̽��ֱ�� of Cambridge - healthcare

Play 'humanises' paediatric care and should be key feature of a child-friendly NHS – report

tdk25 — Mon, 31 Mar 2025 10:01:53 +0000

Play should be a core feature of children’s healthcare in forthcoming plans for the future of the NHS, according to a new report which argues that play ‘humanises’ the experiences of child patients.

̽��ֱ��report, by ̽��ֱ�� of Cambridge academics for the charity Starlight, calls for play, games and playful approaches to be integrated into a ‘holistic’ model of children’s healthcare – one that acknowledges the emotional and psychological dimensions of good health, alongside its physical aspects.

Both internationally and in the UK, health systems have, in recent decades, increasingly promoted play in paediatric healthcare. There is a growing understanding that making healthcare more child-friendly can reduce stress and positively improve younger patients’ experiences.

Despite this recognition, play often remains undervalued and inconsistently integrated across healthcare contexts. For the first time, the report compiles evidence from over 120 studies to make the case for its more systematic incorporation.

In the case of the UK, the authors argue that the Government’s forthcoming 10-year health plan for the NHS offers an important opportunity to embed play within a more holistic vision for childhood health.

̽��ֱ��report was produced by academics at the Centre for Play in Education, Development and Learning (PEDAL) at the Faculty of Education, ̽��ֱ�� of Cambridge. Starlight, which commissioned the review, is a national charity advocating to reduce trauma through play in children’s healthcare.

Dr Kelsey Graber, the report’s lead author, said: “Play and child-centred activities have a unique capacity to support the emotional and mental aspects of children’s healthcare experiences, whether in hospital or during a routine treatment at the GP. It won’t directly change the course of an illness, but it can humanise the experience by reducing stress and anxiety and enhancing understanding and comfort. Hospital-based play opens up a far more complete understanding of what it means for a child to be a healthy or well.”

Adrian Voce, Head of Policy and Public Affairs at Starlight, said: “With the government promising to create the healthiest generation of children ever as part of its new long term health plan, this compelling evidence of the benefits of play to children’s healthcare is very timely. We encourage ministers and NHS leaders to make health play teams an integral part of paediatric care.”

̽��ֱ��report synthesised evidence from 127 studies in 29 countries. Most were published after 2020, reflecting intensified interest in children’s healthcare interventions following the COVID-19 outbreak.

Some studies focused on medically-relevant play. For example, hospital staff sometimes use role-play, or games and toys like Playmobil Hospital to familiarise children with medical procedures and ease anxiety. Other studies focused on non-medical play: the use of activities like social games, video games, arts and crafts, music therapy and storytelling to help make patients more comfortable. Some hospitals and surgeries even provide “distraction kits” to help children relax.

In its survey of all these studies, the report finds strong evidence that play benefits children’s psychological health and wellbeing. Play is also sometimes associated with positive physical health; one study, for example, found that children who played an online game about dentistry had lower heart rates during a subsequent dental procedure, probably because they felt more prepared.

̽��ֱ��authors identify five main ways in which play enhances children’s healthcare based on the available body of evidence:

Reducing stress and discomfort during medical procedures. Play is sometimes associated with physiological markers of reduced distress, such as lower heart rates and blood pressure. Therapeutic play can also ease pain and anxiety.

Helping children express and manage emotions. Play can help to alleviate fear, anxiety, boredom and loneliness in healthcare settings. It also provides an outlet for emotional expression among all age groups.

Fostering dignity and agency. In an environment where children often feel powerless and a lack of personal choice, play provides a sense of control which supports mental and emotional wellbeing.

Building connection and belonging. Play can strengthen children’s relationships with other patients, family members and healthcare staff, easing their experiences in a potentially overwhelming environment. This may be particularly important for children in longer term or palliative care.

Preserving a sense of childhood. Play helps children feel like children, and not just patients, the report suggests, by providing “essential moments of happiness, respite and emotional release”.

While play is widely beneficial, the report stresses that its impact will vary from child to child. This variability highlights a need, the authors note, for informed, child-centred approaches to play in healthcare settings. Unfortunately, play expertise in these settings may often be lacking: only 13% of the studies reviewed covered the work of health play specialists, and most of the reported activities were directed and defined by adults, rather than by children themselves.

