Criminal gangs smuggle 160 million tablets out of the UK’s protected supply chain over three years.

Waiting times for initial consultations for transgender patients soars, despite an NHS pledge.

[unable to retrieve full-text content]

[unable to retrieve full-text content]

[unable to retrieve full-text content]

A recent Health24 article reports how Luxturna, a first-of-its kind genetic treatment for blindness, will cost $850 000 (more than R10 million) per patient.

For the vast majority of people this treatment is so expensive that they could not afford it – even if they sold everything they own.

Backlash against medicine prices

This and other similarly expensive gene-targeting therapies are raising concerns about the affordability of medical care all over the world.

Although drug prices are regulated in South Africa, they are not in the US which means drug manufacturers can set the price as high as they wish. 

The standard explanation for exorbitant drug prices is the high cost of developing a drug, as well as the fact that so many drugs fail during trials and must be abandoned.

Some companies have, however, begun to offer more detailed reasoning as the backlash against excessive drug prices is gaining momentum.

The International Federation of Health Plans, in its 2015 Comparative Price Report, which aims to highlight the variation in healthcare prices around the world, indicates that medicine prices in the US (and UK) are considerably higher than anywhere else.

Apart from Luxturna, here are seven of the most outrageous examples of high medicine and medicine-related prices in the world:

1. Glybera

Glybera was first approved in October 2012 for familial lipoprotein lipase deficiency (LPLD), a rare genetic disorder that disrupts the normal breakdown of fats in the body. 

This drug was never approved in the US, but would have cost more than $1.2 million (±R14.7 million) per year. It will not be marketed any further in Europe by drugmaker uniQure as it has become evident that it will be a commercial failure. 

2. Soliris

Soliris costs patients up to $700 000 a year (±R8.58 million). The drug is used to treat paroxysmal nocturnal hemoglobinuria, which affects only 8 000 people in the world.

The disease destroys red blood cells, causing patients to suffer from infections, anaemia and blood clots.

3. Elaprase

Elaprase is a treatment for Hunter syndrome, a rare condition that affects only 500 people in the US. The disease is also known as Mucopolysaccharidosis type II and occurs almost exclusively in males. It is a progressively debilitating disorder that inhibits brain function and physical development.

Elaprase costs more than $500 000 (±R6.13 million) per year.

4. Naglazyme

Naglazyme costs more than $365 000 (±R4.5 million) and is used to treat Maroteaux-Lamy Syndrome, a rare genetic disorder involving the accumulation of complex carbohydrates called glycosaminoglycans in the body.

Common symptoms can include coarse facial features, corneal clouding, joint abnormalities, various skeletal malformations, an abnormally enlarged liver and/or spleen, and hearing loss. Cardiac disease and restrictive pulmonary disease can also occur.

5. Cinryze

Cinryze is a treatment for angioedema, which affects only one in 50 000 people in America. It costs around $350 000 (±R4.3 million) a year.

Angioedema is often triggered by an allergic reaction, which leads to chemicals being released into the body, causing swelling of the skin. The condition can also be caused by some medications, a genetic fault or unknown triggers.

Exponential price increases

And just as bad as high retail prices are unjustified price increases:

6. EpiPens

In August 2016 the cost of a two-pack of EpiPens (an adrenaline injection for allergy sufferers) jumped to $600 (±R7 300), compared to $90 (±R1 100) a decade earlier.

7. Daraprim

In 2015 the price of Daraprim, which is used by Aids and transplant patients, soared from $13.50 (±R164) per pill to $750 (±R9 120), which sparked a justified outrage. 

^{Image credit: iStock}

Eugene Lotter

In the case of cardiac arrest, an irregular heart rhythm causes the heart to stop beating. This causes sudden cardiac death if the patient doesn’t receive treatment quickly.

A new study has found that survival rates are rising for people who have cardiac arrest while in hospital.

But if cardiac arrest happens at night or on a weekend, you’re more likely to die than if it happens on a weekday.

Cardiac arrest vs. heart attack

The odds of surviving an “off-hours” cardiac arrest are nearly 4% lower than for people who have cardiac arrest in the daytime during the week, the study found.

The study was published in the Journal of the American College of Cardiology.

According to a previous Health24 article, cardiac arrest occurs when your heart function suddenly and unexpectedly stops, you lose consciousness and stop breathing. Your heart either stops completely or the rhythm becomes erratic, which prevents it from pumping blood effectively.

A heart attack, on the other hand, occurs when the flow of blood and oxygen to the heart is blocked by a clot for example, causing damage to the heart muscle. If the clot partially blocks the flow of blood in the arteries of the heart, it can cause a lack of oxygen to the heart muscle tissue called ischemia. If the clot completely stops the blood flow, then a heart attack develops.

The new study findings came from an analysis of data from 2000 through 2014 on more than 151 000 adults who had a cardiac arrest while hospitalised in the United States.

Sudden cardiac death claims the lives of as many as 2 000 young South Africans per year who are seemingly healthy, show no signs of heart disease, and who are unaware that they have an existing heart condition.

Improving survival

In that time period (2000–2014), in the US, overall rates of survival at least until discharge from the hospital increased from 16% to 25% for those who had cardiac arrest on a weekday. Survival also improved for those with an off-hours cardiac arrest, from nearly 12% to 22%. However, that was 3.8% lower than patients whose cardiac arrest occurred during a weekday, the researchers noted.

Each year, about 200 000 people experience cardiac arrest while in a US hospital, according to the study authors.

“Nearly 50% of in-hospital cardiac arrests take place during off-hours. By determining how survival has changed in recent years, we may be able to identify opportunities for quality improvement efforts,” the study’s lead author, Dr Uchenna Ofoma, said in a news release from the American College of Cardiology.

“If we can improve survival for cardiac arrests that occur during off-hours, it could impact a substantial number of patients,” said Dr Ofoma.

^{Image credit: iStock}

More than 30 people in every 10,000 died at one unit in 2017, higher than the Welsh average.

Sleep disorders expert

Dr Alison Bentley is a general practitioner who has consulted in sleep medicine and sleep disorders, in both adults and children of all ages, for almost 30 years. She also researches and publishes on a number of sleep-related topics both in formal research journals and lay publications including as editor of Sleep Matters, an educational newsletter on sleep disorders for doctors.

A BBC investigation reveals parts of the Underground network exceed noise safety levels.