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Researchers Create The Building Blocks Of A Bionic Brain

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Australian bio-engineers have mimicked the human brain with an electronic chip that uses light to create and modify memories.

How it works:

The chip is based on an ultra-thin material that changes electrical resistance in response to different wavelengths of light, enabling it to mimic the way that neurons work to store and delete information in a human brain.

Why it matters:

The technology is a step further towards artificial intelligence that can harness the brain’s full sophisticated functionality. Forming the early stages of a bionic brain – a brain-on-a-chip that can learn from its environment the same as a human brain does.

The research is also hoped to better understand the brain and how it’s affected by disorders that disrupt neural connections, like Alzheimer’s disease and dementia.

Ask the expert:

Dr Sumeet Walia RMIT Universities MicroNano Research Team Leader:

“Our chip imitates the fundamental biology of nature’s best computer – the human brain.”

“Being able to store, delete and process information is critical for computing, and the brain does this extremely efficiently.”

“We’re able to simulate the brain’s neural approach simply by shining different colours onto our chip.”

Enough Talking – Time for Action on Long-Term Health Policy Vision

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Dr Bartone begun his address by talking of his own personal story and experience with the health system – his mother’s patient journey.

He spoke of being in Brisbane in November 2018 to launch the AMA Indigenous Health Report Card when, that same night, his elderly frail mother fell at home and was admitted to hospital.

“She has not been able to return home since that night. She was eventually admitted to an aged care facility”, Dr Bartone said.

“It gave me, as AMA President and a community GP, an unwelcome front row seat to the care journey of a loved one in our health system. Unfortunately, my mother’s story is not uncommon. It is the same story for many patients in our health system.”

Dr Bartone discussed the significant changes to the health system in 2018, including the 2019 election which he mentioned that “two months on from the election, the need for significant health reforms remains – and it must still be the Government’s highest priority”.

The speech slammed the current health system for its under-funding, under-resourcing, poor access, waste, inequality, and inefficiencies. “From maternity services to primary care, prevention to public hospitals, private health insurance to the Medicare Benefits Schedule, mental health care to indigenous health to aged care” he didn’t hold back on his criticisms.

Dr Bartone said that, for Health Minister Hunt, the time for talk was over. It was now time for action.

Included in his critique of the health system, Dr Bartone called on the Federal Government to ensure the private health sector remains efficient, robust, and productive.

The private health insurance sector has experienced 15 successive quarters of decreasing coverage despite a comprehensive Government review and the transition to the new Gold, Silver, Bronze and Basic policy structure.

However, Dr Bartone said he believes the situation is even worse, citing the “increases in premiums averaging 3 to 5 per cent a year, when wages growth is firmly stuck at around 2 per cent”.

“Sooner or later, the number of people with private health insurance will fall further – and dramatically. This would mean the option of private hospital access would be unaffordable for many Australians,” Dr Bartone said.

“This reform needs to start now – we can’t wait for another dozen quarters of decline. The death spiral is already underway.”

Dr Bartone rounded out his address with a clear call for economic rationalism, highlighting that health care in Australia employs 14 per cent of the nation’s total workforce.

“Driving economic activity through our largest workforce sector would also add extra capacity in general practice, hospitals and other front-line areas.”

Informed Financial Consent Guide launched

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The AMA’s Informed Financial Consent Guide, a collaboration between doctors and patients, is aimed at helping patients better understand medical treatment fees and out of pocket costs.

The Guide will be made available from doctors, medical practices and organisations, and the AMA website.

Providing an estimate of fees and the costs payable by a patient after any government and health insurer rebates is the foundation for informed financial consent. Most doctors do it well already.

The new Guide will complement the Federal Government’s activities to provide improved medical specialists’ costs transparency, to make our system more effective and sustainable.

The Government announced that the improved transparency will help people choose the right specialist, taking cost into account without waiting for an appointment when they may feel locked in regardless of cost.

The Government’s out-of-pocket costs transparency website is being developed in consultation with consumers, medical professionals and insurers to make sure it includes appropriate information and features to assist and support consumers about decisions on their health care.

The website is expected to incorporate MBS benefits and information about insurer gap payment arrangements, in addition to the doctor’s maximum fee and the most common out-of-pocket costs for a treatment.