̽��ֱ��report also highlights a major gap in research on the use of play in mental healthcare. Just three of the 127 studies focused on this area, even though 86% emphasised play’s psychological benefits. ̽��ֱ��report calls for greater professional and academic attention to the use of play in mental health support, particularly in light of escalating rates of mental health challenges among children and young people. More work is also needed, it adds, to understand the benefits of play-based activities in healthcare for infants and adolescents, both of which groups were under-represented in the research literature.

Embedding play more fully in healthcare as part of wider Government reforms, the authors suggest, could reduce healthcare-related trauma and improve long-term outcomes for children. “It is not just healthcare professionals, but also policy leaders who need to recognise the value of play,” Graber said. “That recognition is foundational to ensuring that children’s developmental, psychological, and emotional health needs are met, alongside their physical health.”

̽��ֱ��Cambridge report argues that play should be a recognised component of children’s healthcare in the Government’s forthcoming 10-year plan for the NHS.

Hospital-based play opens up a far more complete understanding of what it means for a child to be a healthy or well

Dr Kelsey Graber

Sturti, via Getty Images

Children’s hospital ward

̽��ֱ��text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

Yes

̽��ֱ��art of partnerships

skbf2 — Wed, 12 Feb 2025 17:44:23 +0000

Tammy Dougan on why it's so important that universities work with industry to get fundamental science out of the lab and into the real world.

Cambridge joins forces with ARIA to fast-track radical new technologies to revolutionise brain health

Anonymous — Wed, 09 Oct 2024 12:57:22 +0000

̽��ֱ��collaboration, which includes researchers from the ̽��ֱ�� of Cambridge, aims to accelerate progress on new neuro-technologies, including miniaturised brain implants designed to treat depression, dementia, chronic pain, epilepsy and injuries to the nervous system.

Neurological and mental health disorders will affect four in every five people in their lifetimes, and present a greater overall health burden than cancer and cardiovascular disease combined. For example, 28 million people in the UK are living with chronic pain and 1.3 million people with traumatic brain injury.

Neuro-technology – where technology is used to control the nervous system - has the potential to deliver new treatments for these disorders, in much the same way that heart pacemakers, cochlear implants and spinal implants have transformed medicine in recent decades.

̽��ֱ��technology can be in the form of electronic brain implants that reset abnormal brain activity or help deliver targeted drugs more effectively, brain-computer interfaces that control prosthetic limbs, or technologies that train the patient’s own cells to fight disease. ARIA’s Scalable Neural Interfaces opportunity space is exploring ways to make the technology more precise, less invasive, and applicable to a broader range of diseases.

Currently, an implant can only interact with large groups of neurons, the cells that transmit information around the brain. Building devices that interact with single neurons will mean a more accurate treatment. Neuro-technologies also have the potential to treat autoimmune disorders, including rheumatoid arthritis, Crohn’s disease and type-1 diabetes.

̽��ֱ��science of building technology small enough, precise enough and cheap enough to make a global impact requires an environment where the best minds from across the UK can collaborate, dream up radical, risky ideas and test them without fear of failure.

Professor George Malliaras from the ̽��ֱ�� of Cambridge’s Department of Engineering is one of the project leaders. “Miniaturised devices have the potential to change the lives of millions of people currently suffering from neurological conditions and diseases where drugs have no effect,” he said. “But we are working at the very edge of what is possible in medicine, and it is hard to find the support and funding to try radical, new things. That is why the partnership with ARIA is so exhilarating, because it is giving brilliant people the tools to turn their original ideas into commercially viable devices that are cheap enough to have a global impact.”

Cambridge’s partnership with ARIA will create a home for original thinkers who are struggling to find the funding, space and mentoring needed to stress-test their radical ideas. ̽��ֱ��three-year partnership is made up of two programmes:

̽��ֱ��Fellowship Programme (up to 18 fellowships)

Blue Sky Fellows – a UK-wide offer - we will search the UK for people from any background, with a radical idea in this field and the plan and personal skills to develop it. ̽��ֱ��best people will be offered a fellowship with the funding to test their ideas in Cambridge rapidly. These Blue Sky Fellows will receive mentorship from our best medical, scientific and business experts and potentially be offered accommodation at a Cambridge college. We will be looking for a specific type of person to be a Blue Sky Fellow. They must be the kind of character who thinks at the very edge of the possible, who doesn’t fear failure, and whose ideas have the potential to change billions of lives, yet would struggle to find funding from existing sources. Not people who think outside the box, more people who don’t see a box at all.

