Category: Medical Industry

Categories : Medical Industry Mental HealthTags :

Study Reveals Higher Suicide Rates among Pharmacists

On By ModernMedia
Phot by Mulyadi on Unsplash

While the COVID pandemic put the spotlight on the issue of mental health and burnout among doctors and nurses, less was known about the mental health of pharmacists. Results of a longitudinal study published in the Journal of the American Pharmacists Association reveal a suicide rate among pharmacists nearly twice that of the general population.

The figures are based on data from 2003 through 2018, show a suicide rate of 20 per 100 000 pharmacists compared to 12 per 100 000 in the general population. Study authors expect numbers to be even higher in subsequent years due to the additional stressors of the pandemic, and are currently evaluating more recent data.

“If we learned anything from the pandemic, it’s that there is a breaking point for health professionals,” said corresponding author Kelly C. Lee, PharmD, professor at UC San Diego.

The study identified the most common means of suicide in this population, with 49.8% of cases involving firearms, 29.4% involving poisoning and 13% involving suffocation. The use of firearms was similar between pharmacists and the general population, but poisoning via benzodiazepines, antidepressants and opioids was more frequent among pharmacists.

The data also provide some insight into contributing factors, including a history of mental illness and a high prevalence of job problems. Job problems are the most common feature of suicides across health care professions.

For pharmacists, Lee said job problems reflect significant changes in the industry in recent years, with more pharmacists being employed by hospitals and chain retailers as opposed to the small, private pharmacies more common in the past. Pharmacist responsibilities have also grown considerably, with larger volumes of pharmaceuticals to dispense and increasing demands to administer vaccines and other health care services.

“Pharmacists have many more responsibilities now, but are expected to do them with the same resources and compensation they had 20 years ago,” said Prof Lee. “And with strict monitoring from state and federal regulatory boards, pharmacists are expected to perform in a fast-paced environment with perfect accuracy. It’s difficult for any human to keep up with that pressure.”

Future research will further evaluate which job problems have the biggest impact and how the field can better respond. In the meantime, Prof Lee advised pharmacists to encourage help-seeking behaviours amongst themselves and their colleagues.

“Mental health is still highly stigmatised, and often even more so among health professionals,” said Prof Lee. “Even though we should know better, there is such an expectation to appear strong, capable and reliable in our roles that we struggle to admit any vulnerabilities. It’s time to take a look at what our jobs are doing to us and how we can better support each other, or we are going to lose our best pharmacists.”

Source: University of California San Diego

Categories : Medical IndustryTags :

Storm on the Horizon for Life Insurance: Rising Prices and Long COVID

On By ModernMedia
Business data
Photo by Towfiqu barbhuiya on Unsplash

Coming out of 2021, Price Waterhouse-Cooper analysed major life insurers in a new report, and found that they were able to maintain their policy holder obligations and maintain their financial positions. However, uncertainty is growing as global commodity prices spike amid lackluster growth and COVID’s potential long-term impacts.

PwC analysed 2021 results for five major insurers:  Discovery, Liberty, Momentum Metropolitan Holdings Limited (MMH), Old Mutual, and Sanlam.

 Alsue du Preez, PwC Africa Insurance Leader, said that the results are presented in the context of rapidly changing circumstances in which insurers are conducting their businesses. “Significant shifts are still occurring, the latest being the invasion by Russia of Ukraine and flooding in KZN, impacting not only the economy but environmental and social conditions,” she said. “These factors, as well as ongoing shifts in customer expectations and needs, have the potential to continue to materially influence future performance.”

While the COVID pandemic in 2020 was unpredictable, the impact of the second and third waves in 2021 was underestimated by life insurers, the report noted. The year 2021 did however come with a realisation of just how complicated the variables are, bringing risk variance losses of R6.8bn.

Key indicators showed that profitability growth was subdued even pre-pandemic, with earnings growing in line with inflation. Value of New Business (VNB) margins – ie, profit from new policy signings – was trending downwards slightly. VNB was 2.7%–3.1% over the period 2011–2015 but decreased to 2.4% in 2018 and 2019. The VNB margin achieved in 2021 is lower still at 1.9%, but still an improvement from 2020’s result of 1.49%.

