The study, published in the journal European Child & Adolescent Psychiatry, involved over 550 adolescents aged 11 to 18 who had been referred to children and adolescent mental health services (CAMHS) in England, comparing those who received bespoke social prescribing referrals while waiting for treatment with those who did not.

The research team found that young people who received social prescribing reported improvements in behaviour (including reductions in conduct difficulties), enhanced relationships with others, and increased resilience, including greater confidence in solving problems and higher self-esteem.

As of late 2024, over 350,000 children and young people were waiting for specialist mental health care in England, with average wait times of just under eight months.

Lead author Dr Daniel Hayes (UCL Behavioural Science & Heath) said: “Previous research from our team has shown that many young people and families find waiting for mental health services difficult and often feel they lack support during that period. Our new study suggests that social prescribing may provide a valuable source of support while young people are waiting, helping them strengthen relationships, build resilience and improve day-to-day functioning.”

One of the young people in the trial who received social prescribing said: “I think one of the things that has changed is if my mum or someone at school like a teacher asked me about how I’m feeling, I think I’m a lot more open to discussing it. I wasn’t as much before [social prescribing].”  Another participant said their link worker “really helped me get back into social groups and social settings, so I was more comfortable around people”. A third young person said: “It felt like someone was listening, and [my social prescriber] always turned up and actually cared.”

Activities and resources that young people in the study were connected to by their link workers included karate clubs, art classes, Pokemon tournaments, book clubs and nature wandering clubs. Link workers also helped young people plan days out with friends.

Senior author, Professor Daisy Fancourt (UCL Behavioural Science & Heath), noted that the study did not find evidence of changes in symptoms of depression, anxiety or stress over the six-month follow-up period, although this is partly expected. “Social prescribing should not be seen as a substitute for evidence-based psychological treatments. Instead, the findings suggest its value for young people on waiting lists for mental health services is in supporting day-to-day functioning and strengthening protective factors during this high-risk waiting period. Instead of merely ‘waiting’, young people and their families can engage in activities that may help them be more ‘treatment ready’ when they reach the end of the waiting list.”

Amanda Thompson, Children & Young People’s Link Worker at Sunderland Counselling Service, said: “One of the aspects I value most about the social prescribing model is its person-centred approach. It focuses on what is important and meaningful to the young person, placing them at the heart of the process.

“I have seen firsthand how this approach gives young people the opportunity to take ownership of their own journey, while recognising and celebrating the achievements they make along the way. It also extends beyond the individual, often having a positive impact on the wider family unit by reducing pressures, strengthening relationships, and creating a more supportive home environment.

“Seeing a young person who may have previously struggled socially begin to engage in clubs or activities, develop hobbies, learn new skills, build friendships, and grow in confidence is incredibly rewarding. What may seem like small steps to others can represent significant achievements and personal progress for a young person.

“Looking back on a young person’s journey and recognising how far they have come is one of the most fulfilling aspects of the role.”

The new study follows on from research earlier this year by members of the same team, published in Nature Health, which found that adults referred for social prescribing (including young people) gained “sizable” improvements in wellbeing in the months after initial referral.

That research looked at data from 19,627 people in the UK who had accessed social prescribing (either through a GP or through community referrals) and who had answered questions about their wellbeing. The team found consistent improvements across all the measures they assessed, including a 20% improvement in general mental wellbeing, alongside additional improvements in happiness, life satisfaction, anxiety levels and a sense of life being worthwhile.

In 2023, more than a million people in England alone were referred for social prescribing services by their GP.

The latest Wellbeing While Waiting study was carried out in partnership with 11 NHS child and adolescent mental health trusts in England. The work was funded by the Prudence Trust, with additional support from Wellcome and the Economic and Social Research Council (ESRC).

The adult social prescribing study was funded by the ESRC, supported by the National Academy for Social Prescribing (NASP) and utilised anonymised patient data from Access Elemental, a social prescribing software provider.

