Gary Finnegan

Gary Finnegan is a freelance journalist contributing to health and business publications. He has a BA in physiology and an MSc in science communication. He has been a magazine editor and newspaper columnist, and has written a book about China.

A new report on Laboratory Medicine in Poland highlights the role of laboratory diagnostics in the timely treatment of chronic conditions. Not only can investment in early diagnosis save and improve lives, it can also save money on long-term care. ‘There is not enough data on how health budgets are spent,’ says Jozef Jakubiec, Director General of IPDDL which compiled the report with Deloitte. ‘We wanted to show hard evidence to illustrate to decision-makers that that situation in Poland is considerably worse than in neighbouring countries, such as the Czech Republic.’ Take diabetes, for example. Serious complications from the advanced stages of the condition can include chronic kidney disease (CKD). This, in turn, may lead to a life-long dialysis or kidney transplantation – both of which come at a considerable personal and economic cost. Some people live with diabetes mellitus without symptoms for many years. Indeed, it may not be until complications arise that their condition is diagnosed. However, by that stage considerable damage may have been done. Even small changes in blood glucose can begin the process of degeneration of blood vessels. In order to intervene early and with the right treatment, glucose testing is essential. If Poland were to increase glucose testing by 25% a year, savings of PLN 0.5 billion (€0.12 billion) would be made within six years. For patients with diabetes-related conditions, the annual cost was estimated at PLN 5 (€1.17) in pre-diabetes compared to PLN 9,269 (€2,168) in diabetes with complications (an over 1800-fold difference). ‘The earlier the treatment is taken and monitored regularly, the more effective and less expensive it is,’ the report says. Prevention is cheaper than cure For CKD, it’s a similar story: the disease may remain asymptomatic until the last stage of renal failure. ‘There’s a big shift towards CKD because...
As Germany goes to the polls, the VDGH, which represents in vitro diagnostics companies in Germany, has published a new policy paper on the future of healthcare. VDGH Managing Director Martin Walger tells Gary Finnegan why this is a crucial moment for health policy The paper was released just ahead of federal elections in Germany and seeks to highlight the value of laboratory diagnostics. Tackling major challenges such as access to laboratory innovations, pricing challenges and personalised medicines, the report also applies to other European markets. What practical steps can be taken to accelerate access to laboratory innovations? This is one of the most difficult tasks we have to tackle and there are no simple solutions. If assessment procedures take significantly longer than the IVD product lifecycle, industry will suffer. But do we persuade politicians and decision makers with that argument? We are asking for appropriate methods and decision procedures which are transparent. Are you concerned that prices do not match the quality/value of diagnostic products? Is the situation any worse for diagnostics than it is for devices, IT or medicines? The German market is faced with very low prices for most diagnostics services, and this is especially pronounced in clinical chemistry. A high market concentration among the medical laboratories makes this problem worse. In the long run, the innovation capabilities of our industry also depend on the level of remuneration. Can you give an example of how early diagnosis can improve outcomes for patients and deliver long-term value for the economy and society? As far as I can see, the benefits of early diagnosis to prevent colon cancer are the best documented. Germany will rearrange its early detection programme this year, introducing specific cancer screening tests called "iFOB-Tests" and regular invitations for statutory health insurance patients to participate. The...
A World Health Organisation report has found that increasing access to hearing devices is ‘a sound investment’. Are decision-makers listening? For individuals, hearing loss can have a profound impact on quality of life: they lose independence, educational opportunities and earning power. Some people also suffer social isolation, lost confidence and a decline in wellbeing. Now consider the fact that over 5% of the world’s population – that’s 360 million people – are living with disabling hearing loss. In addition to the personal burden borne by millions, the global impact on societies and economies is enormous. Many of those 360 million people require support from their families, communities and – where available – social insurance funds. But there are actions that can be taken to address this serious issue. A sound investment The burden of deafness and hearing problems has come into sharp focus in the wake of a WHO report entitled ‘ Action for hearing loss: make a sound investment ’. The report looks at the economic impact of hearing loss and the cost of intervening to restore hearing using devices such as hearing aids and cochlear implants. These technologies require investment. The big question for the WHO experts behind the report was how the cost of treating hearing loss compares to the cost of inaction. The answer was clear: doing nothing is simply not an option . According to the WHO, the cost of hearing loss runs to around $750 billion per year. On the other side of the scales, the total cost of hearing care globally is estimated to be around $15 billion annually. ‘Provision of hearing devices is a cost-effective strategy, especially when used regularly and supported with rehabilitation service,’ according to the report. Screening children and adults aged over 50 is also considered to be a...
People with a rare eye disease known as retinitis pigmentosa (RP) suffer a gradual loss of vision; some become completely blind. Now, an innovative new approach to treatment has given dozens of people the chance to see again. With the help of a retinal implant, special glasses and intensive training, people who were blind have a new way of viewing the world which could one day benefit people with other degenerative eye diseases. We spoke to Professor Marie-Noelle Delyfer, University Hospital of Bordeaux, who has already performed eight such operations. What is retinitis pigmentosa (RP) and what is the prognosis for patients? RP is actually around 300 distinct genetic disorders that lead to the loss of photoreceptors on the retina. Some affected individuals have a reduction in their visual field while others become blind. With such a rare disease, it is difficult to describe a typical patient. Some lose their sight early in life or in early adulthood but there are others who become blind only in their 70s or 80s. Until 20 years ago, there were no treatments at all and the disease was not well understood. The first genetic cause of the disease was identified in 1984 – before that it was thought of as an inflammatory disease. What treatments are available? Some pharmaceutical therapies help to maintain photoreceptors but this only slows the progression of the disease – it’s not a cure. In the longer-term, there is some research on gene therapy targeting the mutations responsible for RP. How can technology help? I have used a new technology, from SecondSight, with eight carefully selected patients living with end-stage RP. These patients have an electrode array implanted in their retina. They wear glasses that are fitted with a camera that ‘sees’ their surrounding environment. This signal is sent...
High-tech innovation and advanced surgical techniques have transformed the field of ophthalmology, with new treatment options making surgery faster and more accurate. We speak to Professor Rudy Nuijts, a leader in the field of cataract surgery, about the radical changes he has seen and what the future may hold. How has cataract care changed since you began working as an ophthalmic surgeon ? I was trained in extracapsular surgery which involved making incisions of at least 6mm to remove the patient’s lens. In the early 1990s, ophthalmologists in the Netherlands started to embrace phacoemulsification – a new alternative where the lens is broken into tiny fragments using ultrasound energy before being removed. That changed everything. How did these advances help patients? The recovery process was much faster and there was less post-operative astigmatism . Since then, technology has improved further: the machinery we use results in a more stable anterior chamber, with less risk of posterior capsule rupture and there is much more choice and versatility in the range of lenses available for implantation. Are there other technological advances that have improved outcomes for patients? The introduction of multifocal intraocular lenses (IOLs) has meant patients can be spectacle-independent after cataract surgery. Instead of just fixing the cloudy vision caused by their cataract, patients can now have a refractive lens implanted which improves their vision. These include toric IOLs which allow us to correct astigmatism and make patients spectacle independent for distance. Another big leap forward has been multifocal lenses. Most surgeons in Europe have, over the last year or two, moved from bifocal to trifocal lenses. This has big advantages for patients. For example, with multifocal trifocal lenses they can read at intermediate distances – for iPads or reading a computer screen, this is a distinct advantage. Bifocal lenses were...