Terrifying Reason The UnitedStates Just Approved a Drug For an Eradicated Disease

The report, distributed in June, said that the re-production of known pathogenic infections like smallpox utilizing the procedures of engineered science ought to be of the “most elevated worry” for the US.


The Food and Drug Administration (FDA) reported on July 13 that it had out of the blue affirmed a medication that could treat smallpox on the off chance that it were ever discharged as a weapon in a fear monger assault. The solution is called TPOXX (tecovirimat).

“To address the danger of bioterrorism, Congress has found a way to empower the improvement and endorsement of countermeasures to frustrate pathogens that could be utilized as weapons,” FDA Commissioner Scott Gottlieb said in an announcement.

“The present endorsement gives an imperative turning point in these endeavors. This new treatment bears us an extra alternative should smallpox ever be utilized as a bioweapon.”

The potential release of smallpox as a weapon is an extremely concerning scenario; many experts think that a weaponised form of disease is one of the biggest risks humanity faces.

The world isn’t prepared for that probability, nor is it prepared to react to a pandemic sickness that happens normally. That implies it’s conceivable that some kind of lethal pathogen – likely an infection – could spread far and wide.

As Bill Gates said in a recent talk, world governments are ill prepared for these sorts of scenarios.

“In the case of biological threats, that sense of urgency is lacking,” Gates said. “The world needs to prepare for pandemics in the same serious way it prepares for war.”

The return of smallpox

There are good reasons to be concerned about a potential smallpox release.

In theory, only two labs in the world are authorised to possess the variola virus: the CDC in Atlanta, and the State Research Center of Virology and Biotechnology in Russia.

But more samples of the virus may be out there. In 2014, vials containing smallpox were found in a cold storage room of an FDA lab at the National Institutes of Health’s campus in Bethesda, Maryland.

The possibility of an accidental release from that kind of forgotten sample is remote but real.

More concerning is the fact that researchers think it wouldn’t be difficult for an ill-intentioned actor to create a version of the smallpox virus – even a more dangerous one – in a lab.

Since smallpox has been “destroyed”, the vast majority never again get an immunization, which means most by far of the world would be helpless against a flare-up.

The Department of Defense as of late appointed a provide details regarding guard against organic weapons from the National Academy of Sciences, Engineering, and Medicine.

The report, distributed in June, said that the re-production of known pathogenic infections like smallpox utilizing the procedures of engineered science ought to be of the “most elevated worry” for the US.

“The US government should give careful consideration to this quickly advancing field, similarly as it did to propels in science and material science amid the Cold War period,” Michael Imperiale, an educator of Microbiology and Immunology at the University of Michigan and the seat of the council that composed the report, said in an announcement.

Last year, a Canadian researcher studying synthetic biology demonstrated that it was possible to create pox viruses related to smallpox from scratch using genetic material purchased through the mail.

Doing that cost the researcher US$100,000 and “did not require exceptional biochemical knowledge or skills, significant funds, or significant time,” according to a World Health Organisation report.

Specialists depend on something beyond [information] for medicinal basic leadership

This instinct assumes a significantly more grounded part amid the main day or two of a patient’s healing center stay, when the measure of information specialists have on patients is not exactly on resulting days.

Numerous innovation organizations are taking a shot at man-made brainpower frameworks that can dissect medicinal information to encourage analyze or treat medical issues. Such frameworks bring up the issue of whether this sort of innovation can execute and additionally a human specialist.

Another investigation from MIT PC researchers proposes that human specialists give a measurement that, so far, man-made reasoning does not. By breaking down specialists’ composed notes on emergency unit, the analysts found that the specialists’ “premonitions” about a specific patient’s condition assumed a huge part in deciding what number of tests they requested for the patient.

“There’s something about a specialist’s involvement, and their long stretches of preparing and practice, that enables them to know in a more thorough sense, past simply the rundown of manifestations, regardless of whether you’re doing great or you’re not,” says Mohammad Ghassemi, an examination offshoot at MIT’s Institute for Medical Engineering and Science (IMES). “They’re taking advantage of something that the machine may not see.”

This instinct assumes a significantly more grounded part amid the main day or two of a patient’s healing center stay, when the measure of information specialists have on patients is not exactly on resulting days.

