NHS provokes fury with indefinite surgery ban for smokers and obese

[MattyM 09/109]

That drug is unlikely to get approved in the EU. The manufacturer applied for marketing authorisation with the EMA in 2013 but withdrew the application when they were asked to some questions regarding their trial data. I think the median result of the drug was a weight reduction of 9lbs in 40 months which to be honest is 5hite. they have never come back with answers and never resubmitted their application in the preceeding 5 years so i would suspect that it is either very unlikely to come to market and if it does will have heavily regulated use. This is mainly due to poor outcomes and high cost. Never a good combination for the NHS to approve.

There is a big difference in US as the FDA are more relaxed in their approach to approvals as cost effectiveness is not so much of an issue due to the insurance companies being largely responsible for costs and nobody to such as NICE/CMUs or local procurement to drive down the price.

Well that sucks. I assume theres a shit tonne of money going into the area as cutting folk open to hoy in gastric bands cant be an answer and some people are just not going to be able to do it without serious help. Whoever cracks it is gonna cash in big time.

I reckon they'll be loads of anorexics gagging to get their hands on those.

BADUM-TISH!

 

[pavarotti1980]

Well that sucks. I assume theres a shit tonne of money going into the area as cutting folk open to hoy in gastric bands cant be an answer and some people are just not going to be able to do it without serious help. Whoever cracks it is gonna cash in big time.


BADUM-TISH!

Very modest outcomes from lorcaserin so it will need someone else to come along and cash in.

Currently nearly 10 billion
https://www.diabetes.org.uk/resources-s3/2017-11/diabetes uk cost of diabetes report.pdf

this figure does not include social care either

Social care These figures do not include the costs of diabetes in social care. However, we do know that one in four care home residents have diabetes8 . In the USA, 16.4 per cent of the cost of nursing and residential facilities is attributable to diabetes9 . In the UK this figure may be lower as diabetes prevalence is lower.

Indirect costs While this is an underdeveloped area of research, the costs of reduced productivity at work (due to people with diabetes not working because of death or poor health or working at a lower level of productivity) are estimated at nearly £9billion12.

etc etc

I would hope NHS England are more on point with the figure than the charity. And especially since this figure was from 2018 (NHSE) and that link is from 2014 (DUK)

Thanks for copying and pasting though

 

[MattyM 09/109]

Very modest outcomes from lorcaserin so it will need someone else to come along and cash in.

What were the upper end responses, still shite? I've been on a tonne of hugely expensive psoriasis medications that have been tried out to see if i get a good response on that particular one. I mean if this thing could help 10% of folk who try it its 10% of however many billions are getting spent treating people?

 

[Some Random Guy]

ps its not just obesity and poor diet that are responsible for developing type 2 diabetes

It's not. But it is about 80% of the time isn't it?

 

[pavarotti1980]

It's not. But it is about 80% of the time isn't it?

something like that

What were the upper end responses, still shite? I've been on a tonne of hugely expensive psoriasis medications that have been tried out to see if i get a good response on that particular one. I mean if this thing could help 10% of folk who try it its 10% of however many billions are getting spent treating people?

I cant find the full text. It was a meta analysis of the phase III trials and it just doesnt seem like it will be that effective. There are other factors such as the average age of participants was 64 so there is no evidence of a good response in younger people. As usual drug trials should be taken with a huge pinch of salt (not in the literal sense in this cohort). They are manipulated massively by the sponsors and drug companies when in reality the actual evidence is rubbish. A good read on is Bad Pharma by Ben Goldacre.

I would imagine exercise and diet modifications over the same course of time would achieve better results

 

[Harry Angstrom]

I am all for what you say Harry. People have to make some effort to change their lifestyles as type 2 is self inflicted no other cause whatsoever, and once diagnosed will cost on average over £14,000 per person per year by way of NHS and Social care.

Unfortunately there's now over 4 million with diabetes in the UK and by far the biggest percentage being type 2. There is also an estimated 1 million with it and not even diagnosed yet.

Apparently Bariatric surgery can prevent and reverse Type 2 at a cost of around £3,995 to £15,000 throughout the UK. Gastric Band prices typically cost between £5,000 and £8,000. Gastric Balloon prices typically cost between £2,000 and £5,000. Gastric Bypass prices typically cost between£9,500 and 15,000. but once done and lifestyle changes could make a big difference for the patient and the NHS

Surely at this rate the burden to the UK is untenable and not acceptable. Yes by becoming diabetic you have obviously spent more on food and drink and contributed in paying tax and vat ...but its comes at a significant cost in ill health and premature death to you as a person.

Surely its a no-brainer ?

personally, I think we need a shift in attitude. people need to take responsibility for their own lives and that includes weight and fitness.

Whereabouts do you get your figures from for the average £14,000 per patient?

NHS England quote £6billion costs for treatment and complications for type 2 diabetes patients. 4 million patients which works out around £1,500 per patient per year. Are social costs making up the remaining £12,500 per patient?

NHS England » Flagship NHS Type 2 Diabetes Prevention Programme exceeds expectations as patients shed the weight of 15 double cheese burgers

ps its not just obesity and poor diet that are responsible for developing type 2 diabetes

True some people are susceptible to type 2 who are not obese but a rapid weight loss in most people reverses it.

 

[pavarotti1980]

True some people are susceptible to type 2 who are not obese but a rapid weight loss in most people reverses it.

