Medika Life has covered the halls of JPMorgan in San Francisco, ViVE in Nashville, and the Digital Health Summit in Boston. But the outreach received before BIO—from stakeholders in Austin, Belfast, Milan, Riyadh, and Tulsa—suggested something seismic was shifting. At BIO 2025, that story came into focus: a world where health innovation is no longer limited by geography but defined by vision, investment and intention.

The Biotechnology Innovation Organization isn’t just where technologies are launched and global biotech identities are shaped. What we witnessed in Boston this year wasn’t just presence, but purpose. From Riyadh to Milan, leaders arrived not merely to exhibit, but to engage. They came to say, ‘We are here. We are investing. We are innovating.’ BIO 2025 stood out for its sheer scale and energy—a mosaic of emerging voices ready to help steer the next wave of life science breakthroughs.

Global Trends: Infrastructure, Incentives and Inclusion Drive Expansion

A common thread across these rising biotech regions is the power of public-sector catalysts. Investment in R&D tax credits, translational research centers, and workforce training has de-risked innovation for early-stage companies. Regions like Oklahoma and Northern Ireland exemplify how government partnerships with academia and industry can create a vibrant life sciences pipeline.

In parallel, digital innovation is enabling smaller regions to leapfrog traditional limitations. AI-led discovery, digital twins, and virtual trial platforms are reducing costs and increasing speed-to-data. This convergence of science and software is helping new hubs like Austin and Riyadh accelerate globally competitive capabilities in diagnostics, personalized medicine, and regulatory science.

“We’re not competing with Boston—we’re complementing it,” said a delegate from Invest Northern Ireland. “In a connected world, biotech ecosystems aren’t isolated—they’re collaborative nodes on a global grid.”

Meanwhile, leaders from Italy’s Ministry for Foreign Affairs and Saudi Arabia’s SFDA emphasized the importance of regulatory agility. Their message was clear: modern biotech requires modern policy. Whether through centralized ethics boards, digital review platforms, or alignment with international standards, regulatory transformation is essential to scale innovation.

These developments signal a broader inflection point—biotech is no longer about place. It’s about purpose, policy, and partnerships.

Austin: Where Tech Meets Translational Medicine

Austin is no longer just the city of live music and digital startups. With more than 300 life science companies and a 74% employment boom in biotech over the past five years, it’s transforming into a powerhouse of translational medicine.

Heavyweights like Thermo Fisher, Natera, and Luminex now call Austin home, joined by trailblazers such as Paradromics, Elligo Health Research, and Prophase Biostudios. These companies blend biotech, medtech, and AI in ways that are shaping the next frontier in diagnostics, therapeutics, and digital health.

“As one of the country’s fastest-growing emerging life sciences hubs, the Austin region is responsible for a significant portion of the biotechnology sector’s growth in Texas,” said Ed Latson, CEO of Opportunity Austin. “Our tech talent, VC ecosystem, and institutions like UT Austin are driving an uptick in innovations, with over 350 life science patents issued to Austin companies in the past five years.”

Austin’s 4.4 million square feet of science innovation space—plus another 1.1 million square feet under construction—signals that this rise is more than momentum. It’s movement.

Italy: From Scientific Legacy to Global Scale

Italy’s BIO 2025 pavilion was both a showcase and a statement: this country is stepping into biotech leadership. Long known for its academic excellence, Italy is now connecting its research infrastructure to industrial manufacturing and global markets.

With 770 production sites and the largest Contract Development and Manufacturing Organization output in Europe (€3.6B), Italy is scaling up innovation across oncology, AI diagnostics, and organ-on-chip development. Companies like BiomimX, Math Biology, Genenta Science, and InSilicoTrials are bridging cutting-edge science with clinical utility.

“Italy’s presence at BIO Boston reflects years of work by the Italian Trade Agency to promote an integrated system of scientific expertise, high-tech supply chains, and a talent-rich ecosystem,” shared Erica Di Giovancarlo, Director of the ITA New York Office.

Initiatives like the Montalcini Global Biotech Tour and policy instruments from the Ministry for Foreign Affairs support this ambition.

“Pharma is one of Italy’s top global exports,” noted Mauro Battocchi, Director General. “That would be unthinkable without a strong base in R&D, regulation, and manufacturing.”

Northern Ireland: Precision Science with Global Reach

With 250+ companies and $2.5 billion in revenue, Northern Ireland’s life sciences sector has grown 75% in just three years. The delegation to BIO was led by Invest Northern Ireland and featured companies from drug discovery (AMPLY), CRO services (Almac, Celerion), and diagnostics (Randox).

Queen’s University Belfast and Ulster University deeply anchored the region’s ecosystem. Global companies are noting that Celerion recently relocated its UK Phase I operations to Belfast’s new iREACH facility, betting on local talent and translational research capacity.

From scientific rigor to export capability—145+ countries and counting—Northern Ireland proves that locale doesn’t limit global vision.

Oklahoma: Equity-Focused Innovation with Local Roots

Oklahoma’s biotech renaissance is rooted in intentionality—it is focused on equity, local workforce development, and community-based innovation. Biosciences now contributes more than $16 billion to the state’s economic impact, with more than 750 companies and 42,000 jobs.

The Oklahoma delegation at BIO emphasized sustainability, manufacturing, and health equity, with standout organizations including Wheeler Bio, BioTC, ParaNano, and Utopia Plastix.

“We’re not here to be a branch office,” one delegate told me. “We’re here to bring Oklahoma’s soul to the bioscience table.”

With significant support from the Oklahoma Center for the Advancement of Science & Technology (OCAST), OKBioStart, and the University of Oklahoma, this state is redefining what it means to be an innovation hub.

Saudi Arabia: A New Powerhouse for Biotech Partnerships

Saudi Arabia came to BIO with a clear strategy and global ambitions. Led by His Excellency Prof. Dr. Hisham Saad Aljadhey, CEO of the Saudi Food and Drug Authority (SFDA), the Kingdom made its voice heard across two key sessions.

At “Global Biotechnology at a Crossroads,” Dr. Aljadhey discussed Saudi Arabia’s modernization of clinical trials and regulatory frameworks, aligning with international standards. At “Partnering for Progress,” he showcased the Kingdom’s integrated biotech ecosystem, spanning R&D, data, manufacturing, and patient care.

Beyond BIO, the SFDA delegation engaged with Harvard University and global pharmaceutical leaders and joined a private sector roundtable hosted by BIO and the U.S. Chamber of Commerce. These engagements reflect Saudi Arabia’s commitment to cross-border collaboration, secure supply chains, and sustainable innovation infrastructure.

With leaders from the Saudi Ministry of Health, King Faisal Specialist Hospital, and the National Institute of Health also in attendance, the message was clear: Saudi Arabia is ready to be a regional biotech hub with global reach.

The New Map of Global Innovation

This isn’t just a reshuffling of zip codes. It’s a redrawing of the innovation map—pushed forward by ecosystems committed to inclusion, science, sustainability, and scale.

These five rising regions aren’t simply showing up. They’re standing up—challenging legacy thinking, collapsing silos, and reminding the world that leadership in life sciences doesn’t require a familiar address. It requires ambition, alignment, and action.

At BIO 2025, the message was unmistakable: where you innovate matters less than why you innovate—and for whom.

From Austin’s AI-powered translational medicine to Saudi Arabia’s regulatory reinvention, the next wave of breakthroughs will be shaped not by old borders but bold commitments.

Expectations are high. Patients in Milan and Muskogee, Belfast and Boston, Riyadh and Rochester are not waiting for innovation to trickle down. They are looking globally—for the fastest path to solutions that sustain and save lives.

The future of biotech is already in motion. It’s inclusive. It’s intentional. And it’s unstoppable.