Ghassemi and software engineering graduate understudy Tuka Alhanai are the lead creators of the paper, which will be introduced at the IEEE Engineering in Medicine and Biology Society meeting on July 20. Other MIT creators of the paper are Jesse Raffa, an IMES inquire about researcher, and Roger Mark, a teacher of wellbeing sciences and innovation and of electrical building and software engineering. Shamim Nemati and Falgun Chokshi of Emory University are additionally creators of the examination.

The most effective method to quantify emotions

Specialists consider an enormous number of elements — including indications, seriousness of ailment, family history, and way of life propensities — when choosing what sorts of exams to arrange for their patients. Notwithstanding those elements, Ghassemi, Alhanai, and their partners pondered whether a specialist’s “hunches” about a patient additionally assumes a part in their basic leadership.

“That premonition is most likely educated by a background marked by encounter that specialists have,” Ghassemi says. “It’s similar to how when I was a child, my mother could simply take a gander at me and tell that I had accomplished something incorrectly. That is not a direct result of something mysterious, but rather in light of the fact that she had so much experience managing me when I had accomplished something incorrectly that a basic look had a few information in it.”

To attempt to uncover whether this sort of instinct assumes a part in specialists’ choices, the scientists performed opinion examination of specialists’ composed notes. Conclusion examination, which is frequently utilized for measuring purchaser states of mind, depends on PC calculations that look at composed dialect and count positive or negative estimations related with words utilized as a part of the content.

The specialists played out their investigation on the MIMIC database, an accumulation of restorative records from 60,000 ICU patients admitted to Beth Israel Deaconess Medical Center in Boston over a 10-year time span. This database incorporates specialists’ notes on the patients and also seriousness of sickness, indicative imaging exams, and a few different components.

The specialists needed to figure out what, on the off chance that anything, the specialists’ notes included best of the data accessible in the therapeutic records. They processed assumption scores from the notes to check whether there was any connection with what number of symptomatic imaging tests the specialists requested for patients.

In the event that restorative information alone was driving specialists’ choices, at that point opinion would not have any connection with the quantity of tests requested. Notwithstanding, the specialists found that when they represented every single other factor, the specialists’ estimations did to be sure help foresee what number of tests they would arrange. This impact was most grounded toward the start of a patient’s clinic stay, when specialists had less therapeutic data to go on, and after that declined as time passed by.

They additionally found that when specialists felt more negative about a patient’s condition, they requested all the more testing, yet just up to a specific point. On the off chance that they felt contrarily about the patient’s condition, they requested less tests.

“Unmistakably the doctors are utilizing something that isn’t in the information to drive some portion of their basic leadership,” Alhanai says. “What’s essential is that a portion of those concealed impacts are reflected by their slant.”

Nostalgic machines

Next, the scientists want to take in more about exactly what factors add to specialists’ premonitions. That could conceivably prompt the improvement of computerized reasoning frameworks that could figure out how to consolidate a similar data that specialists are utilizing to assess patients.

“The inquiry is, would you be able to get the machine to accomplish something to that effect? It would be extremely fascinating to train the machine to rough what the specialist encodes in their assessment by utilizing information not as of now caught by electronic wellbeing frameworks, for example, their discourse,” Alhanai says.

The exploration was financed by the National Institutes of Health (NIH) Neuroimaging Training Grant, the Abu Dhabi Education Council, the NIH Critical Care Informatics Grant, and the NIH Research Resource for Complex Physiologic Signals Grant.

4 Things We Now Know About [Treatment] Resistant Depression

Imagine being depressed and trying medication after medication—only to find none work. That’s the plight of people with treatment-resistant depression. We look at this little-understood condition, and how researchers are working to crack its code.

For many people coping with major depressive disorder—which includes different types of depression that persist for at least two weeks—antidepressants can play an invaluable role in helping relieve symptoms, enabling them to resume the life they once enjoyed. But for those who experience a form known as treatment-resistant depression (TRD), standard medications tend to provide little to no relief.

The disorder isn’t rare: Up to one-third of adults with major depression battle symptoms—such as persistent feelings of sadness, sleep disturbances, low energy and thoughts of death or suicide—that don’t respond to treatment.

“In spite of the fact that there is some difference with respect to how to characterize treatment-safe despondency, a patient is by and large considered to have it if the individual hasn’t reacted to satisfactory measurements of two unique antidepressants taken for an adequate span of time, which is normally a month and a half,” clarifies Jaskaran Singh, M.D Senior Director of Neuroscience, Janssen Pharmaceuticals, some portion of the Johnson and Johnson group of organizations.

