Monday October 22, 2018

Government to launch a scheme that will offer free diagnostic tests

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By NewsGram Staff Writer

The Central government has come up with a scheme that will offer free diagnostic tests to people visiting public health centers.

A bench of experts has prepared a list of diagnostic tests which are regarded as essential for all categories of health facilities. The Health Ministry has also contacted some of the biggest names in the diagnostic sector like Dr. Lal PathLabs, Quest Diagnostics, Mahajan Imaging and Star Imaging.

The scheme would improve the diagnostic infrastructure in government hospitals. Under the scheme, private health service providers will be engaged for the collection of blood samples, analysis and reporting at places where the government infrastructure is lacking. CT scan services will also be developed at district level under public-private partnership.

This action taken by the Centre would not only reduce the health expenditure of the masses but according to a newspaper report, it would also promote the diagnostics and reagents sectors, whose share currently amounts to only 20% in the medical technology market.

However, the initiative has also drawn flak from a lot of people. Sakthivel Selvaraj, a health economist told the Times of India, “With a slashed health budget and no allocation in the budget for the scheme, where will they find additional resources for this? Tamil Nadu and Rajasthan are already providing diagnostic facilities more efficiently without outsourcing. Why not follow that model? Why follow a model of outsourcing that has failed in several states like Bihar and Chhattisgarh? Outsourcing only adds to the cost.”

According to the report, some public health technology experts felt that selective outsourcing has been shown to work in certain other technology intensive areas such as ambulance care. The development of these technologies would not have been possible without the assistance of private sector.

“Experience suggests that measured formula-based centralized outsourcing is recommended only for ancillary services that are technology intensive,” told one such expert to TOI.

Many people have questioned whether the outsourcing would lead to private sectors extorting extravagant charges for their services. A doctor working in a railway hospital told NewsGram, “To prevent private sectors from exploiting people, the government should fix price rates for the diagnostic services. This scheme proposed by the government should follow the same model of Central Government Health Scehme (CGHS) which engages with only those private hospitals which agree to follow the price rate set by it. ”

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Immunotherapy Drugs Show Significant Improvement Against Breast Cancer: Study

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts.

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Breast Cancer
This undated fluorescence-colored microscope image made available by the National Institutes of Health in September 2016 shows a culture of human breast cancer cells. For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. VOA

For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. But the benefit for most women was small, raising questions about whether the treatment is worth its high cost and side effects.

Results were discussed Saturday at a cancer conference in Munich and published by the New England Journal of Medicine.

Drugs called checkpoint inhibitors have transformed treatment of many types of cancer by removing a chemical brake that keeps the immune system from killing tumor cells. Their discovery recently earned scientists a Nobel Prize. Until now, though, they haven’t proved valuable against breast cancer.

Breast Cancer
Weight loss may lower breast cancer risk for post-menopausal women. Pixabay

In the study

The new study tested one from Roche called Tecentriq plus chemo versus chemo alone in 902 women with advanced triple-negative breast cancer. About 15 percent of cases are this type, their growth is not fueled by the hormones estrogen or progesterone, or the gene that Herceptin targets, making them hard to treat.

Women in the study who received Tecentriq plus chemo went two months longer on average without their cancer worsening compared with those on chemo alone, a modest benefit. The combo did not significantly improve survival in an early look before long-term follow-up is complete.

Failed protein test

Previous studies found that immunotherapies work best in patients with high levels of a protein that the drugs target, and the plan for the breast cancer study called for analyzing how women fared according to that factor if Tecentriq improved survival overall.

breast cancer
FILE – A patient receives chemotherapy treatment for breast cancer at the Antoine-Lacassagne Cancer Center in Nice, July 26, 2012. VOA

The drug failed that test, but researchers still looked at protein-level results and saw encouraging signs. Women with high levels who received the combo treatment lived roughly 25 months on average versus about 15 months for women given chemo alone.

That’s a big difference, but it will take more time to see if there’s a reliable way to predict benefit, said Dr. Jennifer Litton of the MD Anderson Cancer Center in Houston. She had no role in running the study but enrolled some patients in it and oversees 14 others testing immunotherapies.

“We’re really hopeful that we can identify a group of women who can get a much bigger and longer response,” she said.

Another breast cancer specialist with no role in the study, Dr. Michael Hassett at Dana-Farber Cancer Institute in Boston, said he felt “cautious excitement” that immunotherapy may prove helpful for certain breast cancer patients.

Breast Cancer
Breast cancer cell, Wikimedia Commons

Side effects and cost

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts, but serious ones were more common with the combo treatment and twice as many women on it stopped treatment for that reason.

Three of the six deaths from side effects in the combo group were blamed on the treatment itself; only one of three such deaths in the chemo group was.

Also Read: New DNA Tool To Predict People’s Height And Risk For Cancer

Cost is another concern. Tecentriq is $12,500 a month. The chemo in this study was Celgene’s Abraxane, which costs about $3,000 per dose plus doctor fees for the IV treatments. Older chemo drugs cost less but require patients to use a steroid to prevent allergic reactions that might interfere with the immunotherapy. Abraxane was chosen because it avoids the need for a steroid, said one study leader, Dr. Sylvia Adams of NYU Langone Health.

The study was sponsored by Roche and many study leaders consult or work for the company or own stock in it. (VOA)