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Drawing on a large and diverse national sample, researchers found that formulary rejections occurred frequently and, in many cases, resulted in treatment being delayed or never received at all. The findings underscore the persistent tension between efforts to control drug spending and patients’ ability to obtain the medications their clinicians prescribe.

Single-source branded drugs—medications available from only one manufacturer with no generic equivalent—can be particularly vulnerable to access problems when insurers decline to cover them under their formularies, the lists of drugs a health plan agrees to pay for.

The authors say the results highlight the real trade-offs patients face between cost and access, and point to the need for closer scrutiny of how formulary decisions affect the people who depend on these treatments.

The study was led by corresponding author Joseph F. Levy, PhD, of Johns Hopkins University. Additional details, including author affiliations, conflict of interest disclosures, and funding sources, are available in the full article (doi:10.1001/jama.2026.8702).

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The June cycle also includes a significant update to the existing recommendation for nusinersen in spinal muscular atrophy, as well as a positive second appraisal for a CAR-T cell therapy in large B-cell lymphoma — a treatment pathway that continues to expand within the NHS.

Oncology

Tivdak recommended for cervical cancer

Tisotumab vedotin (Tivdak), an antibody-drug conjugate developed by Genmab and Pfizer (via Seagen), received a positive NICE recommendation on 11 June 2026 for previously treated recurrent or metastatic cervical cancer. Tivdak targets tissue factor, a protein highly expressed on cervical cancer cells, and delivers a microtubule-disrupting payload directly to tumour cells. The approval addresses a population with limited options following progression on first-line platinum-based chemotherapy.

Libtayo recommended for non-small cell lung cancer

Cemiplimab (Libtayo), developed by Regeneron, was recommended on 16 June 2026 for previously untreated non-small cell lung cancer (NSCLC) in patients whose tumours express PD-L1. Libtayo is a PD-1 checkpoint inhibitor that restores the immune system’s ability to recognise and destroy cancer cells. The recommendation offers a further immunotherapy option in first-line NSCLC alongside existing PD-1 and PD-L1 inhibitors already available on the NHS.

Darzalex Faspro quadruplet recommended for multiple myeloma

NICE recommended the four-drug combination of daratumumab SC, lenalidomide, bortezomib, and dexamethasone (D-VRd; Darzalex Faspro, Revlimid, Velcade) on 24 June 2026 for newly diagnosed multiple myeloma. Submitted by Janssen Biotech, this subcutaneous daratumumab-based quadruplet regimen builds on the established VRd backbone by adding the anti-CD38 monoclonal antibody daratumumab, which has consistently demonstrated improved response rates and progression-free survival in myeloma. The approval positions D-VRd as a potential new standard of care for eligible transplant-eligible and ineligible patients.

Hansizhuang recommended for extensive-stage small cell lung cancer

Serplulimab (Hansizhuang), in combination with chemotherapy and submitted by Shanghai Henlius Biotech and Fosun Pharma, received a positive recommendation on 18 June 2026 for extensive-stage small cell lung cancer (ES-SCLC). Small cell lung cancer is an aggressive malignancy with a historically poor prognosis, and first-line chemoimmunotherapy has become the standard approach following earlier immunotherapy approvals in this setting. Serplulimab is an anti-PD-1 antibody, and its recommendation provides a further immunotherapy option for patients presenting with extensive disease.

Imfinzi plus FLOT chemotherapy recommended for gastric and gastro-oesophageal junction cancer

Durvalumab (Imfinzi) in combination with FLOT chemotherapy (fluorouracil, leucovorin, oxaliplatin, and docetaxel) was recommended by NICE on 3 June 2026 as a neoadjuvant and adjuvant treatment for resectable gastric cancer and gastro-oesophageal junction cancer (GEJC). Developed by AstraZeneca, the perioperative regimen adds PD-L1 blockade to an established chemotherapy backbone, reflecting evidence that immunotherapy can improve surgical outcomes and reduce the risk of recurrence in patients with potentially curable disease.