While there’s still much to learn, several recent and promising advances are shedding new light on how to understand and manage TRD. Recently, for Mental Health Month, we highlighted some of the most important findings—and why there may be new hope for people who’ve been living with the disorder for far too long.

Your age, gender and health status may increase your risk for treatment-resistant depression.

There’s no way to predict for sure who with depression will be unresponsive to treatment, but researchers have observed that certain populations are more vulnerable than others. Women and senior citizens, for example, seem to experience TRD at higher rates, for reasons that are likely both biological and psychological. Individuals who endure severe or frequently recurring bouts of depression also appear to be more susceptible.


A depressed person’s overall health can also play a role.

“Patients with depression who have some medical illnesses—such as thyroid disease and chronic pain—are at greater risk for TRD,” says Alexander Papp, M.D., a psychiatrist at UC San Diego Health.

Other conditions associated with TRD include substance abuse and eating and sleep disorders, which have the potential to make you more prone to being resistant to treatment with antidepressants.

Depression may have causes we don’t yet understand—which may be why antidepressants don’t work for everyone.

While the science of sadness is still to a great extent a secret, the most prevalent hypothesis is that it’s caused by low cerebrum levels of such neurotransmitters as serotonin and norepinephrine, which are related with sentiments of satisfaction and prosperity. In any case, late research recommends that these neurotransmitters may not be the solitary guilty party—so antidepressants, which work to expand serotonin or norepinephrine levels, may not be a one-estimate fits-all treatment.

“One of the more present day speculations is that discouragement makes irritation in the mind, or that aggravation in the cerebrum makes sorrow,” Dr. Papp says. “Customary antidepressants just influence neurotransmitters, so this might be the reason a few patients don’t react to them.”

Regardless of whether this ends up being valid, what we do know is there’s still no ensured settle for the issue—which can be baffling for the two patients and their friends and family.

“When I had a clinical practice, I saw numerous patients with treatment-safe gloom who disclosed to me that loved ones trusted they favored being discouraged, or weren’t making enough of an effort to enhance, on the grounds that their antidepressants weren’t working,” Dr. Singh says. “This isn’t about an absence of inspiration. I’ve never met a patient who would not like to improve.”

There are established methods for managing treatment-resistant depression.

While the words “treatment-resistant” might seem synonymous with “no hope,” the reality is that tools do currently exist to help people with TRD. A 2012 study published in the journal Patient Preference and Adherence identified five main treatment strategies—optimization, switching, combination, augmentation and somatic therapies—that psychiatrists can use to create a personalized plan for patients.

Improvement, for example, implies that “a few people with TRD may profit essentially from giving their upper more opportunity to work or by taking a bigger measurements,” Dr. Papp says.

For others, changing to an alternate class of upper—or adding one to the present treatment for a consolidated approach—may prompt reduction. Also, growth may include utilizing pharmaceuticals that were produced for different utilizations, however that have since been endorsed for the treatment of TRD.

There are additionally physical (nondrug) treatments, including transcranial attractive incitement—which targets nerve cells in the district of the cerebrum associated with mind-set control and gloom—and electroconvulsive treatment (ECT), which prompts changes in mind science to help turn around side effects of TRD.

ECT—which individuals regularly allude to erroneously as “electroshock treatment”— “is exceptionally trashed, to a great extent because of how it was depicted in the motion picture One Flew Over the Cuckoo’s Nest,” Dr. Singh says. In any case, the system is significantly more secure and more bearable today, he notes, and regularly saved for individuals with extreme, tranquilize safe discouragement. “It’s not for everybody, but rather it might be powerful in 70 to 80% of patients,” he includes.

Life science industry with Digital Technology (Rebooting)

Digital technology is connecting genetic information with real world data and companies are already combining drugs, advanced application devices, and apps to be more patient-centric.

Digital technology has been driving change throughout the life science industry for years, however the sector is currently standing on the precipice of revolutionary development – some organizations have already taken the jump towards a more digital future.

Data collection and visualization for decision making to improve the overall performance of themanufacturing supply chain is a huge opportunity for the life science industry, however it’s not about being new – it’s about using proven solutions andapproaches to decision making to improve quality, reliability and reducing waste.