The post BIO – Biotech Without Borders  appeared first on Medika Life.

We live in a very exciting time! Alzheimer’s medications that are more promising than past drugs are starting to hit the shelves, with others on the way. Eli Lilly’s new daratumumab medication has been suggested to slow the progression of early Alzheimer’s by up to 35%. So if it took someone five years to progress to more serious Alzheimer’s without medication, this could slow it, so it could instead take seven years, meaning more years being more present with one’s family. Lecanemab (Leqembi), from Eisei and Biogen, was also found to reduce cognitive decline, keeping our parents or ourselves fully present as we traverse life’s journey together!

In this article, I will talk about why these drugs offer society hope yet will also cause a big problem, at least in the short term (i.e., until generics become available when the drugs’ patents expire). As for my background, I earned my M.D. in the United States to soon earn my Ph.D. in Canada, focusing on Genetics. Today, I work as a postdoctoral scientist at Massachusetts General Hospital, studying the genetics of Alzheimer’s disease. In my medical training, I have seen the tragedy that can happen to people’s parents or themselves as they face newly diagnosed dementia and late-stage disease.

To be clear, these medications are a good thing. They could help many of those around us, whether a parent, sibling, or ourselves. Dementia is a horrible disease; until now, not much could be done about it. A family member is diagnosed with the disease in the office and told that they are showing signs of this illness and that very little can be done to help them. Over time, their personality changes, and they slowly become less like themselves daily, aware of what is happening.

This can cause significant distress for those with this illness and their family and friends. We spend years with these people. We are forced to watch, unable to make a difference, as they lose their ability to function and lose who they are. These medications could slow these changes, finally offering some semblance of hope for those with these diseases.

As with any medication, these drugs do not come without risks. One in four people who received Leqembi had a “transfusion reaction,” which in most people means that they may have had redness and swelling in the arm they received the medication. While such reactions can be severe, causing one’s airway to close up in an anaphylactic reaction, these responses are generally uncommon. Some individuals who received Leqembi or Donanemab experienced swelling in their brain, known as cerebral edema. While not necessarily a problem, in that it does not necessarily produce symptoms, one in four people who took Donanemab developed this swelling, one of four of which had symptoms. So if we considered a group of 1000 people who took this drug, using the study’s results, about 60 in 1000 could experience headaches or confusion. Some of these 60 individuals may develop bleeding in their brains. Around two could die from the swelling or bleeding. While concerning, 940 of these hypothetical 1000 people had no side effects. Even if you took this med and experienced side effects, you could be sure that your doctor would do everything they could to keep you safe, including discontinuing the medication that often resolves adverse effects.

So it sounds like my opinion is that these drugs sound promising. Why the doom and gloom article title? This is because these are or will be very expensive drugs. The price for a single person to receive enough Leqembi for a single year is forecasted to be $26,500. While Donanemab does not yet have an official cost, it is predicted to be over $26,000 annually. Think about that amount of money for a moment. The federal poverty line for a family of four, which could include a couple, a child, and a grandparent, is $30,000. More than one in 10 people in the United States are impoverished and struggling to make ends meet. This number is likely even higher, considering you do not have to be impoverished to have financial difficulty. What would happen if a couple’s loving grandmother or grandfather started showing signs of dementia?

While the elderly are entitled to Medicare, would Medicare cover such an expensive drug when it has to care for the entire country’s elderly population? Even if it pays for it, how much of it? After consulting physician colleagues of mine, we think it is unlikely that Medicare as is would pay this much. It would be great if they did, but there are likely not enough Medicare dollars to permit this.

Families could face impossible decisions or immense stress once these medications are more broadly available, and they have hope in front of them, yet this hope is financially inaccessible. While some private insurance may help pay for these cutting-edge treatments, perhaps with Medicare offering a small contribution, insurance is expensive, and we sadly do not all have health plans that enable us to not think about how we are going to make managing our health work, alongside taking care of supporting children, family, and parents.

There is also the concern that these medications may offer more benefit to those of certain ancestral groups, as reported by Reuters. This was not because the study’s designers or the company sought to exclude non-whites. For medical research to be approved, generally, one must communicate how the research will benefit a more diverse group. Describing how people are recruited into appropriately designed clinical trials and why medications may help people of European descent more than those of African descent is its own article, so I will not touch on this here. This is important because non-whites have higher rates of Alzheimer’s and have historically had less access to healthcare resources.

Such a financial predicament is not unique to these upcoming new medications (or healthcare in general in the United States). Research and development of new medications often cost over $2 billion when a new treatment is available for the general public. Companies need to give treatments a price that enables them to make up for what they spent and enable their other projects, which can also provide hope for better health management. While this approach is understandable (companies need to avoid going bankrupt. Even non-profits need to do that), it can still limit our access to treatments that could save or improve our lives.

The only fix that could address these issues is legislation, which the American Medical Association is consistently striving to improve people’s health in the United States, including driving healthcare reform and expanding (versus cutting) Medicare coverage. Your doctors are not just treating you in the office. They are going to Washington, D.C., and suffering the stresses of politics to improve your lives!

In conclusion, we have reasons to be optimistic about these new drugs. We are also facing the same problems that we have in the past, with promising treatments often being beyond the reach of those with less financial resources and those who have historically had limited access to treatments that could mitigate suffering.

The post New Alzheimer’s Drugs Will Worsen Inequality appeared first on Medika Life.

It is critical that this oversight be completely divested of any interests within the pharmaceutical industry, beyond the reach of lobbyists and political influence. Not, you’ll readily agree, an easy ask in the world we currently occupy. Two things need to occur, preferably globally, to ensure our survival as a species is not compromised by the never-ending quest for profits and industry glory. We need to create the oversight and pharma needs to be forced into legal compliance.

And these things need to happen soon!

Where does the danger lie?

Contrary to the populist nonsense circulating on social media and right-wing conspiracy websites, mRNA vaccines don’t pose a risk to our DNA. At least not yet. The current slew of mRNA vaccines is unable to engage the mechanisms required to alter our DNA. It’s a complex topic which I’ve tried to simplify in another article you can reference here if it’s of interest.

That isn’t to say, however, that all future development of mRNA technology will obey the same delivery paths or mechanisms of action, but for now, the mRNA vaccines, in their current forms, cannot interact with your DNA. You can happily get vaccinated without the risk of growing a tail.

The real danger currently lies with another branch of pharma that is going to be at the forefront of new medicines for a while to come as we rage an ongoing war against our most deadly enemy. The virus.

I am, of course referring to antivirals. drugs that are designed to deliver their payloads to and engage with our genetic machinery. While these medicines, take for instance the antivirals developed for AIDS, can be hugely effective and lifesaving, they pose a very real risk of interfering negatively with our genetic code, or DNA. Not all antivirals have this ability, but many do and many newer drugs undoubtedly will.

Not only our DNA is at risk here. Antivirals work by mutating the DNA of the virus they’re designed to attack. The risk exists that resulting mutations can create drug-resistant new strains or variants of a virus, and some experts believe insufficient data exist on drugs like Merck’s new antiviral to combat Covid, Molnupiravir, to allow the drug to be released into the market. The UK has recently approved the drug for use.

Currently, we have to accept the assurances of the pharmaceutical companies, the same companies that develop these drugs, that the treatments are, in fact, safe.

Read that sentence again. There is no world in which that statement makes logical, sane sense or fosters an environment of trust and transparency. We don’t self-police well and if you don’t understand why then drop by your local police precinct and ask them to explain it to you. We simply cannot be trusted, and when the stakes are as high as they are in the world of big pharma, even independent bodies struggle to maintain any autonomy.

