13 de juny 2022

Sharing health risks

 Mutualism and health care. Hospital contributory schemes in twentieth-century Britain

The British hospital contributory schemes movement was described in 1936 as ‘one of the most outstanding examples of social organisation during the last two or three decades’.1 Contributory schemes had flourished in response to the considerable financial challenges faced by the voluntary hospitals in the twentieth century, although their roots lay in the nineteenth-century Hospital Saturday and Sunday funds (described in chapter 2).2 The aim was to elicit the support of working-class subscribers (people whose incomes were insufficient for them to be able to pay for treatment by a private medical practitioner) in the form of regular contributions to hospital finances. A small weekly contribution was levied, typically 2d or 3d, or a penny in the pound of wages, mostly through payroll deductions. The funds raised were either handed over directly to individual hospitals or pooled for distribution between groups of hospitals. The principal benefit of membership was free treatment in a voluntary hospital, without having to pass the means test set by the hospital almoner



09 de juny 2022

Longevity medicine scams

 The Price of Immortality. THE RACE TO LIVE FOREVER

Peter Ward immerses himself into an eccentric world of startups, scam artists, scientific institutions, and tech billionaires to deliver this deeply reported, nuanced, and sometimes very funny exploration of the race for immortality — and the potentially devastating consequences should humanity realize its ultimate dream.




08 de juny 2022

Valuing health

 Measuring and Valuing Health Benefits for Economic Evaluation

This book addresses the theoretical and practical considerations in the measurement and valuation of health benefit with empirical examples and applications to help clarify understanding and make relevant links to the real world. It includes a glossary of key terms and provides guidance on the use of different methods and instruments. This updated edition provides an-up-to date review of the theoretical basis of the QALY; the definition of health; the techniques of valuation (including ordinal); the modelling of health state values (including mapping between measures); a detailed review of generic preference-based measures and other instruments for obtaining health state utility values (with recent developments); cross-cultural issues (including the disability-adjusted life year); the aggregation of QALYs; and the practical issues surrounding the use of utility values in cost-effectiveness models. The book concludes with a discussion on the way forward in light of the substantial methodological differences, the role of normative judgements, and where further research is most likely to take forward this fascinating component of health economics.



09 de maig 2022

Pharma, big pharma (10)

 Inside the FDA: The Business and Politics Behind the Drugs We Take and the Food We Eat

Inside the FDA takes a closer look at the practices, people, and politics of this crucial watchdog in light of the competing pressures and trends of modern society, revealing what the FDA is supposed to do, what it actually does-and fails to do-who it influences, and how it could better fulfill its mandate. The decisions that the FDA makes are literally life and death. Inside the FDA provides a sophisticated account of how this vitally important agency struggles to balance bureaucracy and politics with its overriding mission to promote the country's health.



 

08 de maig 2022

Pharma, big pharma (9)

 Devalued and Distrusted: Can the Pharmaceutical Industry Restore its Broken Image?

Starting with "4 Secrets that Drug Companies Don't Want You to Know," Devalued and Distrusted provides a fact-based account of how the pharmaceutical industry works and the challenges it faces. It addresses such critical issues as:

  • Why pharmaceutical R&D productivity has declined
  • Where pharmaceutical companies need to invest their resources
  • What can be done to solve core health challenges, including cancer, diabetes, and neurodegenerative diseases
  • How the pharmaceutical industry can regain public trust and resuscitate its image

Our understanding of human health and disease grows daily; however, converting science into medicine is increasingly challenging. Reading Devalued and Distrusted, you'll not only gain a greater appreciation of those challenges, but also the role that the pharmaceutical industry currently plays and can play in solving those challenges.



 

07 de maig 2022

Pharma, big pharma (8)

 Drug Truths: Dispelling the Myths About Pharma R & D

This book answers the questions about the process and costs of pharmaceutical R & D in a compelling narrative focused on the discovery and development of important new medicines. It gives an insider's account of the pharmaceutical industry drug discovery process, the very real costs of misperceptions about the industry, the high stakes--both economic and scientific--of developing drugs, the triumphs that come when new compounds reach the market and save lives, and the despair that follows when new compounds fail. In the book, John LaMattina, former president of Pfizer Global Research and Development, weaves themes critical to a vital drug discovery environment in the context. This is a story that Dr. LaMattina is uniquely qualified to tell.