Im at high risk simply because my mam has. I dont fancy rapid weight loss like

 

[Harry Angstrom]

Im at high risk simply because my mam has. I dont fancy rapid weight loss like

i was diagnosed as getting close. I wasn't particularly over weight. i dropped 10lbs fairly rapidly and i went back to normal. I now weigh even less and expect to be fine for ever.

Black people are much more prone to type2, Indians too. So they may need to on average lighter to avoid the issue.

but diet and exercise are the wonder cures for the NHS. IMHO.

if doctors weighed people and measured their waists and told people to lose weight, most would.

 

[raindog]

personally, I think we need a shift in attitude. people need to take responsibility for their own lives and that includes weight and fitness.

Agree entirely, young people need to be educated early about fast food and fizzy drinks and the older end need to eat a better diet and learn about a low glycemic index diet http://documents.hants.gov.uk/hms/HealthyEatingontheRun-LowGlycemicIndexFoodList.pdf

Dont eat convenience foods takeaways etc., make your own meals, meat and veg / salads etc drink more water, take up a sport, walk more, an outdoor hobby, or swimming etc to burn off excess calories.

Maybe for some its a complete change of lifestyle but its pretty doable if you're committed

 

[Harry Angstrom]

Agree entirely, young people need to be educated early about fast food and fizzy drinks and the older end need to eat a better diet and learn about a low glycemic index diet http://documents.hants.gov.uk/hms/HealthyEatingontheRun-LowGlycemicIndexFoodList.pdf

Dont eat convenience foods takeaways etc., make your own meals, meat and veg / salads etc drink more water, take up a sport, walk more, an outdoor hobby, or swimming etc to burn off excess calories.

Maybe for some its a complete change of lifestyle but its pretty doable if you're committed

there needs to be a change in the zeitgeist as well. people feeling a bit ashamed that they are lazy and fat.

 

[Marsden Mackem]

there needs to be a change in the zeitgeist as well. people feeling a bit ashamed that they are lazy and fat.

Its a change in health provision totally thats needed all the NHS does in the main now is treat symptom not causes, for example high blood pressure heres a tablet, heart problems stick a stent in or take these tablets, lets get everyone on statins etc etc. Rather than looking at the causes which are often diet and lifestyle which as mentioned earlier changes in can reverse and prevent the things in the first place and get you off the tablets.

If you are in a group at risk of type 2 or heart disease then you should be being encouraged/educated to adopt lifestyle now that stops it developing not waiting "till you have it" before taking action as most of these things are accumulation over years not an acute event that suddenly happens.

Trouble is our doctors dont get much nutrition education and the Pharmacy companies spend a fortune ensuring the status quo stays.

 

[Harry Angstrom]

Its a change in health provision totally thats needed all the NHS does in the main now is treat symptom not causes, for example high blood pressure heres a tablet, heart problems stick a stent in or take these tablets, lets get everyone on statins etc etc. Rather than looking at the causes which are often diet and lifestyle which as mentioned earlier changes in can reverse and prevent the things in the first place and get you off the tablets.

If you are in a group at risk of type 2 or heart disease then you should be being encouraged/educated to adopt lifestyle now that stops it developing not waiting "till you have it" before taking action as most of these things are accumulation over years not an acute event that suddenly happens.

Trouble is our doctors dont get much nutrition education and the Pharmacy companies spend a fortune ensuring the status quo stays.

Agreed the medical profession needs to do more but we as a nation need to say that it is no longer acceptable to be a fat lazy fucker.

It won't happen though because people love convenience. That is the word that has ruined the world. IMHO.

 

[Mary Hinge]

Yep. But you'll only get people saying "well I pay ni contributions, so fuck off"


I don't have to post my opinion on the link though, Mr north Korea

Scratters and Fattys don't pay ni, but they get cars, blue badges and leccy scooters for the day trip to ASDA

 

[pavarotti1980]

Scratters and Fattys don't pay ni, but they get cars, blue badges and leccy scooters for the day trip to ASDA

Don't forget 60" TVs, tabs and beer

 

[fyl2u]

I know you're joking but just in case anyone's under the illusion of tax raised on smoking being a net contributor to the economy:

Every cigarette smoked costs taxpayer 6.5p think tank warns

Have you seen what she's included in her figures?

"That total includes £2.7 billion of NHS care, £2.9 billion lost in productivity during smoking breaks, the £342 million cost of cleaning up butts and £507 million spent putting out fires.

Lost productivity due to the deaths of smokers and passive smoking victims costs £4.8 billion and £2.9 billion is lost in increased absenteeism, their report - Cough Up - concluded."

Also it doesn't take into account the difference in pensions paid out to non-smokers compared with smokers, nor does it mention the increased money non-smokers take out of the system in the years they're alive that smokers aren't, from GP visits, prescriptions, old age care etc.

Lost productivity from smoking breaks ffs. Cost of putting out fires. Lost productivity due to deaths of smokers. Fuck off man, twisting the figures at its worst. The only relevant figure in that article is the £2.7Bn of NHS care, but it still doesn't compare that over the expected lifespan of the smoker against the cost to the NHS of a non-smoker over their longer lifespan so it's a bollocks article from beginning to end.

 

[offshore]

Hasn’t the nhs said the weight loss surgery will save them £59 million a year? How can that be a bad thing?