Systematic review on the evaluation criteria of orphan medicines in Central and Eastern European countries.

BACKGROUND: In case of orphan drugs applicability of the standard health technology assessment (HTA) process is limited due to scarcity of good clinical and health economic evidence. Financing these premium priced drugs is more controversial in the Central and Eastern European (CEE) region where the public funding resources are more restricted, and health economic justification should be an even more important aspect of policy decisions than in higher income European countries. OBJECTIVES: To explore and summarize the recent scientific evidence on value drivers related to the health technology assessment of ODs with a special focus on the perspective of third party payers in CEE countries. The review aims to list all potentially relevant value drivers in the reimbursement process of orphan drugs. METHODS: A systematic literature review was performed; PubMed and Scopus databases were systematically searched for relevant publications until April 2015. Extracted data were summarized along key HTA elements. RESULTS: From the 2664 identified publications, 87 contained relevant information on the evaluation criteria of orphan drugs, but only 5 had direct information from the CEE region. The presentation of good clinical evidence seems to play a key role especially since this should be the basis of cost-effectiveness analyses, which have more importance in resource-constrained economies. Due to external price referencing of pharmaceuticals, the relative budget impact of orphan drugs is expected to be higher in CEE than in Western European (WE) countries unless accessibility of patients remains more limited in poorer European regions. Equity principles based on disease prevalence and non-availability of alternative treatment options may increase the price premium, however, societies must have some control on prices and a rationale based on multiple criteria in reimbursement decisions. CONCLUSIONS: The evaluation of orphan medicines should include multiple criteria to appropriately measure the clinical added value of orphan drugs. The search found only a small number of studies coming from CEE, therefore European policies on orphan drugs may be based largely on experiences in WE countries. More research should be done in the future in CEE because financing high-priced orphan drugs involves a greater burden for these countries

Production and spraying solutions neutralizing unpleasant smells in the wastewater pretreatment plant in SUPERFISH Company

Celem głównym prowadzonych prac badawczych było otrzymanie roztworów neutralizujących przykre zapachy pochodne ścieków i osadów technologicznych, budowane na wywarze z płatków róży, liści mięty, skórek pomarańczy. Przeprowadzono również wstępną ocenę skuteczności neutralizacji przykrych zapachów za pomocą otrzymanych roztworów neutralizujących z ww. roślin, opartą o doświadczenie neutralizacji zapachu w hali technologicznej Przedsiębiorstwa SUPERFISH w Kukini koło Ustronia Morskiego.Obtaining solutions neutralizing unpleasant smells from wastewater and technological deposits using rose petals, mint leaves, skins for orange was a main purpose of carried out research work. Also preliminary assessment of the effectiveness of neutralization of unpleasant smells using solutions obtained from given plants, based on experiments on smell in wastewater pretreatment plant in the SUPERFISH Company in Kukinia by Ustronie Morskie, Poland. The method of distillation with steam was applied in this work for the purpose of obtaining essential oils from plant material. Choice of this method is important to analysed plant material. It is applied at getting poorly watersoluble oils and the possible loss of soluble elements does not influence the quality of oil. This method is characterized by uncomplicated apparatus, as well as relatively low costs of carrying the process in comparing to other methods of obtaining oils. Apparatus for production of essential oils obtained from rose petals and mint leaves is presented in fig. 1. Apparatus for production of essential oils obtained from orange skins is presented in fig. 2. In order to determine if substance obtained using method of distillation with steam has aromatic properties, it was essential to create the system of testing and comparing studied substance against established standard. As a starting point standard substance was established, i.e. substance which gave no smell off during examinations. Distilled water was used here as a standard. Next five degree scale of smell intensity was determined contractually (table 1), where lowest degree of the scale "0" means the lack of the smell (standard), 1 is a weak smell, next: average perceptible smell, intense smell and very intense smell. In order to examine effectiveness of action of obtained aromatic solutions it was decided to spray the determined dose of each of them in the pretreatment plant of wastewater from a SUPERFISH fish- plant Examinations consisted in measuring the time of the fragrance duration of sprayed substance by the research team in two zones. It is possible to present the following conclusions on the base of analysis of ex-aminations carried out: As a result of distillation with the steam of substrates from rose, mint and orange, extracts characterized by aromatic properties were obtained. Obtained extracts, depending on the amount of substrate used for distillation, differed in intensity of the fragrance. Biggest concentration of aromatic substances (intense fragrance) in extract, were obtained for biggest amount of substrate used for the process of distillation. Extracts with biggest concentration of dissolved substances are characterized by an intense fragrance. Examinations carried out in the SUPERFISH wastewater pretreatment plant showed the effectiveness of obtained aromatic substances in the neutralization of unpleasant smells. The neutralization duration depends on the amount of substrate used for obtaining aromatic extract. The increase of extract concentration is lengthening duration of effective dezodorization. Research carried out in the wastewater pretreatment plant of SUPERFISH company showed good effectiveness of used fragrance substances in neutralization of unpleasant smells