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International Health News Brief: 2019, no. 7

News period covered: July–September 2019

Prescription Drugs

Opioid Prescriptions Drop in Canada Though Remain Widespread

The number of Canadians prescribed opioids in 2018 fell by 8 percent in three provinces — Ontario, Saskatchewan, and British Columbia — compared to 2013, the Canadian Institute for Health Information (CIHI) reported in October. Meanwhile, the number of people starting opioid treatments fell nearly 10 percent during the same period. Opioid prescribing guidelines, provincial prescription monitoring programs, changes to prescription drug coverage, and campaigns aimed at increasing awareness about opioids’ dangers are likely influencing prescribing trends, officials say.

Canadians and Americans are far more likely to fill a prescription for opioid painkillers following routine surgery than are patients in Sweden, according to a recent study in JAMA Network Open. About 79 percent of patients undergoing a routine surgical procedure in Canada and 76 percent of those in the U.S. filled an opioid prescription in the seven days following their procedure, compared to just 11 percent of patients in Sweden, the study found. Canadian authorities published national guidelines in 2017 to help clinicians navigate opioid prescribing for chronic pain patients, but no such guidelines were issued for acute pain.

Canada Combats High Drug Prices Through National Policy

Canada’s Patented Medicine Prices Review Board announced a series of moves in August that could potentially save CAD 13 billion (USD 9.8 billion) in drug spending over the next decade. The first change removes the United States and Switzerland from the “basket” of comparator countries that Canada uses to set its prescription drug prices; drug prices in the two nations are among the highest in the world. The board also announced it will use actual market prices in Canada to assess whether a price is reasonable, and it will consider whether the price of a drug reflects the clinical value it provide to patients.

In an open letter to federal party leaders in August, more than 1,200 health care and public policy experts urged the development of a national “pharmacare” program for Canada. They argue that comprehensive publicly funded insurance programs for prescription medications have improved access and reduced costs everywhere they’ve been implemented. Such an effort, they claim, could save about CAD 5 billion (USD 3.8 billion) a year.

Switzerland, England Reduce Drug Prices, Save Money

Prices for 257 pharmaceuticals were reduced by an average of 16.3 percent following a three-year review of prescription drugs by Switzerland’s Federal Office of Public Health (Bundesamt für Gesundheit, or BAG). Cost savings are expected to reach CHF 100 million (USD 101 million). Switzerland, which audits one-third of drugs annually for effectiveness, expediency, and price, lowered prices on 54 percent of the 478 of drugs reviewed.

England’s National Health Service (NHS) also achieved substantial savings on prescription drugs through its campaign to maximize use of generic and “best value” biologic treatments. The uptake of best-value medicines lowered costs by GBP 294 million (USD 387 million) last year, on track to meet the NHS target of a further GBP 400 million (USD 526 million) in annual savings by 2021. That money is slated to be reinvested in other innovative, cost-effective treatments.

Health Care Tech

German Doctors Can Now Prescribe Mobile Apps for Patients with Chronic Diseases

Starting in 2020, doctors in Germany will be able to prescribe mobile applications for patients with chronic diseases like diabetes or high blood pressure that can help them manage their condition. Under the Digital Supply Act, passed in July 2019, the Federal Institute for Drugs and Medical Devices must evaluate the quality and data security of all apps before they can be prescribed. Physicians and other service providers are expected to be connected to the country’s telematics infrastructure by March 2020; pharmacies will be connected by September 2020 and hospitals by January 2021.

Facebook Reviews Track Closely with Hospital Quality Indicators in Norway

Researchers in Norway have found a correlation between hospital reviews on Facebook and user experiences and 30-day survival rates. Using data from hospitals’ Facebook pages — as well as from unofficial Facebook pages of hospitals that do not have an official one — Norwegian Institute of Public Health researchers compared average review scores with research-based quality indicators from national user experience surveys and with 30-day survival, hospital size, and 30-day readmissions.