HTA Explainer – Devices Vs Pharmaceuticals

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[vc_row][vc_column][vc_column_text]Medical and pharmaceutical technologies have key differences which have important implications for how they are evaluated, both clinically and economically. As such, a thorough understanding of the differences that exist within both the industry and the technology is required to accurately assess the benefits associated with them.

The MedTech industry is diverse and medical procedures involving devices can be therapeutic, diagnostic, prognostic or pathological. The companies that make medical devices also differ from pharmaceutical companies in both size and number. While pharmaceutical companies tend to be large, the median size of a medical device company is less than 50 people (in the US). Medtech companies also often provide much more support to the health care providers or surgeons to ensure technical standards are met and the device is used effectively.

Medical technology is characterised by a high rate of innovation, often resulting in shorter life cycles than pharmaceuticals. This key difference can limit the opportunity for generation of clinical evidence to support marketing approval and reimbursement of devices. Innovation is often based on feedback from medical practitioners and their patients to improve an existing technology’s functionality.

There are inherent constraints in clinical trials design for devices to prove efficacy.  The large-scale, blinded, randomised, placebo-controlled trials common for pharmaceuticals are often difficult or unrealistic to perform for medical devices, particularly surgically implantable devices.

Most clinical trials also have limited patient recruitment capacity since devices typically have smaller numbers of potential end users and even fewer eligible clinical trial candidates than a typical pharmaceutical clinical trial.

Another common limiting factor is that many devices require specialised training or skills to install or monitor them. Success of the implantable device may be dependent on the skill of the surgeon implanting it, not on the performance of the device alone.

Care must also be taken when assessing the benefit and harm profile of devices compared with pharmaceuticals. The effect of a medical device is physical whereas the effect of a pharmaceutical is chemical; this poses differences in addressing adverse events. The risk posed by the device remaining in the body must be weighed against the risk of removal. Often the implants are introduced into the body via surgery and these procedures contribute to the complication of evaluation of the implants, while adverse events related to a pharmaceutical can be addressed by discontinuation of treatment or changes in dosing.

All the issues described above mean a pragmatic approach is required when assessing medical devices for reimbursement. Data may be more limited while clinician hands-on experience with the devices may be more relevant. Nonetheless, it is important that the benefit/risk profile of the devices is evaluated and an assessment is made of the value to patients and the healthcare system.

The original version of the February 2017 Prostheses Guide identified that there are differences between medical devices and pharmaceuticals and that this would be taken into account by committees and advisory groups assessing sponsor applications. Unfortunately, this was removed from the latest version published in June. As demonstrated above, the differences between devices and pharmaceuticals are very clear, and must be recognised in HTA assessment if the Prostheses List process is to be an effective enabler of patient access to valuable technology.

Devices Pharma
Industry composition Over 80% small and medium-sized companies Very large multinationals dominate
Innovation Majority of new products bring added functions and clinical value based on incremental improvements Usually large step innovation
Clinical trials Limited patient recruitment capacity due to smaller numbers of potential end users and eligible clinical trial candidates Large-scale, blinded, randomised, placebo-controlled trials
Addressing adverse events Risk posed by device remaining in the body must be weighed against risk of removal Discontinuation of treatment or change in dosing

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The Grattan Institute Confronts The Private Health Insurance ‘Death Spiral’

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[vc_row][vc_column][vc_column_text]“It’s inevitable that government will have to make tough decisions about whether more subsidies are the answer to the impending crisis,” said lead author and Grattan Institute Health Program Director Stephen Duckett.

“Governments have failed to clearly define the role of private health insurance since Medicare was introduced in the 1980s. The upshot is we have a muddled health care system that is riddled with inconsistencies and perverse incentives,” Professor Duckett said.

The working paper has generated a broad-ranging set of responses, with the Consumers Health Forum CEO Leanne Wells urging the Federal Government to establish a Productivity Commission inquiry into the role of private health insurance, a call that has been echoed by a number of other healthcare stakeholders.

Australian Private Hospitals Association Michael Roff said that the report shows a lack of understanding of the private health sector to Australian health care.