What about Federal and Government bodies

Doesn’t the FDA look out for our safety, you ask? Technically, yes, however their admirable mission statements and what actually occurs in practice, are two totally different realities. Woefully understaffed departments, political pressure, pharma lobbyists, and staff, many of whom owe their training and loyalty to large pharma companies, having served as interns or former employees, oversee clinical trials and approval processes, all contributing to potential breakdowns in safety protocols.

The recent scandal involving a whistleblower and the falsification and fabrication of results from a company engaged in submitting Covid vaccine data highlights the problem. Complaints around possible breaches in protocols designed to protect the public are often simply ignored. Lack of resources and manpower are usually assigned the blame and this instance was no exception.

Despite this, systems like the FDA still offer the public a certain level of protection and if they fail, as callous as it may sound, a worst-case scenario results in a few hundred deaths. Until now, that is. Treatments that can affect our DNA work differently. They operate silently and can take years, even decades before we are faced with the consequences. Genetic mutations may be passed on to descendants rather than affecting the patient directly.

Without wanting to sound melodramatic, the biggest challenge we will face in the coming decades will be ensuring the integrity of our human DNA. The reason is simple.

Antiviral medications work. There are very few effective mechanisms to combat viruses and antivirals are one of our best hopes to interfere with the virus’s interaction with our cells. Now, mRNA technology has also entered the fray, and will, undoubtedly stray into the world of DNA before long. It’s a sensible place to go if you’re looking to cure all that ails humanity.

While targetted DNA treatments may benefit the patient of the future, we need to ensure now that in our haste to produce profits, we don’t throw the baby out with the bathwater. Oversight is required.

If not governments, where do we turn?

Does the World Health Organization (WHO) still hold enough credibility globally to be entrusted with a task like this? It’s a difficult question to answer. They botched the Covid response spectacularly, erring on the side of cautious statements when they could have closed the whole planet down in days, buying us time to contain the virus.

They failed to address flawed policies on aerosolized particles when presented with new evidence that contradicted 50-year-old flawed science, evidence that affected how the virus was being distributed. The list goes on, and yet, what other option are we left with?

Only the WHO is placed in a position to engage globally with all pharmaceutical companies. New treatments in development or undergoing clinical trials that target our DNA or may, in any remote fashion, risk contaminating our DNA, would require full WHO approval prior to having a license granted for taking the treatment to market.

It’s by no means a clean or perfect solution, but it would offer a starting point. A place that we could look to and say with confidence, we are doing something to ensure we don’t accidentally self-destruct as a species. A hugely embarrassing and eminently avoidable scenario, but only if we take action to avoid it.

Don’t blame the Tech

Our levels of technology are expanding exponentially, allowing us a deeper and more complex understanding of diseases and viruses on a cellular level. Nanotechnology enables us to deliver microscopic particles to cells, that even five years ago, were only pipe dreams, dreamt by molecular biologists with a vision of what the future might hold. The wonders that await us in the next decade could very well change the face of medicine forever.

Eradication of cancer and other genetic conditions are now real possibilities thanks to technologies like mRNA treatments. Antivirals may very well finally achieve the unthinkable, a world free of influenza. It’s heady times for the industry, exciting times and times for great fortunes to be made, gambled, and lost. Therein lies the biggest danger.

It is not technology, in and of itself, that poses the risk, but rather what we choose to do with it, and given our history as a species, we know we cannot leave that to chance.

The post Does Pharma Need Independent DNA Oversight? appeared first on Medika Life.

Championing Frontline Health Professionals Dedicated to Improving Access and Care, PPN Reaches over 100K+ listeners, Pharmacists, and Other Health System Influencers

NEW YORK, November 22, 2021 — Global independent marketing and communications firm FINN Partners today announced that starting December 1st, the Pharmacy Podcast Network (PPN) – a news
organization known for hosting and distribution of content that reaches 100,000+ in the pharmacy community – will join the agency. PPN and its new digital magazine Rx Influencer will operate as a unique unit of FINN, led by Todd Eury, vice president and executive producer. Eury, based in Pittsburgh, PA, will report to Gil Bashe, Global Health Chair, FINN Partners.

“Iconic newsstand media such as Forbes and BusinessWeek are evolving their business models – inviting once-readers to become paid ‘participant columnists’ – while The Atlantic and Wall Street Journal thrive
on edgy digital content and mainstage conferences. Today, ideas and opinions are honed and expressed across medium and channels – and FINN is following that lead, too,” said Peter Finn, Founding Partner,
FINN Partners.

“Pharmacists are central in every health setting – from neighborhoods to hospitals; long-term care residences to payer formulary committees; and in Federal and state policy forums. Payer, provider, and product innovation clients seek to reach this influential community, and PPN has evolved into the go-to content and digital platform for connection to this influential audience,” said Todd Eury, vice president, and Executive Producer, Pharmacy Podcast Network, a FINN division.

Growing Importance of the Pharmacy Community in Public Health

PPN has 100K+ monthly listeners to its programs and is ranked as one of the nation’s leading business audio programs alongside the Wall Street Journal, CNBC, and Bloomberg podcasts, making it the dominant leader in podcasting for the pharmacy industry. PPN also has some 20+ clients across the health ecosystem that sponsor their own podcast series, including the American Pharmacists Association, Omnicell, Surescripts, and Rx Safe. The PPN Twitter handle is followed by more than 25,000
people.

Producer Todd Eury will be part of the FINN community and continue to operate PPN independently and maintain authority over content decisions. FINN will have a direct connection to breaking trends, policies, and the needs of this front-line health professional community – growing in its importance to driving public health measures and operationalizing decentralized clinical trials for patient participation in drug development.

FINN at the forefront of an “omni-channel” communications approach.

“Beyond our leadership strength in earned and content media, thought leadership platforms, publishing, social media, and podcasting, FINN has been expanding its reach to enable client voice and priorities to be heard and reinforced,” said Gil Bashe, Global Health Chair, FINN Partners. “Our goal is to explore how
to be a stronger, direct bridge between clients and their customers. Pharmacists have that direct connection and demonstrated their life-saving importance once again in responding to COVID-19 vaccination urgencies,” he added.

A number of FINN clients – across Practices, geographies, and services – are focusing on the pharmacy sector for many reasons. These include leaders in consumer personal care, over-the-counter products, behind-the-counter devices to monitor and keep-in-check health concerns, and vaccines that prevent
serious, preventable illnesses. Pharmacy is the link from sick care to self-care.

About Pharmacy Podcast Network

Pharmacy Podcast Nation is the flagship show hosting all of the Pharmacy Podcast Network 1400+ episodes. With more than 30 different podcast programs and some 40 different co-hosts helping to develop audio content about the pharmacy sector, its reach includes communities, hospitals senior-care residences, military, and public health settings that meet the information needs of 300,000 pharmacists with more than 100,000 monthly listeners. PPN also delivers a unique publication called Rx Influencer to all healthcare professionals with a specific focus on pharmacy.

For more information visit: pharmacypodcast.com

About FINN Partners, Inc.

Founded in 2011 on the core principles of innovation and collaborative partnership, FINN Partners has more than quadrupled in size over the past 10 years, becoming one of the fastest-growing independent, integrated marketing agencies in the world. The full-service marketing and communications company’s record-setting pace is a result of organic growth and integrating new companies and new people into
the FINN world through a common philosophy. With more than 900 professionals, FINN provides clients with global access and capabilities in the Americas, Europe, and Asia. In addition, FINN provides its clients with access to top-tier agencies around the world through its membership in the global network PROI.

Headquartered in New York, FINN’s other offices are in Atlanta, Boston, Chicago, Denver, Detroit, Fort Lauderdale, Frankfurt, Hong Kong, Honolulu, Jerusalem, London, Los Angeles, Munich, Nashville, Paris, Portland, San Francisco, Seattle, Shanghai, Singapore, Southern California, and Washington D.C.

