Dalli EU lead in health and DG Sanco gets responsability for pharma

John Dalli from Malta will be in charge of Health and Consumer Policy in the new Barrosso commission. At the same time the reponsability for pharmaceuticals is being moved to DG Sanco. Mr Dalli who today is Social Policy Minister has a background both in industry as well as in consultancy and should be well equiped to manage the change in responsability. Its going to be very interesting to see what this will mean formost for the patient information proposal - maybe some of the tension around the issue can be eased with this transfer since DG Sanco now has to take responsability for the dossier instead of viewing their role only to safeguarde the safety of the patients and consumers.

Healthcare not the big driver of UK public sector cost

Sometimes those really boring statistical documents shows very interesting figures and I must say that the latest report from the UK Office for National Statistics (ONS) Centre for the Measurement of Government Activity is one of the most interesting documents I seen for a long time.

They have studied how the costs in public sector have grown over a period of 10 years. And they make a productivity measure by looking at cost per unit. Interesting enough the results shows that the healthcare expenditure actually with its average of 3.8 % per year grows exactly on average in the public sectors! The educational, social care, Police, Public order and safety, Children and Adult social care all grew more. Now this type of material is not my speciality but I did miss a comparison with the general inflation in society. I didn’t see anywhere that this material was inflation adjusted and if not its sort of hard to put the yearly 3.8 % increase in cost in perspective.

What was in there was a calculation showing that labour cost grew faster than in the broader economy (5.6% against 4.5% on average). So the reason the lower total spend despite the higher spend on cost of labour is probably that in healthcare the cost of goods and services only increased with 1% compared to the average 2.5%. Generic substitution is pointed out as one of the major reasons behind this low increase in costs for goods and services.

I can only make two conclusions:
1. Its not healthcare that is the problem in public spending.
2. To increase productivity for the future its not the products used in the system that needs to be in focus but the processes and not products to ensure a lower price per unit.

Healthcare is the largest individual spending area (30 % out of the total) in the UK. The study took place from 1997 to 2007 and can be found here.

A bit easier to get EU funding for health projects

Found some good news for researchers, NGOs and others longing for EU funding for their projects. The EU Commission, the will publish a call for proposals in line with the Work Plan for the implementation of the EU Health Programme 2010, for projects, operating grants, conferences and joint actions already in 2009. The deadline for submitting proposals will be around March 2010. This might not seem important but my experience is that especially for those who want to find funding for projects this will make a big change as you must find money also somewhere else than from the EU Commission. This of course takes time and has its special limitations. I.e. other organisations also have budgets and financial steering instruments with deadlines etc for commitments of funds.

So far this have been quite complicated as the publication of tenders have been made in the spring with a deadline early summer the same year.Thus this formally small change in procedure is an important adaptation to other realities such as organisations being able to adopt their budgets before the new budget to the calls they might participate in the following year. Better financial planning will be possible and hopefully more organisations will be able to submit proposals for their projects.

More info on calls for proposals on the Executive Agency for Health and Consumers website.

The shift in the perception of health

I had a meeting a couple of days ago with a representative of Swedish Haemophilia Society association. Chatting about various things he mentioned that he recently had been climbing in Nepal and that the team had been monitoring their oxygen levels. He rightly pointed out that in these times of swine flu of course their oxygen levels while climbing would had caused quite some concerns at an emergency ward. And then he ended in an: But of course we were all healthy people.

A totally natural comment for him but for me who knows that not only has he haemophilia but the treatment given to him in the 80th as a child also as a side effect gave him HIV this was a bit well it wasn’t what I expected to hear.

Haemophilia today at least if you receive treatment in line with the Swedish preventive strategy is just a chronic disease that needs regular treatment. Quite similar is the HIV situation. In Sweden. But if you live in other parts of the world and do not get the medicines you need it is very different. Without treatment each of these 2 diseases is deadly – your life expectancy is substantially shortened.

This might seem trivial but give it some thought what this shirt in perception of health means for our healthcare system. And what it means that the innovation in medicines have given to society. The achievements my friend has managed during in his case very active working life would never have been possible without new modern medication.

It should also makes me to seriously doubt the use of pan European measurement of self-reported health status as for example have been done by for example the Eurofounds European Quality of Life Survey database and the Eurobarometer 2009 on not the childrens but the parents view of their childrens health. It all comes down to subjective individual perceptions and cultural contexts. Not really comparable on a European level.

Pharmacy monopoly in Sweden now sold out

The part of the Swedish Pharmacy monopoly that was devided into clusters to enable the privatisation is now sold at a final price of SEK 5.9 billion.

Apoteket Hjärtat, owned by Altor, acquires 208 pharmacies, with a turnover of SEK 7.1 billion and 1500 employees.

Kronans Droghandel, owned by Oriola-KD and KF, acquires 171 pharmacies, with a turnover of SEK 4.4 billion and 930 employees.

Medstop Holding AB, onwed by Segulah, aquires 62 pharmacies, with a turnover of SEK 3.1 billion and 660 employees.

Its a pity non of the international playeers have entered the market - I hope the reason is that they will establish new pharmacies instead of taking over old stores with old staff.

More information can be found here.

Changes in rutines due to Swine Flu mistakes that will benefit all

It has turned out that 4 out of 6 in Sweden that died from Swine Flu actually visited a clinic or hosital in order to get care at an earlier stage but where sent home again. One region (Skåne) has learned from the mistake and has changed their routines and as from now no-one shall be sent home without having seen a doctor…

Still if the care centres and emergencies would use very simple routines albeit with modern medical technology could help them as pointed out yesterday in Aftonbladet. At Södersjukhuset one of the Stockholm hospitals they use a triage sorting method. There are a several ( see more here) but at this hospital they check pulse, blood pressure, oxygen level in the blood, fever and the patients breathing capability. For measuring the oxygen level in the blood they use a devise that is very simple to use and cost them only 800 Euros to buy.

Let’s hope that those clinics where you don’t get to see a doctor at least ensure they sort patients a bit more careful in the future and make use of the devices available.

Another good thing is the boost the Swine flu discussions have for general hygiene standards. Hand washing seems too been given a real and needed boost. Long term I think this will saving more life’s than the vaccines in many disease areas!