Breyanzi receives positive recommendation for diffuse large B-cell lymphoma

Lisocabtagene maraleucel (Breyanzi), a CD19-directed CAR-T cell therapy developed by Bristol Myers Squibb (via Juno Therapeutics and Celgene), received a positive second appraisal recommendation on 3 June 2026 for relapsed or refractory diffuse large B-cell lymphoma (DLBCL). CAR-T therapies represent a complex and highly personalised treatment modality in which a patient’s own T cells are engineered to recognise and destroy cancer cells. The updated recommendation reflects revised cost-effectiveness evidence and expands NHS access to this potentially curative one-time treatment for patients who have failed two or more prior lines of therapy.

Respiratory & Cardiovascular

Nucala recommended for eosinophilic COPD

Mepolizumab (Nucala), developed by GSK, received a positive recommendation on 17 June 2026 for eosinophilic chronic obstructive pulmonary disease (COPD). Nucala is an anti-interleukin-5 monoclonal antibody already established in severe eosinophilic asthma, and this approval extends its indication to a subset of COPD patients characterised by elevated blood eosinophil counts. It represents an important development in COPD management, which has traditionally relied on bronchodilators and inhaled corticosteroids, by targeting an underlying inflammatory mechanism in eligible patients.

Winrevair recommended for pulmonary arterial hypertension

Sotatercept (Winrevair), developed by Acceleron and Merck, received a positive NICE recommendation on 3 June 2026 for pulmonary arterial hypertension (PAH). Sotatercept is an activin signalling inhibitor — a first-in-class mechanism of action in PAH — that addresses vascular remodelling, the underlying pathological process driving the progressive increase in pulmonary artery pressure that characterises this condition. Current PAH therapies largely target vasodilation; sotatercept’s distinct mechanism makes it a meaningful addition to the treatment armamentarium, particularly in combination with existing background therapy.

Nexlizet recommended for dyslipidaemia

The combination of bempedoic acid and ezetimibe (Nexlizet), submitted by Esperion Therapeutics and Daiichi Sankyo, was recommended on 24 June 2026 for dyslipidaemia in patients unable to tolerate statins or with an inadequate response to statin therapy. Bempedoic acid inhibits ATP-citrate lyase, an enzyme upstream of HMG-CoA reductase in the cholesterol biosynthesis pathway, while ezetimibe reduces intestinal cholesterol absorption. The combination provides a non-statin LDL-lowering option for a patient group that includes those with statin intolerance, an issue frequently encountered in clinical practice.

Hepatology & Gastroenterology

Livdelzi recommended for primary biliary cholangitis

Seladelpar (Livdelzi), developed by Gilead Sciences and CymaBay Therapeutics, received a positive recommendation on 24 June 2026 for primary biliary cholangitis (PBC), a rare chronic autoimmune liver disease that can lead to cirrhosis if inadequately treated. Seladelpar is a selective PPAR-delta agonist that reduces the production of bile acids and suppresses biliary inflammation. The recommendation is significant for patients who have had an inadequate response to or cannot tolerate ursodeoxycholic acid, which has long been the only licensed first-line treatment for PBC in the UK.

Neurology & Paediatrics

Spinraza recommendation updated for spinal muscular atrophy

Nusinersen (Spinraza), developed by Biogen and Ionis Pharmaceuticals, received an updated NICE recommendation on 4 June 2026 for spinal muscular atrophy (SMA). SMA is a rare and often severe inherited neuromuscular disease caused by mutations in the SMN1 gene. Spinraza was among the first disease-modifying treatments to be approved for SMA and works by modifying splicing of the SMN2 gene to increase production of functional SMN protein. The updated recommendation likely reflects revised clinical or cost-effectiveness evidence, potentially expanding eligible patient groups or amending existing access criteria.

