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The UK Health Security Agency (UKHSA) said last week (Aug 5) there were "early signs" that the monkeypox outbreak was plateauing across the country and that its expansion had slowed. "While the most recent data suggests the growth of the outbreak has slowed, we cannot be complacent," Dr Meera Chand, director of clinical and emerging infections at UKHSA, said. There were 2,859 confirmed and highly probable cases of monkeypox in the UK as of Aug. 4, with nearly 99 per cent of the cases among men, the country's health authority said in a statement. The recent analysis by the UKHSA showed that "monkeypox continues to be transmitted primarily in interconnected sexual networks of gay, bisexual, or other men who have sex with men", it added. British authorities in June were recommending gay and bisexual men at higher risk of exposure to monkeypox be offered a vaccine, as the outbreak of the viral disease had gathered pace, mostly in Europe.

Britain has become the first country to approve a Codiv-19 vaccine that targets both the original and Omicron variant of the virus. Medicines regulator MHRA approved the so-called bivalent vaccine made by US drug company Moderna as a booster for adults. The agency's decision was based on clinical trial data that showed the booster triggered "a strong immune response" against both Omicron (BA.1) and the original 2020 virus, it said. The MHRA also cited an exploratory analysis in which the shot was also found to generate a good immune response against the currently dominant Omicron offshoots BA.4 and BA.5. "The first generation of Covid-19 vaccines being used in the UK continue to provide important protection against the disease and save lives," MHRA chief executive June Raine said in a statement. "What this bivalent vaccine gives us is a sharpened tool in our armoury to help protect us against this disease as the virus continues to evolve."

Community pharmacies are well placed to play a role in preventing deaths from cardiovascular disease (CVD) said Director of NHS Services. The recent analysis by the British Heart Foundation (BHF) revealed that nearly 100,000 more people with cardiovascular disease than expected have died since the start of the pandemic in England. Latest figures show that the number of people waiting for time-sensitive cardiac care was at a record high of nearly 390,000 at the end of April in England. Average ambulance response times for heart attacks and strokes have consistently been above 30 minutes since the beginning of 2022, and in December 2022 they even breached 90 minutes. The target is 18 minutes, though the Government has set a new average target of 30 minutes over 2023/24. Director of NHS Services, Alastair Buxton, said: "It is concerning to hear that there have been tens of thousands of preventable deaths from cardiovascular disease (CVD) since the start of the COVID-19 pandemic. We share BHF's desire to see more action on preventing the causes of CVD and, subject to appropriate funding being in place, community pharmacy teams are well placed to play a role in this.

The NHS Business Services Authority (NHSBSA) has published the Drug Tariff Category M price list for July which reflects an increase in reimbursement level of approximately £5m per quarter. An adjustment of -£23.8m was announced, in light of the results of the margin survey (latest result up until end of December 2022), and the phasing down of the additional £100m agreed across years 4 and 5 as part of the Community Pharmacy Contractual Framework and uplifts for underlying market prices (between January - March 2023). Community Pharmacy England has agreed the adjustments based on the analysis of margin delivery and on current projections for 2023/24. It said: "The objectives are to ensure full delivery of agreed margin and smooth delivery as much as possible. As always, the impact on individual pharmacies will vary depending on dispensing mix."

National Institute of Health and Care Excellence (NICE) has not recommended 'Tirzepatide', also known as Mounjaro, developed by Eli Lilly, in its draft guidance issued on Tuesday (27 June) for treating type 2 diabetes in adults alongside diet and exercise. The independent NICE committee recognised the importance of new treatment options given that fewer than two-thirds of the adults with type 2 diabetes have adequate glucose control when using current treatment options. Evidence submitted to the committee from clinical trials showed the use of tirzepatide at any dose resulted in better glucose control and lower weight compared with semaglutide or insulin therapy. The weight reduction was more pronounced with higher doses of tirzepatide, while the effect on glucose levels seemed less dose-dependent. Similar effects were observed against all GLP-1 receptor agonists in company's network meta-analysis, but this was uncertain. The committee have asked the company to provide more data to address the uncertainties in the clinical evidence, when compared to all relevant alternative treatments.

