Have You Heard. September 2016

POC testing for ABX

Things have changed. ‘Just in case’ antibiotics may be a thing of the past in remote communities. The media release said “on-the-spot blood test is fighting superbugs”. It was talking of promoting a point-of-care (POC) pathology test as helping doctors do the right thing: a result within 15 minutes means more accurate prescribing of antibiotics for respiratory infections, which in turn means less antibiotics overall (a 23-36% drop in Europe) and probably fewer resistant superbugs. PathWest’s Network Director of Regional Service Dr Narelle Hadlow supported the claims, quoting a BMJ review that showed CRP (the test in question) and procalcitonin (if you are in hospital) can help direct correct use of antibiotics. She said 70% of medical decisions rely on pathology results. A CRP at Esperance, Busselton, Margaret River, Augusta, Exmouth, Fitzroy Crossing and Halls Creek are trained and the testing is monitored by PathWest for quality. The test is a good backup for remote hospitals and nursing posts, which they say might decrease hospital bed-stays.

Pharma payments hit sunlight

For pharma members of Medicines Australia, it will be mandatory from October 1, under the ACCC-inspired new Code, to publish names and amounts of payments and transfers of value to individual healthcare professionals. Pharma companies have been collecting the information for the past 12 months but health professionals could opt out of disclosure. The RACGP says the mandatory changes mean greater transparency. Published information relate to payments for services (e.g. giving a lecture, chairing an educational meeting, serving on an advisory board or consulting) and airfares and/or accommodation bundled with educational or consulting services and conference registration fees. In the nine months from January 1 to September 30, 2015, 689 consultants were paid an average of $2,642.95 each by 33 companies. Mind you, during 12 months until December 30, 2015, an average of $33,174 was provided by 33 companies to 276 health consumer NFP organisations. For instance, Astrazeneca gave $90,750 to the Lung Foundation to assist it to develop patient materials for its national COPD program and two other campaigns. Some say whoever pays the piper calls the tune but Medicines Australia sets rules of engagement and talks of enhancing quality use of medications.

Is there a mesh mess?

The TGA is urging doctors and health consumers to report adverse events with urogynaecological surgical meshes, believing events are under-reported perhaps because some patients have not joined the dots. Urogynaecological meshes (supplied as a ‘sling’, ‘tape’, ‘ribbon’, ‘mesh’ and ‘hammock’) are used to treat pelvic organ prolapse and stress urinary incontinence. The TGA says between July 2012 and June 2016, 99 adverse reports were received, most frequently pain and erosion. It lists a stack of adverse events in 30 bullet points which makes the reader wonder what is the upside of this surgery?

Genesis eyes Asia

GenesisCare Limited, which owns cardiology, radiation oncology, and sleep disorder services in WA, has sold a controlling stake of its business to a new investment consortium comprised of a Hong Kong-based China Resources Group and Macquarie Capital, an advisory arm of Macquarie Group. According to the Australian Financial Review the sale price equates to an enterprise value of $1.7b a big step-up from August 2012 when the company’s enterprise value was put at $550m. The sale will require sign-off from the Foreign Investment Review Board. The consortium is investing with management and 150 or so doctors for a stake in the business of between 50 per cent and 70 per cent. The deal also requires shareholder approval. GenesisCare Chairman said Australian expertise and technology will enter new markets that include China from an Australian base with the management team remaining in Sydney. He reassured investors that clinical governance will not change, and the GenesisCare MD said the company will continue its expansion plans into Western Europe (it says it is the largest provider of private cancer services in Spain and the UK), and under new arrangements, accelerate plans for Asia.