Activator Fellows - a UK-wide offer - those who have already proved that their idea can work, yet need support to turn it into a business, will be invited to become Activator Fellows. They will be offered training in entrepreneurial skills including grant writing, IP management and clinical validation, so their innovation can be ready for investment.

̽��ֱ��Ecosystem Programme

̽��ֱ��Ecosystem Programme is about creating a vibrant, UK-wide neurotechnology community where leaders from business, science, engineering, academia and the NHS can meet, spark ideas and form collaborations. This will involve quarterly events in Cambridge, road trip events across the UK and access to the thriving online Cambridge network, Connect: Health Tech.

“This unique partnership is all about turning radical ideas into practical, low-cost solutions that change lives,” said Kristin-Anne Rutter, Executive Director of Cambridge ̽��ֱ�� Health Partners. “Cambridge is fielding its best team to make this work and using its networks to bring in the best people from all over the UK. From brilliant scientists to world-leading institutes, hospitals and business experts, everyone in this collaboration is committed to the ARIA partnership because, by working together, we all see an unprecedented opportunity to make a real difference in the world.”

“Physical and mental illnesses and diseases that affect the brain such as dementia are some of the biggest challenges we face both as individuals and as a society,” said Dr Ben Underwood, Associate Professor of Psychiatry at the ̽��ֱ�� of Cambridge and Honorary Consultant Psychiatrist at Cambridgeshire and Peterborough NHS Foundation Trust. “This funding will bring together different experts doing things at the very limits of science and developing new technology to improve healthcare. We hope this new partnership with the NHS will lead to better care and treatment for people experiencing health conditions.”

Cambridge partners in the project include the Departments of Engineering and Psychiatry, Cambridge Neuroscience, the Milner Therapeutics Institute, the Maxwell Centre, Cambridge ̽��ֱ�� Health Partners (CUHP), Cambridge Network, the Babraham Research Campus, Cambridgeshire and Peterborough NHS Foundation Trust, and Vellos.

A team from across the Cambridge life sciences, technology and business worlds has announced a multi-million-pound, three-year collaboration with the Advanced Research and Invention Agency (ARIA), the UK government’s new research funding agency.

Science Photo Library via Getty Images

Illustration of human brain

Yes

Five hubs launched to ensure UK benefits from quantum future

sc604 — Fri, 26 Jul 2024 06:30:07 +0000

̽��ֱ��hub, called Q-BIOMED, is one of 5 quantum research hubs announced on 26 July by Peter Kyle MP, the Secretary of State for Science, Innovation and Technology, supported by £160 million in funding.

̽��ֱ��hub will exploit advances in quantum sensors capable of detecting cells and molecules, potentially orders of magnitude more sensitively than traditional diagnostic tests.

This includes developing quantum-enhanced blood tests to diagnose infectious diseases and cancer quickly and cheaply using portable instruments, and sensors measuring tiny changes to the magnetic fields in the brain that have the potential to detect early markers of Alzheimer’s disease before symptoms occur.

Other research will include quantum-enhanced MRI scans, heart scanners and surgical and treatment interventions for early-stage and hard-to-treat cancers.

“Quantum technologies harness quantum physics to achieve a functionality or a performance which is otherwise unattainable, deriving from science which cannot be explained by classical physics,” said Hub Co-Director Professor Mete Atatüre, Head of Cambridge’s Cavendish Laboratory. “Q-BIOMED will be delivered by an outstanding team of researchers from academia, the NHS, charities, government and industry to exploit quantum-enhanced advances for human health and societal good.”

“Our hub aims to grow a new quantum for health innovation ecosystem in the UK, and has already shaped the UK's new Quantum Mission for Health,” said Hub Co-Director Professor Rachel McKendry, from the London Centre for Nanotechnology and Division of Medicine at UCL. “Our long-term vision is to accelerate the entire innovation pipeline from discovery research, to translation, adoption and implementation within the NHS and global health systems, for the benefit of patients and societal good.”