The present value of new business premiums (PVNBP), which is the present value of total confirmed premiums that will be received from present to future, increased by 13% from 2019, but this could not offset the fall in margins compared with pre-pandemic levels. 

The report paints a grim picture for economic growth. Stifled GDP growth – with a per capita GDO fall of 4.2% – has been compounded by Russia’s invasion of Ukraine, with supply chain disruptions and knock-on global price increases. 

“Given the consequent higher inflation, weaker external demand and an unreliable power supply (the country’s largest growth inhibitor), we now forecast a real GDP growth rate of 2.0% this year (from 2.3% previously) with continued downside risk,” du Preez said. “Alongside this, weaker economic outlook provides even greater concern about the speed of the country’s jobs recovery. There is little scope for South Africa’s unemployment rate to improve this year if local business sentiment is weighed down by these factors.” 

Pressure on low/medium income households will impact their ability to afford new or existing insurance products

Increasing living costs will adversely impact all households during 2022, though this will impact the various income groups differently. 

“Middle to higher income groups are re-evaluating their discretionary spending patterns and are either ‘buying down’ or reducing insurance and savings products,” du Preez said. “On the other hand, households in the lower to lower-middle income categories will struggle to sustain their monthly basket of goods purchases. Given increased costs of necessities, these households will need to carefully consider the affordability of other discretionary monthly expenses, including insurance products.”

More than half of the income of low-income households goes on food and non-alcoholic beverages, which will be impacted by increasing commodity prices.

As we now proceed out of the rollercoaster that was 2021, a fair amount of uncertainty lingers in the industry. Talk is now moving more towards whether cost savings insurance entities achieved during the lockdown will be sustainable, as well as what allowance should be made for COVID’s impacts on long term mortality and long-COVID. 

Moving out of the rollercoaster of 2021, there is still significant uncertainty in the industry, with discussion over whether insurance companies will sustain their cost savings made during lockdown. Another question is how COVID will impact the industry in terms of mortality and long COVID.

The major life insurers’ Stronger performances in FY21 showed sustained strength in operational and capital management, and the relative benefits of diversification amongst their business portfolios. “The post-COVID financial ‘recovery’ is pleasing to see, but the pre-COVID comparison, coupled with the difficult macro-economic backdrop into the medium term, demonstrates the need for insurers to continue to innovate and invest on multiple fronts,” du Preez said. 

Categories : Medical IndustryTags :

Nearly Half of Care Home Nurses Report Medication Errors

On By ModernMedia
Bottle of pills
Source: Pixabay CC0

In a questionnaire-based study published in Pharmacology Research & Perspectives, nearly half of all nursing staff made at least one error within the last year when administering medications.

The aim of the study was to find out how often medication errors occur and whether they are related to training, quality assurance measures (use of the double-check principle (DCP)), and other structural conditions of home care services. 

In the study, 41.6% of nurses reported medication errors within a 12-month period, and 14.8% did not provide an answer. Medication errors experienced by patients include taking the wrong dose or quantity of a particular drug, as well as omission of a drug or taking unlicensed drugs. 

Nurses who had attended medication training within the last 2 years were less likely to make errors.  Years of professional experience, patient numbers per shift, and full time versus part time work were not statistically significantly associated with reported medication errors. 

“The study results underline the need for regularly recurring medication training for nurses to ensure a high level of patient safety – especially in the home care sector, as nurses are the only professional group on site,” said lead author Sandra Strube-Lahmann, RN, MSc, PhD, of Charité – Universitätsmedizin Berlin, in Germany.

Source: Wiley

Categories : Medical IndustryTags :

Cake Decoration Identifies Pills, Fighting Drug Fraud

On By ModernMedia
Chocolate drops covered with candy nonpareils (left), a bowl of colourful candy nonpareils (centre), pharmaceutical caplets coated with nonpareils (right). Credit: William Grover/UCR

During lockdown, UC Riverside bioengineering professor William Grover kept busy counting the colourful candy sprinkles perched on top of chocolate drops. In the process, he hit upon a simple way to prevent pharmaceutical fraud and detailed it in the journal Scientific Reports.

He calls the technique ‘CandyCode’ and uses tiny multi-coloured candy nonpareils commonly known as ‘hundreds and thousands’ in South Africa as a uniquely identifiable coating for pharmaceutical capsules and pills.