Find us at finnpartners.com and follow us on Twitter and Instagram at @finnpartners.

FINN CONTACTS:
Gil Bashe
gil.bashe@finnpartners.com
CELL: 732 371 0922

Celia Jones
celia.jones@finnpartners.co

The post FINN Partners Brings Aboard the Pharmacy Podcast Network appeared first on Medika Life.

Alan Rosenbloom, president, and CEO of the national non-profit Senior Care Pharmacy Coalition is the voice for many of the nation’s independent, long-term care (LTC) pharmacies. LTC pharmacies serve daily some 850,000 people residing in skilled nursing facilities, assisted-living facilities, and other long-term care settings. In this exclusive conversation, Rosenbloom provides insights into why lower medical costs and better outcomes are possible but require health ecosystem fair-play and clear Congressional support.

Bashe: You are a noted antitrust attorney dedicated to patient health access. How did you embark on your public health career and what attracted you to the Senior Care Pharmacy Coalition (SCPC) as the next step in that journey?

Rosenbloom: After law school, I developed expertise in long-term care (LTC) issues, including senior care. I represented nursing homes, assisted living, and continuing care retirement communities, and also ran healthcare trade associations. When SCPC approached me, I already knew the important role medications and access to them play in seniors’ quality of life and quality of care — and that of others with LTC needs. It was a natural extension of my expertise.

Policymakers Need to Prioritize Senior Care Needs

Bashe: Could you define the differences between LTC and retail pharmacies?

Rosenbloom: This is precisely why the SCPC, which represents LTC pharmacies exclusively, came together: policymakers often don’t understand the difference. This results in less-than-ideal outcomes for LTC pharmacies and the people they serve.

A retail pharmacy is in a store. People come in for medication and then buy chips, shampoo, and other kinds of convenience items; that’s where retail makes most of their profits. LTC pharmacies don’t provide anything but medications and services; they only get paid for those essentials.

Retail pharmacists are aware of the prescriptions consumers fill at their location. However, they have no legal or professional obligation to have insights into prescriptions that may be filled at other retail locations. When you leave the pharmacy, that clinical relationship ends. LTC pharmacies are very different. The pharmacy is required by Medicare and Medicaid (and typically by states) to know much more about each patient’s overall condition including their entire medication profile. Often, people are coming from hospitals into LTC settings with a discharge summary including a detailed history of all their medications.

Bashe: The reality is we’ll all be under the senior care umbrella at some point and need a structure in place. In a nation where some 25% of the population will be over the age of 60 by 2030, what does SCPC see as the looming need?

Rosenbloom: If you need LTC, you ought to have access to the services that LTC pharmacies provide that retail pharmacies don’t. These services affect your quality of care and quality of life. Our mission is to influence public policy so that people who need LTC pharmacy services have access to them, regardless of who they are or where they live.

An estimated 14 million in America need LTC; a meaningful percentage are younger and disabled. They suffer physical and sometimes mental impairments that impact so-called Activities of Daily Living, such as getting out of bed in the morning, dressing, feeding themselves, and going to the bathroom independently. LTC is crucial for them.

Long-Term Care Pharmacies Prioritize Care Outcomes

Bashe: You and SCPC also conduct research on the LTC needs of Medicare beneficiaries. Can you share your insights?

Rosenbloom: We partnered with ATI Advisory and published a report in July 2021 analyzing Medicare patient data. This is part of what we hope will be an effective test of our hypothesis that LTC pharmacy services improve medication therapy for people in very meaningful ways.

For almost 30 years there’s been a movement to expand choices for seniors. Our research found that people dual-enrolled in Medicare and Medicaid, due to lower incomes and assets, are more likely to be women, and they are more likely to be Black or Latinx and living at home.

That’s a very important finding. It challenges some of the assumptions made about the need for expanded LTC services in the community by policymakers and advocates, who tend to divorce health care needs from LTC needs. Our analysis showed that if an individual needs LTC they are likely to have substantial health care needs, whether they’re living in a facility or at home.

As We Age, How Can Our Policy Leaders Protect Our Health

Bashe: What role does policy play in protecting our citizens’ interests, and which policies need to be addressed to ensure equitable care?

Rosenbloom: LTC pharmacy is overlooked in public policy to ill effect. A few years ago, there was an ongoing battle between two branches of the U.S. Department of Health and Human Services (HSS) — The Centers for Medicare and Medicaid Services (CMS) and the U.S. Food and Drug Administration (FDA), which had conflicting guidance. It took two years of effort and lobbying in Congress, with HHS, and with the White House to get an incomplete solution. Such conflicts put patients at risk and that’s why we are advocating for the Long-Term Care Pharmacy Definition Act, which would finally define LTC pharmacies in statute.

Also significant is the effort to expand Medicaid-funded home- and community-based services (HCBS) as part of the current reconciliation bill. Congress, the Biden Administration, and the Democrats have proposed adding at least $150 to $175 billion over 10 years for Medicaid-funded HCBS. We support expanding HCBS; it’s a good opportunity for LTC pharmacies to play a role in home-based settings.

Bashe: I appreciate your analysis of the complexities of rules, law, and policy and the internal conflict within HHS. Why don’t people realize that someone has to pay when people without sufficient economic resources arrive at an ER, not to mention that a hospital discharge staffer has to find a place — good, bad, or indifferent — for that patient’s post-acute care setting follow-up?

Rosenbloom: That’s a challenging question and it’s not unique to LTC policy or health care policy. I do think that the American health care system, which has been supported by government payment programs since 1965, has evolved into one that focuses on treatment, not prevention.

Silos exist throughout the Federal payment programs. Medicare pays for hospital care and skilled nursing care, which is a small percentage of LTC, but part of the LTC system. If a skilled nursing facility transfers a patient to the hospital, it hits the hospital’s Medicare budget. It’s then an issue for Medicare policymakers on the hospital side but lowers costs on the nursing home side. This creates very perverse incentives from both budgeting and payment points of view, especially if the payers are incentivizing treatment over outcomes.

Bashe: LTC pharmacies strike me as organizations that cut out that middle layer — they get the medications in, they deliver them. It’s a tight link of the supply chain, which in other places is stretched out with several players taking their little percentage. What’s your perspective?

Among the Many Reasons Drug Costs Climb

Rosenbloom: One of the significant drivers of higher drug costs are the middlemen: pharmacy benefit managers (PBMs) and the insurance companies that provide drug coverage. The Medicare Part D program was created in such a way that the health insurers and Part D plans get payments, called rebates, from the manufacturer, which keeps premiums down. The Part D program is an unwitting accomplice: insurance companies demand ever-higher rebates through their PBMs, and manufacturers raise prices. Each blames the other, but insurance companies, manufacturers, and PBMs see their revenues go up.

Pharmacies do not see a revenue increase, it’s quite the opposite as insurance companies and PBMs charge pharmacies administrative fees well beyond what would be reasonable for processing claims. The projections for Part D expenditures are going down, in part due to increasing fees charged to pharmacies. Pharmacies subsidize the Federal spend to their own detriment; there aren’t huge margins in the pharmacy business, especially in the LTC pharmacy business.

If there’s a new fee that’s going to cost you 2% each claim, you pay the fee — you don’t have a lot of choices. You cannot exist as an LTC pharmacy if you don’t participate in Part D. Even if you are the largest LTC pharmacy, you have limited negotiating power compared to health insurers and PBMs.

Bashe: It seems that one hand pays the other. They’re making money on the spread on both sides of the patient-care model — on the drugs themselves and then on the margin. Do any existing policy solutions support lowering drug prices?