Terminated Appraisals

Inluriyo appraisal terminated for ER-positive breast cancer

The appraisal of imlunestrant (Inluriyo), an oral selective oestrogen receptor degrader (SERD) submitted by Eli Lilly and Loxo Oncology, was terminated on 18 June 2026 for oestrogen receptor-positive, HER2-negative breast cancer with ESR1 mutation. ESR1 mutations are a recognised mechanism of resistance to aromatase inhibitors and represent a clinically important unmet need. The reasons for termination were not specified in the available data, though terminated appraisals typically reflect a withdrawal by the company or an inability to agree a managed access arrangement.

Anktiva appraisal terminated for BCG-unresponsive bladder cancer

The appraisal of nogapendekin alfa inbakicept (Anktiva), submitted by ImmunityBio and Accord Healthcare for BCG-unresponsive non-muscle-invasive bladder cancer, was terminated on 4 June 2026. BCG-unresponsive disease represents a challenging clinical situation in which patients have failed intravesical BCG immunotherapy — the standard treatment for high-risk non-muscle-invasive bladder cancer — and face a choice between radical cystectomy or further bladder-sparing treatments. The termination leaves this patient population without a new approved option via NICE at this time.

Decisions referenced carry NICE Positive 1, NICE Positive 2, NICE Update 1, or Terminated status, issued between 3–24 June 2026. This article is based on data from the NICE Technology Appraisal Programme for England and Wales.

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A privileged but pressured role

GPs sit “at the forefront” of the NHS, seeing large numbers of patients each day, often within 10 or 15-minute consultations, says Dr Vautrey. The role spans the full spectrum of life, from young children to elderly patients living with long-term conditions or reaching the end of life. Much of the challenge lies in the unpredictability of each consultation: clinicians frequently do not know in advance what a patient will bring to them, making it a “real privilege” but also a demanding job, particularly when trying to spot emerging conditions among the many patients whose long-term conditions are already well understood.

What “seamless” means for patients

Patients simply expect their GP and pharmacist to be working from the same information, says Dr Vautrey. Electronic prescribing has already transformed this relationship, replacing handwritten and printed prescriptions with direct electronic transfer to the pharmacy. Where practices and pharmacies have a good working relationship, patients experience this as a single, joined-up local health service, with consistent messaging from both sides. Co-located or closely-linked pharmacies and surgeries tend to achieve this most effectively, he notes.

The 10-year plan: promising rhetoric, uncertain delivery

Asked about the NHS 10-year health plan, Dr Vautrey is cautiously optimistic but wary of a familiar pattern. The ambition to move care into the community and build up neighbourhood health services is “long overdue”, he says, but it must be matched by sustained investment, since community services – including community nursing – have been “overstretched and underfunded” for years. Real investment is needed not only in workforce but in premises, many of which are currently too small to expand services such as community cardiology, dermatology, ENT or gynaecology clinics that could otherwise be delivered locally.

Digital records and data confidence

General practice has led the NHS on digital records for years, says Dr Vautrey, citing electronic prescribing as a case in point: patients can now receive a prescription within minutes wherever they are in England, rather than having to track down a local GP while travelling. Increasing use of the NHS app and shared access to patient information is welcome, but any new digital systems must preserve patients’ confidence that their data will remain confidential and properly safeguarded, he emphasises.

Prevention: good intentions, but funding gaps remain

On the plan’s emphasis on tackling obesity and smoking, Dr Vautrey highlights the frustration many GPs feel at being unable to prescribe newer, highly effective weight-management medications more widely because of cost. He also points to years of cuts to locally commissioned preventive services – weight management, smoking cessation, drugs and alcohol and sexual health services – as local authority budgets have come under pressure, warning that a long-term, wholesale commitment to prevention funding is needed to reduce future NHS costs.

