Comparative Analysis of Legislative Requirements About Patients' Access to Biotechnological Drugs for Rare Diseases in Central and Eastern European Countries

Objectives: The aim of the study was to compare the access of patients with rare diseases (RDs) to biotechnological drugs in several Central and Eastern European countries (CEECs). We focused on the legislative pricing and reimbursement requirements, availability of biotechnological orphan medicinal products (BOMPs) for RDs, and reimbursement expenditures. Methods: A questionnaire-based survey was conducted among experts from 10 CEECs: Bulgaria, Croatia, Estonia, Greece, Hungary, Poland, Romania, Slovakia, Serbia, and Macedonia. The legal requirements for reimbursement and pricing of BOMPs were collected. All BOMPs and medicines without prior orphan designations were extracted from the European list of orphan medicinal products, 2017. The reimbursement status of these medicinal products in 2017 in the public coverage of the included CEECs as well as the share of their costs in relation to the total public pharmaceutical spending for the period from 2014 to 2016 were defined. Results: Our survey revealed that some differences in the legal requirements for pricing and reimbursement of BOMPs amongst the countries included in the study. All European Union countries have developed and implemented pharmacoeconomic guidelines with or without some specific reimbursement requirements for orphan medicinal products. Cost-effectiveness analysis, cost-utility analysis, Markov models, meta-analysis, and discount levels of costs and results were required only in Bulgaria, Poland and Hungary. The number of reimbursed BOMPs and biotechnological medicinal products for RDs without prior orphan designation was the highest in Hungary (17 and 40, respectively). Patient-based reimbursement schemes were available only in Hungary for 11 out of 17 BOMPs. Poland and Greece have the highest pharmaceutical expenditure of reimbursed BOMPs with are similar to 214 million and 180 million EUR, respectively in the observed period from 2014 to 2016. High proportion of the pharmaceutical expenditure on the reimbursed biotechnological medicinal products for RDs for the observed period 2014-2016 is presented in Bulgaria and Slovakia. Conclusions: The non-European Union CEECs face a significant delay in the legal implementation of pharmacoeconomic guideline for assessment of BOMPs. The access to BOMPs is similar among the observed CEECs and the countries with the best access are Hungary and Greece. The influence of BOMP expenditures on the budget in the individual countries is significant

Herbal medicine use by surgery patients in Hungary: a descriptive study

BACKGROUND: The popularity of non-conventional treatments, especially the consumption of herbs is showing an increasing tendency all over the world. The consumption of herbal medicines might cause several complications during perioperative care. METHODS: The survey was conducted at the First Department of Surgery of Semmelweis University and focused on the demographics of patients consuming herbal medicines who had undergone elective surgery between July 1(st) 2014 and February 28(th) 2015. A one-page questionnaire, that the patients filled in individually and anonymously, was used. The response rate was 17.3 %. RESULTS: Out of the 390 patients who filled in the questionnaire, 7.2 % (28 patients) used herbal medicines, 3.6 % (14 patients) of them two weeks prior to their hospitalization. The other 3.6 % (14 patients) took herbal medicines sometime in the past. The majority of those who have ever consumed herbs are women (18/28), have completed secondary or tertiary education (23/28), more than half of them suffer from tumorous diseases and only a quarter of them (7/28) informed their physician about their use of herbal medication of their own accord. CONCLUSIONS: Attention must be paid to the exploration of herb consumption habits of surgery patients during the preoperative examinations in order to avoid potential side effects, complications or drug interactions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12906-015-0890-2) contains supplementary material, which is available to authorized users

The Gifted and Gifted Education in Hungary

The real challenge is to see value that is not yet in its true form. Becoming gifted is a process, during which characteristics of giftedness are present throughout, but not necessarily in a form perceptible or acceptable to the environment. Giftedness does not hide itself, only to the extent that the environment believes it hidden. Perception defines the pattern that manifests itself. The beginning of the 20th century is a success story of Hungarian gifted education. Outstanding teachers and their students have reached outstanding achievements through gifted education linked to everyday education. Their methods and ideas are durable, and are therefore worth recalling

Radiative-capture cross sections for the La139(n,γ) reaction using thermal neutrons and structural properties of La140

A set of prompt partial γ-ray production cross sections from thermal neutron capture were measured for the 139La (n,γ) reaction using a guided beam of subthermal (thermal and cold) neutrons incident on a nat La2O3 target at the Prompt Gamma Activation Analysis facility of the Budapest Research Reactor. Absolute 140La cross sections were determined relative to the well-known comparator 35Cl(n,γ) cross sections from the irradiation of a stoichiometric nat LaCl3 sample. The total cross section for radiative thermal neutron capture on 139La from the sum of experimentally measured cross sections observed to directly feed the 140 La ground state was determined to be σ0 = 8.58(50) b. To assess completeness of the decay scheme and as a consistency check, the measured cross sections for transitions feeding the ground state from levels below a critical energy of Ec = 285 keV were combined with a modeled contribution accounting for ground-state feeding from the quasi continuum to arrive at a total cross section of σ0 = 9.36(74) b. In addition, a neutron-separation energy of Sn = 5161.001(21) keV was determined from a least-squares fit of the measured primary γ-ray energies to the low-lying levels of the 140La decay scheme. Furthermore, several nuclear structure improvements are proposed for the decay scheme. The measured cross-section and separation-energy results are comparable to earlier measurements of these quantities