News and Media

The National Health Service in the UK discontinues the coverage of 25 cancer drugs
Twenty five drugs that each year give a last chance to patients with cancer – including breast, prostate and colon cancer will not be funded by the National Health Service in the UK (NHS), which plans to optimize the costs for 2015, and to restructure the budget in an optimal way.

Non-governmental organizations accuse the health authorities in taking “a dramatic step backwards” and destroying the lifeline, which extends the lives of thousands of cancer patients. Annually more than 3000 patients with colon cancer, as well as 1 700 patients with breast cancer will be affected by the decision. Medications that no longer receive funding in some cases, have been increased the life expectancy from eight months to two and a half years, according to the statistics.

In 2011 the center-right coalition in the UK set up a special fund for cancer drugs, following the publicly requested by the conservatives commitment not to deny more treatments because of financial considerations. Although the Fund’s budget was increased from 200 to 280 million pounds, the demand proved to be such that by the end of the financial 2015 it is expected to have spent nearly 380 million.

At the beginning of the year the NHS announced it would increase its annual budget to 340 mln., but even with this increase the fund cannot afford to continue paying for all cancer treatments, which have been financed until now. The patients, who have  already received funding approval  up to April, will continue receiving their medicines from the NHS.

The Chair of the Fund said that “difficult decisions” had to be taken in order to give priority to the medicines that show best values, and that such a step has been obligatory. From the 84 treatments, examined in the analysis of the fund, 59 continued to be funded after March this year, while 25 were “written off”. Five treatments for colon cancer, four for leukemia, three for breast cancer, three for lymphoma, three for sarcoma, as well as drugs used to treat prostate, ovary, lung, pancreas and kidneys cancer  are among those which are no longer financed.

There are three new drugs that will continue to be funded after the analysis – Panitumumab – for treating colon cancer; Ibrutinib – for treating mantle cell lymphoma, non-Hodgkin’s lymphoma type; and Ibrutinib – for treating chronic lymphocytic leukemia.

Professor Peter Clark, Chair of the Fund, said: ” We have been through a robust, evidence-based process to ensure the drugs available offer the best clinical benefit, getting the most for patients from every pound.” “These are difficult decisions, but if we don’t prioritise the drugs that offer the best value, many people could miss out on promising, more effective treatments that are in the pipeline.” The decisions were taken as a result of the analysis of experts on the national level – including oncologists, pharmacists and representatives of patients who independently of each other reviewed the drugs available so far in the Fund, as well as the new applications. Their evaluation included clinical benefit, survival and quality of life, safety and toxicity of treatment, the level of unmet need and the average cost per patient.

Lord Darzi, former Labor health minister, said that the NHS should stop the unnecessary treatment of dying patients in order to help financing and this way – the increase in the cost of new cancer drugs. He told The Times, that the reduction of unnecessary tests and treatments with little chance of success will free up money for expensive modern and better medicines that the health service is struggling to provide for patients.

Tchaikapharma High Quality Medicines Inc. was distinguished among the most profitable and influential companies in Bulgaria for the 2014 business rating “300 Business leaders in Bulgaria”.

In this year’s forth edition the business analysts from the ICAP Group rated the most successful companies in the country accordingto the Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA) criterion.

For a consecutive year Tchaikapharma marked a growth in profit and equity. In 2014 the Company’s profit grew by nearly 9 % over previous year, the average value of this indicator of the companies in the rating is only 4.7%.

In its sector “Production of medicines and medicinal products” Tchaikapharma is ranked first based of the criterion “profitability of EBITDA”, i.e. shows the best ratio between profit and the amount of sales revenue. The profitability of Tchaikapharma (40.19 %) significantly exceeded the indicators of other companies in the sector – Sopharma (19.94 %), Balkanpharma – Troyan (19.02 %), Biovet (14.59 %) and Balkanpharma Dupnitsa (10.51 %).
These are the main reasons for the high market capitalization of the company amounting to nearly 255 million BGN (as of 20.10.2015).

The participants in the National Round Table on Reforms and Healthcare without Restrictions insist that the government restores the principle “the funding follows the patient”

“We do not accept and will not accept in the future the activities of the medical institutions to limit and thereby to put bounds on the rights of patients to have access to timely and quality treatment.” So begins the declaration which has been signed by the Center for the Protection of the Rights in Healthcare, the Federation Bulgarian Patients’ Forum and the Bulgarian Association for Patient Rights, the National Association of Private Hospitals, the Association of Municipal Hospitals, and the directors of more than 30 hospitals. The participants were against the norms that lead to the administrative closing down of hospitals, the forced mergers, and the imposing of administrative limitations on the construction of new hospitals. According to them, the success or failure of a hospital should depend entirely on whether the patients are satisfied or not by the treatment provided.

“We insist that the government restores the principle “the funding follows the patient ” and creates the necessary rules for the effective and objective control by the institutions, as well as by the consumers of medical services, over the quality of medical activity,” states the declaration.

According to a reference of the Health Fund,  provided to the Medical Association, from March to July the hospitals have exceeded their limits for BGN 31.8 million, which at the end of the year is expected to reach BGN 60-65 million. In a letter to the NHIF the chairman of the BMA Dr. Ventsislav Grozev points out that the healthcare providers are becoming “unpaid donors of the healthcare system.” The Professional Association recalls the legal precedents so far which show that ultimately the NHIF will have to pay the hospitals for the performed activities together with the accrued interest.

