Identifying Key Benefits in European Off-Patent Biologics and Biosimilar Markets: It is Not Only About Price!

Biosimilar medicines have shown similarity with the originator biologic and offer a similar clinical outcome generally at a lower cost. This paper identifies benefits of off-patent biologics and biosimilars, and illustrates these benefits with empirical data from Europe. We provide a narrative review of published literature on values and benefits of biosimilars in Europe. The results describe cost savings as the key driver stemming from the lower price of biosimilars, than that of originator products, and from price competition between biosimilar(s), originator, and next-generation products. Cost savings may then translate into a number of other associated benefits. The lower price of biosimilars and similar effectiveness to the originator biologics improve cost effectiveness, implying that reimbursement can be granted or extended to other pa

Internet of robotic things : converging sensing/actuating, hypoconnectivity, artificial intelligence and IoT Platforms

The Internet of Things (IoT) concept is evolving rapidly and influencing newdevelopments in various application domains, such as the Internet of MobileThings (IoMT), Autonomous Internet of Things (A-IoT), Autonomous Systemof Things (ASoT), Internet of Autonomous Things (IoAT), Internetof Things Clouds (IoT-C) and the Internet of Robotic Things (IoRT) etc.that are progressing/advancing by using IoT technology. The IoT influencerepresents new development and deployment challenges in different areassuch as seamless platform integration, context based cognitive network integration,new mobile sensor/actuator network paradigms, things identification(addressing, naming in IoT) and dynamic things discoverability and manyothers. The IoRT represents new convergence challenges and their need to be addressed, in one side the programmability and the communication ofmultiple heterogeneous mobile/autonomous/robotic things for cooperating,their coordination, configuration, exchange of information, security, safetyand protection. Developments in IoT heterogeneous parallel processing/communication and dynamic systems based on parallelism and concurrencyrequire new ideas for integrating the intelligent “devices”, collaborativerobots (COBOTS), into IoT applications. Dynamic maintainability, selfhealing,self-repair of resources, changing resource state, (re-) configurationand context based IoT systems for service implementation and integrationwith IoT network service composition are of paramount importance whennew “cognitive devices” are becoming active participants in IoT applications.This chapter aims to be an overview of the IoRT concept, technologies,architectures and applications and to provide a comprehensive coverage offuture challenges, developments and applications

Oscillating grid turbulence in shear-thinning polymer solutions

Oscillating grid apparatuses are well known and convenient tools for the fundamental study of turbulence and its interaction with other phenomena since they allow to generate turbulence supposedly homogeneous, isotropic, and free of mean shear. They could, in particular, be used to study turbulence and mass transfer near the interface between non-Newtonian liquids and a gas, as already done in air-water situations. Although frequently used in water and Newtonian fluids, oscillating grid turbulence (OGT) generation has yet been rarely applied and never characterized in non-Newtonian media. The present work consists of a first experimental characterization of the flow properties of shear-thinning polymer (Xanthan Gum, XG) solutions stirred by an oscillating grid. Various polymer concentrations are tested for a single grid stirring condition. The dilute and semidilute entanglement concentration regimes are considered. Liquid phase velocities are measured by Particle Image Velocimetry. The existing mean flow established in the tank is described and characterized, as well as turbulence properties (intensity, decay rate, length scales, isotropy, etc.). OGT in dilute polymer solutions induces an enhanced mean flow compared to water, a similar decay behavior with yet different decay rates, and enhanced turbulence large scales and anisotropy. In the semidilute regime of XG, turbulence and mean flows are essentially damped by viscosity. The evolution of mean flow and turbulence indicators leads to the definition of several polymer concentration subregimes, within the dilute one. Critical concentrations around 20 ppm and 50 ppm are found, comparable to drag reduction characteristic concentrations

Percutaneous cholecystostomy:Single centre experience in 111 patients with an acute cholecystitis

'Purpose: 'To evaluate the safety and long-term outcome of percutaneous cholecystostomy (PC) under radiologic guidance for acute calculous cholecystitis (ACC) and acute acalculous cholecystitis (AAC) in all patients undergoing that procedure at our institution. 'Materials and methods: 'We performed a retrospective analysis of 111 patients who underwent PC from 2004 to 2012. Patients were divided into two groups: AAC and ACC. For all patients, comorbidity and American Society of Anesthesiologists (ASA) classification were determined. The indications, complications, recurrence rate and long-term outcome for both groups were analysed. The mean follow-up was 55 months. 'Results: 'Twenty-four patients with AAC and 87 patients with ACC underwent PC. The most common sonographic findings of ACC and AAC were gallbladder wall thickening (90,9%) and hydrops (72,9%). Twelve of 24 patients with AAC (50%) were hospitalized at the Intensive Care Unit (ICU). Overall, the procedure failed in 2 (1,8%) patients. There were 4 (3,6%) abscesses and 2 (1,8%) fistulas post PC. Drain dislodgment was found without sequelae in 8 (7,2%) patients. Elective cholecystectomy was performed in 35/111 (31,5%). Fifty-one of 87 (58,6%) patients with gallstones underwent cholecystectomy; 36/87 (41,3%) did not undergo surgery due to a too short follow-up or death of nonbiliary disease. In the AAC group, there was no recurrent cholecystitis in 17/24 (70,8%) patients; 3/24 (12,5%) underwent surgery and 4/24 (16,6%) patients died in the ICU. 'Conclusion: 'PC is a minimally invasive treatment with low complication rate for patients with acute cholecystitis whom considered being at high-risk for urgent cholecystectomy. Good selection (ASA III and IV) and indication is needed in patients with ACC before PC because the majority will be operated later on. AAC can be managed nonoperatively and further treatment might not be needed

A health economic guide to market access of biosimilars

Introduction: Little is known about market access to biosimilars from a health economic perspective, except for studies that compute the budget impact of biosimilar use. Areas covered: This comprehensive health economic guide to the market access of biosimilars focuses on the role of biosimilars in pharmaceutical innovation and competition, the objective of biopharmaceutical policy, the budget impact of biosimilars, and the cost-effectiveness of biologic therapy in the presence of biosimilars. Expert opinion: We argue that the objective of biopharmaceutical policy in a health system should be to create a competitive and sustainable market for off-patent reference biologics, biosimilars, and next-generation biologics that makes biologic therapy available to patients at the lowest cost. Market access of biosimilars can contribute to this objective as a result of the lower price of biosimilars and price competition with alternative therapies. The resulting improvement in the cost-effectiveness of biologic therapy needs to be accounted for by revisiting reimbursement decisions and conditions. When examining the cost-effectiveness of biologic therapy following patent expiry, stakeholders need to consider residual uncertainties at the time of biosimilar marketing authorization, the nocebo effect, market entry of a second-generation reference biologic with a different administration form than the biosimilar, and value-added services

Particle Image Velocimetry (PIV) measurements in a water film, application to a tire rolling through a puddle

International audienceA measurement method based on Particle Image Velocimetry with refraction of the laser sheet at a win-dow/water interface is proposed for the measurement of the velocity field of a water flow formed by a tire moving inside a water puddle. This study focuses of the feasibility and repeatability of this optical measurement method. The characterization of the optical properties of the measurement technique defines the integration effect in height of the measurement method. The analysis of the overall features of the flow is focused on two main zones in front and around the tire. The flow inside the first zone is defined by a characteristic velocity of the water displaced in an area located in front of the tire ; in the second zone a characteristic velocity representative of the flow in the vicinity of the shoulder of the tire is also defined. Correlations of both characteristic velocities with the car speed and water film height are established. New and worn tires were tested in this work