Millions of people are harmed by counterfeit or substandard medicine, a problem which costs an estimated $200 billion annually. One in 10 medical products in developing countries is fake, according to a WHO estimate.

Prof Grover’s lab has previously worked on simple, low-cost ways of verifying the authenticity of pharmaceuticals. Other researchers have tried putting unique codes onto pills, but these solutions have drawbacks.

“The inspiration for this came from the little colourful chocolate candies. Each candy has an average of 92 nonpareils attached randomly, and the nonpareils have eight different colours. I started wondering how many different patterns of coloured nonpareils were possible on these candies,” explained Prof Grover. “It turns out that the odds of a randomly generated candy pattern ever repeating itself are basically zero, so each of these candies is unique and will never be duplicated by chance.”

This gave Prof Grover the idea that the nonpareils could be applied as a coating to each pill, giving it a unique pattern that could be stored by the manufacturer in a database. Consumers could upload a smartphone photograph of a pill and if its CandyCode matches one in the database, the consumer could be confident that the pill is genuine. If not, it is potentially fraudulent.

To test this idea, Prof Grover stuck nonpareils onto Tylenol (acetaminophen) capsules and developed an algorithm that converts a photo of a CandyCoded pill into text which could be stored on a database and accessed by consumers. Using this algorithm to analyse a set of CandyCode photos, he found they serve as universally unique identifiers, even after subjecting the CandyCoded pills to physical abuse that simulates the wear-and-tear of shipping.

“Using a computer simulation of even larger CandyCode libraries, I found that a company could produce 1017 CandyCoded pills – enough for 41 million pills for each person on earth – and still be able to uniquely identify each CandyCoded pill,” Grover said.

More colours and different shapes of nonpareils could generate even more unique CandyCodes. CandyCoded capsules or tablets have an unexpected benefit for the consumer as well. 

“Anecdotally, I found that CandyCoded caplets were more pleasant to swallow than plain caplets, confirming Mary Poppins’ classic observation about the relationship between sugar and medicine,” Prof Grover remarked.

Source: EurekAlert!

Categories : COVID Medical IndustryTags :

Closure Threat for SA’s COVID Vaccine Plant as Orders Dry up

On By ModernMedia
Female scientist in laboratory
Photo by Gustavo Fring on Pexels

South Africa’s COVID vaccine production plant, the first of its kind in Africa is at risk of closure after failing to secure a single according to a report from Reuters. President Cyril Ramaphosa is reported to be in talks with three other African nations in effort to save the venture.

The World Health Organization had called the licensing deal between Johnson & Johnson and Aspen Pharmacare to manufacture the Aspenovax COVID vaccine, a “transformative moment” in the pursuit of equitable access to vaccines. The vaccine is the J&J adenovirus vector vaccine sold under the Aspen brand.

However, after initial vaccine delivery shortfalls, the African continent is now well stocked with vaccines, while the poor infrastructure hampers vaccine distribution.

“There’ve been no orders received for Aspenovax,” Reuters reported, citing a phone conversation with Aspen senior director Stavros Nicolaou.

“If we don’t get orders, we would have to repurpose these lines back into other things that we were previously doing,” he told CapeTalk.

There are several other such vaccine plants in various stages, as the African Union aims at 60% of locally produced vaccines for continent locally by 2040, up from the current 1%.

“If Aspen doesn’t get production, what chance is there for any of the other initiatives?” Nicolaou remarked.

Regarding possible options, he said: “We are exploring various options. It is our medium-to-long-term objective to look at providing a sterile [processing] platform and solutions for the continent but the short-term needs to be sorted out.”

Moderna announced an agreement with Kenya to set up its first mRNA manufacturing facility in Africa with the aim of producing up to 500 million doses a year.

Source: Seeking Alpha

Categories : COVID Medical IndustryTags :

Life Insurance Premium Hike on the Cards for the Unvaccinated

On By ModernMedia
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Photo by adrianna geo on Unsplash

After a staggering increase of R24.9 billion in claims from COVID, South African life insurers are faced with little option but to implement a premium hike on policies for the unvaccinated. Death rates among unvaccinated people could remain elevated even as the pandemic eases, despite the lower severity of Omicron.