Wearables and shifting expectations

It is “too early to know for sure” how useful wearable technology will prove, says Dr Vautrey. Home blood pressure monitoring is already valuable, partly because it avoids the anxiety some patients feel in clinical settings, but other wearables can sometimes generate anxiety rather than reassurance. Simple tools such as phone step-counters, however, can meaningfully encourage physical activity. More broadly, patient expectations of living longer with long-term conditions are rising, and society will need honest conversations about what the NHS can sustainably provide versus what may need to be funded differently, particularly as highly specialised, expensive medicines become available.

Drug shortages: a persistent, largely economic problem

Medicine shortages remain a daily frustration for GPs, pharmacists and patients, says Dr Vautrey. The causes range from global manufacturing issues to manufacturers choosing to sell more profitably elsewhere rather than into the UK market. He believes government has yet to grapple seriously with the issue, including the case for greater domestic medicine production. At present, all too often, pharmacists bear the brunt of patients’ frustration when common medicines become hard to source.

A closing message

Reflecting on his years representing GPs nationally, Dr Vautrey’s message to government is unambiguous: practice teams, community pharmacists and other primary care professionals are already working closely together on patients’ behalf, but they need long-term, sustained investment. Strengthening these foundations, he argues, would improve care quality, ease pressure on secondary care, and ultimately leave both patients and the NHS as a whole better off.

About Dr Richard Vautrey

Dr Richard Vautrey is a GP partner, Meanwood Group Practice, Leeds and Clinical Director, Leeds Central North PCN.

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Oncology and dermatology feature prominently in this cycle, with notable recommendations for novel antibody-drug conjugates, a new JAK inhibitor indication, and an innovative combination approach in multiple myeloma. The cycle also includes three vaccine recommendations addressing chikungunya, meningococcal disease, influenza, and orthopoxvirus infections.

Oncology

Datroway recommended for triple-negative breast cancer

Datopotamab deruxtecan (Datroway), an antibody-drug conjugate developed by Daiichi Sankyo and AstraZeneca, has received a positive CHMP recommendation for triple-negative breast cancer (TNBC). TNBC remains one of the most challenging breast cancer subtypes to treat, given its lack of hormone receptor and HER2 expression. Datroway targets TROP2, a protein overexpressed in many epithelial tumours, and delivers a cytotoxic payload selectively to cancer cells, offering a more targeted approach than conventional chemotherapy.

Tecvayli and Darzalex Faspro combination recommended for multiple myeloma

Johnson & Johnson has received a CHMP recommendation for the combination of teclistamab and daratumumab (Tecvayli and Darzalex Faspro) for multiple myeloma. Teclistamab is a bispecific T-cell engager targeting BCMA and CD3, while daratumumab is a well-established anti-CD38 monoclonal antibody. Combining the two mechanisms in a chemotherapy-free regimen represents a significant advance in the treatment of relapsed or refractory multiple myeloma, a condition that typically requires repeated lines of therapy over time.

Jaypirca recommended for chronic lymphocytic leukaemia

Pirtobrutinib (Jaypirca), a non-covalent BTK inhibitor developed by Loxo Oncology at Lilly and Eli Lilly, has been recommended for chronic lymphocytic leukaemia and small lymphocytic lymphoma (CLL/SLL). Unlike covalent BTK inhibitors such as ibrutinib, pirtobrutinib is designed to remain active in patients who have developed resistance mutations, offering a treatment option for a population with limited alternatives following prior BTK inhibitor therapy.

Denosumab biosimilar recommended for bone complications in cancer

Denosumab Ascend, a biosimilar of denosumab developed by Ascend GmbH, has received a CHMP recommendation for the prevention of skeletal-related events in patients with bone metastases and for giant cell tumour of bone. The availability of a biosimilar version of this widely used bone-targeted agent is expected to improve patient access and reduce costs for health systems across the EU.

Pegfilgrastim biosimilar recommended for neutropenia

Nylaspeg, a biosimilar of pegfilgrastim submitted by Qilu Pharmaceuticals, has received a positive recommendation for chemotherapy-induced neutropenia. Pegfilgrastim is routinely used to stimulate white blood cell production and reduce the risk of febrile neutropenia in cancer patients receiving myelosuppressive chemotherapy. The biosimilar recommendation supports continued access to this supportive care treatment at competitive cost.