Rosenbloom: There are some proposals currently pending to address having Medicare negotiate drug prices with an international reference point, which would dramatically reduce rebates. Independent pharmacies are at risk of financial instability and possible bankruptcies because policymakers are not considering the downstream consequences on smaller market players. If we change models, we have to ensure LTC pharmacies don’t get stuck with the bill.

What we’ve seen on the insurance company, health care provider, PBM, and the large pharmacy chain side is both vertical and horizontal integration into health care conglomerates that dominate significant chunks of the market. We need to seriously look at enforcing the antitrust laws because when competition is suppressed, consumers may pay more for their medications or be directed to less effective medications if they are more profitable than the plans and PBMs.

Bashe: What concerns me is that health is more than a product or a pill that’s delivered on time. There’s also an inherent duty to help the patient. As we move towards scale and away from individualized care are we endangering the relationship between care provider and patient?

Rosenbloom: There are state laws and Medicare and Medicaid requirements that medications get to a resident in a facility within a certain period of time; in some cases, as quickly as four hours. Historically the LTC pharmacy was the model for serving people in nursing facilities, and there, the relationship is primarily with the facility. The LTC pharmacy has expanded into the assisted living environment, where the relationship is more directly with the patient. As we expand more into the home care environment, that personal dynamic becomes even more important.

Bashe: What’s the one thing health professionals, policy leaders, and people reading this piece really need to remember when looking at LTC pharmacies?

Rosenbloom: People should know the value that LTC pharmacy services provide to people with LTC needs, and recognize their positive impact on patient care outcomes. And then, pay for it appropriately.

Bashe: Mr. Rosenbloom, thank you. Health professionals must recognize that when the office visit is over, a patient still has health needs that must be addressed. The right medicine at the right time at the right cost will always be a lifesaving factor in the care relationship. In order for us to live long, sustainable lives, then supply chain management, digital information, and access to affordable medicines are essential. But, along with high-tech, the high-touch of long-term pharmacies is a key piece in the fragmented health ecosystem puzzle.

The post When We Incentivize Treatment Over Outcomes, People Suffer appeared first on Medika Life.

Doctors should no longer prescribe daily doses of aspiring to pre-CVD patients because of the increased risk of bleeding, a risk that increases with age.

We’ve known for a long time that aspirin reduces risk for those who’ve already experienced a heart attack or stroke, and logic and research supported the idea that administering aspirin to a patient prior to a cardiac event would reduce the likelihood and/or severity of CVD or stroke.

Simply put, aspirin works by thinning your blood (an anticoagulant), making the blood less likely to form clots and thinner blood requires less effort to circulate, so the heart doesn’t have to pump as hard. Benefits were seen to extend not only to CVD but also to the incidence of strokes.

Now, the U.S. Preventive Services Task Force, an independent panel of experts, has just released an updated draft recommendation that says most adults should not take aspirin to prevent first heart attacks or strokes.

The newly updated guidance recommends that adults in their 40s and 50s only take aspirin as a preventive measure if their doctors determine they are at higher risk for heart disease and that aspirin may lower the risk without significant risk of bleeding. Previous guidance didn’t address anyone younger than 50.

People ages 60 or older are now advised not to start taking aspirin to prevent first heart attacks or strokes.

So what has changed?

The timing of the new advisory couldn’t have been worse. It follows on the heels of an Israeli study and this study that points to the efficacy of aspirin for treating severe Covid and mounting evidence that a daily dose of aspirin may reduce the risk of infection from the virus.

The new advisory is seen by many as an attempt to smear aspirin as a cheap and effective treatment for Covid, forcing people instead to opt for more costly treatment options. They cite the recent examples of Ivermectin and Hydroxychloroquine to support the pattern, but mistakenly so, as data shows neither drug to be effective.

Aspirin does however appear to reduce the risk of severe Covid for some patients.

Conspiracies, baseless or otherwise, aside, the new advisory is still under review, pending input from providers. We have known for many years that aspirin poses a risk for bleeding in some individuals and that this risk increases for the elderly. Every doctor that prescribes aspirin takes these risk factors into consideration when treating a patient.

Aspirin remains one of the safest and well-tolerated drugs we have at our disposal. Poll any doctor over the age of 40 and you’ll find many drink an aspirin each day, that’s how entrenched the belief in the drug has become and it is available without prescription in almost every country on the planet as an over-the-counter (OTC) medicine.

So how should you as a patient, respond to the latest advice? If you do fall into the new categories (60+) defined as high risk, discuss your medication regimen with your doctor. Patients should be aware that these advisories apply to patients that have not yet experienced CVD or suffered a stroke.

Doctors recommend daily low-dose aspirin for many patients who already have had a heart attack or stroke and the task force guidance does not change that advice.

If you’re self-medicating with aspirin, there are a few things you should consider.

• Don’t simply start using aspirin because you’ve reached a certain age and if you’re over 70, definitely don’t take aspirin unless advised by your doctor.
• If you’re a candidate for CVD, in other words, if you smoke and drink heavily, if you have elevated blood pressure, high BMI, or suffer from obesity and have a family history of CVD, aspirin may benefit you, but again, a doctor is best placed to advise you.
• Aspirin will thin your blood, but won’t address the contributing factors that result in CVD. It won’t drop your blood pressure, lower your cholesterol or help you lose weight. Eventually, these factors will negate any positive effect aspirin may have on your heart.
• You may, inadvertently be compromising your health if you are over 50 and risk ulcers and bleeding. Your doctor is best qualified to properly assess this risk.

Dr. Erin Michos, an associate director of preventive cardiology at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, who isn’t part of the task force, had this to say about widely known recommendations that endorsed daily aspirin use for decades;

“We’ve gotten a lot better with other medical therapies, and the aspirin recommendations were developed during trials conducted before statins were widely used and smoking was more widespread. The incremental benefit of aspirin in contemporary medicine does not provide as strong of a benefit for primary prevention as it once would.”

There is no magic medication for negating your risk of heart disease and stroke, and aspirin, although beneficial, won’t make you bulletproof. You will need a multifaceted approach that includes a healthy diet and regular exercise, and yes, perhaps an aspirin a day. Talk to your doctor.

The post Aspirin. Your Heart’s Best Friend, or Maybe Not appeared first on Medika Life.

In every sector of science that mankind excels in, peers recognize exceptional individuals and achievements. These acknowledgments strengthen the sector and express appreciation for the talented individuals who so often change our lives.

Even before the pandemic ravaged the nation, pharmacists across the United States were experiencing significant burnout and mental fatigue based on the metrics & expectations of their employers in the retail pharmacy chain sector of the industry. The pandemic compounded the issue of pharmacist burnout and has caused hundreds of pharmacists to question their choice of careers based on the stress they experience daily.

In a recent article from Crain’s Chicago Business, Dr. Maurice Shaw PharmD was quoted saying that he struggled to keep pace with surging demand for flu shots, answer constantly ringing phones, fill prescriptions and fetch front-end items such as milk and hair dye for drive-thru customers who were afraid to enter the store. By October, he could take no more.  

‘There’s no way I can keep working here because this is just too much.’ And that was without COVID vaccines.”

Shaw now works at the University of Illinois at Chicago College of Pharmacy. Dr. Elizabeth H. Padgett, PharmD participated in research published in the May 2020 edition of U.S. Pharmacist titled “Pharmacist Burnout and Stress” where she outlines data collected regarding the impact the pandemic has had on retail chain pharmacists.  

While burnout in traditional occupations focuses on the well-being of the individual worker, burnout in the healthcare setting must also consider the potential negative effects on patients’ healthcare outcomes. Pharmacy technicians are under similar stresses within the retail pharmacy space & experience burnout and mental breakdowns from the high volume of work expected with a shortage of staff during flu season.