Businesses across the life science industry have been collecting data using large historian systems for years. Many currently have so much data arising from different sources it can be hard to focus on what is important. Right now, almost every device in a GMP manufacturing facility collects data and our clients have been completing projects to physically connect all these devices and systems for many years. The drive to physically connect the systems has come from many strategic objectives, including serialization.

All this excellent work has put the industry in a great position to use the data it is currently collecting in the best possible way.Although the robotics and automotive industries may be in a better position to use Artificial Intelligence (AI) and self-learning systems to improve manufacturing in efforts linked to Industry 4.0 – the life science industry has been using data and evidence to improve its manufacturing for nearly forty years.


New tools and processes are emerging that can enable smart, decentralized production, with intelligent factories, integrated IT systems, the Internet of Things (IoT), and flexible, highly integrated manufacturing systems. In addition, future developments may mean that machine learning algorithms will be able to quickly adjust manufacturing lines and production scheduling. New developments will also pave the way for predictive maintenance and the opportunity to identify and correct issues before they happen.

Integrating with single use systems
The adoption of single-use technologies, such as single-use bioreactors and other unit operations is on the rise. Fueled by the growing pipeline of high potency and biological drugs and coinciding with the growth in personalized medicine and its inherent need for smaller batches, single-use technology will play an increasingly important role in the coming years.

Both upstream and downstream manufacturing processes benefit from single-use systems. During this manufacturing method the biopharma process system is disposed of after use as opposed to being cleaned, enabling quick set up while reducing cleaning and validation need.

Currently,the integration of manufacturing execution system (MES) solutions with start-to-finish technologies and single-use manufacturing platforms is helping the industry to deploy biopharmaceutical manufacturing with increased productivity and efficiency.The upshot is that manufacturers can significantly reduce the time-to-market for new products.

Single-use components are also an enabling technology for smaller scale production of biopharmaceuticals, including antibodies, proteins, vaccines and cell therapies, which would otherwise be much more difficult to produce. Increased productivity and efficiency are also a necessity when it comes to manufacturing smaller batches and a wider range of product. In this environment, single-use technology will naturally flourish as a simple, cost-effective solution.

Digital manufacturing
The first steps towards fully connected, self-optimizing production processes have been taken – the advent of digital manufacturing is on the horizon. Enterprise Manufacturing Intelligence (MI) involves accessing more meaningful data to give a better, more holistic view of operations and allowing for improved analytics and real-time responsive decision-making to drive continuous improvement.

Access to this data, or Big data, also allows for the creation of digital twins. A digital twin can be made up of data captured from the entireend-to-end manufacturing process of a product – this twin can then be used to find invaluable insights. Extension of the traditional ‘golden batch’, where data was very much process control-based, will be supplemented and surrounded with environmental data, raw material data, training data and any other digital data available that goes towards influencing the golden batch.

With this digital information available across multiple
Sites, batches and suppliers, sophisticated analytics can provide a digital twin that best represents the golden batch and alerts controllers to any problems based on these specific data sets.

Patient centricity
Digital technology is connecting genetic information with real world data and companies are already combining drugs, advanced application devices, and apps to be more patient-centric. This push towards customized medicines solutions, driven by technological advances and pressure from patients who want to be more involved in their own care, will take the market in new directions.

The impact on the market, and more notably manufacturers, is that there will be a growing demand for smaller batches which will highlight any inflexibility in a manufacturer’s supply chain.

The propagation of product variants and smaller batch sizes will mean that launch approaches, process technologies and validation concepts will need to be overhauled.

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Why it’s good for your health to be outdoors

Referencing a study where students who spent time in the forest had lower levels of inflammation than those who spent time in the city.

Sure, there are treadmills at climate-controlled gyms and Nintendo’s Wii is still going strong with indoor workouts like Zumba Fitness 2.

And yet, old-fashioned advice to “go outside and play” is still the best for your health, according to researchers the world over. In one study published by the NCBI, researchers found a decrease in both heart rate and cortisol levels when participants spent time in the forest instead of the city.

“Stressful states can be relieved by forest therapy,” the researchers concluded.

The encouragement to “get outdoors” for health holds even in the face of the Asthma and Allergy Foundation of America’s assertion that pollen seasons have gotten stronger and longer over the years. The workaround: the AAFA recommended limiting outdoor activities, but only on days when pollen is high for the trees or grasses you are allergic to.

