chronic pain, asthma, arthritis and diabetic ulcers.

“Physiotherapists and podiatrists play a vital role in ensuring patients receive integrated care that helps them recover after treatment or manage a long-term condition,” said Health Minister Lord Howe.

“By introducing these changes, we aim to make the best use of their skills and allow patients to benefit from a faster and more effective service.”

Dr Helena Johnson, chair of the Chartered Society of Physiotherapy, commented that being able to prescribe would “hugely improve” the care therapists could provide, giving patients “a more streamlined and efficient service”.

The College of Podiatry said the changes would particularly benefit patients with foot wounds, infections and diabetic ulcers, for whom rapid access to medication can prevent hospital admissions.

The changes are expected to become law in April 2013, and physiotherapists and podiatrists will be able to become prescribers by 2014.

The arthritis therapeutics market is expected to experience significant growth in the coming years, a new report predicts.

Research found that arthritis therapeutics are becoming a “gigantic attraction” for pharmaceutical companies as the condition continues to be one of the most common causes of disabilities.

Rising incidence rates of osteoarthritis, rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis are expected to see revenues reach $35.8 billion by 2018.

Several major pharmaceutical and biotechnology companies have already shown an interest in obtaining market share and have made investments in the potentially lucrative industry.

Pfizer, Amgen, Merck, Roche and Novartis, the report found, have increased R&D efforts in the field with several promising therapies in late-stage development.

The current pipeline includes many small molecule drugs and biologic therapies, as well as novel oral Disease-Modifying Anti-rheumatic Drugs (DMARDs).

Biologics, the report predicts, will feature heavily as the market expands and drive growth during the coming years.

Existing market leaders are also expected to benefit from the predicted demand.

Amgen’s patent on blockbuster drug Enbrel was recently extended until 2028 by the FDA following a number of court proceedings. Other well-established brands have also had their protection protected.

However, the patents for Rituxan (rituximab), Remicade (infliximab), Celebrex (celecoxib) and Humira (adalimumab) will see a number of generic alternatives enter the market.

Despite cheaper therapeutic products being made available, the report estimates the market will grow at a compound annual growth rate (CAGR) of 7.2% for the next six years.

The Department of Health plans to give patients with rare illnesses better access to unlicensed or off-label drugs to treat their conditions.

The idea is for the DH to commission expert assessments of the use of off-label medication to inform doctors and patients to make “the best clinical decisions together”, says Health Secretary Andrew Lansley.

Andrew Wilson, Chief Executive of the Rarer Cancers Foundation, said: “This announcement is good news for patients with rare cancers and will help ensure all patients get access to good standards of care.”

Mr Lansley continued: “Wherever possible we should apply common sense solutions – especially to longstanding problems such as this – to ensure that patients can access the treatment they and their doctor think best for them.”

Treatment for hard-to-treat conditions, such as rarer cancers and autoimmune diseases, are sometimes only available for use in conditions where drug manufacturers are able to recruit enough patients to participate in clinical trials.

Mr Wilson commented: “When there are no licensed drugs available for a condition, it can be difficult to know how best to treat it. It is important that doctors are able to use their clinical judgement.”

At local level, NICE often does not have the evidence to make an informed decision to recommend the drug on the NHS.

Professor Anthony Redmond, Chair of the Arthritis and Musculoskeletal Alliance (ARMA), said: “NICE could play a valuable role in collating the evidence about what works in these conditions and this will be an important resource for clinicians in providing the best possible treatment to patients, and for patients in making an informed decision about the most appropriate option for them.”

Approximately 1,000 specific requests for off-label drugs are made to NHS commissioners every year.

Advanced MRI techniques can be used to detect changes in joint cartilage microstructure, enabling early diagnosis of osteoarthritis (OA), according to a new study.

Through this method, clinicians will be able to shift the treatment of the disease from joint reconstruction to long-term preservation, according to researchers at the NYU Langone Medical Center in the US.

Laith Jazrawi, Associate Professor of Orthopaedic Surgery and lead author of the study, said: “Imaging technology is now sensitive and powerful enough to enable detection of subtle changes in the intricate balance of water, chondrocytes and the collagen fibers and protein molecules that make up our joint cartilage - which we now know can point to future osteoarthritis”.

The newly developed techniques have “opened up a new window into the understanding and possible treatment of arthritis before irreversible structural and morphological changes has occurred”, commented members of the Department of Radiology at the NYU Medical Center.

The study has been published in the Journal of the American Academy of Orthopaedic Surgeons.

Roche’s RoActemra has been approved in Europe for the treatment of Systemic Juvenile Idiopathic Arthritis (sJIA).

The medicine is intended to treat patients two years of age and older who have responded inadequately to previous therapy with NSAIDS and systemic corticosteroids.

RoActemra is known as Actemra outside of Europe can be prescribed alone or in combination with methotrexate.

Hal Barron, Chief Medical Officer and Head of Global Product Development at Roche, stated: “RoACTEMRA is the first and only biological treatment to demonstrate significant efficacy in this patient population and offers physicians a new option for this extremely difficult to treat disease.”

sJIA is the rarest form of Juvenile Idiopathic Arthritis (JIA), also known as Juvenile Rheumatoid Arthritis (JRA). The disease affects about 10-20% of children with JIA, with the peak age of developing sJIA being between 18 months and two years of age, although the disease can persist into adulthood. 

Roche is a biotechnology company with focus on pharmaceuticals and diagnostics. The organisation manufactures medicines to be used in areas of oncology, virology, inflammation, metabolism and CNS.