It’s been a rough 18 months in pharmacy. Pharmacists in consultant roles focusing on geriatric care, pharmacists in the specialty sector, and hospital pharmacy technicians and the pharmacists they help are not spared from the incredible amount of pressure the pandemic has placed on their roles. 

In a recent interview with Pharmacy Times®, Melissa Santibañez, PharmD, BCCCP, critical care clinical pharmacist at Memorial Regional Hospital, said understanding the impact of burnout is essential.  Santibañez said there is a lack of data on this subject, especially among subsets of pharmacists such as hematology and oncology pharmacists.

She believes the high prevalence of burnout is largely because of 3 components: high emotional exhaustion, high levels of disconnect from colleagues, and a lower sense of personal accomplishment or satisfaction. According to Santibañez,

“Pharmacists, just like any other health care provider and professional, have direct patient care at the core of everything that we do on a daily basis, no matter what setting we work in. That high responsibility comes with very severe implications if we are not managing all of the aspects of our jobs in a healthy manner.”

Since 2009, the Pharmacy Podcast Network (PPN) has advocated for the pharmacist and pharmacy professional. Founder and CEO Todd Eury who began his pharmacy career in 2004 recognized a need for an audio publication that catered specifically to the pharmacy profession.

In the last 12 years, the Pharmacy Podcast Network has blossomed into the leading audio publication within healthcare focused on pharmacy and the publication now has more than 40 participating podcast hosts focused on a multitude of themes and topics regarding the clinical, business, and continuing education for the pharmacy professional. 

Eury, an avid podcaster & audio learner, created an awards program to honor his profession, the ’50 Most Influential Leaders in Pharmacy’. It sets out to inspire and advocate for the pharmacy profession. According to Eury;

“It’s taken a long time to build this network and today it’s a mission to build high-quality audio to supplement the written word, continuing education, and subject matter experts in the form of podcasting. Pharmacists and the pharmacy profession get overlooked a lot in national news and the majority of the general public doesn’t realize how complex the pharmacy industry is nor what pharmacists and technicians go through every day to ensure their communities are taken care of and are kept safe”

The PPN began collecting nominations in September and will be accepting names through an online form which will be closed on November 8th, 2021 at 5:00 PM EST. After a selected panel of judges thoroughly evaluate the nominees, the organization will announce the honorees on November 15, at 12 PM ET on a Live podcast episode.

Nominations can be submitted here: https://surrvey.app/f/5fkep 

The post Advocating for Leaders in Pharmacy. Drawing Attention to Unsung Heroes appeared first on Medika Life.

Hiller, PA, Oct 4. 2021 / In the effort to recognize leaders in the pharmacy industry, the Pharmacy Podcast Network is launching the 50 Most Influential leaders in Pharmacy Awards and Recognition Program.

The organization aims to recognize people who’ve made their mark through innovation, momentum, and distinction. These Rising Stars, Innovators, Trailblazers, Visionaries, and Leaders will be recognized with various awards from the organization.

To ensure that the awards are recognizing the right people, the process is peer-driven. The Pharmacy Podcast Network is encouraging professionals in the industry to nominate peers who they believe have made a difference, not only in their organizations but also in their own careers.

“Our pharmacists and teams of people who support our pharmacists are under so much pressure right now. Many are experiencing burnout & mental breakdowns”, says Todd Eury CEO & Founder of the Pharmacy Podcast Network, the 1^st podcast dedicated to the profession. “We want to bring re-instill pride in our industry and honor innovative leaders who are helping to transform pharmacy, making it better for our patients, who we exist to better serve.”

The timing of the Awards initiative is hugely relevant. In a pandemic society, pharma has undoubtedly suffered at the hand of misinformation, tainting the profession with a reputation of profit-seeking at the expense of all else. Nothing could be further from the truth and where individuals within the sector are driven by altruism, innovation, and patient wellbeing, the time for recognizing and honoring these ‘stars of pharma’ is long overdue.

A panel of judges will evaluate nominees and decide which individuals have the most influence in the industry. Nominees are accepted from all sectors of pharmacy for elected officials, high-level government administrators, and thought leaders.

Starting 30th September 2021, the Pharmacy Podcast Network will be accepting nominations through an online form and nominations will be closed on 8th November 2021 at 5:00 PM EST.

After a thorough evaluation, the organization will announce the honorees on November 15, 2021.

The Pharmacy Podcast Network has always been passionate about honoring professionals who made a difference in the pharmacy industry through their hard work, advocacy, and innovation. Since 2009, it has been ranked as the number one podcast in healthcare focused on the Business of Pharmacy and the top 25 podcasts in the U.S. Business News.

For many years, the Network has published audio content featuring different thought leaders and experts in the pharmacy industry, which is why it is known as a leading authority in the industry with more than 1,400 episodes, 80,000 followers, and 40+ hosts.

Nominate an individual now

About Pharmacy Podcast Network

Started in 2009, the Pharmacy Podcast Network is ranked as the number one podcast in healthcare dedicated to the Business of Pharmacy and TOP 25 Podcasts in U.S. Business News. The most influential voices in the pharmacy industry are published on the Pharmacy Podcast Network (PPN). The PPN is the leading audio authority of the pharmaceutical & pharmacy industry with more than 40 hosts, 1,400+ episodes, supporting more than 25+ pharmacy industry associations, with more than 80,000 listeners worldwide. 

The Pharmacy Podcast Network specializes in offering useful information about the healthcare system, long-term care, community care, industry trends, and of course, the business side of the pharmacy industry. The program will aid professionals to do more to help their organizations and the industry in general.

Those who are interested in advertising alongside the honorees’ published issue can get in touch with a Pharmacy Podcast Account Executive at publisher@pharmacypodcast.com.

Todd Eury

Pharmacy Podcast Network

Tel: 412.585.4001

Publisher@PharmacyPodcast.com

904 First Street, Hiller, PA 15444

The post The 50 Most Influential Leaders in Pharmacy Awards Opens for Nominations appeared first on Medika Life.

We Americans have a long and glorious history of snake oil salesmen. There is always someone peddling useless — and sometimes harmful — concoctions when there’s sickness and suffering. John D. Rockefeller’s father was just such an itinerant quack. What finer pedigree could you ask for?

It should be no surprise then that here in the US of A, we’ve taken the most dubious claims of hydroxychloroquine’s effects on COVID-19 and hyped them from the highest podium in the land: “What do you have to lose?”.

Aside from the shame of snake oil salesmen being encoded into the DNA of our country is the fact that Americans always seem eager to buy what the shameless hucksters are selling.

And then, there’s the question of the snake oil itself. The stuff in the bottle. What is it anyway?

What is hydroxychloroquine, and where does it come from?

The short answer is that hydroxychloroquine is a modification of an earlier drug called chloroquine, which in turn is a synthetic version of a natural drug derived from tree bark that many of us have heard of, called quinine. Quinine has a veeery long history as an antimalarial drug. Still, it is also commonly known as an additive in tonic water (as in gin and tonic), giving it its characteristic bitter taste. Quinine is a plant alkaloid. Alkaloids can be toxic and are known for their bitterness. Think of caffeine — a classic alkaloid.

With some very smart commentators blogging on current issues with these drugs (Derek Lowe on the Science Magazine website is particularly good).

Despite the fun of digging into that black hole of technical information, I thought the back story was even more interesting.

Countess Ana de Osorio

It all starts with Ana de Osorio, wife of Luis Jeronimo de Cabrera, Count of Chinchon and importantly, Viceroy of Peru from 1629 to 1639.

I love the names and titles.

