Thanks BaulklikeGresh, Good comment thanks, however I think that...

Thanks BaulklikeGresh,

Good comment thanks, however I think that this is perhaps a little bit different.

Doctors certainly can be very conservative, and slow to change their prescription habits, and red tape can be a problem everywhere.

Pentrox, as I understand it from a brief discussion with my GP, has a bit of a bad history…kidney and liver damage etc., and I imagine getting it authorised for paramedic use in ambulances across 30 different countries would be a nightmare.

Nevertheless, it’s a fair point that you make.

I’m taking a slightly more optimistic view of things, along these lines:

In Western Europe, Scandinavia, North America, Oceania, and Japan (and excluding everywhere else), about 150,000,000 people have visited their GP, and, after tests, MRIs, X-rays, or specialist referrals, been given a diagnosis of arthritis of one kind or another, along with the following message.

‘You have arthritis, if you lose some weight, that might slow down the progression, but otherwise there’s absolutely nothing we can offer you. There is no treatment for arthritis, and no cure, but if the pain gets unbearable we can give you opioids. You may need a TKR, or a THR, but, even then, the arthritis will probably recur in another area of your body. Very sorry about that“

That’s pretty much it.

If all continues to go well, PAR will turn this on its head, and doctors will have an easy, cheap, safe, prescription option to offer their patients, that will not only reduce pain, but, potentially, offer the possibility of a ‘cure’, i.e. reversing existing bone damage, and cartilage loss.

There’s a huge difference, in my view, between convincing doctors to switch from one prescription drug, with which they’re completely familiar, to a different one, which is entirely new to them, and offering those doctors a cheap, safe, effective, drug to address a condition for which hitherto there was no treatment at all.

PPS is a well-established medication, with which most doctors are already somewhat familiar, and the identical drug in its injectable format (iPPS) is already authorised for use in Germany, and several other countries. Nobody’s suggesting that it will be an OTC medication (although it is in Italy), or that paramedics will be using it in ambulances, as per Pentrox.

I’m sure you right in suggesting that the various countries with the EU will each be working to their individual timelines, but my view is that once there is a safe, authorised, and legitimate treatment for arthritis in, say, Germany, the pressure on the regulatory agencies in other European countries will become irresistible. This logic will apply also in North America and elsewhere imo.

So, on reflection, I’m not uncomfortable with a prediction that within say 3-4 years, subject to regulatory fast tracking, and no left field surprises, iPPS should be able to reach a 1% - 2% share of the ‘arthritis pool’, (with the other 98% sadly continuing to receive no treatment at all).