The World Health Organisation (WHO) issued hepatitis B advice for the first time today, recommending that monitoring be carried out through non-invasive tests, that treatment should involve Viread (tenofovir) or Baraclude (entecavir) and that patients with cirrhosis should be prioritized.
The organisation also stressed the importance using “smart” needles to prevent the spread of hepatitis B, explaining that while treatment can prolong patient life an equal emphasis should be placed on preventing new infections.
A WHO spokeswoman told in-Pharmatechnologis.com “Safety engineered syringes also called ‘smart syringes’ have a feature that prevent from reuse of the devices. There are different mechanisms.
“One mechanism is a metal clip which blocks the plunger after the injection is given not allowing to pull back the piston” she said, adding that “another is the presence of a weak point at the end of the plunger which breaks after the injection is given.
“Other smart syringes have also a needle stick protection feature consisting in a plastic cover we push over the needle after the injection.”
Cost savings
The guidance comes a few weeks after the WHO warned that needle reuse is a major cause of disease spread citing data from a recent study indicating that as many as 1.7m people with hepatitis B virus and 315,000 people with HIV were infected by dirty needles.
Around 70 delivery technology firms are developing so called “smart” needles according to the WHO, which says such technologies should be chosen preferentially by national healthcare programmes.
The big hurdle to the adoption of such technologies is the cost. Smart needles cost between $0.03 and $0.04 according to the WHO, which is around double what more basic syringe technologies sell for.
The WHO’s suggestion is that smart needle manufacturers – which include Unilife and BD (formerly Becton, Dickinson and Company) BBraun, Terumo, Retractable Technologies RTIs, Medeco, SafeGard Medical – donate the newer techs to health programmes.
The idea is that these donations will increase demand, allowing manufacturers to cut production costs and lower prices.
The WHO spokeswoman stressed that preventing infections will generate savings, explaining that: “A cost effectiveness analysis was done by WHO which shows that for each dollar invested in safe injection programmes, including procurement of the devices, training, sharps waste management, there is a saving of 14 dollars.”
Source: PLoS ONE 9(6): e99677.
“Evolution of the Global Burden of Viral Infections from Unsafe Medical Injections, 2000–2010” by J Pépin et al.
doi:10.1371/journal.pone.0099677.