Politics apart, grave shortages are being observed within the public pharmaceutical health care system. Most of these said shortages are essential, and also, costly medicines, that cannot be replaced by out-of-pocket expense.
It is high time that some measure of accountability and transparency is brought to the situation. Both healthcare professionals delivering the service, and the patients on the receiving end, deserve to be kept in the loop.
Unfortunately, a sense of apathy seems to pervade all involved, with no tangible and constructive public debate being held. It is no wonder that most patients I meet tend to shrug their shoulders and say: Does anybody care?
Tuesday, 27 September 2011
Sunday, 25 September 2011
Taken from Reuters news feed earlier today
Roche bone drug eases pain in prostate cancer trial
Trial investigators said the level side effects of Boniva -- known generically as ibandronate (IB) -- were also comparable with radiotherapy, suggesting it could offer an alternative option for advanced cancer patients suffering pain.
Bone metastases, or secondary tumors in the bone, are common in many advanced cancers and "are a serious problem for men with prostate cancer," said Peter Hoskin a professor clinical oncology at University College, London, who presented the data at the European Multidisciplinary Cancer Congress (EMCC) in Stockholm on Sunday.
"We found that using IB was as good as single dose radiotherapy in controlling pain," he said.
Boniva is one of a class of osteoporosis drugs known as bisphosphonates, which work by sticking to calcium and binding to it. Others in the same class include Novartis's Zometa and Merck's Fosamax.
They prevent bone loss by inhibiting the activity of cells that break down bone, called osteoclasts.
For the late stage, or Phase III, trial, researchers gave 470 patients with painful secondary tumors in the bone either a single dose of radiation or an intravenous infusion of Boniva.
Patients reported their main site of pain when they began the trial, and then again at four, eight, 12, 26 and 52 weeks after treatment.
Those who had not responded to the first treatment at four weeks crossed over to the alternative therapy and received their second treatment no later than week eight.
Pain levels were measured at four and 12 weeks by analysing how many painkillers patients were needing to take, and by scoring their reported pain levels using two standard methods called the WHO pain ladder and the Mercadante method.
"Although there were more patients in the IB group with worse Mercadante scores at four weeks who needed re-treatment, at six and 12 months, there was no long-term difference in pain relief between the two groups," Hoskin said
The median survival of the four groups was 11.8 months for those on radiotherapy only, 11.4 months for those on the Roche drug only, 12.7 months for those on radiotherapy then Boniva, and 16.8 months for those on Boniva and then radiotherapy.
But Hoskin said it was too early to draw any conclusions from these data about the drug's relative impact on survival in this group of patients.
"We hope to analyze these survival differences further in the hope that it can give us... pointers as to how and whether we should use a combination of treatments," he said. "Currently we are unsure about the optimal timing and scheduling of treatment for these patients."
For now Hoskin said Boniva, which is also sold under the brand name Bonviva, would be addition to the arsenal of other possible treatments for cancer pain and could potentially be useful in other types of the diseases such as breast cancer, where secondary bone tumors are also common.
(Editing by John Stonestreet)
STOCKHOLM |
(Reuters) - Roche's bone strengthening drug Boniva is as good for pain relief as single dose radiotherapy in patients whose prostate cancer has spread to their bones, according to data from a late-stage trial released on Sunday.Trial investigators said the level side effects of Boniva -- known generically as ibandronate (IB) -- were also comparable with radiotherapy, suggesting it could offer an alternative option for advanced cancer patients suffering pain.
Bone metastases, or secondary tumors in the bone, are common in many advanced cancers and "are a serious problem for men with prostate cancer," said Peter Hoskin a professor clinical oncology at University College, London, who presented the data at the European Multidisciplinary Cancer Congress (EMCC) in Stockholm on Sunday.
"We found that using IB was as good as single dose radiotherapy in controlling pain," he said.
Boniva is one of a class of osteoporosis drugs known as bisphosphonates, which work by sticking to calcium and binding to it. Others in the same class include Novartis's Zometa and Merck's Fosamax.
They prevent bone loss by inhibiting the activity of cells that break down bone, called osteoclasts.
For the late stage, or Phase III, trial, researchers gave 470 patients with painful secondary tumors in the bone either a single dose of radiation or an intravenous infusion of Boniva.
Patients reported their main site of pain when they began the trial, and then again at four, eight, 12, 26 and 52 weeks after treatment.
Those who had not responded to the first treatment at four weeks crossed over to the alternative therapy and received their second treatment no later than week eight.
Pain levels were measured at four and 12 weeks by analysing how many painkillers patients were needing to take, and by scoring their reported pain levels using two standard methods called the WHO pain ladder and the Mercadante method.
"Although there were more patients in the IB group with worse Mercadante scores at four weeks who needed re-treatment, at six and 12 months, there was no long-term difference in pain relief between the two groups," Hoskin said
The median survival of the four groups was 11.8 months for those on radiotherapy only, 11.4 months for those on the Roche drug only, 12.7 months for those on radiotherapy then Boniva, and 16.8 months for those on Boniva and then radiotherapy.