The Association for Savings and Investment SA (Asisa) provided death claims data from 1 April 2021 to 30 September 2021, a period which covered the third COVID wave (May to September). Compared to the same pre-pandemic period in 2019, there was a 53% surge in claims was reported, with a more than doubling of value of death claims. There were 565 522 claims, totalling R44.42 billion, compared to the pre-pandemic period’s 369 892 claims of R19.53 billion.

Though deaths were greatly reduced in the fourth wave, with Asisa acknowledging “anecdotal evidence” showing reduced severity from the Omicron variant, there was still “overwhelming evidence” that COVID mortality risks are far higher for the unvaccinated. Asisa’s data reflects that of the South African Medical Research Council (SAMRC), which shows a huge increase in the number of excess deaths over that period.

This information comes as the government debates easing lockdown measures even as various institutions warn of an impending fifth wave, which according to Absa bank could come as early as next month. However, Absa noted that its life claims were much reduced over the fourth wave as compared to the third, and therefore expects the fifth wave to be less severe.

Hennie de Villiers, the deputy chair of Asisa’s life and risk board committee, said that the importance of life insurance cover had been clearly demonstrated. “The reality is that most of us know at least one person who lost his or her life due to COVID. We also know of many more people who lost their income during the pandemic, highlighting the importance of having access to savings.”

He cautioned that, “While the death rate has been lower during the fourth wave than in previous waves due to vaccinations and the emergence of the Omicron variant, death claims rates have not yet returned to pre-pandemic levels. Also, less than 50% of our adult population has been vaccinated.

“There is overwhelming evidence that the risk of severe illness or death is significantly lower in those who are fully vaccinated.”

He added in a later statement that if the situation does not change and vaccinations are not embraced by the country, insurers may have “little choice but to adjust premiums in line with the higher risk presented by someone who is not vaccinated and therefore more likely to die from COVID”.

De Villiers said a “staggering” 1.59-million death claims were received in the 18 months from 1 April 2020 to 30 September, with life insurers paying out benefits of R92 billion.

Group life insurance premiums have already increased for the unvaccinated, De Villiers pointed out. Employers with mandatory vaccination policies are meanwhile benefitting from preferential rates.

When unvaccinated status is combined with age and comorbidities, premium increases, this resulted in premium increases of as much as 100% and in some cases coverage was even declined.

Source: Business Live

Categories : HIV Medical IndustryTags :

Generic Options for HIV Prophylactic Cabotegravir Locked Out, MSF Warns

On By ModernMedia
Image of a syring for vaccination
Photo by Mika Baumeister on Unsplash

Médecins Sans Frontières (MSF) has warned that pharmaceutical company ViiV’s recent decision not to pursue voluntary licensing for the long-acting HIV prophylactic cabotegravir (CAB-LA) means that lower cost generic production in low- and middle-income countries (LMICs) is effectively locked out for countries like South Africa.

CAB-LA was approved for the prevention of HIV infection by the USFDA in December 2021, and ViiV currently charges $3700 (R55 000) per vial in the US ($22 200/R333 000 annually per person). The Clinton Health Access Initiative (CHAI) has shown that generic manufacturers could produce this drug for around $2.60 (R39) per vial (less than $20/R3000 per person per year). Although ViiV has publicly said they would provide CAB-LA for their at-cost price in many LMICs, they have yet to announce what that price is.

According to MSF, generic manufacturer prices are often much lower than the patented drug – and they can even produce complicated formulations like CAB-LA.  The generic equivalent [PDF] of ViiV’s paediatric formulation of the HIV drug dolutegravir costs 22 times less.

Amanda Banda, Infectious Diseases Policy and Advocacy Advisor of the MSF Access Campaign, said: “What good is HIV prevention if the people who need it can’t afford it? This is the most effective form of HIV prevention for vulnerable and marginalised communities and yet ViiV is delaying the ability of generic manufacturers to supply the drug, meaning that many people across low- and middle-income countries who would benefit from the medicine to prevent HIV infection won’t be able to access it. CAB-LA will need to be available at a price that is comparable to currently available oral PrEP if country treatment programs and donors are expected to scale up its use to the levels needed – and it’s hard to imagine that ViiV will make CAB-LA available at less than $40 (R600) per year.  ViiV needs to immediately sign a licensing deal with the Medicines Patent Pool so that more affordable generics can be produced, and more lives can be saved.”