Sweden Tests Drones for Medical Transport

Sweden has begun two experiments to see whether drones are a viable way to make medical deliveries. The first is focused on hard-to-reach rural places, where transport of medicines and samples by car can be slow or even impossible. The drones can carry up to eight kilos (about 17 pounds) and travel a total of 70 kilometers. One of the challenges experts face is developing platforms in remote areas that can use 4G and 5G technology.

The second experiment involves using drones to deliver blood and blood samples in the more urban Gothenburg region. While the drones can carry only one-half kilo (about 1 pound), speed is the primary goal. “If you can get your blood in less than half the time, or have your blood sample delivered to the lab faster, it should give big benefits to the patient,” said Magnus Kristiansson, a project manager with the Innovation Platform in Sweden’s Västra Götaland region.

NHS to Offer Health Advice in Novel Partnership with Amazon

The U.K. National Health Service (NHS) announced in July what it claims is a world first: a partnership with Amazon’s popular Alexa voice service to offer health advice, verified by health professionals, from the NHS website. To date, Alexa has provided answers to medical questions from a variety of sources, including unverified ones. Officials hope the initiative will offer people a new way to access reliable medical advice for minor ailments such as coughs, colds, or migraine symptoms to look out for, while also alleviating some of the resource burden faced by the health system.

"I want people to get the best medical advice…rather than the sort of spurious stuff that turns up on the Internet," said U.K. Health Secretary Matt Hancock.

The NHS hopes the project also will benefit individuals with sight impairment and other disabilities who have difficulty using computers or smartphones to find health information.


WHO Report Finds Health Gains in Europe Not Equally Shared

The World Health Organization (WHO) in September published its first-ever report on health equity in the 53 countries belonging to the WHO European region. The main finding: Despite overall improvements in health and well-being over the past 15 years, these successes have not been distributed equally, and strong inequities within countries persist.

The report identifies five essential conditions needed to create and sustain a healthy life: good-quality, accessible health services; income security and social protection; decent living conditions; social and human capital; and decent work and employment conditions. Also considered were factors fundamental to creating more equitable societies, including policy coherence, accountability, social participation, and empowerment.

Other News

Out-of-Pocket Health Costs in France Have Never Been Lower

France, whose residents already have the world’s lowest out-of-pocket expenses for health care, saw those costs decline further in 2018, according to a report issued by the Ministry of Health in September.

Patient out-of-pocket expenses, which now stand at 7 percent of total health expenses incurred, began to decline in 2016, following the introduction of complementary health insurance in France. All private-sector employees and their families are now covered for services not included in the country’s compulsory health insurance; many were reimbursed for expensive dental and optical care.

While the rate of health expenditure growth rose in the rest of Europe between 2013 and 2017, it remained at about 2.2 percent per year in France over that period.

New Zealand Now Has a Suicide Prevention Director

New Zealand’s Ministry of Health announced in September the appointment of Carla na Nagara to lead the newly established Suicide Prevention Office, tasked with reducing the nation’s historically high rate of suicide. In 2016, 553 New Zealanders took their own life.

“We need a strong system that supports well-being,” said na Nagara. “Every New Zealander has a role to play in contributing to suicide prevention. The answers are not going to be just in delivering more services, although that will be part of it.”

New Zealand’s action follows that of the United Kingdom, which appointed its own minister for suicide prevention in October 2018.

Editorial Team

Editors: Roosa Tikkanen and Paul Frame

Project Manager: Aisha Gomez

Country Correspondents

World News — Roosa Tikkanen

Australia — Sonĵ Hall

Canada — Fredrika Scarth

France — Angèle Malâtre-Lansac

Germany — Michael Laxy

Netherlands — Marit Tanke

New Zealand — Andrew Old

Norway — Marianne Storm

Sweden — Ulrika Winblad

Switzerland — Lars Hemkens

United Kingdom — Adam Briggs

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