3,076 research outputs found

    The effect of new biosimilars in rheumatology and gastroenterology specialities on UK healthcare budgets: Results of a budget impact analysis

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    Background: The approval of new biosimilars of infliximab, etanercept and adalimumab by the European Medicines Agency is expected to produce further cost savings to the healthcare system budget. Objectives: This study aimed to estimate the budget impact of the introduction of new biosimilars FlixabiĀ®, ErelziĀ®, SolymbicĀ®, AmgevitaĀ® and ImraldiĀ® in rheumatology and gastroenterology specialities in the UK. Methods: A published budget impact model was adapted to estimate the expected cost savings following the entry of new biosimilars FlixabiĀ®, ErelziĀ®, SolymbicĀ®, AmgevitaĀ® and ImraldiĀ® in the UK over three-year time horizon. This model was based on retrospective market shares of biologics used in rheumatology and gastroenterology which were derived from DEFINE Software and healthcare professional perspectives. Results: The model predicted that infliximab and etanercept biosimilars would replace their corresponding reference agents by 2020. Adalimumab biosimilars were predicted to achieve 19% of the rheumatology and gastroenterology market by 2020. Without the introduction of further biosimilars, the model predicted a reduction in expenditure of Ā£44 million on biologics over the next three years. With the entry of FlixabiĀ®, ErelziĀ®, SolymbicĀ®, AmgevitaĀ® and ImraldiĀ® the model estimates cumulative savings of Ā£285 million by 2020. Conclusions: The introduction of new infliximab, etanercept and adalimumab biosimilars will be associated with considerable cost savings and have a substantial favourable impact on the UK NHS budget. The number of biosimilars and time of entry of is critical to create competition which will result in maximum cost savings

    Preparar la guerra

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    Publicat a El PeriĆ³dico

    Evaluating the importance of metamorphism in the foundering of continental crust

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    The metamorphic conditions and mechanisms required to induce foundering in deep arc crust are assessed using an example of representative lower crust in SW New Zealand. Composite plutons of Cretaceous monzodiorite and gabbro were emplaced at ~1.2 and 1.8ā€‰GPa are parts of the Western Fiordland Orthogneiss (WFO); examples of the plutons are tectonically juxtaposed along a structure that excised ~25ā€‰km of crust. The 1.8ā€‰GPa Breaksea Orthogneiss includes suitably dense minor components (e.g. eclogite) capable of foundering at peak conditions. As the eclogite facies boundary has a positive dP/dT, cooling from supra-solidus conditions (Tā€‰>ā€‰950ā€‰ĀŗC) at high-P should be accompanied by omphacite and garnet growth. However, a high monzodioritic proportion and inefficient metamorphism in the Breaksea Orthogneiss resulted in its positive buoyancy and preservation. Metamorphic inefficiency and compositional relationships in the 1.2ā€‰GPa Malaspina Pluton meant it was never likely to have developed densities sufficiently high to founder. These relationships suggest that the deep arc crust must have primarily involved significant igneous accumulation of garnetā€“clinopyroxene (in proportions >75%). Crustal dismemberment with or without the development of extensional shear zones is proposed to have induced foundering of excised cumulate material at Pā€‰>ā€‰1.2ā€‰GPa

    Do cerebrospinal fluid transfer methods affect measured amyloid Ī²42, total tau, and phosphorylated tau in clinical practice?

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    Introduction Cerebrospinal fluid (CSF) neurodegenerative markers are measured clinically to support a diagnosis of Alzheimer's disease. Several preanalytical factors may alter the CSF concentrations of amyloid Ī² 1ā€“42 (AĪ²1ā€“42) in particular with the potential to influence diagnosis. We aimed to determine whether routine handling of samples alters measured biomarker concentration compared with that of prompt delivery to the laboratory. Methods Forty individuals with suspected neurodegenerative diseases underwent diagnostic lumbar punctures using a standardized technique. A sample of each patient's CSF was sent to the laboratory by four different delivery methods: (1) by courier at room temperature; (2) by courier, on ice; (3) using standard hospital portering; and (4) after quarantining for >24 hours. AĪ²1ā€“42, total tau (tā€tau), and phosphorylated tau (pā€tau) levels measured using standard enzymeā€linked immunosorbent assay techniques were compared between transfer methods. Results There were no significant differences in AĪ²1ā€“42, tā€tau, or pā€tau concentrations measured in samples transported via the different delivery methods despite significant differences in time taken to deliver samples. Discussion When CSF is collected in appropriate tubes, transferred at room temperature, and processed within 24 hours, neurodegenerative markers can be reliably determined

    30 days wild: development and evaluation of a large-scale nature engagement campaign to improve well-being

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    There is a need to increase peopleā€™s engagement with and connection to nature, both for human well-being and the conservation of nature itself. In order to suggest ways for people to engage with nature and create a wider social context to normalise nature engagement, The Wildlife Trusts developed a mass engagement campaign, 30 Days Wild. The campaign asked people to engage with nature every day for a month. 12,400 people signed up for 30 Days Wild via an online sign-up with an estimated 18,500 taking part overall, resulting in an estimated 300,000 engagements with nature by participants. Samples of those taking part were found to have sustained increases in happiness, health, connection to nature and pro-nature behaviours. With the improvement in health being predicted by the improvement in happiness, this relationship was mediated by the change in connection to nature
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