Global health challenge shifts toward chronic illness

by JoelLane 17. December 2012 16:13

Insulin The focus of global healthcare is shifting from preventing early death to helping people live with chronic illness, according to the Global Burden of Disease Study 2010.

The five-year study noted a decline in child mortality and deaths from infectious diseases worldwide, but a major increase in cancer, diabetes and heart disease.

Major factors driving the fall in deaths from infectious diseases include the widespread use of drugs to treat diarrhoea, TB and measles.

Lead study author Professor Christopher Murray of the University of Washington commented: “There’s been a progressive shift from early death to chronic disability. What ails you isn’t necessarily what kills you.”

The report concluded that medical and demographic changes had caused a broad shift from acute and communicable diseases to chronic and non-communicable ones.

Between 1990 and 2010, deaths from non-communicable diseases increased by nearly 8 million: they now account for two in three deaths.

Cancer deaths rose by 38% to 8 million people in 2010, while diabetes-related deaths rose by 100% to 1.3 million.

Life expectancy for both men and women has risen by more than 10 years since 1990, but far more people are now living with a serious illness.

The highest risk factors for ill-health worldwide are now high blood pressure and smoking, whereas in 1990 the leading risk factor was malnutrition.

Diabetes and lung cancer have become more prevalent, while TB and diarrhoea have become less so.

However, sub-Saharan Africa continues to have very high rates of premature death, and the gap in life expectancy between the countries with the highest and lowest figures remains the same.

Inhaler to treat lung infections

by emma 26. September 2011 17:01

TOBI Podhaler

The first antibiotic inhaler device has been launched in the UK to treat chronic lung infections in adults and older children with cystic fibrosis (CF).

The TOBI Podhaler (pictured) from Novartis is a hand-held inhaler that delivers a new dry powder form of tobramycin to fight chronic Pseudomonas aeruginosa (Pa) lung infections, a common cause of death in people with CF.

The new device is estimated to save almost half an hour treatment time per day in people with CF over the age of 6, increasing their independence and quality of life.

CF affects 9,000 people in the UK. A life-threatening condition, it makes the lungs vulnerable to chronic infections.

Clinical studies have shown that treatment with tobramycin inhalation powder reduces treatment time by 72% compared with the nebulised drug.

Professor Stuart Elborn, Professor of Respiratory Medicine at Queen’s University, Belfast, commented: “People with CF have to endure a lengthy regimen of treatments and physiotherapy every day, so the time saved using tobramycin inhalation powder is significant.”

The new tobramycin inhalation powder has been produced using Novartis’ patented PulmoSphere technology. In trials, it was successfully inhaled in 5–6 minutes, whereas the nebuliser solution takes 20 minutes. For a twice-daily regimen, this saves approximately 28 minutes per day.

The dry powder inhaler is also less vulnerable to bacterial growth than the nebuliser, and needs no battery.

“We are proud to be launching TOBI Podhaler: a product that clearly demonstrates how we are applying innovative technology to better meet the needs of people with CF, helping them to lead independent and active lives,” said Dr Tim Cave, Medical Director of Novartis Pharmaceuticals UK.

Based in Basel, Switzerland, Novartis supplies a diversified portfolio of healthcare products including pharmaceuticals, diagnostics and drug delivery devices.

Janssen’s Incivo approved in Europe

by emma 22. September 2011 12:01

Pf product news

The European Commission has approved Incivo (telaprevir) for the treatment of genotype-1 chronic hepatitis C virus (HCV) in combination with peginterferon alfa and ribavirin.

The decision follows data from clinical studies which showed the direct acting antiviral (DAA) protease inhibitor significantly improved cure rates.

Ramon Polo, Telaprevir Compound Development Team Leader, Tibotec Virco-Virology BVBA, is delighted patients have “a significantly improved treatment option”.

Tibotec Virco-Virology BVBA is a division of Janssen.

Incivo is a class of medicine which offers patients with genotype-1 chronic HCV patients more chance than ever of a cure.

Its approval offers an improved and efficacious therapy regimen when compared to standard treatment with the shortest duration course of medication which is currently available. The DDA protease inhibitor may also reduce the total therapy time by half in the majority of those previously untreated patients and those who have relapsed.

Before the introduction of these inhibitors, treatment for HCV “required a long duration and cured less than half of genotype-1 chronic HCV patients”, said Professor Graham Foster, Queen Mary's University Hospital of London.