Being outside delivers other health rewards, too, from sharp mental health benefits to improved memory and decreased inflammation.

Here are four of the most significant health benefits from spending time outdoors, according to Business Insider:

Walking in the woods can improve your short-term memory.

“Nature walks have memory-promoting effects that other walks don’t,” BI noted, citing a study where participants who walked among trees did 20 percent better on a memory test than those who had taken in city sights.

Outdoor experiences can fight depression and anxiety.

Time in nature may combat depression, anxiety and other mental health issues, especially when combined with exercise.

One study associated walks in the forest with decreased levels of anxiety and bad moods while another found outdoor walks could be “useful clinically as a supplement to existing treatments” for major depressive disorder, BI reported.

Being outdoors has a demonstrated de-stressing effect.

One study published by NCBI found that students sent into the forest for two nights had lower levels of the stress marker cortisol than those who spent that time in a city.

Spending time outside reduces inflammation.

Inflammation in overdrive is associated with ills that include autoimmune disorders, inflammatory bowel disease, depression and cancer. “Spending time in nature may be one way to help keep that in check,” BI noted, referencing a study where students who spent time in the forest had lower levels of inflammation than those who spent time in the city.

More at https://on-ajc.com/2uDKqPT

Health grant to help AU study on how blood pressure impacts cognition

Which specific interneuron subtype drives neuronal response in the face of cardiovascular disease, suspecting it instead drives neuronal activity upward.

High blood pressure puts a squeeze on blood vessels in the brain that can disrupt a protective process that works to balance blood flow to the brain with the activity of resting neurons. When blood flow decreases due to hypertension, astrocytes – neuron-nurturing brain cells – may instead tell neurons to increase their activity, Filosa said.

The miscommunication between the brain blood vessels, astrocytes and neurons could be an early factor in how high blood pressure can impair cognitive function, according to Filosa.

“Untreated hypertension can lead to cognitive impairment but exactly how it happens, we don’t really know,” she said. “We need to understand the window of change or shift in function in all these different cells. By the time patients are symptomatic, a lot of the physiology of the vasculature has deteriorated so the question is: How can we diagnose impairments in vascular function way before that, years before cognitive impairments are established and become symptomatic.”

Filosa is hoping the grant will help her to find answers.

Regulation of blood flow is a normal body function, especially in the brain which doesn’t like extreme changes in blood flow. For example, large increases in flow can result in swelling, especially if blood pressure also rises. Lower pressure and decreased blood flow mean less energy for neurons which require a continuous stream of oxygen and nutrients found in blood to function.

“Neurons don’t have energy reserves so their activity is dependent on continuous blood flow,” said Filosa.

This is why brain cells can die quickly in the event of a stroke or head trauma, and why they likely do not function well with chronic hypertension.

High blood pressure also causes the parenchymal arterioles that carry blood for neurons constrict, so less blood is carried. Astrocytes then sense the increased pressure, and it appears to trigger an increase in calcium inside the astrocytes cells. Researchers believe this calcium increase causes increased constriction of blood vessels and promotes inflammation. One of the research goals is to find out what then happens to the neurons.

“A lot of these things get activated as a protective mechanism, but chronically they can shift into being more deleterious,” Filosa said.

The researchers will look at how a healthy balance occurs and what hypertension does to it. They will look at what happens to calcium levels in astrocytes in response to various blood pressure levels in the brains of booth normal mice and those that have impaired blood flow, and what mediates any change. They will also look at “which specific interneuron subtype drives neuronal response in the face of cardiovascular disease, suspecting it instead drives neuronal activity upward,” according to the release.

UK-US post-Brexit trade deal risks increased drug prices

US-UK bilateral trade deal is a key post-Brexit priority, with conversations already taking place to achieve this.

A trade deal between the UK and USA could risk increasing drug prices in the UK, which could diminish the affordability and accessibility of the NHS, according to a Viewpoint published in The Lancet.

The opinion piece outlines how the USA’s targeting of so-called ‘foreign free-riding’ in trade deals could lead to a poor deal on pharmaceuticals for the UK post-Brexit. The authors raise concerns that the USA could pressure the UK to change the way it regulates pharmaceuticals in trade deals.