“Quantum sensing allows us to gather information at cellular and molecular levels with unprecedented sensitivity to electric and magnetic fields," said Dr Ljiljana Fruk from the Department of Chemical Engineering and Biotechnology, a member of the Q-BIOMED team. "I look forward to learning from colleagues and engaging in challenging discussions to develop more sensitive, affordable tools for doctors and patients, advancing the future of healthcare.”

Cambridge researchers are also involved in three of the other newly-announced hubs:

̽��ֱ��UK Hub for Quantum Enabled Position, Navigation and Timing (QEPNT), led by the ̽��ֱ�� of Glasgow, will develop quantum technologies which will be key for national security and critical infrastructure and sectors such as aerospace, connected and autonomous vehicles (CAVs), finance, maritime and agriculture. Luca Sapienza (Engineering), Louise Hirst (Materials Science and Metallurgy/Cavendish Laboratory) and Dave Ellis (Cavendish Laboratory) are part of the QEPNT team.
QCI3: Hub for Quantum Computing via Integrated and Interconnected Implementations, led by the ̽��ֱ�� of Oxford, aims to develop the technologies needed for the UK to play a key role in the development of quantum computers, a market estimated to be worth $1.3 trillion by 2030. Ulrich Schneider (Cavendish Laboratory), Helena Knowles (Cavendish Laboratory), and Chander Velu (Institute for Manufacturing) are part of the QCI3 team.
̽��ֱ��Integrated Quantum Networks (IQN) Quantum Technology Research Hub, led by Heriot-Watt ̽��ֱ��, will undertake research towards the ultimate goal of a ‘quantum internet’, globally interlinked quantum networks connecting multiple quantum computers to produce enormous computational power. Richard Penty, Adrian Wonfor and Qixiang Cheng (Engineering), Atatüre and Dorian Gangloff (Cavendish Laboratory) are part of the IQN team.

̽��ֱ��fifth hub, UK Quantum Technology Hub in Sensing, Imaging and Timing (QuSIT), is led by the ̽��ֱ�� of Birmingham.

̽��ֱ��five hubs are delivered by the UKRI Engineering and Physical Sciences Research Council (EPSRC), with a £106 million investment from EPSRC, the UKRI Biotechnology and Biological Research Council, UKRI Medical Research Council, and the National Institute for Health and Care Research. Added to this are contributions from industry and other partners worth more than £54 million.

Peter Kyle, Secretary of State for Science, Innovation and Technology, said: “We want to see a future where cutting-edge science improves everyday lives. That is the vision behind our investment in these new quantum technology hubs, by supporting the deployment of technology that will mean faster diagnoses for diseases, critical infrastructure safe from hostile threats and cleaner energy for us all.

“This isn’t just about research; it’s about putting that research to work. These hubs will bridge the gap between brilliant ideas and practical solutions. They will not only transform sectors like healthcare and security, but also create a culture of accelerated innovation that helps to grow our economy.”

EPSRC Executive Chair Professor Charlotte Deane said: “Technologies harnessing quantum properties will provide unparalleled power and capacity for analysis at a molecular level, with truly revolutionary possibilities across everything from healthcare to infrastructure and computing.

“ ̽��ֱ��5 Quantum Technology Hubs announced today will harness the UK’s expertise to foster innovation, support growth and ensure that we capitalise on the profound opportunities of this transformative technology.”

A major new research hub led by the ̽��ֱ�� of Cambridge and UCL aims to harness quantum technology to improve early diagnosis and treatment of disease.

James Tye/UCL

L-R: Professor John Morton (UCL), Professor Rachel McKendry (UCL), Professor Mete Atatüre (Cambridge), Professor Eleni Nastouli (UCL)

Yes

Cambridge and SAS launch partnership in AI and advanced analytics to accelerate innovation in the healthcare sector

skbf2 — Tue, 23 Jul 2024 13:41:30 +0000

̽��ֱ��SAS Advanced Analytics Hub will embed SAS experts and its AI platform capabilities into the ̽��ֱ��, enabling targeted collaboration with leading researchers and early-stage entrepreneurs.

Based on the Cambridge West campus, the Hub will have capacity to recruit and support several high-quality, high-impact academic research projects and promising early-stage startups in the health-tech space, providing their innovative ideas with extra momentum.