Dermatology & Immunology

Rinvoq recommended for vitiligo and alopecia areata

AbbVie’s upadacitinib (Rinvoq), a selective JAK1 inhibitor, has received two separate CHMP recommendations expanding its indications into dermatology: one for vitiligo and one for alopecia areata. Vitiligo is a chronic autoimmune condition causing depigmentation of the skin, while alopecia areata results in patchy or total hair loss driven by immune-mediated attack on hair follicles. Both conditions have historically lacked effective systemic treatments, and these recommendations follow growing clinical evidence supporting JAK inhibition as a mechanism of action in autoimmune skin diseases. Rinvoq is already approved for several inflammatory conditions including rheumatoid arthritis, psoriatic arthritis, and atopic dermatitis.

Opzelura recommended for atopic dermatitis

Ruxolitinib cream (Opzelura), developed by Incyte Corporation and Maruho, has received a CHMP recommendation for atopic dermatitis (eczema). Opzelura is a topical JAK1/JAK2 inhibitor that provides targeted anti-inflammatory activity at the site of application, offering an alternative to topical corticosteroids for patients with mild to moderate disease. The recommendation addresses a highly prevalent condition that places significant quality of life burden on patients, particularly those with disease affecting visible areas of skin.

Neurology & Paediatrics

Daybue recommended for Rett syndrome

Trofinetide (Daybue), developed by Acadia Pharmaceuticals, has received a CHMP recommendation for Rett syndrome, a rare and severe neurodevelopmental disorder caused by mutations in the MECP2 gene, which predominantly affects girls. The condition leads to progressive loss of motor and communication skills and has no approved disease-modifying treatments in the EU. Daybue is a synthetic analogue of the naturally occurring tripeptide GPE (glycine-proline-glutamate) and represents the first pharmacological treatment specifically developed for this condition to receive a positive EU recommendation.

Crexont recommended for Parkinson’s disease

A prolonged-release combination of carbidopa and levodopa (Crexont), submitted by Amneal Pharmaceuticals and Zambon, has been recommended for Parkinson’s disease. Levodopa remains the cornerstone of Parkinson’s pharmacotherapy, but standard formulations are associated with motor fluctuations and wearing-off effects as the disease progresses. The extended-release formulation aims to provide more consistent plasma drug levels throughout the day, potentially reducing the frequency and severity of motor complications in patients with advanced disease.

Stelara recommended for paediatric ulcerative colitis

Ustekinumab (Stelara), developed by Johnson & Johnson, has received a CHMP recommendation for paediatric ulcerative colitis. Ustekinumab is an interleukin-12 and interleukin-23 inhibitor already established in adult inflammatory bowel disease and psoriasis. This paediatric recommendation addresses a significant unmet need in younger patients with moderate to severe ulcerative colitis who have an inadequate response to conventional therapy.

Infectious Diseases & Vaccines

Ixchiq recommended for chikungunya fever

Ixchiq, a live-attenuated chikungunya vaccine developed by Valneva SE and Instituto Butantan, has received a positive CHMP recommendation. Chikungunya is a mosquito-borne viral illness characterised by fever and severe joint pain, with outbreaks increasingly reported in southern Europe due to the northward spread of the Aedes albopictus mosquito. The approval of a preventive vaccine represents an important public health tool as the geographical range of the disease continues to expand.

MenQuadfi recommended for meningococcal disease

MenQuadfi, a conjugate vaccine targeting meningococcal serogroups A, C, W, and Y, developed by Sanofi, has received a CHMP recommendation. Meningococcal disease can cause life-threatening bacterial meningitis and septicaemia, particularly in infants, young children, and adolescents. The conjugate formulation is designed to produce a robust and long-lasting immune response and is suitable for use in paediatric populations.

