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Innovation — A new treatment concept that uses pulsating electromagnetic fields can cure patients with chronic depression. But, according to the inventor, it is an open question whether Denmark is too conservative for something so new to win over the health system.
Professor of Biochemistry and Doctor of Science Steen Dissing has been working on a new method to cure people with chronic depression for 15 years. People with chronic depression do not get sufficient effect from antidepressant drugs or any other type of antidepressant treatment.
“Denmark is not necessarily the innovative country that we would like to perceive it as.”
Steen Dissing, inventor, Professor at the Department of Cellular and Molecular Medicine at the University of Copenhagen (UCPH)
In medical language, they are called ‘refractory patients’. Steen Dissing’s method uses pulsating electromagnetic fields that stimulate the brain’s blood vessels and nerve cells, enhancing the natural activity of the brain. The positive effects of the method have already been documented through studies described in several scientific articles, and published among others in the recognized journal Biological Psychiatry in 2010.
One of the latest articles on the method cites a research study documenting that over 70 per cent of refractory patients can be declared healthy after only eight weeks of 30 minutes daily treatment even if they have had a depression for more than two years.
Steen Dissing has received more patents in Europe and in the US for his treatment concept, Re5-NTS. He got European approval for treatment of refractory depression a year and a half ago (in 2015) and a Norwegian company, Navamedic ASA, has started introducing the use of the device (T-PEMF) in Denmark.
Employed as Professor at the Department of Cellular and Molecular Medicine at the University of Copenhagen. For 15 years, he has been working on his method to cure patients with chronic depression.
Yet Steen Dissing, who works at the Department of Cellular and Molecular Medicine at the University of Copenhagen, feels like he has hit a brick wall when it comes to disseminating his treatment to those who need it the most. He fears that without permanent financial support for treatment, the treatment may stop in Denmark within half a year.
Six psychiatric departments affiliated with Danish hospitals are still investigating the effect of Steen Dissings treatment method. After spending 15 years of his research life on it, this matters a great deal to Steen Dissing. He has also worked for many years in the United States and cannot see why things are going so slow at home.
“Denmark is too conservative a country when it comes to finding money for new therapies in psychiatry. The government has good reports worked out on developing its pharmaceutical and medico industry to new heights, but nothing happens when it comes to the treatment of psychiatric disorders,” says Steen Dissing. He finds it frustrating.
“I cannot get a single krone for research from the large foundations in Denmark, and I can tell you that it’s hard,” he says.
Poul Videbech, professor of psychiatry and head doctor at the Psychiatric Center Glostrup, is one of the people investigating the effect of Steen Dissing’s treatment concept on refractory patients. From his point of view things have to take time.
“I understand Steen Dissing’s frustrations that things are going too slowly, but I do think it is sensible to await the results of the analysis we are doing, and we will release our recommendations this summer,” says Poul Videbech.
I was sceptical about it initially because it seemed too good to be true, but we have tried it on patients here at Glostrup. It has a fantastic effect and we have not observed any side effects.
In his view, the biggest problem with T-PEMF is something different.
“I do not understand that Navamedic ASA will only lease the devices. For the psychiatrists’ finances, there is a big difference between a one-off investment, which is a manageable expense, or whether to have to pay for each treatment where they provide the device. This is an obstacle to using it,” says Poul Videbech.
Steen Dissing defends Navamedic ASA’s principle of leasing out the device:
“T-PEMF is a so-called Class IIa device where the authorities require a continuous supervision. The batteries may need replacing and there are parts in it that have an expiry date. They are governed by EU regulations, and if a hospital or clinic bought it, they would be subject to an administrative burden and expense that is far greater than the cost of leasing it. So it is much better with a lease agreement.”
Poul Videbech mentions an example of how it already works in some clinics with a similar device (a TMS), which is used for another type of magnet treatment, which costs a few hundred thousand kroner.
“The TMS is a much more expensive and much more complicated device than the T-PEMF, but once we have purchased TMS, we can use it for as long and as much as we want and I cannot understand why there should be special conditions attached to T-PEMF,” he says.
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Poul Videbech also sees opportunities in using Steen Dissing’s treatment concept.
“I was sceptical about it initially because it seemed too good to be true, but we have tried it on patients here at Glostrup. It has a fantastic effect and we have not observed any side effects.This is very, very interesting, and our patients with chronic depression have started to ask us if they can buy it to have at home the next time their depression returns. I would do the same if I was in their situation,” says Poul Videbech.