̽��ֱ��partners have already demonstrated the effectiveness of the collaboration in addressing an important healthcare challenge. A ̽��ֱ�� of Cambridge-led project on kidney transplants, PITHIA, developed an AI-based decision support approach using SAS’s dynamic analytics platform. It is being used to automate the process of scoring biopsies for kidneys to better identify those organs that can be used for transplantation. ̽��ֱ��aim is to increase the number of transplants and improve the function of those kidneys used. This has the potential to save lives and transform the quality of life for more than 100 people each year who would otherwise require dialysis, as well as saving the NHS millions of pounds annually.

This collaboration was initiated and led by Dr Alex Samoshkin (Deputy Head, Office for Translational Research, School of Clinical Medicine) who facilitates interactions between clinicians and researchers from the Biomedical Campus with researchers in science and technology working with the Maxwell Centre. Dr Samoshkin said: “In 2018 I supported the PITHIA project led by Prof. Gavin Pettigrew, looking to optimise qualification of kidneys for transplantation, for which SAS turned out to be the perfect industrial partner. We demonstrated that synergy between the ̽��ֱ�� and SAS was instrumental in accelerating the process of transitioning from ideas to the clinic.”

This initial success paved the way for a more ambitious partnership between Cambridge and SAS. ̽��ֱ��Cambridge team visited the SAS headquarters at Cary, NC, USA in June 2023 to discuss collaboration opportunities with the SAS senior leadership team including Dr Jim Goodnight, co-founder and CEO. Today, the SAS Advanced Analytics Hub at the Maxwell Centre begins building a pipeline of new collaborative projects with potential to improve health outcomes for millions of patients around the world.

̽��ֱ��Maxwell Centre Director, Dr Aga Iwasiewicz-Wabnig, commented: “We are excited to interface Cambridge’s world-class research and innovation with SAS’ leading expertise in advanced analytics and AI forming a partnership for societal good. We are starting with a strong focus on healthcare and will build momentum to support future interdisciplinary projects on sustainability and social equality.”

Roderick Crawford, Senior Vice President, SAS Northern Europe, commented: “There are many examples we’re seeing of how AI can have a truly transformational effect, not just on businesses, but in areas such as healthcare and society as a whole. We’re delighted to deepen our relationship with the ̽��ֱ�� of Cambridge through this partnership, and there is enormous potential when you consider the additional expertise our partners, such as Microsoft, and customers, such as AstraZeneca, can provide.”

̽��ֱ��Maxwell Centre at the ̽��ֱ�� of Cambridge and SAS, leaders in data and AI, are launching a partnership aimed at accelerating healthcare innovation through enhanced access to advanced analytics.

Maxwell Centre, ̽��ֱ�� of Cambridge

Yes

How do we protect doctors, media and NGOs in war? - a time to discuss

zs332 — Mon, 18 Mar 2024 18:02:21 +0000

Dr Saleyha Ahsan explores why journalists and medics are now increasingly seen as targets in warzones and what can potentially be done to support them.

Clinicians rank patient views as least important in diagnosis, study finds

cjb250 — Mon, 18 Dec 2023 00:16:36 +0000

̽��ֱ��research, led by a team at the ̽��ֱ�� of Cambridge and Kings’ College London, found that clinicians ranked patient self-assessments as least important in diagnostic decisions, and said that patients both over- and under-played their symptoms more often than patients reported doing so.

One patient shared the common feeling of being disbelieved as “degrading and dehumanising” and added: “If I had continued to have regard for clinicians’ expertise over mine, I would be dead… When I enter a medical appointment and my body is being treated as if I don’t have any authority over it and what I’m feeling isn’t valid then that is a very unsafe environment… I’ll tell them my symptoms and they’ll tell me that symptom is wrong, or I can’t feel pain there, or in that way.”

In a study published today in Rheumatology, researchers used the example of neuropsychiatric lupus, an incurable autoimmune disease that is particularly challenging to diagnose, to examine the different value given by clinicians to 13 different types of evidence used in diagnoses. This included evidence such as brain scans, patient views, and the observations of family and friends.

Fewer than 4% of clinicians ranked patient’s self-assessments in the top three types of evidence. Clinicians ranked their own assessments highest, despite acknowledging that they often were not confident in diagnoses involving often invisible symptoms, such as headache, hallucinations, and depression. Such ‘neuropsychiatric’ symptoms can lead to low quality of life and earlier death and were reported to be more often misdiagnosed – and therefore not correctly treated – than visible ones such as rashes.

