A recent study reveals medical innovation is less accessible to U.S patients than it is for their Europeans counterparts due to regulatory challenges at the U.S Food and Drugs Administration.

Conducted by Josh Makower, M.D., consulting Professor of medicine at Stanford University, CEO of ExploraMed Development and Venture Partner at NEA and Aabed Meer, an M.D.-MBA candidate at Stanford University and Lyn Denend, a Stanford University research associate; the study, which took form of a survey, gathered responses from 204 companies comparing their experiences working with the FDA to their experiences working with European authorities. As a result, only 16 percent of the respondents rated their overall experience with the FDA very good or excellent while 75 percent were very satisfied with the European process. U.S regulatory process is seen as unpredictable, inefficient, expensive and characterized by disruptions and delays. This can be viewed as discouraging for inventors who can make their products available much faster in Europe. For instance, respondents answered that seeking pre-market approval, it takes an average of 54 months in the U.S from first communication to being approved to market the device compared to an average of 11 months in Europe, for high risk devices.

These delays are reflecting on the patients as well, U.S patients wait two years longer than Europeans for the same technology such as spine, hypertension or obesity devices.

Dr. Makower precise the FDA has to make changes quickly warning that otherwise, inventors and patients will seek overseas what they cannot access in the USA, taking valuable jobs and revenues with them.

Today, the question on everyone’s lips: Is the US losing its leadership position in medical technology innovation?

Interesting to note in the below article Fortis reported that this growth rate of 30-35% per year does not include the non-resident Indians coming to the country for treatment. those statistics would be very interested to find.

The Americans are coming… for medical treatment
Published: Thursday, Nov 4, 2010, 1:14 IST
By Somita Pal | Place: Mumbai | Agency: DNA

India could soon become a prime health tourism destination for many Americans.

The Americans are increasingly visiting Mumbai for medical treatment, as healthcare facilities are cheaper, compared to the United States.

The Indian healthcare industry hopes that US president Barack Obama’s visit will fetch them goodwill and that the American government may look at some form of association.

Fortis Healthcare CEO Vishal Bali said, “There has been a 30-35% rise in American patients being treated in Mumbai per annum. And we are not including non-resident Indians. They find treatment here more affordable, and it is high quality healthcare.”

“Healthcare reforms were part of Obama’s presidential campaign. With the increasing number of Americans visiting Mumbai for affordable healthcare, the industry in India is looking forward to some form of collaboration with the US,” Bali said. Official figures show nearly five lakh Americans came here for cheap treatment in the last one year.

“A cardiac surgery in India costs a foreigner $13,000, including stay and travel. The same surgery in the US costs $55,000-$75,000. While a joint replacement surgery in India costs $9,500, in the US it costs $50,000. With the recent economic slowdown, people in developed countries like the US, are looking for better value for money, and India offers the best deals,” said Bali.

Besides, low treatment cost, availability of world-class hospitals with latest technology and skilled doctors, contribute to more foreigners visiting the country for treatment.

A senior tourism ministry official said, “Earlier, people came to India for ayurvedic treatment. The trend of foreigners coming to India for treatment has gained momentum in the last five years. With more multi-specialty hospitals coming up in the country, we are tough competition for medical hotspots like Singapore, Thailand and Malaysia.”

An American patient, Misty, who is undergoing spinal surgery at Fortis hospital at Mulund, said, “When the doctors in the US said I need to undergo spinal surgery, the only option I had was a spinal fusion surgery as disc replacement was not covered under medical insurance because I am self-employed. That’s when I thought of looking out for options, at a quality place at an affordable price. I researched on the Internet for almost six months and Fortis came up. My surgery would have cost $200,000 in the US, whereas I have paid $20,000 here, which includes travel, hospital stay and surgery cost.”

A boom in private hospitals is changing the nation’s health delivery landscape beyond recognition.

“A recent study by the Federation of Indian Chambers of Commerce and Industry—Ernst & Young shows 15-20% growth for the Indian medical equipment market. It is slated to grow from Rs9,000 crore to Rs22,500 crore by 2012. Private hospitals are taking the lead in introducing latest technological wonders. With easy access to visa facilities, medical tourism is turning out to be another potential source of income for the healthcare industry,” said the official.

http://www.dnaindia.com/india/report_the-americans-are-coming-for-medical-treatment_1461904

This is why it is extremely important for people who are assiting traveling patients to be transparent and educate patients about potential concerns. Half of the people travelling do not understand risk of infectious diseases inherent just in travel, let alone in traveling for medical care.

Contact: Jennifer Gundersen Harris
jgundersen1@partners.org
617-724-6433
Massachusetts General Hospital

Half of those travelling internationally not aware of potential health risks
More than 30 million people in the United States travel to resource-limited areas of the world each year. This global mobility may contribute to the spread of infectious diseases – such as influenza, measles, and meningitis – and may also put individual travelers at risk for malaria, typhoid, dengue fever and hepatitis. Despite these potential risks, a recent study conducted by the Division of Infectious Diseases at Massachusetts General Hospital (MGH) and published in the Journal of Travel Medicine found that 46 percent of travelers to resource-limited countries did not seek health advice or vaccinations prior to departure.

