The Healthy OptionIs that the Route to Funding?

Sport and Recreation Alliance Annual Conference 4th May 2011

Dr William Bird MBEGP

Intelligent HealthPhysical Activity Alliance

Meet Julie; she has PA deficiency

Julie’s dad has PAdeficiency

Julie’s grandmother hasPA deficiency

Symptoms of PA deficiency

• Increase risk of poor mood/low self esteem• Weight gain• Sallow Skin• Poor Sleep• Muscle wasting• Constipation• Increased falls (Elderly)• Accelerated cognitive decline

Fitirex®• Fitirex® is a natural

supplement for PA deficiency• In a practice of 10,000 about

6,600 have PA Deficiency. However 7100 believe they do not have deficiency

• Give Fitirex® to 60 men over 60 yrs with PA deficiency and every year one less will die compared to the control group

Fitirex Treatment

• 30% reduced risk of death• 35% reduced risk in CVD CHD and Stroke• 35% reduced risk in Type 2 Diabetes• 35% reduced risk in Hip Fracture• 80% reduced risk in Osteoarthritis Disability• 30% reduced risk of Colon Cancer• 20% reduced risk in Breast Cancer• Reduced risk of Alzheimers Disease

Dose of Fitirex®

• Low Dose– elderly and those recovering from any illness – No previous encounter– Can be used to treat metabolic conditions

• Moderate Dose– Most treatments fall in this range

• High Dose– Only under trained supervision unless already taking

regular dose

Side Effects of Fitirex®

• At low dose there are no known side effects• Most side effects at moderate dose are minor

musculoskeletal. • High dose can cause musculoskeletal damage,

immune deficiency, metabolic disturbance and possibly collapse.

• It is encourage to build up the dose slowly and review during this increase in dose.

Cost of PA deficiency

• Those with PA Deficiency have– 38% more days in hospital– 5.5% more family physician visits– 13% more specialist services– 12% more nurse visits

• A Total of 27 million people suffer from deficiency

• Total cost to NHS over £1 billion

Cost per Quality Adjusted Life Year

• Cost of Statin suppliment up to £17,000 • Cost of Smoking Cessation up to £9515• Cost of Fitirex® suppliment up to £440

• NICE recommend that a drug or intervention that costs up to £30,000 per QALY is justified

• 68 patients can be treated with Fitirex® for one intervention costing £30,000

GPs Choice

• Antidepressant• Bisphosphonate• Statin• ACE Inhibitor• Aspirin• Beta Blocker• NSAID• Metformin• Orlistat

HOW DO YOU SELL FITIREX TO A GP CONSORTIA?START WITH A DIAGNOSIS

Diabetes and Fitirex® – You just need to treat 6 people with Fitirex® to

prevent those with impaired GTT from developing Diabetes.*

– The equivalent is • 10 for diet• 6 for diet and Fitirex® • 11 for anti diabetic drugs and • 6 for Orlistat

– Fitirex® can delay onset of diabetes for an average of 3.6 yrs even up to 14 yrs after intervention.**

*Gillies et al BMJ 334 19 Jan 2007**Li , G Lancet 2008; 371:1783-89

Hip Fracture and Fitirex

• In older women The Numbers Needed to Treat to prevent one hip fracture is estimated at 90 for bisphosphonates

McClung MR, Geusens P, Miller PD, Zippel H,

• But a recent study of 160 women of which half were prescribed FITREX there were no hip fractures compared to five in the control group.

Bensen WG, Roux C, New England Journal ofMedicine 2002; 344: 333-340.

Pain in Osteoarthritis

• Although most GPs understand the importance of prescribing Fitirex® to control pain in Osteoarthritis.

• 29% from a recent study thought that rest was the best treatment.

• Although Fitirex® is recommended in NICE guidelines GPs are not told whether they should – refer patients– advise patients– or prescribe to patients

Depression and Dementia

• Fitirex® has similar effect than any other antidepressant and cognitive behavioural therapy and is considerably cheaper.

• A long term supplement of Fitirex® can delay the onset of dementia and can certainly increase independence in the elderly

Record Outdoor Health Questionnaire

HOW DO YOU SELL FITIREX TO PUBLIC HEALTH?

PEOPLE, PURPOSE, PLACE

People

Purpose

Place