Lead author, Dr Melanie Sloan from the Department of Public Health and Primary Care at the ̽��ֱ�� of Cambridge, said: “It’s incredibly important that we listen to and value patients’ insights and their own interpretations of their symptoms, particularly those with long-standing diseases – after all, they are the people that know what it is like to live with their condition. But we also need to make sure that clinicians have the time to fully explore each patient’s symptoms, something that is challenging within the constraints of current health systems.”

Almost half (46%) of the 676 patients reported never or rarely having been asked for their self-assessments of their disease, although others discussed very positive experiences. Some clinicians, particularly psychiatrists and nurses, valued patient opinions highly, as a psychiatrist from Wales explained: “Patients often arrive in clinic having had multiple assessments, having researched their own condition to a very high level and having worked hard to understand what is going on with their own body… they are often expert diagnosticians in their own right.”

Patients’ and clinicians’ personal characteristics such as ethnicity and gender were felt to sometimes influence diagnosis, particularly a perception that females are more likely to be told their symptoms are psychosomatic. ̽��ֱ��data showed that male clinicians were statistically more likely to state that patients over-played symptoms. Patients were more likely than clinicians to say that symptoms were directly caused by the disease.

̽��ֱ��study authors acknowledged that patient reasoning will be inaccurate at times, but concluded that there were likely to be many potential benefits (including diagnostic accuracy, fewer misdiagnoses, and greater patient satisfaction) to including patients’ “attributional insights” and experiences into decisions about diagnosis. This is particularly important when diagnostic tests in neuropsychiatric lupus are widely known to be “unenlightening”, according to one neurologist, in common with many other autoimmune diseases and long Covid.

Dr Tom Pollak, senior study author from the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said: “No human being is always going to be able to accurately pinpoint the cause of symptoms, and patients and clinicians can both get this wrong. But combining and valuing both views, especially when the diagnostic tests aren’t advanced enough to always detect these diseases, may reduce misdiagnoses and improve clinician and patient relationships, which in turn leads to more trust and more openness in symptom reporting.”

Sue Farrington, Co-Chair of the Rare Autoimmune Rheumatic Disease Alliance, said: “It’s time to move on from the paternalistic, and often dangerous, ‘doctor knows best’ to a more equal relationship where the patients with lived experiences and the doctors with learnt experiences work more collaboratively.”

̽��ֱ��research was funded by ̽��ֱ��Lupus Trust and LUPUS UK.

Reference
Sloan, M et al. Attribution of neuropsychiatric symptoms and prioritisation of evidence in the diagnosis of neuropsychiatric lupus: mixed methods analysis of patient and clinician perspectives from the international INSPIRE study. Rheumatology; 18 Dec 2023; DOI: 10.1093/rheumatology/kead685

Experts today call for more value to be given to patients’ ‘lived experiences’ as a study of over 1,000 patients and clinicians found multiple examples of patient reports being under-valued.

It’s incredibly important that we listen to and value patients’ insights and their own interpretations of their symptoms – after all, they are the people that know what it is like to live with their condition

Melanie Sloan

Natalia Gdovskaia (Getty Images)

Doctor consulting with patient

̽��ֱ��text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

Yes

How new model boosts supply and lowers prices for generic drugs

Anonymous — Thu, 21 Sep 2023 15:31:28 +0000

Civica Rx, a not-for-profit drug manufacturer founded by seven US health systems and three philanthropic organisations, increased supply security and lowered cost on aggregate for 20 drug products, according to the first empirical evidence of Civica’s impact published in the journal NEJM Catalyst.

“Results show that Civica was able to improve generic drug access above the wholesaler model,” says the article in NEJM Catalyst, a publication that is part of the New England Journal of Medicine family. “Chronic drug shortages have been an extremely challenging problem and elusive to sustainable improvement in the past. This makes these early results highly promising.”

̽��ֱ��NEJM Catalyst article (entitled “Vaccinating Health Care Supply Chains Against Market Failure: ̽��ֱ��Case of Civica Rx”) – is co-authored by the co-founders of the Healthcare Utility Initiative at Cambridge Judge Business School: Carter Dredge, Senior Vice President and Lead Futurist at SSM Health in St. Louis, Missouri (one of Civica’s founding health systems), who is a Business Doctorate candidate at Cambridge Judge, and by Stefan Scholtes, Dennis Gillings Professor of Health Management at Cambridge Judge.

