Public health versus business – an example of the dilemma

Hernia Discussion Forums Hernia Discussion Public health versus business – an example of the dilemma

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    • #28572
      Good intentions
      Participant

      I just stumbled across these two things on the internet and thought that they illustrated the basic problem with using free market economic business principles to drive healthcare advancements. The profit-making competition principle skews the efforts. The titles alone tell a lot.

      Medtronic is the owner of the Covidien line of mesh products. You can see that their “innovation” is just a different shape to a 3D mesh.

      The second article is a look at one of the “mesh” products that has been used for decades in the poorer parts of the world. Mosquito net.

      https://www.medtronicsolutions.com/dextile-webinar-register?cid=PPC:GOOG:%2Binguinal%20%2Bhernia%20%2Bmesh:USDextileLaunch

      Look at all of the “internal report”s used to support the claims. https://www.medtronic.com/covidien/en-us/products/hernia-repair/dextile-anatomical-mesh.html#:~:text=The%20Dextile%E2%84%A2%20anatomical%20mesh,to%20minimize%20risk%20of%20recurrence

      The mosquito net paper –

      https://innovations.bmj.com/content/early/2020/12/14/bmjinnov-2020-000535

      Review
      Double standards in healthcare innovations: the case of mosquito net mesh for hernia repair
      Mark Skopec1, Alessandra Grillo2, Alvena Kureshi2, Yasser Bhatti3, Matthew Harris1

      Summary box
      What is already known?
      Mosquito net mesh has been used in low-income countries for many years and there is strong, clinical evidence to suggest that it is as safe and as effective as commercial mesh for inguinal hernia repair.

      Mosquito net mesh is a fraction of the cost of commercial mesh and therefore offers cost-saving opportunities even for high-income country health systems.

      What are the new findings?
      Our research finds that mosquito net mesh more closely resembles the biological and mechanical properties of the abdominal wall and therefore more suitable for use in hernia mesh repair.

      The absence of its recommendation for use in high-income settings represents a glaring double standard and is not explained entirely by challenging commercial and regulatory environments.

      Safe and effective innovations should be considered in all settings, not discounted prematurely based on the settings from where they have originated.

    • #28577
      Alephy
      Participant

      I bet in 20 years or so they will find out that for small hernias proper PT might just work fine…so much for the mantra that surgery is the only way….(hopefully not the famous last words for me, in case I end up under the knife:)

      ps: who among the doctors in this forum did actually get an hernia and a mesh/pure tissue surgery to fix it?
      considering the high probs for this problem, I would expect the other half of the sky to be affected too…just curious…

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