Geoff Twist, managing director of Roche Diagnostics (UK and Ireland) explains the firm’s current activities in the field of pre-eclampsia, and why recent changes in the UK are long overdue.
In a welcome move, NHS England earlier this month signalled their commitment to improving outcomes for expectant mothers with pre-eclampsia, with a focus on rapid and accurate testing for the condition.
This has been a long time coming. In recent years, new methods for testing have been made available and approved by NICE. However, uptake in the NHS has been very low, which has meant that less than 3% of women in England have had access to these more accurate tests. This can lead to unnecessary hospital admissions.
In the UK, up to 6% of all pregnancies will be affected by pre-eclampsia, with thousands more suspected of having the condition. The disease is a major cause of maternal and foetal morbidity worldwide, impacting pregnant women and their families. It also places significant economic and capacity burdens on maternity systems. In fact, an estimated 70% of women admitted into hospital with suspected pre-eclampsia don’t actually have the condition. Moreover, the additional cost for treating pre-eclampsia on the NHS has also been estimated at £9,009 per pregnancy.
Better diagnosis of pre-eclampsia is therefore imperative to not only improve patient safety but to also reduce the burden on maternity service. It is welcome news, then, to see the NHS moving in the right direction and start offering these tests routinely.
At Roche Diagnostics, we have a test that can reliably rule out pregnant women who do not have pre-eclampsia and have a very low chance of developing it. What’s more, the test has been selected as one of seven rapid uptake products by NICE’s Accelerated Access Collaborative (AAC), designed to identify highly transformative innovations and to introduce an accelerated pathway to market. This is an important and exciting route for new technologies that will have a demonstrable impact on patients. Women’s health is clearly one of the high priority areas for NHS England and this is very welcome.
Through the AAC, we are working with NICE to increase the uptake of this cost-effective technology. We are also being supported by the Oxford Academic Health Science Network (Oxford AHSN), which is rolling out and adopting the test in hospitals across the Thames Valley. This collaboration has resulted in patients successfully getting access to this innovation in their region.
NHS Trusts have already reported improved patient safety, a reduction in unnecessary admissions, and improved maternity capacity as fewer women are in need of monitoring. Testing for pre-eclampsia has also led to reduced direct costs as it keeps more women on the most appropriate treatment pathway. But most importantly, the most appropriate treatment being provided, meaning better outcomes for both mothers and babies.
While we are on the right track, there is still more work to be done to help patients and the NHS with rapid diagnosis. To do this, it is now more important than ever for Trusts to utilise the latest medical technology to help alleviate pressures on the NHS, make life easier for healthcare professionals, and ensure that patients receive the right treatment at the right time.
Case study: Roche’s diagnostic test for pre-eclampsia
Late last year Roche’s diagnostic test, which predicts with almost 100% accuracy that a pregnant woman will not develop pre-eclampsia within the following seven days, was given the green light to be used as standard clinical practice in one of the UK’s biggest acute hospital trusts.
The blood test, conducted by Oxford University Hospitals (OUH) NHS Foundation Trust at its John Radcliffe Hospital, measures the ratio of two placental factors - maternal serum soluble fms-like tyrosine kinase (sFlt-1) and placental growth factor (PlGF) - that are released into the mother’s blood.
Roche Diagnostics funded the trial, which was conducted at the Women’s Centre at the John Radcliffe Hospital.
The trial results were successful and the response from maternity staff was so enthusiastic that the test was accepted as routine clinical practice at OUH. The introduction of the test was cost-neutral for the trust.
Pre-eclampsia is a serious disease that occurs in 4% of all pregnancies. It causes high blood pressure, protein in the urine and oedema and can result in liver failure, kidney failure and seizures in the mother. It can lead to restricted growth in the baby and often premature delivery.
Currently, any patients with suspected PE are often admitted to hospital, sometimes for several days in order to make the diagnosis.
The trial was led by Dr Manu Vatish, OUH consultant obstetrician and senior clinical fellow with the University of Oxford’s Nuffield Department of Women’s and Reproductive Health.
He said: “The stress experienced by mums and their families can be put into context when we see that almost 70% of patients admitted don't actually have PE.
“With this study and the previously published work, we have shown that we can virtually eliminate all those patients who have no risk of developing pre-eclampsia, allowing us to focus our attention on those with an increased risk.”
Tim James, OUH head biomedical scientist in clinical biochemistry, whose laboratories carried out the tests, said: “The beauty of these tests is that they are not reliant on analysers that are only available in Oxford. The instruments are available at many hospital sites, meaning that the benefits we have demonstrated can be expanded across the UK relatively rapidly and easily, and pregnant women everywhere should be able to benefit".
