Medicine and Science from The BMJ

The new trade deal struck between the UK and US came into force in April. 

The deal will

double the amount that the NHS spends on new medicines, by the end of 2036 (from 0.6 - 0.6% of GDP).

 increase the threshold that the National Institute for Health and Care Excellence (NICE) sets for drug approvals - which will allow more to be approved, but will also allow companies to charge more for their pharmaceuticals,

 include a change to the rebate the NHS receives, to ensure that the extra drug spend occurs.

Cumulatively this will increase our drug spend by £56 billion in the next 10 years, which will have to come out of current healthcare spending - which experts are calling a catastrophe for the NHS.

Joining Kamran Abbasi to discuss are Sally Gainsbury, a senior policy analyst Nuffield Trust and Karl Claxton, professor of economics at the University of York. We also hear from Francis Ruiz, policy analyst at the London School of Hygiene and Tropical Medicine.

Reading list

The UK government must publish a detailed impact assessment of the costs and benefits of the US-UK medicines partnership

A budget apart: the case for ringfencing medicines in the UK

A blockbuster MS drug undergoes FDA re-evaluation. We explore the story of Ocrelizumab, a treatment for primary progressive multiple sclerosis, following a patient petition that highlighted internal disagreements among agency reviewers regarding its efficacy.

We look to Sweden, where new research involving sibling pairs separated by adoption investigates how early-life environments shape long-term health and social outcomes.

Finally, we revisit the dominant medical narrative on Alzheimer’s disease. Why is it so difficult to move towards comprehensive treatments? Has the focus on amyloid plaques hindered our understanding of other critical factors like vascular health and social inequality?

Peter Doshi is a senior editor at The BMJ and an associate professor of pharmaceutical health services research at the University of Maryland.

Erik Peterson is an associate professor at the Karolinska Institute in Stockholm, specializing in psychiatric epidemiology and adoption studies.

Carol Brayne is a professor emerita of public health medicine at the University of Cambridge and a leading expert in the epidemiology of dementia.

Reading List:

Multiple sclerosis: Could Roche's bestselling drug Ocrevus be doing more harm than good in women with primary progressive MS?

Home environment conditions during childhood and psychosocial outcomes across three generations in Sweden: population based adoption-discordant sibling comparison study

Covid 19 was the last Public Health Emergency of International Concern (PHEIC). Our guests in this podcast think that the Trump Administration should be declared the next one.

Joining Kamran Abbasi are, Fatima Hassan,  human rights lawyer and Director of the Health Justice Initiative in South Africa, and Matthew Herder, Director of the Health Justice Institute at Dalhousie University in Canada explain why they think that the actions and consequences of the Whitehouse meet the bar for WHO to delcare an emergency

We examine the global consequences of recent US policy shifts, including:

The withdrawal from the World Health Organization (WHO) and its implications for international health governance.

Significant funding cuts to global health programs, including PEPFAR and the CDC, and how these disruptions affect life-saving HIV and TB treatments in the Global South.

The rise of "unhinged nationalism" in health policy, from North American measles outbreaks to the extraction of trade concessions in exchange for medical aid.

The role of US health leadership in fueling vaccine hesitancy and dismantling scientific research at the NIH.

 

Reading list:

Trump and his administration as a public health emergency of international concern

Why the expanded global gag rule is a deadly triple tripwire for recipients of US foreign aid

The power of the markets: the scandal that keeps on taking

Coming up in this week’s episode:

The 15th Strike: As the latest six-day walkout by resident doctors in England concludes, the BMJ's news team examines the state of the ongoing dispute over pay and training places.

Iain Beardsell, consultant in emergency medicine in Southampton explain why he thinks reintroducing compassion could be the key to tackling the systemic issues facing emergency departments

And finally, The BMA announces major changes to how it represents doctors in private practice - we hear why they think the US has some better legislation around health insurance than the UK.

 

Reading list:

Resident doctor strikes: Streeting demands to “meet with the organ grinders” as latest action ends

The BMJ interviews Jack Fletcher 

Make compassion visible in emergency medicine again

BMA boosts support for private practice as NHS failings prompt more patients to pay for care

The BMJ published a negative result this week. A new trial focuses on a peer support intervention for improving breastfeeding rates in the UK, but finds no major improvement. We hear from the lead author who tells us what went wrong, and the insights that can still be drawn from apparent ‘failures’.

Next we turn our eyes to shisha smoking in the UK. With shisha or “hookah” cafes on the rise, we explore the smoking habit in more detail. What are the effects on health? And why are UK laws poor at regulating the practice?

 

Kate Jolly is professor of public health and primary care at the University of Birmingham.

Zainab Hussain is a UK-based freelance journalist writing on behalf of The BMJ.

Links:

Peer support intervention (ABA-feed) to improve breastfeeding: UK based, multicentre, parallel group, randomised controlled trial

Shisha tobacco’s availability is rising. Why does UK smoking policy fail to tackle it?