Ana de Osorio, Countess of Chinchon…

In 1638, the story goes, Ana de Osorio became very sick from malaria. The governor of Loxa wrote to the viceroy claiming to have been cured by the bark of the quinaquina tree. The governor was summoned, the medicine administered, and Ana was cured. Ana returned soon after to Spain bringing this miraculous bark of the tree eventually named after her as the Cinchona tree.

It turns out that this story, documented in 1663 by an Italian, Sebastiano Bado, was wrong on most counts and was disproved by the discovery in 1930 of the Viceroy’s official diary.

It turns out, for example, that Ana, the first Countess of Chinchon, died three years before Luis even went to Peru as viceroy. The second Countess of Chinchon, who did accompany Luis, was the picture of health the whole time but died on the journey from Peru back to Spain. But the (mis)story of Ana de Osorio persists to this day, like a virus that has become integrated into the DNA of our culture.

The Cinchona Tree

The bark of the Cinchona tree nonetheless bent the curve of medical and human history. It was brought by Jesuit priests to Europe, where the Spanish apparently knew of the bark’s medicinal value as early as the 1570s and was first used to treat malaria in Rome in 1631 (long before the mythical Ana even fell ill).

This bark, also called Jesuit’s bark or Peruvian bark at the time, became one of the most valuable exports from Peru when it became clear that it successfully treated malaria patients in Rome. Rome was once surrounded by marshes, and the name malaria comes from the medieval Italian words mala (bad) and aria (air). Malaria was associated with “bad air” emanating from Roman swamps.

Today we know that the cause of the disease is a single-celled parasite, Plasmodium falciparum, carried by mosquitoes that are endemic to marshlands.

Bad Air

Bad air was typically what Western medieval people blamed for any kind of disease. This was consistent with the ‘miasmic theory,’ passed down almost unchanged from ancient Greece a couple of millennia before. Microscopic organisms were not even known until Robert Hooke published his findings on them in 1665, followed soon after by Anton van Leeuwenhoek’s observations with his famous homemade microscopes. The role played by some of these microorganisms in human disease was still not recognized until Louis Pasteur’s experiments in the 1860s and Lister’s treatise on antisepsis which was published in 1867. Too late to mitigate the savagery of the American Civil War, which killed 2% of the population, most from disease (like malaria) and infection (doctors did not wash their hands or otherwise use aseptic technique while sawing off soldier’s mangled limbs).

But back to Rome, where malaria killed indiscriminately. Popes, cardinals, priests, and many other Romans — rich and poor — died miserably from the disease. The Jesuit’s knowledge of this bark’s curative abilities eventually led to its explosive rise in value and demand throughout 17th and 18th century Europe.

The Peruvian quinaquina tree eventually yielded a purified drug, the active ingredient called quinine, in 1820. Pierre Joseph Pelletier and Joseph Bienaime Caventou, French chemists who discovered caffeine and strychnine, among many other alkaloid plant compounds, found quinine was the active ingredient in the Peruvian tree bark.

Colonial Drugs

Quinine used as a drug enabled Europeans to colonize Africa. Native Africans had evolved certain traits associated with sickle-cell anemia and other genetic diseases, which gave them some resistance to malaria. Europeans did not have these genetic characteristics and were much more susceptible to the parasite. Africa became known as the White Man’s Grave. Quinine rectified that genetic deficiency and led to Europe rapidly colonizing and chopping up Africa in a global game of Risk.

The European’s colonial drive took them around the world, and quinine clearly enabled their global competition for territory, resources, and subjects, especially in equatorial and malaria-infested regions of the world. Although quinine is credited with saving many millions of lives over the centuries, one of the unintended consequences was that it enabled the Western powers’ colonial ambitions and conflicts, thus setting the stage for the slaughterhouse of World War I and its domino effect of WWII.

Quinine’s bitterness spurred British officials in various early 19th century colonial outposts to mix their medicine with soda and sugar — which marked the origin of tonic water. The British in colonial India mixed their tonic water with gin, creating a classic cocktail that is still embedded in our culture to this day.

The value of quinine rose rapidly, causing Jesuit’s bark to focus on global games of Risk and Monopoly. Peru and the neighboring countries tried to corner the market for their native Cinchona trees, but the Dutch managed to smuggle seeds out of South America. Eventually, Dutch plantations in Indonesia became the dominant world suppliers. The wily Dutch outplayed the South Americans and ended up with 97% of the global market and set up a quinine cartel in 1913 to control global supply and prices.

The 20th Century Drug

Quinine played a key role in one of the biggest successes and engineering marvels of the 20th century — the Panama Canal, built between 1904–1914 — driven by the big stick policies and willfulness of Teddy Roosevelt. There were many reasons for the failure of the early French efforts to build a canal across Central America. Still, the immense casualty rate among the engineering and labor forces certainly played a key role in France abandoning the project to the Americans.

Tropical diseases such as malaria were a major if not top contributor to French casualties. Central to the success of the American project was the groundbreaking public health initiatives driven by Dr. William Gorgas and his team — and their application of a new scientific understanding of malaria and other tropical diseases being transmitted by mosquitos. Mosquito control and prophylactic administration of quinine were among the cornerstones of their efforts.

Malaria also played an outsized role in the number of casualties during the First World War (disease — not the enemy — was usually the main killer of soldiers in wars throughout history). Before WWI, scientists and public health experts successfully controlled malaria in parts of Europe like Italy and Greece. However, these public health measures lapsed during the war, and also afterward: malaria became a global scourge again, well into the 20th century. Prophylactic use of quinine was studied and implemented by some countries during the Great War.

The late 19th and early 20th century were a sort of golden age of synthetic and organic chemistry, and quinine played a Muse’s role in this. Chemists tried to synthesize quinine since it was an expensive natural product (remember the Dutch cartel). Their efforts often failed miserably — but in a classic example of experimental serendipity — the failures sometimes bore fruit. William Perkin’s attempt in 1856 to make quinine resulted in abject failure and a mess, but the mess yielded a brilliant purple dye which made him a fortune. He was 18 years old.

The Age of Synthetics

Synthetic organic dyes, triggered by Perkin’s success, were one of the economic foundations of the German economy. Starting in the late 1860s, well-known companies formed that exists to this day: Bayer, BASF, Hoechst, etc.

A number of dyes were proposed as treatments for malaria, including methylene blue developed by Paul Ehrlich in 1890 and first used by him to treat malaria patients in 1891. Aside from not being as effective as naturally derived quinine, the dye-based malaria drugs had the unfortunate side effect of turning patients into various unnatural colors.

Finally, Hans Andersag, a researcher at Bayer AG in Germany, discovered a synthetic version of quinine in 1934 which eventually became known as chloroquine. Bayer ran clinical trials of these drugs in North Africa in the early 1940s during WWII, and this information fell into Allied hands around 1943. US doctors eventually recognized the efficacy of chloroquine, and it was approved for clinical use in the US in 1947.

During WWII, millions of US soldiers were given prophylactic antimalarial regimens, which resulted in a very unexpected and positive side effect. Clinicians noted reduced symptoms in those suffering inflammatory disorders such as skin rashes and some forms of arthritis after taking the drug. Clinical trials subsequently demonstrated the efficacy of antimalarials for a range of inflammatory diseases, starting with systemic lupus erythematosus in 1951. Today chloroquine analogs are administered off-label (i.e., not approved by the FDA) for a wide range of autoimmune diseases since they are among the few effective treatments that reduce symptoms. However, we still do not know exactly how chloroquine-based drugs blunt inflammation.