The researchers surveyed more than 1,200 international travelers departing the United States at Boston Logan International Airport. The study was the result of a broad-based collaboration between MGH, the Centers for Disease Control and Prevention (CDC), the Boston Public Health Commission, and officials from the Massachusetts Port Authority, which owns and operates Logan International Airport. Based on the results from this work, the CDC, travel medicine experts and Logan Airport officials hope to develop better tools to educate people about the public health risks associated with global travel.

Of those surveyed, 38 percent were traveling to countries described as low- and low-middle income by the World Bank’s World Development Report, yet 46 percent of those travelers did not seek health advice prior to departure. Foreign-born travelers – including those traveling to visit family and friends, and those traveling alone or for vacation – were the least likely to have researched health information. The most commonly cited reason for not pursuing health information was a lack of concern about potential health problems.

Of the 54 percent of travelers to resource-limited countries who did seek health information, the Internet was the most common source, followed by primary care practitioners (PCPs).

“These results suggest that the Internet and PCPs are two promising avenues for disseminating information about traveling safely,” says the study’s lead author Regina C. LaRocque, MD, MPH, of MGH’s Division of Infectious Diseases. “Offering online resources at the time of ticket purchase or through popular travel websites would likely reach a large audience of people in need of health advice.”

The rapid global spread of Severe Acute Respiratory Syndrome (SARS) in 2002-2003 and new influenza strains in 2009 exemplified the role played by travelers in disseminating infectious diseases. More recently, dengue fever – a tropical disease found mainly in the Caribbean, Latin America and Asia – has been reported in the southern United States. In India, an epidemic of Chikungunya – a viral infection characterized by fever, headache, weakness and joint pain – was spread to Italy by travelers.

“International travel is the primary way many infections traverse the world,” says Edward Ryan, MD, director of the Tropical and Geographic Medicine Center in the Division of Infectious Diseases at MGH and a senior author of the study. “What many people don’t realize is that, without seeking the correct health information, they are putting themselves at increased risk of infection, as well as creating a public health risk in their home communities after they return.”

###

This study was funded by CDC grants aimed at gathering demographic data on international travelers. Additional ongoing research on U.S. international travelers is being conducted through the Global TravEpiNet, a consortium of travel clinics coordinated by MGH that is focused on improving research and health information regarding international travel.

Ryan is an associate professor and LaRocque an assistant professor of Medicine at Harvard Medical School. Additional authors of the Journal of Travel Medicine study are Sowmya R. Rao, PhD, Athe Tsibris, MD, and Thomas Lawton of the Massachusetts General Hospital; M. Anita Barry, MD, MPH, of the Boston Public Health Commission; and Nina Marano, DVM, MPH, Gary Brunette, MD, and Emad Yanni, MD, of the Centers for Disease Control and Prevention.

Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $600 million. The hospital is home to major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, photomedicine, regenerative medicine, systems biology, transplantation biology.

http://www.eurekalert.org/pub_releases/2010-11/mgh-hot110310.php

Johns Hopkins Medicine has signed an agreement to open the first private, four-year medical school and teaching hospital in Malaysia in the Baltimore-based health system’s latest effort to expand its reach overseas.

Executives from Hopkins signed an agreement with a Malaysian partner Tuesday during a ceremony attended by U.S. Secretary of State Hillary Clinton in the capital, Kuala Lumpur.

Hopkins will act largely in a consultative and advisory role to the Perdana University Graduate School of Medicine and Perdana University Hospital, but will have “significant control over the content and quality of the education delivered,” Mohan Chellappa, president of global ventures for Johns Hopkins Medicine International, said in an e-mail.

While Malaysia has public medical schools, this will be the first four-year medical school based on the North American model, Hopkins executives said. The Hopkins name will be on the banner of the school and hospital. The venture also will largely follow the Hopkins operational model.

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Hopkins has been expanding its international footprint in recent years. It is involved in partnerships that include managing hospitals and providing clinical consulting in countries such as Turkey, Lebanon, Japan, Chile, Mexico, Panama and the United Arab Emirates.

Chellappa said the international growth is part of the institution’s mission to bring knowledge to the world. “It also is important to be involved globally to keep one’s leading position in the USA,” Chellappa said.

The international medical landscape has become more competitive as health care overseas has improved and people can travel to nearby countries for care if it’s unavailable where they live, experts said. So-called “medical tourism” to the United States also dried up after the Sept. 11 terrorist attacks. Hospitals in turn have been trying to better build their name recognition with partnerships overseas.

“Many of the services are now available closer to home and people don’t have to travel across the world,” said Renee-Marie Stephano, president of the Medical Tourism Association. “Hospitals have to strengthen their brand.”