Working together to heal wounds

by emma 9. September 2011 11:56

ernestwaaser

Ernest Waaser, new CEO of global wound care company Systagenix, talks to Medtech Business about the importance of helping clinicians to address the challenge of wound healing across a range of care environments.

Ernest Waaser is the recently appointed CEO of wound care company Systagenix, based in the UK. Formed in 2008 through a buyout of Johnson & Johnson’s advanced wound care business, Systagenix supplies wound dressings to over 100 countries. The recent launch of its ‘Let’s Heal’ brand shows the company addressing the wound management and healing process proactively across primary, secondary and home-based care environments.

What prompted the launch of Systagenix in 2008: what opportunity did the company’s founders identify?
When our investors looked at the business back in 2008 they saw a strong existing business that, with the right focus and strategic investments, had a terrific opportunity to grow. The business had a 75-year heritage, a world-class R&D capability, and a strong reputation in wound care – a clinical area that’s continuing to grow with the ageing population and the increase in diabetes and obesity. It was part of a very large diversified company where it had to fight for investment and resources against other businesses. So by creating a stand-alone company that’s solely focused on wound care, we can be much more responsive to the needs of the market, make those strategic investments and bring real innovation to the world of wound care.

What is the thinking behind the ‘Let’s Heal’ brand?
What has it achieved for the company and for the industry? There are two basic beliefs behind the brand. First, we believe passionately that the goal is wound healing, not wound management. And in today’s practice, too often companies focus on managing individual symptoms in isolation from each other, rather than tackling the whole wound healing process as a continuum. Second, we recognise that there’s no single product or device that will heal every wound. Each patient and each wound is different, and there may be many reasons why a wound is not healing: the patient may have an infection or a high protease level, or a venous insufficiency, or any one of several other underlying illnesses or complications.

So our objective is to take a more holistic approach, to put a system in place, starting with diagnostic tools and leading on to the proper treatment for that wound in that patient. ‘Let’s Heal’ is our approach to providing a range of treatment options and a systematic approach to when to use each product. The huge innovation here is to start that whole process with point of care diagnostics that will provide immediate feedback on the status of the wound, which the clinician then uses to help select the appropriate treatment. ‘Let’s Test’ is our Systagenix umbrella for future wound diagnostics and assessment products, and that’s the entry point for our overall system of care.

Systagenix has particularly focused on treating hard to heal acute and chronic wounds. How are you trying to change the way these wounds are perceived?
The first perception we’re trying to change is that some patients must live with a wound. Our objective is that every wound should be healed, and we think every patient deserves that. Managing life with a wound is not in our vocabulary.

The second thing we’re trying to bring visibility to is that hard to heal wounds are not only affecting the patient’s quality of life, but are very expensive for the healthcare system. In many countries wound care is done partly in hospital, partly in an outpatient setting and partly at home, so the costs are spread around and the total cost tends not to be visible to healthcare administrators. The product that’s used to treat the wound is a small part of the cost: there’s hospitalisation, physician time, multiple home nurse visits, and the very real cost of complications ranging from infections to amputation.

There haven’t been many large-scale economic studies, but the evidence is pretty clear that the faster you get a wound healed, the lower the overall cost to the health system. That really is the focus of our ‘Let’s Heal’ approach: to eliminate trial and error, using point of care diagnostics to get the right treatment started immediately and shorten the overall healing time and cost.

How does that strategy work at the sales and marketing level?
Wound care is a clinical process that is spread not only across different care settings –  hospital, home, clinic – but also across a number of clinical specialties that treat wounds: vascular surgeons, podiatrists, general surgeons and others. One leading international clinician told me that wound care is a team sport. So part of what we do from a sales and marketing point of view is to try and bring these various clinical specialties and different types of clinicians together, to take a look at how the overall care process can be improved.

For example, we recently brought an international group of key opinion leaders together who issued an international consensus document on the use of a diagnostic in wound care to detect high protease levels, which are a known inhibitor to wound healing. They are putting the ground work in place to establish the need for that diagnostic test and determine how it should be used in clinical practice. This element of bringing the clinical community together to look holistically at how we can help them and provide them with the right tools to diagnose and heal wounds is an important part of the marketing effort for us.

How are current changes in the NHS landscape affecting the UK market for wound care companies?
We really haven’t seen the major impacts just yet. Obviously the NHS will be incredibly focused on delivering high-quality care at the lowest possible cost. I think our challenge as a sector is to demonstrate very clearly that our products and services can materially lower the cost of wound care: faster healing, fewer visits and fewer complications. I think as we go forward and the landscape continues to change, we’ll monitor that carefully and adjust as we need to.

