Biosimilaires et facteurs médico-économiques

Although few molecules are available, annual total sales of biotechnology drugs amounted 71 billion $ in 2008) and knew a 17% progression per year. As traditional drugs had their generic, many biotechnology drugs had or will lose their patent and be copied, called “biosimilars” or “follows-on”. According to the economic impact of biotechnology drugs, the availability of biosimilars may result in great reduction of drugs expenditure. In 2004, EMEA has set up specific rules for biosimilars, distinct from those applied to generic drugs, based on clinical research requirement and post-authorization follow-up of these drugs, and then significantly impacting on their costs of research, development and marketing. The economy generated by the availability of biosimilars should be lower than expected, even null, contrasting with those usually generated by generics. In order to better understand the medico-economic factors related to biosimilars availability, this article will described the market of the biotechnology drugs. The differences existing between generics and biosimilars and their impact on costs will be presented. Finally, it will focus on the factors that may facilitate or limit the biosimilars development and their substitution.     

Le poids des contraintes économiques dans les choix alimentaires

Long term trends in food consumption highlight the impact of economic factors on food choices. In France, as in other industrialized countries, consumption has evolved first through a quantitative increase in the consumption of the cheapest foods, and then through a qualitative change in the structure of the diet, reflecting a shift from cheap vegetable products to animal products, fat and sugar. This nutritional transition is now followed by a steady stage during which the macronutrient structure of the diet remains stable. The changes in food prices, in particular those of staple foods, played a prominent role in this evolution. These changes have had large positive effects, however they had as well less desirable consequences, among which nutritional inequalities, obesity and nutrition-related degenerative diseases are the most visible.     

Major interregional differences in France of COVID-19 hospitalization and mortality from January to June 2020

IntroductionEven though France was severely hit by the COVID-19 pandemic, few studies have addressed the dynamics of the first wave on an exhaustive, nationwide basis. We aimed to describe the geographic and temporal distribution of COVID-19 hospitalisations and in-hospital mortality in France during the first epidemic wave, from January to June 2020.MethodsThis retrospective cohort study used the French national database for all acute care hospital admissions (PMSI). Contiguous stays were assembled into “care sequences” for analysis so as to limit bias when estimating incidence and mortality. The incidence rate and its evolution, mortality and hospitalized case fatality rates (HCFR) were compared between geographic areas. Correlations between incidence, mortality, and HCFR were analyzed.ResultsDuring the first epidemic wave, 98,366 COVID-19 patients were hospitalized (incidence rate of 146.7/100,000 inhabitants), of whom 18.8% died. The median age was 71 years, the male/female ratio was 1.16, and 26.2% of patients required critical care. The Paris area and the North-East region were the first and most severely hit areas. A rapid increase of incidence and mortality within 4 weeks was followed by a slow decrease over 10 weeks. HCFRs decreased during the study period, and correlated positively with incidence and mortality rates.DiscussionBy detailing the geographical and temporal evolution of the COVID-19 epidemic in France, this study revealed major interregional differences, which were otherwise undetectable in global analyses. The precision afforded should help to understand the dynamics of future epidemic waves.