Abus d’antibiotiques : une catastrophe annoncée

Bactéries résistantes, la guerre est déclarée – Enquête de santé le documentaire

Les antibiotiques sont l’arme la plus puissante contre les infections bactériennes. Mais à force d’en abuser, ces médicaments ont perdu de leur efficacité et les bactéries ont appris à s’en défendre.

A force d’abuser des antibiotiques, les bactéries ont appris à se défendre. Les médicaments ont perdu de leur efficacité. En France, chaque année, près de 12 500 personnes meurent des suites d’une infection causée par ces formes mutantes. Martelée depuis 2002, cette résistance pousse les plus pessimistes à envisager le pire pour les années à venir. D’autant que cette surconsommation se retrouve également chez les animaux d’élevage dont les bacilles résistantes peuvent se transmettre par la chaîne alimentaire.

2016 Changes to how NICE appraises drugs and other health technologies

The National Institute for Health and Care Excellence is an executive non-departmental public body of the Department of Health in the UK

The recent proposals by NICE and NHS England to change arrangements for evaluating and funding drugs and other health technologies not only tidy up the processes, but introduce some important new elements.

The four proposed elements are to:

  1. Introduce a “fast track” NICE technology appraisal process for the most promising new technologies, which fall below an incremental cost-effectiveness ratio of £10,000 per QALY (quality adjusted life year).
  2. Operate a “budget impact threshold” of £20 million, set by NHS England, to signal the need for a dialogue with companies to agree special arrangements to better manage the introduction of new technologies recommended by NICE.
  3. Vary the timescale for the funding requirement when the budget impact threshold is reached or exceeded, risking disruption to the funding of other services.
  4. Automatically fund, from routine commissioning budgets, treatments for very rare conditions (highly specialised technologies) up to £100,000 per QALY (5 times greater than the lower end of NICE’s standard threshold range), and provide the opportunity for treatments above this range to be considered through NHS England’s process for prioritising other highly specialised technologies.

James Raftery: Changes to how NICE appraises drugs and other health technologies, BMJ Blog, 2 Dec, 16.

The first of these is non-contentious and probably should have been introduced long ago. It is estimated to reduce appraisal time by 25%. Some interventions are likely to be cost effective if they are even mildly effective and incur low cost. From 2007 to 2014, around 15% of NICE’s technology appraisals fell at or below £10k per QALY.

Specialised services, of which 146 exist, cover a diverse range of disparate and complex services, from services for long-term conditions, such as renal and mental health problems, to services for uncommon conditions such as rare cancers. Funded by a variety of means and lacking standard data, responsibility for commissioning specialised services was shunted from agency to agency until 2013 when NHS England took on responsibility.

Proposals two and three, which are to do with specialised services, reflect the recent rows over funding drugs for hepatitis C when NICE’s approval of sofosbufir led to delays by NHS England due their total cost impact. Besides a BMJ investigation, this led to a considered review by the House of Commons Public Accounts Committee (PAC).

The PAC showed that between 2013–14 and 2015–16, the budget for specialised services increased from £13 billion to £14.6 billion, or 6.3% a year, well above that for the NHS. By 2020–21, the budget for these services is expected to rise to £18.8 billion, 16% of the total NHS budget.

In 2013–14, NHS England overspent on specialised services by £377 million (2.9%) and in 2014–15, it overspent by £214 million (1.5%). In 2014–15, the Cancer Drugs Fund accounted for £136 million of the overspend.

NHS England told the PAC that about three-quarters of NICE recommended drugs apply to specialised services and that most of the budget increase for 2016–17 was related to NICE approved drugs.

The PAC showed that the arrangements for pricing (Department of Health), appraising (NICE) and funding (NHS England) of specialized services were misaligned. It recommended that the Department of Health and NHS England should, in collaboration with NICE, ensure affordability is considered when making decisions that have an impact on specialised services. Proposals 2 and 3 formalise arrangements between NICE and NHS England for appraising and funding these services.