Key breakthrough is structural rather than technological

“ ̽��ֱ��results of this study are very encouraging for patients and health systems,” says Carter Dredge. “ ̽��ֱ��innovation of Civica is not technological but rather structural: a new business model that injects a new type of supplier into a decades-old market for generic drugs in order to address a market failure.”

Civica is based on new business model called a health care utility (HCU) that prioritises access over profit. It was founded in 2018 to address generic drug shortages and high prices that have plagued health systems in the US and elsewhere, and now provides more than 75 critical medications at risk for shortages to US health systems.

Government intervention hasn’t solved problems in cost and supply

“Some problems in health care are so complex that traditional private-sector or governmental interventions alone have not been able to solve the problems,” the study says. “Although competition increases quality and reduces the cost of goods and services across a wide spectrum of industries, health care seems intractably resistant to standard forms of competition — particularly in its hyperspecialized supply chains.”

For example, the study says that the average price in 2022 for the uninsured for a box of five pen cartridges of insulin used to manage diabetes was more than $500, which results in 25% of Americans who rely on insulin being forced to ration their medications because of cost.

Study favourably compared Civica to 62 drug wholesalers

̽��ֱ��study focused on a cohort of 14 critical and shortage-prone hospital drugs that represented 20 distinct products (some medicines have multiple products due to different dose and vial size) between 2020 and 2022. Data comes from internal hospital pharmacy operations systems, supply chain purchasing databases, wholesaler product information, the American Society of Health System Pharmacists, and Civica.

̽��ֱ��authors estimated that Civica fulfilled its contractually guaranteed volume at 96%, whereas the wholesalers fulfilled their orders at 86%, with the difference being statistically significant (p=0.03). Further, Civica offered an additional product access benefit of 43% above the contractual minimum volume.

In addition, wholesaler prices at the order level were estimated to be on average 46% above the Civica price for the same product in the same year; however, through highly proactive health system purchasing efforts to buy more volume when prices were low from the 62 non-Civica manufacturers, this closed the actual achieved cost-savings gap between the wholesalers and Civica to 2.7% in aggregate, with Civica still being the lower-cost option.

( ̽��ֱ��14 medicines are: bivalirudin to prevent blood clotting, the antibiotic daptomycin, anti-inflammatory dexamethasone, narcotic pain medicine fentanyl, pre-surgery medicine katamine, labetalol for hypertension, local anesthetic lidocaine, seizure medication lorazepam, naloxone to treat opioid overdose, neostigmine for anesthesia reversal, ondansetron to prevent nausea, rocuronium bromide for general anesthesia, sodium bicarbonate for cardiac arrest, and the antibiotic vancomycin.)

New model sells drugs at same transparent price to all health systems

̽��ֱ��healthcare utility model is governed by stewards rather than owned, and pricing is uniform for all customers in a bid to maximise access rather than profits. Civica members purchase Civica medications at the same transparent price, as determined by the lowest appropriate cost necessary to sustainably provide the drugs over a 5-year period.

̽��ֱ��seven large US health systems that founded Civica are: Catholic Health Initiatives, now CommonSpirit Health; HCA Healthcare; Intermountain Healthcare; Mayo Clinic; Providence St. Joseph Health; SSM Health; and Trinity Health. ̽��ֱ��three founding philanthropies are the Gary and Mary West Foundation, the Laura and John Arnold Foundation, and the Peterson Center on Healthcare.

Civica now serves more than 50 US health systems

̽��ֱ��seven founding health systems have since been joined by more than 50 other health systems covering more than 1,500 hospitals and about 225,000 hospital beds. Through July 2023, more than 56 million cumulative patient doses of Civica medicines have been administered.

In conclusion, the authors say:

“ ̽��ֱ��problems we face in health care are daunting, but many of them are solvable with the right approach. In learning from Civica’s experience, some of the most fundamental answers may already be at our fingertips.

“This article provides the first empirical evidence that this approach is working.”

First empirical evidence for Civica Rx, a health care utility, finds increased supply security and reduced costs for health systems, says study in NEJM Catalyst authored by two Cambridge Judge Business School academics.

Eggy Sayoga via Getty Images

Pills and a capsule on pastel pink colored background. 3D rendered image.

̽��ֱ��text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

Yes