Another positive outcome of WWII was more organizational. The Office of Malaria Control in War Areas, established in 1942, was the immediate predecessor of the CDC, which was first known as the Communicable Disease Center when it kicked off on July 1, 1946. Malaria was the first target on its project roster, with the National Malaria Eradication Program starting a year after the CDC’s founding. Success was declared by 1951. Spraying DDT was one of the cornerstones of the CDC’s efforts to eradicate the mosquito vector of malaria, while chloroquine was the cornerstone of prophylaxis and treatment of the disease.

Where We Are Today

Hydroxychloroquine is a modification of chloroquine where a hydroxyl group (-OH) was appended to the side chain to reduce toxicity and was approved for medical use in the US in 1955.

In the years since chloroquine and hydroxychloroquine were approved in the US, we’ve learned a few things about these antimalarial drugs. We know now that these drugs accumulate in lysosomes and inhibit their acidification, which has subsequent effects on a range of cellular processes, including antigen presentation. We know these drugs reduce cytokine production by macrophages and inhibit toll-like receptor signaling and a variety of other immune pathways. But we remain far from causally linking the drugs to these disparate biological effects or ultimately to their clinical efficacy (against malaria or various inflammatory diseases).

Our long history of using these drugs has given us some insights into their limitations, side effects, and adverse drug interactions. One of the more severe side effects includes QT prolongation, an electrical disturbance of the heart that can lead to a fatal arrhythmia. Another is a 30% mortality among patients administered hydroxychloroquine who also took metformin, an important anti-diabetic drug.

In the US, malaria is no longer a significant clinical problem. But hydroxychloroquine and its analogs are prescribed for a wide range of debilitating autoimmune diseases, and many patients have come to rely on these drugs.

Then in 2020, dubious and poorly executed clinical studies hyped the effects of hydroxychloroquine and falsely claimed this drug had beneficial effects on COVID-19 patients. Didier Raoult, who masterminded these efforts, has since been censured and his papers retracted.

No placebo-controlled, double-blinded, sufficiently-powered clinical studies show hydroxychloroquine works against COVID-19.

Diabetics have a worse outcome with COVID-19, and these patients likely take metformin which is known to have lethal interactions with hydroxychloroquine.

In the rest of the world, over a million people per year, mostly pregnant women and young children, still die from malaria. But in a typical display of poorly allocated healthcare capital, we spend more on baldness treatments than for antimalarial treatments. Drug resistance has become a significant problem in many parts of the world so the need to invest in more antimalarial drug development is acute — but we still mostly use drugs that are almost a century old.

We’re gradually learning more and more molecular details of the intricate and complex life cycle of Plasmodium falciparum, the malaria parasite. Here are a couple of beautiful animations that show how malaria moves through the human host in one video and in the mosquito host in the other.

Molecule Allows Malaria Parasite to Commandeer Red Blood Cells
Two groups of HHMI scientists working independently have identified a critical enzyme that allows a malaria-causing…www.hhmi.org.

I don’t think there is anyone left who believes hydroxychloroquine works against COVID-19. If there are, if it is you, don’t be the last sucker buying snake oil. Instead, get vaccinated against COVID-19. Today.

The post The Evolution of Quinine to Hydroxychloroquine, Covid’s Snake Oil appeared first on Medika Life.

In the study funded by Rutgers University and published in the Journal of Dietary Supplements, Rutgers Research Scientist, Amy B. Howell, Ph.D., Jean-François Dreyfus, MD, Ph.D., and practicing urologist Bilal Chughtai, MD of Weill Cornell Medicine reported that “water-soluble PAC, sourced directly from cranberry juice extract has a direct impact on in vitro and ex vivo AAA of P-fimbriated E. coli bacteria.” The authors explained,

“the bacterial AAA of urine following cranberry juice extract consumption interrupts the initial step in the infection process, a potentially important mechanism for UTI prevention. Preventing infection in this way, rather than killing bacteria, may help reduce resistant uropathogenic bacterial strains. Cranberry, Vaccinium macrocarpon, is already widely utilized by consumers for maintenance of urinary tract health.”

However, since cranberry supplements are not regulated by the FDA, there is no oversight on what must be included for efficacy. As a result, supplements on the market are often formulated using different components of the cranberry that may or may not be effective. This new study explains that this is a key reason why there is high variability in AAA across these products.

Previously, Dr. Bilal Chughtai & Researcher Amy Howell compared AAA of 9 commercially available cranberry supplements in a study published in the American Journal of Obstetrics and Gynecologyin 2016 and discovered significant variability among products. That study elucidated why some supplements don’t work — not enough Anti Adhesion Activity, noting that “products containing 36 mg of PAC have the best AAA,” though there was insufficient evidence to explain the discrepancy in AAA variability even among those containing 36 mg of PAC.

We now know 36 mg of PAC is only part of the story

The source of the PACs is equally important — which part of the cranberry it comes from. In this new study, the scientists concluded that water-soluble PACs found in concentrated cranberry juice extract elicit the highest AAA in urine after intake.

Anti-Adhesion testing of PACRAN, which is comprised of PACs from every part of the cranberry, versus GIKACRAN with PACs taken only from the juice concentrate extract, and fractions of each supplement containing the distinct molecular classes of compounds in each supplement confirmed that only the soluble PACs from the juice concentrate are responsible for AAA. As explained in the study, “The 36 mg PAC level often reported in cranberry products is specifically indicative of the soluble PAC measured only with the DMAC/A2 reference standard and is the recommended daily intake amount according to large meta-analyses on cranberry clinical trials for UTI prevention (Jepson et al., 2012; Jepson, 2013). The majority of AAA is linked to polyphenolic compounds in cranberry, especially A-type (PAC) found in the water-soluble juice portion of cranberry fruit (Howell et al. 1998, Foo 2000, Gupta 2007, Gupta 2012) and their metabolites (de Llano et al. 2015; Mena et al. 2017).”

The AAA testing for both soluble and insoluble PACs reveals a significant difference between them, with AAA of soluble PAC being almost three times higher than insoluble PAC. “High concentrations of soluble PAC per serving in CJD [concentrated cranberry juice extract] correlated with 94 percent ex vivo urinary AAA, while the lower 23 percent AAA value for WCFD [whole fruit components] was likely due to the low soluble PAC content per serving. When PACs are insoluble, they do not have AAA. The PACs that come from the pomace products (the pulp, seeds, stems, skin of the berry) are insoluble because the pomace is fibrous. The PACs get stuck in the cellulose matrix, and can’t be easily extracted out, especially by the human body…The insoluble, non-extractable PACs complexed with cellulose fibers in the cranberry skins that remain after the juicing process (Gullickson et al., 2019; Roopchand et al., 2013) have not shown an effect on bacterial adhesion.”

The study provides long-desired direction for healthcare providers to advise their patients: To get the most anti-adhesion benefit, look for a supplement made from cranberry juice extract.

Brian Flynn, MD, UC Health, Denver said;

“This study demonstrates the important differences in formulating cranberry supplements for urinary tract health, The results show that the type of cranberry fruit component in the supplement directly influences its effectiveness and should guide consumers and healthcare providers when choosing cranberry supplements for urinary tract health.”

About ellura®

Backed by 19 clinical studies and 11 traditional herbal medicine approvals worldwide, ellura, is made from GIKACRAN, and has been available in the US for more than 10 years. ellura is a clinically proven, daily supplement for non-antibiotic management of patients with recurrent urinary tract infections.

ellura’s complex proprietary double extraction manufacturing process, extracting PAC only from the pure cranberry juice concentrate, results in the highest-shown levels of soluble A-type PAC to date and the highest level of bacterial Anti-Adhesion Activity compared to other available supplements on the market.

For studies including dosing, pediatric, catheter and surgical, and more information, visit ellurahcp.com.

The post How to Wee Away your UTI. New Research from Rutgers appeared first on Medika Life.