The fourth proposal marks the most radical change by setting the cost per QALY threshold for highly specialised (as opposed to specialised) technologies at £100k, which is five times greater than the lower end of NICE’s standard threshold range. Although this reflects the higher thresholds that have been allowed for some extreme “orphan drugs,” it lacks any coherent rationale besides political necessity. This leaves NICE with at least three cost per QALY thresholds, one of £20k-30k for standard technologies, one of around £50k for end of life technologies and one of £100k for highly specialised technologies.

Le Distilbène en 2016 (1/4)

Téléchargez le guide pratique pour le suivi médical

Vidéo publiée le 1er septembre 2016 par l’ Association Réseau DES FRANCE DISTILBENE.

En 2016, quelles connaissances scientifiques des conséquences du DES?

Guide Pratique

Suite à l’étude Distilbène 3 générations qu’elle a initiée en 2013, l’association Réseau D.E.S. France a publié, fin 2015, un guide pratique pour les professionnels de la santé, synthétisant les données actuelles de la science. Deux versions sont à télécharger:

Le Distilbène DES, en savoir plus

9ème Journée Internationale des Maladies Rares

Ensemble, faisons entendre la voix des malades

En France, l’Alliance Maladies Rares, collectif de plus de 200 associations et porte-parole des malades et de leur entourage, organise cet événement dans les régions depuis sa création en 2008.

9e Journée internationale des maladies rares, alliance-maladies-rares.org, 29/02/2016

Evénement annuel organisé un 29 février, jour rare, la Journée internationale des maladies rares est l’occasion d’unir nos forces et de sensibiliser aux défis quotidiens à relever pour Faire entendre la voix des malades ! Pour sa 9e édition, la journée sera relayée par de nombreux acteurs sensibles à la cause des maladies rares dans plus de 85 pays dans le monde. 30 millions d’européens, dont 3 millions de Français, sont concernés par l’une des 6000 à 8000 maladies rares dénombrées.

Le slogan, Ensemble, faisons entendre la voix des malades s’adresse au plus grand nombre afin d’unir l’ensemble des forces pour que les besoins des malades et de leurs familles soient mieux pris en compte et ainsi trouver des solutions communes, obtenir des traitements, des soins, des ressources et des services nécessaires pour améliorer le quotidien des personnes concernées.

Le Distilbène DES, maladie rare, en savoir plus

Rare Disease Day 2016 Poster

Download the RDD infopack 2016

Rare Disease Day takes place on the last day of February each year.

The main objective of Rare Disease Day (RDD) is to raise awareness among the general public and decision-makers about rare diseases and their impact on patients’ lives.

OrphaNet, portal for rare diseases and orphan drugs, includes the Diethylstilbestrol DES syndrome as rare disease ORPHA:1916.

More information

How much do you know about DES?

Feb 29 is Rare Disease Day! RDD2016 official video

Raise awareness about DES during Rare Disease Day!

#RDD2016 official video by @rarediseaseday for #RareDisease awareness

Raise awareness about DES during Rare Disease Day ! Use tags #RDD2015 #RareDisease #RareDiseaseDay .

The main objective of Rare Disease Day is to raise awareness amongst the general public and decision-makers about rare diseases and their impact on patients’ lives.

More information
Is DES a rare disease? How much do you know about DES?

National Women’s Health Week

What steps should you take for good health?

May 14-20, 2017 #NWHW

nwhwt logo
Join the National Women’s Health Week celebration and learn what you can do to lead a healthier life at any age.

About National Women’s Health Week

National Women’s Health Week is an observance led by the U.S. Department of Health and Human Services Office on womens’s health. The goal is to empower women to make their health a priority. The week also serves as a time to help women understand what steps they can take to improve their health.

The 18th annual National Women’s Health Week kicks off on May 14, and is celebrated until May 20, 2017.

What steps can I take for better health?

To improve your physical and mental health, you can:

How can I participate in National Women’s Health Week?