Currently, all of the UK’s international trade deals are negotiated through the European Union, but, the UK Government will need to negotiate new deals to replace existing agreements post-Brexit. The USA is one of the UK’s most important trading partners after the rest of the European Union, and a US-UK bilateral trade deal is a key post-Brexit priority, with conversations already taking place to achieve this.

US policies to reduce ‘foreign free-riding’

American drug prices are some of the highest in the world, leading to economic hardship and poorer health outcomes for uninsured Americans and those who cannot afford to pay out-of-pocket. The US Government does not negotiate drug prices, and Medicare is prohibited by law from doing so. In addition, the Affordable Care Act prevents the US Food and Drug Administration and the Secretary of Health and Human Services from basing drug approval decisions on cost-effectiveness.

By contrast, similar drugs are often significantly cheaper in the UK, where the Government negotiates prices with pharmaceutical companies via the Pharmaceutical Price Regulation Scheme, and the NHS makes purchases based on clinical and cost-effectiveness assessments from the UK’s National Institute for Health and Care Excellence (NICE).

In May 2018, the US Department of Health and Human Services introduced the American Patients First blueprint, outlining measures to reduce US drug prices which include putting pressure on other countries to allow drug prices to rise in their jurisdictions. Unveiling the new policy, President Trump stated that “as we demand fairness for American patients at home, we will also demand fairness overseas. When foreign governments extort unreasonably low prices from US pharmaceutical companies, Americans have to pay more to subsidise the enormous cost of research and development”.

The Trump administration blueprint criticises single-payer healthcare systems which impose drug price controls, and accuses foreign governments of not paying their fair share of research and development costs to bring innovative drugs to market – proposing that other nations ‘free-ride’ off of American investment in drug development.

However, the Viewpoint authors argue that this interpretation overlooks the high cost of drugs for patients, and that drugs should be priced in line with how much benefit they give. They raise concerns that, rather than tackling the inherent issues of funding drug development, American Patients First instead represents the interests of pharmaceutical companies and their stakeholders, aiming to maintain or increase revenues.

“American Patients First is an attempt by the Trump Administration to make the USA’s drug pricing problem everybody else’s problem,” says lead author Dr Holly Jarman, University of Michigan, USA. “By shifting the economic, political, and social costs of policies made in the USA onto America’s trading partners, the Trump Administration is attempting to show voters that they are doing something about high drug prices while providing benefits to pharmaceutical companies and sympathetic campaign donors.” [1]

Potential effects for the UK post-Brexit

With the American Patients First policy and a turn towards protectionist, pro-American trade deals, the authors believe that the USA will push to alter drug regulation in future trade negotiations with the UK. This raises concerns because the ability to enter into trade deals is an executive power in the UK.

One of the authors, Professor Tamara Hervey, University of Sheffield, UK, points out: “While deals have to be ratified by Parliament, Parliament cannot amend the agreement that the Government negotiates, or be directly involved as the negotiation takes place. In addition, health groups are rarely consulted on trade deals, and Parliament and other health-focused stakeholders have limited opportunities to hold the Government to account in its trade negotiations.”

This is also exacerbated by the Brexit process. The Trade Bill introduced this year – if passed into law – could further limit parliamentary and public scrutiny of US-UK trade deals.

In addition, until recently the UK did not have a fully functioning trade ministry capable of complex negotiations with a highly experienced country like the USA. The authors say that the UK is unlikely to get a better deal with the USA than it has as part of the European Union, as the UK market is much smaller than the whole of the EU, meaning the UK has less bargaining power in negotiations.

Lastly, the authors raise concerns that pharmaceuticals will be one part of a wider trade agreement between the UK and USA, and could be an area that the UK compromises on to ensure better deals elsewhere.

“Perhaps the ultimate issue is the extent to which UK politicians are willing to defend the existing regulatory regime in the context of risks to their political careers,” says Professor Martin McKee, one of the authors from the London School of Hygiene & Tropical Medicine, and member of the advisory board of Healthier In (an NGO which campaigned to remain in the EU).

He continues: “In view of President Trump’s recent trade policy actions, policy makers should take the administration’s argument over drug prices very seriously. The UK health policy community should press the UK Government to make clear to the public and to the USA that they are not willing to bring the UK’s drug pricing and evaluation regime to the negotiating table in any future UK-US trade talks.”

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