Dr Tom Ellman, Head of MSF’s South African Medical Unit said: “We want to urgently make this drug available for people at high risk of HIV infection in our programs in sub-Saharan Africa – we don’t want a donation with many strings attached from the corporation; it is not the role of ViiV to control the use of a drug that is approved by the USFDA. We want ViiV to sell us this drug at an affordable price.”

Source: MSF

Categories : Medical IndustryTags :

A Synthetic Alternative to Pig-derived Heparin

On By ModernMedia
Photo by Corinna Widmer from Pexels

Scientists have developed a process to synthesise the vital blood thinner heparin, which is normally harvested from pig intestines. This synthetic heparin would help the quality control issues and shortages associated with pig-derived heparin.

The most expensive part of a pig is not a cut of bacon or a chop, but the part of the intestine used to make heparin. About 2000 pigs required to produce a kilogram of heparin, which provides medication to up to 6000 patients. In total, it is estimated that about one billion primarily Chinese food pigs each year also supply intestines for the extraction and processing of heparin.

However, this can cause problems for patients. When making medicines derived from animals, the chemical structure is rarely uniform. There are relatively common but harmless side effects, and in very rare cases severe and life-threatening immune reactions. Additionally, there are ethical and religious concerns for many patients. Bovine- and sheep-derived heparin are also produced but have the same concerns of being of animal origin. In fact, prior to 2000, heparin was derived from cows until the outbreak of mad cow disease.

Therefore, it has long been an ambition among researchers to make heparin in a laboratory to get cleaner heparin without side effects. Now researchers from the Copenhagen Center for Glycomics at the University of Copenhagen are ready with a study that shows that it is possible to make heparin without the use of animals.  which was published in Science Advances.

“By making heparin without the animal, you get a much cleaner and more uniform chemical structure. We show that we can do it in the laboratory, i.e. in a so-called ‘cell factory’, in the same way as many other types of medicine are made. It is a step in the direction of the development that has also happened with insulin, which was previously extracted from the pancreas in pigs before we learned to produce it in the laboratory,” explained Associate Professor Rebecca Miller, who led the study. 

There is already a synthetic alternative to heparin, but it is difficult to dose and can lead to overdose. Because of this, GPs often prescribe pig-derived heparin to their patients.

Heparin is today extracted from pig intestines’ mucosa. Due to the sheer number of patients who need the medicine, the scale of the production is vast, making quality control a recurring problem for manufacturers.

In 2008, a number of stocks of heparin from Chinese pigs were recalled when it was found that the medicine was contaminated. The case ended up costing the lives of more than 100 Americans.

“Of course you want to avoid that, in addition to moving the source from animals to laboratory cells. With our new technology, we have made a design for how to make heparin in a cell that is clean and uniform and it suggests that it has the same medicinal effect as market heparin. In this way, you potentially get a product that leads to neither common nor life-threatening side effects,” said Richard Karlsson, PhD, who has also contributed to the main author of the study.

Right now, the world is facing a shortage of heparin because swine flu has thinned the pig population in China, the largest heparin producer.
Next steps would be to scale up production to provide much larger quantities of the new synthetic heparin. 

Source: University of Copenhagen

Categories : General Interest Medical IndustryTags :

ICD-11 Comes into Effect

On By ModernMedia
Source: Pixabay

The World Health Organization (WHO) has announced that the Eleventh Revision of the International Classification of Diseases (ICD-11) has now come into effect, with the latest update going online on Friday, 11th February.

Compared with previous versions, ICD-11 is entirely digital with a new user-friendly format and multilingual capabilities that reduce the chance of error. It has been compiled and updated with input from over 90 countries and unprecedented involvement of health-care providers, enabling evolution from a system imposed on clinicians into a truly enabling clinical classification and terminology database that serves a broad range of uses for recording and reporting statistics on health. It also allows entries to appear in multiple categories: for example, stroke appears under both the cardiovascular and neurological categories.

