. University medicine is responsible for innovations the teaching and at the same time the “last resort” in the care of difficult-to-treat patients. Internists see their tasks threatened by funding gaps.
If there is to be progress for patients in diagnostics, prophylaxis or therapy, one thing is required: basic research with interfaces to the clinic. Promoting translational research - structurally, personally and financially - is one of the great challenges of internal medicine. Under the main theme of the annual congress "Research becomes medicine" of the German Society for Internal Medicine, President Prof. Dr. med. Michael P. Manns from the Medical University of Hanover on April 26th in Wiesbaden made it clear: “It is more necessary than ever to transfer the problems caused by major diseases such as diabetes, cardiovascular disease, cancer or infectious diseases To promote knowledge in practice even better. ”With regard to pharmaceuticals and biomedical technology, academic medicine with its focus on universities is the starting point for medical innovations by molecularly deciphering the causes of diseases, pathophysiological relationships and mechanisms.
New research principles
The classic approach to medicine in organ-specific disease entities has changed towards research into basic pathophysiological principles, for Example of the molecular basis of inflammatory processes. The interdisciplinary application of antagonists of inflammatory mediators in chronic inflammatory bowel diseases and in rheumatology is an example. At the end of the development of new substances and processes by companies, academic medicine must stand again: in the implementation of clinical studies, on the way to approval and for the optimization of the application and the early detection of risks. "Of course, the cooperation between academic medicine and the pharmaceutical industry must be viewed sensitively," said Manns in his speech. Structures would have to be created in Germany that guarantee the independence of academic medicine and allow “cooperation with industry on an equal footing”. Conflicts of interest would have to be revealed and cooperation between “university medicine as customer” had to be separated.
Examples of how research reaches patients are the development of targeted substances in oncology and the therapy of hepatitis C, the virus that causes it Was discovered in 1989.
. University medicine is responsible for innovations the teaching and at the same time the “last resort” in the care of difficult-to-treat patients. Internists see their tasks threatened by funding gaps.
If there is to be progress for patients in diagnostics, prophylaxis or therapy, one thing is required: basic research with interfaces to the clinic. Promoting translational research - structurally, personally and financially - is one of the great challenges of internal medicine. Under the main theme of the annual congress "Research becomes medicine" of the German Society for Internal Medicine, President Prof. Dr. med. Michael P. Manns from the Medical University of Hanover on April 26th in Wiesbaden made it clear: “It is more necessary than ever to transfer the problems caused by major diseases such as diabetes, cardiovascular disease, cancer or infectious diseases To promote knowledge in practice even better. ”With regard to pharmaceuticals and biomedical technology, academic medicine with its focus on universities is the starting point for medical innovations by molecularly deciphering the causes of diseases, pathophysiological relationships and mechanisms.
New research principles
The classic approach to medicine in organ-specific disease entities has changed towards research into basic pathophysiological principles, for Example of the molecular basis of inflammatory processes. The interdisciplinary application of antagonists of inflammatory mediators in chronic inflammatory bowel diseases and in rheumatology is an example. At the end of the development of new substances and processes by companies, academic medicine must stand again: in the implementation of clinical studies, on the way to approval and for the optimization of the application and the early detection of risks. "Of course, the cooperation between academic medicine and the pharmaceutical industry must be viewed sensitively," said Manns in his speech. Structures would have to be created in Germany that guarantee the independence of academic medicine and allow “cooperation with industry on an equal footing”. Conflicts of interest would have to be revealed and cooperation between “university medicine as customer” had to be separated.
Examples of how research reaches patients are the development of targeted substances in oncology and the therapy of hepatitis C, the virus that causes it Was discovered in 1989.The combination of interferons with ribavirin had been standard for more than ten years: with cure rate of around 50 percent, one year of therapy and significant side effects. The research has now led to the development of direct antiviral drugs that attack three key points in the virus' life cycle: the protease, the polymerase and the NS5A protein. The healing rates with the substances, some of which have already been approved, would be over 80 percent with significantly shorter duration of therapy and better side effect profile. “The developments are groundbreaking,” said Manns. For the first time, chronic viral infection can be cured. At the same time, costs of 20,000 euros per month required discussion about which patients should receive the therapy.
Beyond their research tasks, the university clinics are houses of supramaximal care: “They are the last resort, they cannot reject severe cases "A solution must therefore be found for the underfunding of university medicine with deficit of 161 million euros, including the university outpatient clinics, which are essential for research and teaching and close gaps in outpatient care. The role of the university outpatient clinics, which also serve translational research, must be redefined. A reduction in university medical locations is not solution, given the shortage of doctors. The Professional Association of German Internists estimates this to be 30,000 by 2017.
Wrong developments in the EU
The medical profession sees its competence and professional freedom threatened by efforts by the European Union to set standards for medical matters by private-sector standardization commissions To have action developed to harmonize standards within the EU. “We say 'yes' to common framework conditions for promoting innovation and research or for the mobility of patients and doctors, but 'no' to the EU's efforts to interfere in the original national responsibilities for organizing the health system - and in such sensitive area as the doctor-patient relationship, "said the President of the Medical Association of Lower Saxony and Vice-President of the German Medical Association, Dr. med. Martina Wenker at the internist congress. The institutions charged with standardization are neither technically competent nor democratically legitimized for these tasks.
Dr. rer. nat.The combination of interferons with ribavirin had been standard for more than ten years: with cure rate of around 50 percent, one year of therapy and significant side effects. The research has now led to the development of direct antiviral drugs that attack three key points in the virus' life cycle: the protease, the polymerase and the NS5A protein. The healing rates with the substances, some of which have already been approved, would be over 80 percent with significantly shorter duration of therapy and better side effect profile. “The developments are groundbreaking,” said Manns. For the first time, chronic viral infection can be cured. At the same time, costs of 20,000 euros per month required discussion about which patients should receive the therapy.
Beyond their research tasks, the university clinics are houses of supramaximal care: “They are the last resort, they cannot reject severe cases "A solution must therefore be found for the underfunding of university medicine with deficit of 161 million euros, including the university outpatient clinics, which are essential for research and teaching and close gaps in outpatient care. The role of the university outpatient clinics, which also serve translational research, must be redefined. A reduction in university medical locations is not solution, given the shortage of doctors. The Professional Association of German Internists estimates this to be 30,000 by 2017.
Wrong developments in the EU
The medical profession sees its competence and professional freedom threatened by efforts by the European Union to set standards for medical matters by private-sector standardization commissions To have action developed to harmonize standards within the EU. “We say 'yes' to common framework conditions for promoting innovation and research or for the mobility of patients and doctors, but 'no' to the EU's efforts to interfere in the original national responsibilities for organizing the health system - and in such sensitive area as the doctor-patient relationship, "said the President of the Medical Association of Lower Saxony and Vice-President of the German Medical Association, Dr. med. Martina Wenker at the internist congress. The institutions charged with standardization are neither technically competent nor democratically legitimized for these tasks.
Dr. rer. nat.Nicola Siegmund-Schultze
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