Hopkins chose Malaysia because it is an English-speaking country that’s emerging as the education hub of Asia, Chellappa said. The government wants to train doctors to improve local health care and keep their brightest students from leaving the country.

The new medical school is expected to open during the fall of 2011 and enroll about 100 students its first year. The students will be predominantly Malaysian, although there will be a mix of international students.

Hopkins will develop education programs and help in the design of the campus. It also will take part in clinical affairs. The institution will guide academic development of certain curricula and consult on the teaching environment and infrastructure, pedagogy, administration and student affairs.

The 600-bed teaching hospital will include ambulatory care facilities, diagnostic capabilities and ancillary support services. Hopkins will provide advice on design and development of the hospital.

Hopkins is partnering with Academic Medical Centre Sdn Bhd, a subsidiary of Chase Perdana Sdn Bhd, a Kuala Lumpur-based private development corporation, and an associate company of Turiya Sdn Bhd. Various Hopkins entities will be involved in the project, including the university, the medical school and the international medicine division.

andrea.walker@baltsun.com

http://www.baltimoresun.com/health/bs-bz-hopkins-malaysia-hospital-20101102,0,2928536.story

Acreditación mundial, reto para aumentar los dividendos
Turismo de salud deja frutos

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La red de servicios de salud de Medellín, número uno de Latinoamérica, cuenta con 2.800 camas hospitalarias, 1.800 médicos y odontólogos especializados.
Medellín avanza a la par que importantes ciudades del mundo para atraer más turismo de salud. Sólo en el último año ingresaron 4.700 turistas extranjeros a la ciudad, con el fin exclusivo de realizarse tratamientos médicos

Acciones como la creación del Cluster de Servicios de Medicina y Odontología y su promoción a nivel internacional, con el que se busca aumentar el flujo de turistas de salud que llegan a la ciudad y por consiguiente las ganancias por este concepto que el año anterior sumaron US$6,3 millones.

Los turistas de salud que llegan a Medellín provienen en su mayoría de Estados Unidos, República Dominicana, Aruba, Curazao, España, Venezuela, Panamá y Canadá.

La ciudad incluso supera en algunos aspectos a instituciones reconocidas y pioneras en el tema a nivel mundial, como el Children’s Hospital de Boston, debido a la asociatividad de las instituciones prestadoras de salud y la cadena turística.

En el Children`s Hospital por ejemplo, desde hace 100 años se incursionó en el tema de prestar servicios de salud a extranjeros, sin embargo hasta hace sólo 12 años creó un departamento dedicado al tema.

En cambio Medellín, con menos historial de atención a pacientes internacionales, cuenta desde hace un par de años con el Cluster Servicios de Medicina y Odontología, con orientaciones para las instituciones que quieren hacer parte del tema de turismo en salud, que van desde avances médicos hasta planes de promoción internacional.

El cluster, conformado por 32 clínicas, hospitales, centros odontológicos y facultades de medicina acreditadas de Medellín, tiene alianza con la Asociación de Turismo Medico MTA y el respaldo de la Alcaldía de Medellín, la Cámara de Comercio y Proantioquia.

Con la unión de estas entidades, el siguiente paso es la acreditación internacional y la atención integral del paciente. “El hecho de que nos unamos, tengamos claro puntos para la atención integral o sea, atención desde que se baja del avión hasta que regresa a su país, además se la certificación nos da ventajas a nivel mundial” señaló Mateo Jaramillo director del cluster de salud de Medellín.

Al respecto Pamela Frank, directora del departamento médico internacional del hospital infantil de Boston, Estados Unidos, comentó que Medellín “tienen una ventaja que nosotros (Children’s Hospital) no tenemos y en la que apenas ahora se está empezando a trabajar y es la creación de un plan estratégico que incluya a toda la ciudad, y que esté enfocada en la atención integral del paciente”.

Frank, conoció el proceso de acreditación e internacionalización de la salud, la semana anterior con motivo del Simposio Internacional de Exportación de Servicios de Salud, resaltó la importancia de este tipo de eventos que buscan que toda la ciudad se una en el mismo tema
La directora confesó que incluso el 55% de los requisitos que tienen los hospitales de Medellín para el tema de internacionalización, no se cumplen en la mayoría de los hospitales norteamericanos.

La ciudad en el mundo
Precisamente este trabajo que se adelanta en la ciudad le valió el primer puesto entre los sistemas de salud de Latinoamérica, superando a países como Brasil, México y Costa Rica, quienes iniciaron el proceso con mayor antelación.

Los requisitos que deben cumplir las instituciones de salud para pertenecer al cluster son: tener antecedentes de atención de turistas e salud, contar con atención integral del paciente, relacionamiento con otras instituciones en el mundo, tener responsabilidad social, plan de internacionalización, página web bilingüe, acreditación internacional, oficina de atención a pacientes internacionales y contar con profesionales bilingües.