“International classification of diseases is the cornerstone of a robust health information system”, said Dr Samira Asma, the Assistant Director-General for Data, Analytics and Delivery for Impact at the World Health Organization (WHO). “ICD has been instrumental in helping us respond to the COVID pandemic using standardised data and continues to be crucial for tracking progress towards universal health coverage. We hope all countries will take advantage of ICD-11’s powerful new features.”

Among other updates, ICD-11 improves the clarity of terms for the general public and facilitates the coding of important details such as the spread of a cancer or the exact site and type of a fracture. The new version also includes updated diagnostic recommendations for mental health conditions and digital documentation of COVID certificates.

These updates reflect recent progress in medicine and advances in scientific understanding. For example, codes relating to antimicrobial resistance are now aligned with the Global Antimicrobial Resistance Surveillance System (GLASS). ICD-11 is also more capable of capturing data on health-care safety, thus identifying and reducing unnecessary events that may harm health such as unsafe workflows in hospitals.

ICD is used by health insurers who make reimbursement decisions on the basis of ICD coding, by national health programme managers, by data collection specialists, and by anyone who tracks progress in global health and determines health resource allocation.

“A key principle in this revision was to simplify the coding and provide users with all necessary electronic tooling – this will allow health-care professionals to more easily and completely record conditions,” says Dr Robert Jakob, Team Lead, Classifications Terminologies and Standards, WHO.

In addition to coding and capability updates, ICD-11 includes new chapters on traditional medicine, sexual health, and gaming disorder – which has now been added to the section on addictive disorders.

ICD-11 was adopted at the World Health Assembly in May 2019 and Member States committed to start using it for mortality and morbidity reporting in 2022. Since 2019, early adopter countries, translators, and scientific groups have recommended further refinements to produce the version that is posted online today.

Source: World Health Organization

Categories : Medical IndustryTags :

SA Healthcare Bolstered With Vaccine Lab Investment and Loans

On By ModernMedia
Photo by Louise Reed on Unsplash

Last week, South African healthcare received a double shot in the arm with the opening of a local vaccine manufacturing facility and the approval of a World Bank loan to bolster social safety nets and health systems.

On Wednesday, President Cyril Ramaphosa and health technology billionaire Dr Patrick Soon-Shiong officially opened a new vaccine manufacturing facility in Brackenfell, Western Cape.

The South African-born entrepreneur has been strongly supporting local healthcare, with R3 billion invested to help SA share vaccine technology with the rest of Africa. His company, ImmunityBio, is developing a T-cell based universal COVID vaccine, currently in Phase III trials in SA. The same adenovirus vector technology it uses is also being tested in cancer vaccines.

“It has been a dream of mine, since I left the country as a young physician, to bring state-of-the-art, 21st century medical care to SA and to enable the country to serve as a scientific hub for the continent,” Dr Shoon-Siong had previously said. The technology transfer will help “establish much-needed capacity and self-sufficiency.”

The hub will transfer technology, know-how and materials for DNA, RNA, adjuvant vaccine platforms and cell therapies to SA.

“There is no reason we couldn’t make 500 million doses a year,” said Dr Soon-Shiong, who is also a Wits alumnus. “Subject to the raw material being available.”

He said he wants to tap the country’s expertise on prevalent diseases such as HIV and cervical cancer. “There are fantastic scientists with deep knowledge about these diseases,” he said. “More so than in America because they see these patients every day.”

President Ramaphosa and Dr Soon-Shiong also launched the Coalition to Accelerate Africa’s Access to Advanced Healthcare, which aims to drive the development of innovative therapeutics and ensure the continent is prepared for future pandemics.

The coalition aims to manufacture a billion doses of the COVID vaccine by 2025 and to develop treatments for conditions including cancer, COVID, tuberculosis and HIV.

South Africa also received approval from the World Bank for a US$750 million COVID relief loan aimed at reducing the worst of the pandemic’s impact on the poor.

“The World Bank budget support is coming at a critical time for us and will contribute towards addressing the financing gap stemming from additional spending in response to the COVID crisis,” said Dondo Mogajane, Director General of the National Treasury. “It will assist in addressing the immediate challenge of financing critical health and social safety net programs whilst also continuing to develop our economic reform agenda to build back better.”

Meanwhile, Health Minister Dr Joe Phaahla warned that South Africa will likely enter a fifth wave when cold temperatures in May, though what COVID variants may drive it remain to be seen.