TABLE OF CONTENTS

PART I A MATTER OF THE HEART 1

CHAPTER 1 CHOLESTEROL DRUGS ARE UNNECESSARY 3

CHAPTER 2 INDUSTRY IS MORE INTERESTED IN "ME-TOO" DRUGS THAN IN INNOVATION 13

CHAPTER 3 IT TAKES INDUSTRY TOO LONG TO DISCOVER NEW DRUGS 23

PART II THE ROLE OF PHARMACEUTICAL R&D IN HEALTH CARE 39

CHAPTER 4 DRUGS ARE DISCOVERED BY ACADEMIA 41

CHAPTER 5 NEW MEDICINES ADD COSTS BUT LITTLE BENEFIT 50

CHAPTER 6 BIG PHARMA HAS FAILED AND SHOULD LEARN FROM BIOTECH SUCCESS 59

PART III THE PROFIT MOTIVE 69

CHAPTER 7 THE INDUSTRY INVENTS DISEASES 71

CHAPTER 8 NEW DRUGS ARE LESS SAFE THAN TRADITIONAL MEDICINES 79

CHAPTER 9 INDUSTRY SPENDS MORE ON ADVERTISING THAN ON R&D 91

CHAPTER 10 INDUSTRY DOES NOT CARE ABOUT DISEASES OF THE DEVELOPING WORLD 100

PART IV THE FUTURE 109

CHAPTER 11 BIG PHARMA'S DAY HAS PASSED 111

CHAPTER 12 FINAL REFLECTIONS 122



06 de maig 2022

Two-tier healthcare, or paying twice for the same (2)

 Are we heading for a two tier healthcare system in the UK?

Private healthcare boom adds to fears of two-tier system in UK

Extrapolation from a recent poll suggests that about 16 million adults in the UK found it difficult to access healthcare services during the pandemic, and of these, one in eight opted to access private healthcare.1 This could create the conditions for a two tier system, whereby those with the means to pay have access to healthcare more quickly than those who don’t. This would jeopardise the high levels of support the NHS has enjoyed since its establishment and have serious implications for equity in access to healthcare services.

 

 

05 de maig 2022

Two-tier healthcare, or paying twice for the same

 Is Two-Tier Health Care the Future?

In this book, leading researchers explore the public and private mix in Canada and within countries such as Australia, Germany, France and Ireland. We explain the history and complexity of interactions between public and private funding of health care. We also explain the many regulations and policies found in different countries used to both inhibit and sometimes to encourage two-tier care (for example, tax breaks). If a Canadian court strikes down laws restrictive of two-tier, Canadian governments can (i) permit and even encourage two-tier care to grow; (ii) pass new regulations that allow a small measure of two-tier care; or (iii) take positive steps to eliminate wait times in Canadian health care, and thereby reduce demand for two-tier care. We argue for option three as the best means to ensure Canadian principles of equity in access, ensure timely care, and fend off constitutional challenges.




04 de maig 2022

Against black box medicine (2)

 Time to reality check the promises of machine learningowered precision medicine

Both machine learning and precision medicine are genuine innovations and will undoubtedly lead to some great scientific successes. However, these benefits currently fall short of the hype and expectation that has grown around them. Such a disconnect is not benign and risks overlooking rigour for rhetoric and inflating a bubble of hope that could irretrievably damage public trust when it bursts. Such mistakes and harm are inevitable if machine learning is mistakenly thought to bypass the need for genuine scientific expertise and scrutiny. There is no question that the appearance of big data and machine learning offer an exciting chance for revolution, but revolutions demand greater scrutiny, not less. This scrutiny should involve a reality check on the promises of machine learning-powered precision medicine and an enhanced focus on the core principles of good data science—trained experts in study design, data system design, and causal inference asking clear and important questions using high-quality data.