The primary responsibility of community pharmacists is taking care of their patients but to do that they also need to learn how to run the business. It is one thing to be au fait with profit and loss statements, reimbursement models, budgets analysis, business planning and so much more but quite another when one is hard pressed on everything - time, resources and cash flow. Bas Vorsteveld - the new vice president and general manager in Great Britain & Ireland for Haleon, a new company 100 per cent focussed on consumer healthcare - has witnessed first-hand how "time poor" pharmacists usually are and is committed to helping ease their burden wherever possible. "They can be drowning in work at all times throughout the day. If I happen to spot a community pharmacy while I am out shopping with the family, I almost always pop into the store, with obviously a lot of questions in my head. If the pharmacist has the time, I ask them a few questions and once we start the conversation and they find out that I'm the general manager for a company that provides them with some of their big brand products, I often get a look of total surprise on their face, especially as I've come to visit their store and take the time to speak with them personally. I've really seen first-hand what a busy bunch they are! "I often want to know how the shop front is presented? What does the pharmacy look like from inside? Is there a big queue? What kind of advertisement the pharmacy has in place? How are our products merchandised?

The National Pharmacy Association (NPA) has warned of multi-million financial hit for community pharmacies, while the Pharmaceutical Services Negotiating Committee (PSNC) has renewed its calls for urgent financial support amid a looming energy bill crisis. NPA board member, Olivier Picard, this week shared a screenshot of his estimated electricity bill on WhatsApp groups. Upon expiration of his current arrangements, in October, his electricity bill could rise from its current £1,821 for one pharmacy to an estimated £6,914 - a near fourfold increase. Piccard said: "This is an eye-watering rise in costs for my own pharmacies and adds to the intense financial pressure we're already under. My standing charges will multiply by 10 and the overall cost to each pharmacy amounts to about £5,000." His comments come just ahead of an NPA-commissioned report into pharmacy inflation which will provide an analysis of inflationary costs pressing on the community pharmacy sector, from utilities and workforce to medicines purchasing.

GlaxoSmithKline and Sanofi said on Wednesday (December 15) they expect data from late-stage clinical trials of its booster dose of their Covid-19 vaccine candidate in the first quarter, instead of this year, another delay for the potential shot. The news came as two companies said preliminary data from trials showed the single-dose booster provided strong immune responses. They added that they need more time to test the booster on more people who have not been infected by the virus before they can submit data to regulators. The Phase III trial for the recombinant adjuvanted Covid-19 vaccine recruited most participants in the third quarter, coinciding with a significant increase in the number of people infected globally due to the Delta variant, it said. "To provide the necessary data to regulatory authorities for the booster vaccine submission, the trial will continue to accrue the number of events needed for analysis, with results expected in Q1, 2022." No safety concerns were identified. This is the latest delay for the vaccine's development, putting the companies further behind rivals in the race for Covid-19 shots.

The UK Health Security Agency (UKHSA) has said that monkeypox is to be listed as a notifiable disease in law from Wednesday (June 8). The new legislation means all doctors in England are required to notify their local council or local Health Protection Team (HPT) if they suspect a patient has monkeypox. Laboratories must also notify the UKHSA if the monkeypox virus is identified in a laboratory sample. Wendi Shepherd, monkeypox incident director at UKHSA, said: "Rapid diagnosis and reporting is the key to interrupting transmission and containing any further spread of monkeypox. This new legislation will support us and our health partners to swiftly identify, treat and control the disease. "It also supports us with the swift collection and analysis of data which enables us to detect possible outbreaks of the disease and trace close contacts rapidly, whilst offering vaccinations where appropriate to limit onward transmission."

Atorvastatin was the most dispensed drug in England in 2021/22 with 53.4 million items, revealed the annual Prescription Cost Analysis (PCA) published by NHS Business Services Authority. According to the official statistics, Apixaban (an anticoagulant) was the drug with the highest cost of £401 million. The statistics revealed that the cost of prescription items dispensed in the community in England was £9.69 billion, a 0.87 per cent increase of £83.7 million from £9.61 billion in 2020/21. "The number of prescription items dispensed in the community in England was 1.14 billion, a 2.58 per cent increase of 28.7 million items from 1.11 billion in 2020/21." FreeStyle Libre 2 Sensor kit (a glucose monitoring system) was the presentation with the largest absolute increase in cost between 2020/21 and 2021/22 of £69.8 million, from £2.84 million to £72.6 million.