But Hoskin said it was too early to draw any conclusions from these data about the drug's relative impact on survival in this group of patients.
"We hope to analyze these survival differences further in the hope that it can give us... pointers as to how and whether we should use a combination of treatments," he said. "Currently we are unsure about the optimal timing and scheduling of treatment for these patients."
For now Hoskin said Boniva, which is also sold under the brand name Bonviva, would be addition to the arsenal of other possible treatments for cancer pain and could potentially be useful in other types of the diseases such as breast cancer, where secondary bone tumors are also common.
(Editing by John Stonestreet)
Sunday, 6 March 2011
Pharmacy Symposium 2011
This week is Symposium week at the Old University in Valletta. Please take the opportunity to attend and support the undergraduate and Master students in their efforts.
Follow the link below for the full programme:
http://www.stsimonpharmacy.com/docs/Pharmacy_Symposium_2011_Program_i.pdf
Follow the link below for the full programme:
http://www.stsimonpharmacy.com/docs/Pharmacy_Symposium_2011_Program_i.pdf
An unpublished reply to an editorial in the Times of Malta
In reply to the Editor of The Times of Malta
Dear Sir,
I have always turned to your newspaper as a source of fair, balanced and well-researched information. It is thus with dismay that I read your editorial of the 1st day of this month, and it is with much chagrin that I pen this risposte. As a practicing pharmacist professional, pharmacy owner and also a researcher in the field of local medicine prices and the various factors influencing their levels, I take exception to the manner in which the subject has been addressed and also the manner in which all actors within the highly complex scenario have been caricatured.
Firstly, your editorial states that ‘exorbitant prices’ are the norm, and in some cases two or three times those of other EU countries. I would like to draw your attention to the fact that cross-country comparisons cannot be taken at face-value. In some countries, such as Italy, local councils put aside part of their annual budget to subsidise medicine prices within their area, a fact that some locals here in Malta, take advantage of. Others, such as Belgium, operate a system of co-payment, whereby patients pay a percentage of the purchase price, with the remainder of the cost being borne by the state.
Secondly, the concept of Purchasing Power Parity(PPP) must be taken into consideration. A Euro is not worth the same across all the Euro Zone countries, but rather, adjustments must be made fore the varying cost of living in each country.
Thirdly, no transparent and consistent tool presently exists to measure medicine prices in Malta, and enable realistic inter-country comparisons. Ongoing research under the auspices of the Pharmacoeconmics Section of the Pharmacy Department of the University of Malta, indicates that medicine prices have actually increased at a rate that is substantially lower than that of the general cost of living. It is intended to further develop this field of work and come up with a functional and reliable medicine price monitoring tool.
Even though I would rather not have to reply to unsubstantiated and ill-researched allegations regarding a subject that is, as correctly stated by yourself ‘ xx’, your editorial will hopefully be the stimulus for factual and reasoned discussion on the prices of pharmaceuticals in Malta. There is much to be addressed, and advancement will only be achieved if all of us involved within the field of healthcare and beyond, pool our resources to develop methods and policies for price monitoring and regulation, rather than attempt to generate sensational headlines by means of wide-ranging and generic statements about a complex and sensitive issue.
John Vella
June 2010
Time to stand up and be counted
In view of the events of the last weeks, and also various other occasions in the past, it is my opinion that we, as professional pharmacists, have arrived to a cross-roads. Whether we hail from community or hospital settings, industry, medical detailing, academia, or in many cases, a mixture of a number of these fields of specialization, it is time that we put aside our differences and provide a common front to the serious allegations being levelled at our profession.
Our integrity has been called into question, unfortunately by members of a related healthcare field. Such issues cannot go answered, as not only a comprehensive denial is required but also a public statement of affairs and unified and official representations both to the source of the allegations and also to the general population. Anything less will be construed as acceptance of the matters alleged as fact. What is all the more worrying is that public opinion is well against us, as a cursory glance at web-blogs to the various newspapers reveal. This leaves us open to attack from all sides of the political spectrum, and this can be ill-afforded, especially in view of the upcoming renegotiation of our partial integration into the primary healthcare system.
Whether we come together now, in the face of adversity, will define our own future and also that of pharmacists in the making. We can either shape our own destiny and finally position ourselves as respected and equal partners with other healthcare professionals within the private and primary healthcare systems, or we can go on doing a very good job of self-destructing by means of continual bickering and internal warring.
I, for one, have erred in the past by putting personal ideology before that beneficial to the general good. Many of us, in efforts to get the ball rolling, have formed or associated with various entities. The time has come for all of us to re-evaluate our positions and find common ground, whether under one existing entity, or as a grouping of various associations. Easier said than done, but it is the only way to ensure the survival of our profession as an independent one, and answerable only directly to the competent authorities. It is both our professional, and also moral obligation, to ensure fair and equitable representation for all pharmacists within the society which we humbly serve.
In concluding, I would like to paraphrase Benjamin Franklin, who at a crucial moment in the American Revolution stated very accurately : ‘ We must hang together, (gentlemen)…..else we shall most assuredly hang separately’.
John Vella
March 2010
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