It is therefore important to understand how the system works today if it is to succeed, he believes.
“Right now, within psychiatry, if you need to spend money on a new treatment, you need to find them somewhere else. So those that make spending decisions, like the psychiatrist directors, want to be absolutely certain that they get value for money. I see nothing wrong with this principle,” says Poul Videbech.
Steen Dissing would rather ensure that new, innovative treatment concepts are quickly available at Danish hospitals, and that are more flexible.
“We have no problems with doing a test first. We wanted this ourselves. Our problem is that we have heard that hospitals do not want to reduce the costs of patient treatment in the clinics for, say, DKK 8,000 a month per device,” says Steen Dissing.
Steen Dissing’s co-operation partners:
Teddy Hebo Larsen, cand. med. vet., former director of the pharmaceutical company Ely Lilly and later HR manager at Lundbeck A/S. Teddy Hebo Larsen is experienced in developing and marketing new treatment methods.
Mogens Undén, a psychiatrist and a close friend for many years was the first to suggest that the principle of stimulating the brain’s nerve cells with electromagnetic impulses could be used in patients with depression when no other antidepressant treatments work. In addition, there has been interdisciplinary collaboration between students, civil engineers and biochemists who have each contributed. News.ku.dk has described the helmet and the treatment in articles in both 2014 and 2016.
What do you think is the best way to go about this?
“We must talk to the hospital owners and make them understand that they need to take on the wider societal challenge and look beyond their own finances,” says Steen Dissing.
“Hospitals each have their own finances, and hospital directors think that they are already committed to spending money on both cancer medicine, maternity departments, studies of stomach and intestines and many other things so they have no more money. So someone higher up in the system needs to tell them that they have to do this because society can save so much money. If not, nothing happens,” says Steen Dissing.
So it needs a political decision?
“Exactly, and it should be done in collaboration between health politicians, the regions and the respective hospital administrations,” says Steen Dissing.
The attempts to pass off the costs could be the death of Steen Dissing’s treatment concept, and it irritates him to think that Denmark may not join the new treatment area of electrostimulation which his concept is a part of.
“Electrostimulation is already very large in the United States, Germany and in Israel. In 10-20 years, doctors can treat certain areas of the brain in, for example, Alzheimer’s, Parkinson’s and depressions using focused electric currents. I dare to predict that electrostimulation will largely replace medicine, but the question is unfortunately whether Denmark will be a part of this from the start,” says Steen Dissing.
I dare to predict that electrostimulation will largely replace medicine, but the question is unfortunately whether Denmark will be a part of this from the start
He has scrutinised the report ‘World class life science’ by the government’s ‘growth team for life science’ from March 2017.
Life science includes medical science and the pharmaceutical industry, and recommendation number 12 in the report states that ‘The opportunities for Danish life science companies to attract capital should be strengthened’. In recommendation number 15 it states that ‘work should continue to support a smooth, stable, rational and innovation-enhancing domestic market that can function as a display window for abroad.’
Steen Dissing finds it difficult to see the reason why apparently nothing happens when his treatment method, according to the report, is exactly what the politicians and the authorities want.
“Denmark is not necessarily the innovative country that we would like to perceive ourselves as,” says Steen Dissing:
“A refractory patient can quickly cost the public DKK 350,000-650,000 a year as the patient remains ill. The cost of T-PEMF treatment is DKK 8,000-10,000 a month, but everything still depends on whether the regions will be involved in a permanent subsidy scheme.”
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Per Bech is one of the authors in the 2010 Biological Psychiatry article. He is also employed as clinical professor at the Department of Clinical Medicine at the Capital Region’s psychiatry unit in Hillerød, and he shares Steen Dissing’s opinion that there is a problem:
“The savings with Re5-NTS are massive, but this argument can be lost in the attempt to shuffle costs in the public hospital sector. The financial situation of each hospital can be detrimental to the roll-out of new technology. This can happen if you choose to use, for example, DKK 10,000 per patient due to narrow economic thinking, and instead shove a much larger expense over to other parts of the health service.”
This can include expenses for early retirement and sickness benefits. There may also be costs associated with social services from social workers, job centers or psychologists, or expenses for revisiting general practitioners and psychiatrists, says Per Bech.
The stage is set for a ruling over Re5-NTS when the six Danish hospitals’ study of the effect of the new treatment form is ready after the summer vacation.