The Pharmaceutical Services Negotiating Committee (PSNC) has expressed disappointment as the government continued to refuse to "a much-needed broader funding uplift" for the community pharmacies in England. This follows conclusion of the first Annual Review of the progress of the five-year Community Pharmacy Contractual Framework (CPCF) deal by PSNC, the Department of Health and Social Care (DHSC) and NHS England & NHS Improvement (NHSE&I). "We remain deeply frustrated by government's refusal to agree a much-needed broader funding uplift for the sector, but we are determined to continue to look for better ways forward for the sector throughout 2022 and beyond," said Bharat Patel, PSNC vice-chair, negotiating team member and an independent contractor. Patel noted that despite some important wins such as recognition of key challenges faced by pharmacies, the commitment to consider these as part of our Year 4 negotiations, and agreement to take forward work on service fee and other regulatory changes, the PSNC is disappointed that the review did not lead to "immediate and tangible outcomes and improvements for contractors." The negotiator had put forward data and analysis showing the capacity and cost constraints faced by pharmacies.

Lloyds Pharmacy's closure of all its 1,300 branches will wake-up the ministers and NHS officials to the reality of community pharmacy sector in England has reached crisis point, expressed Nigel Swift Managing Director of Rowlands pharmacy and Deputy Managing Director of PHOENIX UK. On Friday, The SUN reported that the UK's second largest pharmacy provider - is allegedly in the process of selling its entire estate of 1300 branches. Lloyds Pharmacy will no longer be a High Street presence following its decision to put all its pharmacy branches at the risk of closure. In January it has announced to close its 237 Sainsbury-based pharmacies. Nigel highlighted the fact that community pharmacy is struggling due to insufficient government funding and immense pressures on GPs and A&E departments - an ongoing issue which poses a very real threat to the sector. Commenting on the announcement, he said: "It's not just Lloyds - an independent analysis by Ernst & Young estimated that 75% of community pharmacies will be in financial distress in the coming years. £750 million has been taken out of the English contract due to inflation since it began."

Two pharmacies in Rotherham are set to merge into one, if plans are approved by NHS England. Weldricks Pharmacy has applied to merge its two Swinton branches, on Church Street and the Crown Street Surgery. If approved, the branch on Church Street will be modernised, and additional consulting rooms will be added, while the Crown Street site will be closed. Rotherham Met Borough Council's health and wellbeing board are set to make a representation supporting the plans, and say that analysis by public health "outlines the very minimal impact that this change will have in terms of pharmacy access in the borough based on the service offer, opening hours and walking times to this branch and the main pharmacy." They say the current opening hours will remain the same, and there will be no disruption to services during the consolidation. A statement from Weldricks adds that the decision to merge is down to funding cuts, and the company could go out of business if operating costs are not reduced - 'despite having been a local, family-owned business for almost 100 years'.

The current structure of global incentives to develop new antibiotics is insufficient and requires urgent resolution revealed a new report 'Incentivising new antibiotics' by the Office of Health Economics (OHE). OHE analysis demonstrates that on a global level, it is estimated that an effective 10-year incentive would require £3.5bn ($4.2bn) to adequately cover the entire research and development process for a new antibiotic. The report considers how health systems in the UK and around the world can stimulate the research and development (R&D) of new antibiotics. In 2020, the National Institute for Health and Care Excellence (NICE) and NHS England initiated an Antimicrobial Resistance pilot with the aim of incentivising pharmaceutical companies to develop new antibiotics by addressing the issues associated with reimbursement, which historically has deterred companies from pursuing AMR research.

