devices

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 iFOB-Tests and regular invitations for statutory health insurance patents to participate. The same applies to cervical cancer...
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...
International efforts to tackle the hepatitis pandemic have reached new heights, especially in the past year since the 69 th World Health Assembly (WHA) endorsed the Global Health Sector Strategy (GHSS) on viral hepatitis 2016–2021 . It is estimated that some 325 million people worldwide are living with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection alone, and a large portion of these people lack access to life-saving testing and treatment. As a result, millions are at risk of chronic liver disease, cancer and death. To this end, the GHSS calls for the elimination of all types of viral hepatitis (A, B, C, D & E) as a public health threat by 2030 ‒ reducing new infections by 90% and mortality by 65%. Indeed, mortality caused by viral hepatitis is on the rise, with 1.4 million deaths believed to be caused by the disease in 2015. The focus is on HBV and HCV, both blood-borne infections that are responsible for 96% of all hepatitis mortality. Medtech’s contribution On a positive note, a Global Hepatitis Report published by the World Health Organization (WHO) in April 2017 says that eliminating viral hepatitis is “technically feasible”. Medical technology will play a critical role. The report points out, for example, that key innovations include rapid serological tests to detect antibodies to HCV as well as point-of-care tests to diagnose HCV infection. Newer and cheaper point-of-care rapid tests, such as those for HBV and affordable ones for HCV, could accelerate the elimination of hepatitis. The WHO’s first-ever viral hepatitis testing guidelines recommend the use of rapid diagnostic tests for hard-to-reach populations and targeted testing in groups most affected by HBV and HCV, such as people who inject drugs, those with HIV and children of mothers with HBV or HCV infection. Simple and...
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...
eHealth technologies are pulling together personal information from diverse sources to ensure a more personalised, informed healthcare service – it’s what patients expect Precision medicine is the use of all available information about a patient to produce the most informed care plan possible. This is often associated with using genetic or other “-omics” information to help doctors select which medicine to prescribe for their patient. For example, testing a cancer patient for specific biomarkers can tell doctors which chemotherapy will work best. But it’s much bigger than that. If you look at what contributes to premature death, around 30% is thought to be genetic. The rest is a combination of our environment, diet, exercise, work, mental health, social interactions and other exogenous factors. So why limit ourselves to genetic data alone? As healthcare is now in the information era, the challenge is to pull together the vast quantity of data that exists and aggregate it in a way that allows health services to be tailored to each patient. There is already a wealth of data and this is expected to increase 50-fold in the next eight years. There is no way any physician can cope with this volume of information. That’s why software companies are playing an increasing role in healthcare. Information overload is essentially an IT challenge: how do we access and surface these data in a way that makes them accessible and actionable? How do we acquire and aggregate data, then reason against it to help manage populations and drive insights? Healthcare is unique but software experts have already overcome huge challenges in areas such as e-commerce and financial services to deliver a more tailored and user-friendly experience while safeguarding data privacy. In fact, the public is so used to this kind of customised intelligence that some patients...
Professor Kevin Warwick is pushing the boundaries of artificial intelligence and cyborg technologies How can artificial intelligence (AI ) improve healthcare? AI can be used to learn what is going on in different parts of the body and to predict problems. This gives us the power to prevent problems before they arise or to counteract malfunctions which are detected by sensors. Could you give us an example that will be part of the near future? One immediate application is in the use of deep brain stimulation or DBS. This technology is already used in people with Parkinson’s disease, epilepsy or depression to stimulate the nervous system with electrical pulses in order to alleviate symptoms. AI allows us to take it a step further by predicting when stimulation is needed. This means we could apply DBS before the patient experiences symptoms. What areas of future research are most exciting? An interesting area is the use of cultured neural networks. Typically, we use neurons (brain cells) taken from rat embryos and connect them to a robot. Sensors from the robot stimulate the culture and we have observed different pathways in the cell culture changing the direction of the robot. How do you do this? Firstly, we separate the brain cells using enzymes and them lay them out on a multi-electrode array (essentially a small dish). Very quickly the neurons start connecting with each other. We have to feed the brain cells using minerals and nutrients. The growing brain, consisting of approx. 150,000 cells has to be kept in an incubator at a controlled temperature of 37 degrees C. After about 10 days the brain has lots of connections so we give it a body. The brain is connected to its body, bi-directionally, via a Bluetooth link. Sensory signals from the robot body...