Biosimilars, Insomnia, Abortion at home

Copycat biologic drugs, to treat conditions from arthritis and psoriasis to breast cancer and lymphoma, could save hundreds of millions of pounds off the NHS drugs bill. Called biosimilars, these close copies give the same clinical benefit at a fraction of the cost. Up to now the problem has been take-up, but a new initiative led by the specialist UK cancer centre, London's Royal Marsden, run across the NHS Cancer Vanguard, has demonstrated that patients can be switched effectively onto the cheaper drugs. Chief pharmacist at the Royal Marsden, Dr Jatinder Harchowal, who led the national staff education programme, tells Mark that getting clinicians and patients on board was key to achieving an 80% take up for the blood cancer biosimilar, rituximab. This month a biosimilar copy of the breast and stomach cancer drug, Herceptin (generic name trastuzumab) is being introduced to patients too.

Imogen had sleep problems for almost 30 years and she admits that at times, her insomnia left her in a desperate state. For years she took sleeping tablets but she ended up increasing the dosage, to no effect. Eventually she found help at Queen Victoria Hospital's Sleep Disorder Clinic in East Grinstead. Mark visits the clinic and finds out from its Clinical Director Dr Peter Venn that sleeping tablets aren't the answer to insomnia and cognitive behaviour therapy, which Imogen used, is the best treatment.

Scotland has led the UK nations in allowing early medical abortion at home. Wales in the past 10 days has followed their lead. So where does this leave England? Dr Margaret McCartney reports from Glasgow about the choice now available for Scottish women who opt for a medical termination. Since last autumn the second pill that induces the breakdown of the womb lining can be taken at home, a practice that already happens in Scandinavia and parts of the USA. Dr Audrey Brown, a consultant in sexual and reproductive healthcare, tells Margaret that the impetus for the change in practice in Scotland came directly from women who didn't want to make the second clinic visit for the second set of drugs and risk cramping and bleeding on the way home. A woman who has opted for early medical abortion at home in Scotland shares her experience with Inside Health.

Producer: Fiona Hill.