Good news for South African AIDS patients
De Beers, the well known industrial giant which tries to control most of the Worlds legal diamond trade, has taken the decision to introduce anti-retroviral treatment as another integral component in its strategy in fighting HIV/AIDS. This follows a similar move by other companies, including Shell. One may remember that last year Annals News frequently commented on the fight of South Africa and Brazil to produce locally, cheaply, effective AIDS drugs, sometimes in violation of patents held by large pharmaceutical companies.
The rollout of the drug treatment programme should begin in January 2003. To encourage compliance with treatment regimes, participants in the drug treatment programme will be expected to make a 10% contribution towards the costs. Managing Director of De Beers, Gary Ralfe has been reported in the Swiss press to have stated that companies have had to move because the local government was slow in responding. It seems that controversy surrounds some statements of President Thabo Mbeki, who supposedly does not believe in tritherapy.
Swiss drug cost calculations
Switzerland, which some people would like to see as an isolated national paradise in the middle of the turmoil, has its share of problems and scandals, like any country. In the medical area one should realize that efforts of the government to reduce drug costs are sometimes ridiculed by aberrations in the law. We have thus learned that it is less expensive to prescribe 3 x 30 tablets of a hormonal agent rather than one box of 100, because of some complexities within the price fixing mechanism of drugs below a certain per box cost. We are, however, also happily informed that no insurance company has yet decided to sue a physician who has prescribed the larger box (as one did in the past to save money) because of violation of the chapter on economicity of treatment contained in Swiss law.
Will the league for protection of animals help humans who fight for a smoke-free environment?
A new study shows that passive cigarette smoke at least doubles the risk of cancer in cats. Indeed, cats living in homes where people smoke cigarettes are more than twice as likely as non-exposed cats to acquire a deadly form of cancer known as feline lymphoma, according to a study conducted by scientists at Tufts University School of Veterinary Medicine and the University of Massachusetts. The study, entitled Environmental Tobacco Smoke and Risk of Malignant Lymphoma in Pet Cats, was published in the August issue of the American Journal of Epidemiology. The authors conducted a casecontrol study of this relationship in 180 cats who were treated at Tufts Veterinary Schools Foster Hospital for Small Animals between 1993 and 2000. Eighty of the cats were treated for lymphoma and 100 were treated for renal failure. After adjusting for age and other factors, the relative risk of lymphoma for cats exposed to any household environmental tobacco smoke was more than double (2.4) that of cats not exposed to tobacco smoke. The risk of cats acquiring cancer increased with both their duration and quantity of tobacco smoke exposure. Cats that were exposed for five or more years had a risk of more than triple (3.2) that of non-exposed cats. Risk of lymphoma also appeared to be related to the number of smokers living in the home, with nearly a double relative risk (1.9) for cats living with one smoker, and a four-fold increase in risk (4.1) for cats living with two or more smokers. In addition, cats living in households where humans smoked a pack or more of cigarettes per day had a significant three-fold (3.3) increase in risk compared to cats living in homes where people did not smoke. The authors conclude that these findings offer a compelling reason for further study of the relationship between passive smoke and non-Hodgkins lymphoma in humans, which is similar to lymphoma in cats. According to the Tufts team, several recent studies in humans have suggested that people who smoke tobacco may have an increased risk of contracting non-Hodgkins lymphoma. In addition, other studies have suggested that children of parents who smoke may have an increased risk of developing lymphoma.
Should men be encouraged to apply to medical school?
According to Annabel Ferriman (BMJ 2002; 325: 66) UK medical schools and the British government should do more to encourage male students to apply to study medicine. At the British Mecial Association General Assembly representatives were told that the present split of about 60% female and 40% male students would lead to problems in the future when many of the women graduates would want to take time out to have children or work part-time. That trend, combined with the introduction of the European working time directive, limiting doctors hours to 48 hours per week, was going to cause serious problems.
Drug companies accused of spending too little on research and development?
President Bush and drug companies favour high and fast-rising drug prices to support R&D. But a report compiled by the consumer health organization Families USA, states that the nine US publicly traded companies that market many of the most commonly used drugs spent a total of $45.4 billion on marketing, advertising and administration, and only $19.1 billion on R&D last year. Eight of the nine companies are said to have spent more than twice as much on marketing, advertising and administration as they did on R&D. It is certain that this report will lead to considerable discussion. What one cannot deny is that drug companies periodically bring to the public excellent drugs, some life-saving, others palliative, and that they have paid their share of taxes, and many other contributions for the benefit of the community. It does not seem apparent that drug companies in the states where their expenditure is controlled by the government and drug use strictly regulated have brought as much, so maybe a more adequate way to measure the performance of drug companies would be to look at the results of their research rather than at the way they run their business.
Dr Gro Harlem Brundtland, WHO Director-General, to quit in 2003
Gro Harlem Brundtland announced in August 2002, to the Executive Board of the World Health Organization, that she will not be a candidate in January 2003 for nomination to a second term as Director General of the WHO. In her statement to announce this news, Dr Brundtland stated that: "supported by our Member States, we have made significant and substantial progress towards my objectives: help anchor health firmly on the international development agenda; prioritize the improvement of the health of the poor; the need for the WHO to reach out and mobilize a range of partners, based on solid evidence". Unlike other persons in such high positions, Dr Brundtland felt that her age was not a reason to stay, but rather to retire.
While AstraZeneca shares tumble 12% after the Iressa study data press release, OSI Pharmaceuticals and Genentech update on Tarceva
Iressa, which AstraZeneca was banking on to be a blockbuster treatment for cancer, with anticipated sales of more than $1bn (£654m) a year, failed to make any significant improvement in survival rates among 1000 newly diagnosed lung cancer sufferers who also started chemotherapy. The premature presentation of these data, which should have been released at the ESMO meeting in Nice, seems to come from pressure from the business world, according to the specialized financial press. Sir Tom McKillop, AstraZenecas chief executive, said the findings began to emerge a few days before the press conference. He stated that: "although the final data will not be prepared for another month (i.e. for the ESMO meeting), it is already clear that Iressas use in combination with traditional chemotherapy will not be possible". It is regrettable that such information, which has no immediate meaning for patients (as Iressa alone continues to be provided for compassionate use and has been approved in Japan), was not first disclosed to and discussed by experts, who would have been able to put it into perspective.
At around the same time, OSI Pharmaceuticals and Genentech announced an update and commentary on the progress of the companies clinical trial candidate, Tarceva (erlotinib). "Overall we continue to be pleased with the progress of our comprehensive Tarceva development program", stated Dr Colin Goddard, Chairman and CEO of OSI. "Although both Iressa and Tarceva block the EGFR pathway, there are important differences between the agents and clinical programs including structure, formulation, pharmacokinetics and phase III design and dosing". ESMO members and all delegates attending the Nice meeting will benefit from extensive discussion of these facts.