What are the major business challenges facing UK wound care companies seeking to export to global markets?
I’d point out three challenges. The first is regulatory. Our products are covered under medical device and/or pharmaceutical regulations in every country they’re sold in, and once you get outside the EU they’re all different. The second is reimbursement. Just because you have regulatory approval doesn’t necessarily mean you can get paid for the product. The reimbursement systems are different in literally every country in the word. So those two issues, regulatory and reimbursement, require the combination of a fairly sophisticated infrastructure with the right skills and expertise and good local partners in your export markets. And finally, you really have to tailor your offering to local needs, taking into account local clinical practice and pricing expectations.

What do wound care companies need to do to address the clinical and commercial challenges of healthcare in the 21st century?
21st-century healthcare is all about finding more cost-effective ways to deliver high-quality care to a growing population of patients. As an industry we need to help clinicians in wound care get the right treatment to the right patient quickly and avoid much of the costly trial and error process that exists today. That requires thinking about innovation in a different way, looking not only at your product but at the overall process for treating a patient.

‘Electronic nose’ sniffs out heart failure

by emma 5. September 2011 12:22

MB Innovation news

A new “electronic nose” is being developed to be used in routine screenings to “smell” out chronic heart failure (CHF).

The project’s results demonstrated that the technology is able to diagnose heart failure non-invasively with almost 90% accuracy.

Vasileios Kechagias, investigator of the study at University Hospital Jena, in Germany, said: “The early detection of CHF through periodical screening facilitates early treatment application”.

The system consists of three thick-film metal oxide-based gas sensors with heater elements, with each sensor tailored to react with different odorant molecular types. Reactions between the sensor and molecules are caused by oxygen on the heated sensor surface, altering the free charge carrier concentrations, which change conductivity in the metal oxide layer.

During the trial, the electronic nose assigned 126 patients to one of three groups: no heart failure, compensated and decompensated, with 90% accuracy. Compensated heart failure reacts to treatment, whereas the decompensated version of the condition has no treatment and can cause such conditions as infections, arrhythmias and electrolyte disturbances.

The sensor is simply placed on the arm much like a blood pressure monitor for three minutes at a time and then analyses for heart failure markers.

Heart failure is a common, costly and potentially deadly condition. Approximate 2% of adults suffer from the condition in developed countries, and increases to 6% in adults over the age of 65.

Scientists say more research is required, but ultimately hope to create a rapid, minimally invasive method to screen, diagnose and monitor compensated heart failure.

SBRI funds innovative healthcare

by emma 8. August 2011 11:36

MB medtech news

Eight companies have been chosen to receive up to £100,000 funding each to help them develop medical technologies to support people with long-term health conditions.

The East of England Small Business Research Initiative (SBRI East) is investing in medical innovations that address the needs of the growing number of chronically ill patients by reducing acute admissions and delivering care in the community.

Of the 70 companies that applied for SBRI East funding this year, the eight selected are:

• Advanced Therapeutic Materials (Warwickshire) for its technology for long-term management of venous ulcers and circulatory failure. Data from a 3D imaging device is used to design customised compression garments.

• Aseptika (Huntingdon) for its rapid, home-based test for bacterial respiratory infections in patients with cystic fibrosis.

• Edixomed (Edinburgh) for its dressing for chronic diabetic leg ulcers. The system delivers nitric oxide directly to the wound, increasing blood flow.

• Sky Medical Technology (Cheshire) for its disposable adhesive device for self-treatment of an overactive bladder by external neuromuscular stimulation.

• Pintrack (Essex) for its Outminder independent living solution, which offers the user support as well as enabling the carer to deliver support remotely via a mobile device.

• PneumaCare (Cambridgeshire) for its non-contact respiratory assessment system, which can diagnose deterioration in patients with COPD.

• PolyPhotonix (Sedgefield) for its home-based treatment for diabetic retinopathy and AMD.

• Radisens Diagnostics (Cork, Ireland) to add a kidney disease test to its point-of-care blood analyser platform, which diagnoses and monitors various chronic conditions.

Karen Livingstone, Director of Strategic Partnerships at NHS East of England, said: “It is heartening to see British companies seeking to develop healthcare technologies to benefit those living with long-term conditions. These new technologies will mean that in the future, more people will be able to receive treatment in their own homes. This not only makes for an improved patient experience but also saves healthcare resources and costs.”

SBRI East is supported by NHS East of England, the European Regional Development Fund and the Technology Strategy Board.

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