Stoycho Katsarov from the Center for the Protection of the Rights in Healthcare stated that all agree that currently the system is not good and needs to change, but he is skeptical whether the reforms undertaken would lead to the desired effect. “The healthcare system would be at its best when it is viewed as a market that offers business services, and not as an administration,”  he noted.

The National Association of Private Hospitals commented that the limitations achieve the opposite of what the government claims, namely that the reform works in favor of a higher quality and comprehensive treatment. “The patient goes to the hospital, where he is told he cannot be admitted because of the restrictions. He returnes home and waites to be admitted by this particular doctor at this hospital which he has chosen while his illness is getting worse and his treatment is becoming more expensive. Doctors are beginning to lose confidence in the system and motivation. What this reform achieves is a more expensive treatment, not better quality. ”

Patients’ representatives stressed that the populist statements of politicians that the restrictive policies are in the interest of patients, are not true. “When you undertake reforms in healthcare, it is useful to hear the voice of both – the patient and the professional organizations.”

“If someone steals through clinical pathways, this should be controlled and determined by the NHIF,” said the chairman of the Association for the Protection of Patients and noted that the vicious circle of generating activity that exceeds the limit is due to the planned budget deficit of the NHIF in the recent years .

“We need an urgent discussion on the subject matter of the healthcare budget for 2016,” said the representative of the Supervisory Board of the NHIF Grigor Dimitrov. As an employer,  the representative of the Confederation of Employers and Industrialists in Bulgaria in the Supervisory Board was adamant that the limitations are not the way to manage any kind of activity.

The Roundtable participants agreed on the idea that the state should take care to increase the collection of the health insurance contributions, as well as the payment of the full amount. They insisted on increasing the percentage of the GDP for healthcare, which is separated from the budget. The guild accepts the stated intention of the government to provide comprehensive treatment in full, observes that it is available not only through the impoverishment of the structures, but also through organizational and financial mechanisms.

The specialized hospitals of the Bulgarian Cardiac Institute in Varna, Veliko Tarnovo, Shumen and Yambol mark the World Heart Day with an appeal for prevention and free consultations

Every year on the 29th of September  the world celebrates the International Heart Day. In connection with this the experts reminded us that according to the “black statistics” every third death in our country is a result of cardiovascular disease, although 80% of the cardiac problems are preventable if detected on time.

“Atherosclerosis and cardiovascular disease are considered to be the largest non-infectious epidemic diseases of our time, in a word – they are the biggest killer of the 21st century,” said the national consultant in Cardiology Assoc. Prof. Ivo Petrov, MD.

“The high level of lipids in the blood is a major risk factor in the early development of cardiovascular disease. The lipids that circulate in our blood come mainly from two sources. One depends on how a person eats and the second, which is even more dangerous, is genetically determined – these are the lipids that our own organism has synthesized. A lot of people have this kind of family history, but it may be less or more risky, depending on the case. In such people the developing of cardiovascular diseases is not potential, it is the rule.

In order to determine whether we are genetically endangered or not it suffices that we know the history of the disease and the cause of the fatal end in our parents or their parents. We, cardiologists, constantly insist on mass screening which should follow simple clinical criteria and laboratory tests. The verification through the lipid profile is widely available throughout the country. But any changes in the electrocardiogram and the echocardiogram should be monitored as well, which, however, are carried out during the second stage. And mainly in people who have cases of early signs of atherosclerosis in their family – either a stroke or myocardial infarction. This is the target group of the Bulgarians who definitely have to be tested, in order to determine if they have a hereditary predisposition to these diseases or not. ”

This year the hospitals of the Bulgarian Cardiac Institute – the Specialized Hospital for Active Treatment in Cardiology in Varna, the Specialized Hospital for Active Treatment in Cardiology in Veliko Turnovo, the Specialized Hospital for Active Treatment in Cardiology in Yambol, and the Specialized Hospital for Active Treatment in Cardiology in Madara – Shumen are joining together in the celebration of the World Heart Day by offering free examinations, taking blood pressure and providing individual consultations.

For the first time clinical trials will be conducted to check if a drug prolonged life, said magazine  Sciences et Avenir. The medicine in question is metformin, which is often administered to patients affected by diabetes type 2. In 2008, the study of Russian scientists showed that it prolonged the lives of mice, probably by restricting the calorie intake and controlling the level of glucose. The published in 2014 results from the statistical survey conducted by scientists from the University of Cardiff, UK, included 180 000 people and showed that the treated with metformin diabetics had higher life expectancy than non-diabetics.

This is why, the expert Nir Barzilai at the Albert Einstein College of Medicine in New York launched the TAME / Targeting Aging with Metformin /project. It will monitor the health of 3 000 non-diabetics aged over 70, some of which will be taking metformin for five years, while the other participants will be included in the control group.

Other anti-aging drug – rapamycin, is also being tested. It suppresses the immune response and is often prescribed during transplants. It has been tested on mice and prolongs their lives. Currently, the scientists from the University of Washington in Seattle tested the drug on dogs. Their hopes are that rapamycin will extend the life of the four-legged animal from 2 to 5 years.

Tchaikapharma High Quality Medicines Inc. offers on the Bulgarian market  Metformin-Tchaikapharma (metformine), indicated for the treatment of type 2 diabetes mellitus.