“The report – which by its own admission raises questions but provides no answers – fails to understand the basics of private hospital care. This is concerning when it claims to be the basis for discussing Government support of health insurance,” said Mr Roff.

“As a basis for policy-maker decision making, its failure to understand what private hospitals offer Australians it is a poor starting point for the debate,” Mr Roff said.

Private Healthcare Australia CEO Rachel David criticized the report for being “light on solutions” and claimed to “already know what the issues are with private health and how to fix them”.

“It is time to repeat the successful collaborative effort demonstrated through the Government’s PHI reforms package,” said Ms David, who then went on to point the finger at the medical devices industry, who are to date the sole contributor to delivering the lowest PHI premium increase in 18 years.

According to Medical Technology Association of Australia CEO Ian Burgess, the costs for medical devices have fallen in every quarter since the Agreement with the Federal Government signed in 2017.

“These cost reductions are a direct result of the $1.1 billion dollars in cuts delivered by the MedTech industry through the Agreement and demonstrate the our industry’s active contribution to the affordability of healthcare in Australia,” Mr Burgess said.

“The Agreement signed in October 2017 will save private health insurers $1.1 billion in payments for medical devices over the next four years.

“Recent APRA data on private health insurers shows them continuing to enjoy strong profitability, with after tax profits up almost 20% over the past three years as affordability for ordinary Australian families goes down,” said Mr Burgess.

APRA recently called out the private health insurance industry for being too reliant on lobbying government to provide solutions and underprepared for the challenges that lie ahead.[/vc_column_text][/vc_column][/vc_row]

Government Accepts Stillbirth Recommendations

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[vc_row][vc_column][vc_column_text]In Australia, about 6 babies are stillborn every day, and two die in the neonatal period within 28 days of birth, due to congenital anomalies which account for almost a third of all perinatal deaths.

Rates of perinatal death have remained relatively constant since 1997. Rates of stillbirths among Indigenous women, while decreasing, are still at an alarming rate compared to other demographics.

Last year Labor Senator for NSW, Kristina Keneally, was moved to tears when discussing the Stillbirth Research and Education Report, which she said would be “part of the legacy” of those children who had been lost and their brave parents who had to endure that loss.

Australian Institute of Health and Welfare (AIHW) spokesperson, Dr Fadwa Al-Yaman, said ongoing monitoring of perinatal deaths could help build the evidence-base to drive better outcomes.

“The report provides valuable information to enable effective policy, practice and services for mothers and babies,” Dr Al-Yaman said.

The AIHW said it was also working to improve the quality of data around the contributing factors to stillbirths.

Minister for Health, Greg Hunt, said reducing the rate of stillbirth in Australia, including providing the best possible support services for families living with the tragedy of stillbirth, is a priority for the Morrison Government.

“We understand the importance of this issues not only for the women affected, but for their partners, families and the broader community,” Mr Hunt said.

Red Nose Australia CEO, Keren Ludski, welcomed the Government’s funding announcement and commended the Government for accepting all recommendations in the Senate Select Committee on Stillbirth Research and Education Report.

“The stillbirth rate in Australia is six a day – that’s one baby every four hours. Enough is enough – it’s time we made reducing stillbirth a national priority,” Ms Ludski said.

“Red Nose Day on Friday 9 August will have a significant focus on raising awareness and funds for stillbirth research, with a goal of reducing stillbirth by 20 per cent over the next three years – equalling 500 little lives saved, and I urge all Australians to get involved by buying a red nose or making a donation,” she said.

The recommendations accepted by the Federal Government include:

  • Developing a National Stillbirth Action and Implementation Plan
  • Investing in stillbirth research
  • Developing best practice and culturally appropriate resources, and
  • Working with States and Territories to make improvements in key areas including improving national perinatal mortality data collections, improving access to publicly funded stillbirth autopsies, building the perinatal pathology workforce, developing more culturally and linguistically appropriate models of care, bereavement support and protocols for public hospitals and community health services.

You can download the Federal Government’s response to the Stillbirth Research and Education Report here.[/vc_column_text][/vc_column][/vc_row]

New PBS Listings

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How it works:

Under the PBS, treatment for diabetes, severe cystic acne, depression and lung cancer will be available to patients for just $40.30 per script, or $6.50 with a concession card.