AstraZeneca on Wednesday (April 5) said a combination of its cancer drugs Imfinzi and Lynparza met the main goal in a late-stage trial in patients with advanced ovarian cancer. The drugmaker said treatment with a combination of those drugs, along with chemotherapy and bevacizumab - the existing standard of care - improved progression-free survival in newly diagnosed patients with advanced ovarian cancer without certain mutations. Lynparza is jointly developed with U.S.-based Merck & Co as a treatment for breast cancer in early stage with certain mutations. Imfinzi alone, along with chemotherapy and bevacizumab, did not reach statistical significance in its interim analysis, the drugmaker added. Philipp Harter, director, Department of Gynaecology and Gynaecologic Oncology, Evangelische Kliniken Essen-Mitte, Germany and principal investigator for the trial, said: "DUO-O showcases the power of academia and industry collaboration in advancing new treatment combinations for patients with ovarian cancer. I'm grateful for the academic cooperative study groups and patients around the world that made this trial possible and look forward to sharing the results with the clinical community." Susan Galbraith, executive vice president, Oncology R&D, AstraZeneca, said: "While there has been significant progress for patients with advanced ovarian cancer, an unmet need still remains. These data from the DUO-O trial provide encouraging evidence for this this Lynparza and Imfinzi combination in patients without tumour BRCA mutations and reinforce our continued commitment to finding new treatment approaches for these patients. It will be important to understand the key secondary endpoints as well as data for relevant subgroups."

The Medicines and Healthcare products Regulatory Agency (MHRA) on Wednesday (9 January) announced that the novel type 2 oral polio vaccine (nOPV2) has been quality-assured (prequalified) by the World Health Organization (WHO). Developed by a team including scientists from the MHRA, nOPV2 is considered a safer polio vaccine that helps to protect children from the disabling and life-threatening disease and lower the risk of vaccine-derived outbreaks. The vaccine received WHO Emergency Use Listing three years ago, and since then 950 million doses have been delivered worldwide. The UN health agency's decision to add it to the list of prequalified vaccines is based on the analysis of outcomes in vaccinated populations that has confirmed strong safety profile and effectiveness.

More than 1.5 million courses of Pfizer's COVID-19 antiviral drug Paxlovid have expired unused in European countries by the end of November, the health analytics firm Airfinty has revealed. It is predicted that the figure could surge to 3.1 million, at a value of $2.2 billion (around £1.73 billion), by the end of Feb 2024. According to Airfinty analysis, Britain has the highest unused stock, with an estimated one million expired drug courses worth $700 million (over £550 million). With 2.2 million courses estimated to expire unused by the end of June 2024 due to the low prescription of the antiviral in the country, the total drug value wasted in the UK could reach $1.5 billion (£1.1 billion), the report added.

Challenges in accessing the NHS waiting list are pushing more and more people toward private-funded alternatives for access, diagnosis and treatment, thereby increasing the demand for private health cover. According to a report published by health data provider LaingBuisson, the demand for private health cover, including medical and dental insurance and cash plans, has surged to its highest levels since 2008. The UK's overall health cover market reached £6.7 billion in 2022, an increase of £385 million from the previous year. During the period from 2020 to 2022, the market experienced annual growth rate of 6.1 per cent, a significant increase compared to the average annual growth rate of 1.7 per cent observed between 2008 and 2019, the research found. A total of 4.2 million people were subscribed to medical cover schemes in 2022. When dependents covered by these policies were included, the number reached 7.3 million - the highest count since 2008. LaingBuisson's analysis showed that medical cover volumes were steady through most of the 2010s, but began to increase alongside rises in the NHS waiting list from 2018.

Women who are trying to conceive should stop vaping as it may affect fertility, a study by the women's health firm Hertility has suggested. Analysis of blood samples from more than 8000 women revealed that vapers and smokers have lower levels of anti-mullerian hormone (AMH), which indicates how many eggs women have left in their ovaries. Across all age groups, AMH levels were found to be lower in people who vaped than non-vapers, suggesting that vaping could accelerate age-related decline in egg reserve. Concerningly, the report revealed that one in five British women vape while trying to get pregnant, with a significant portion also engaging in other lifestyle "vices" such as alcohol, drugs and smoking.

A recent study presented at the European Congress on Obesity in Venice sheds light on the detrimental effects of obesity on workplace absenteeism and economic productivity. The analysis, encompassing data from millions of workers across Europe, reveals a direct correlation between body mass index (BMI) and the likelihood of taking sick leave. According to the study, obese individuals are up to twice as likely to take time off work due to health issues compared to those of a healthy weight. The increased sick notes among obese individuals is attributed to various complications associated with obesity, including joint pain, diabetes, depression, and heart disease. In the United Kingdom, where obesity rates are among the highest in Europe, the impact of obesity on workplace absenteeism is particularly pronounced.