Ask the Minister:

Greg Hunt, Minister for Health.

“Every medicine was recommended to be added to the PBS by the independent expert Pharmaceutical Benefits Advisory Committee. By law the Federal Government cannot list a new medicine without a positive recommendation from the PBAC.”

“The four pillars of our long term national health plan are: guaranteeing Medicare and improving access to medicines, supporting our hospitals, prioritising mental health and preventive health and investing in health and medical research.”

The details:

The added drugs are:

• Pemetrexed®, a medicine for the treatment of metastatic non-small cell lung cancer, and mesothelioma will also have its authority level reduced to make it easier for doctors to prescribe. In 2018, over 950 patients accessed this medicine and could benefit from this change to the listing which will make it easier to prescribe. Without PBS subsidy, patients would pay up to $200 for each course of treatment.

• Oratane® (isotretinoin), will be listed to the PBS to help treat the 21,000 people per year with severe cystic acne, providing doctors with an alternative for patients who require a lower therapeutic dose. Without PBS subsidy, this medicine would cost patients $43 for each course of treatment.

• Phenelzine®, will be made available through the PBS for the treatment of patients with depression, when all other anti-depressant therapy has failed. In 2018, over 900 patients accessed alternative brands and are expected to benefit from this listing. Without PBS subsidy the medicine would cost patients around $800 a year.

World-First Treatment for Viral Conjunctivitis

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Why it matters:

Also known as “pink eye” or “flu of the eye”, viral conjunctivitis is usually caused by the adenovirus and can last up to three weeks.

Unlike bacterial conjunctivitis, which responds to antibiotic eye drops, there are currently no treatments available to reduce the signs, symptoms and contagious nature of viral conjunctivitis.

How it works:

The drug OKG-0301 works by reducing the ability of the adenovirus to reproduce itself.

Ask the expert:

 Associate Professor Mei-Ling Tay-Kearney, Principal investigator at the Lions Eye Institute.

“Acute adenoviral conjunctivitis is a highly contagious, widespread disease which frequently reoccurs and causes significant discomfort, and in some cases, permanent damage to a person’s vision.”

“To limit the spread of the infection within the family and the community, patients are typically instructed to avoid work, school or day care so finding new treatments which reduce its impact both on eye health and day-to-day living is important.”

Australian Tech on Show At The Alzheimer’s Association International Conference

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The selected initiatives are:

‘The Better Visit’ app.

The app features a range of two-player games designed to enhance communication and facilitate positive social interactions between people with dementia and their visitors.

‘Customised Technology Solutions’.

The project works by asking participants what difficulties they were experiencing with their dementia, such as loneliness, boredom and problems remembering to perform everyday tasks. The technology was then customised and used to address these concerns, including introducing iPads, Smart lights, Google Home and GPS solutions.

Ask the expert:

Maree McCabe, CEO Dementia Australia.

“AAIC is the largest and most influential international meeting dedicated to dementia science.”

“I am thrilled Dementia Australia’s efforts to improve the lives of people living with dementia will be on display at such a prestigious international conference.”

“I hope the AAIC will be an opportunity for other international leaders in dementia research and services to not only learn from some of our ideas but that the conference will also provide Dementia Australia with the chance to learn from others.”

Government Website Wins Top Design Award

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How it works:

The Good Designs Award was won by the Brisbane-based digital agency Liquid Interactive who led the design process.

Why it matters:

The website links online and phone mental health services, information and resources, and can connect people to online and phone mental health services appropriate for their individual needs.

Providers including the Butterfly Foundation, CanTeen, Beyond Blue and Kids Helpline. There are also free or low-cost apps, online support communities, online courses, and phone services that are private and secure.

Ask the expert:

The Good Design Awards Jury

“It is great to see content that is specific to Aboriginal and Torres Strait Islander sensitivities and culture. Effective navigation tells a story of the content on offer in the site really well.”

“The Head to Health solution brings all this information together well and offers helpful suggestions in taking the next steps.”

The details:

Good Design Australia is an international design promotion organisation responsible for managing Australia’s annual Good Design Awards and other signature design events.

The award dates back to 1958, aim to promote the importance of design to business, industry, government and the general public.

To view the website visit www.headtohealth.gov.au