Imvanex recommended for monkeypox and orthopoxvirus infections

Bavarian Nordic’s Imvanex, a modified vaccinia Ankara-based vaccine, has received a CHMP recommendation for protection against monkeypox (mpox) and other orthopoxvirus infections. Imvanex was already authorised for smallpox prevention in the EU and was used extensively during the 2022 mpox outbreak. This recommendation formalises its indication for mpox and broader orthopoxvirus prophylaxis, reflecting the continued public health relevance of the product.

Aujemflu recommended for influenza

Aujemflu, an adjuvanted trivalent influenza vaccine developed by Seqirus/CSL, has received a CHMP recommendation for the prevention of influenza. The adjuvanted formulation is designed to enhance immunogenicity, particularly in older adults and immunocompromised populations where vaccine responses may be suboptimal. The recommendation adds to the existing portfolio of seasonal influenza vaccines available to EU member states.

Symtuza and Prezcobix recommended for HIV

Two HIV antiretroviral regimens have received CHMP recommendations. Symtuza — a single-tablet combination of darunavir, emtricitabine, cobicistat, and tenofovir alafenamide (TAF), developed by Johnson & Johnson and Gilead Sciences — offers a complete one-tablet-once-daily regimen for HIV-1 infection. Separately, Prezcobix — a combination of darunavir and cobicistat developed by Janssen Therapeutics — provides a boosted protease inhibitor backbone for use in combination with other antiretrovirals. Both recommendations likely reflect updated indications or label revisions for these established regimens.

Cardiovascular & Diabetes

Leqvio recommended for hypercholesterolaemia

Inclisiran (Leqvio), a small interfering RNA (siRNA) therapy developed by Novartis, has received a CHMP recommendation for hypercholesterolaemia. Inclisiran works by inhibiting the production of PCSK9, a protein that reduces the liver’s ability to clear LDL cholesterol from the blood. Administered just twice yearly by subcutaneous injection, inclisiran offers a highly differentiated dosing schedule compared with daily oral statins or monthly PCSK9 inhibitor antibodies, which may improve adherence in patients requiring long-term lipid-lowering therapy.

Onswik recommended for type 2 diabetes

Insulin efsitora alfa (Onswik), a once-weekly basal insulin analogue developed by Eli Lilly, has received a positive CHMP recommendation for type 2 diabetes. The treatment represents a significant step forward in insulin therapy, offering a weekly injection as an alternative to the daily or twice-daily basal insulin regimens that many patients find burdensome. A reduced injection frequency is expected to support better adherence and patient quality of life, particularly in the early stages of insulin initiation.

All nineteen decisions listed carry CHMP Recommended status. CHMP recommendations are subject to final marketing authorisation by the European Commission. This article is based on data from the European Medicines Agency CHMP opinion cycle.

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Researchers found that many online GLP-1 RA prescription vendors did not require any interaction with a clinician, instead relying largely on patient-reported questionnaires. According to the study, these questionnaires may fail to capture important elements of a patient’s clinical and social history.

Several findings pointed to limited safety oversight. Investigators observed multiple GLP-1 RA prescriptions being issued by the same clinicians, prescriptions granted even when required photos were missing, and prescriptions completed in five minutes or less.

The findings add to growing scrutiny of the direct-to-consumer telehealth market, which has expanded rapidly alongside surging demand for weight-loss and diabetes medications.

The study’s corresponding author is Reshma Ramachandran, MD, MPP, MHS, of Yale University. The full study is available in JAMA (doi:10.1001/jama.2026.9131).

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Reduced NHS spending on other health interventions would have an adverse impact on public health which could increase excess preventable deaths by 229,000 by 2036 – more than the covid-19 pandemic between March 2020 and June 2022 (137,000). If the indirect effect on adult social care is also included, excess deaths increase to 291,000, argue the authors. Most of these deaths are expected to be people with cardiovascular, respiratory, and gastrointestinal disease and cancer.

The UK-US pharmaceuticals deal was announced by the UK government on 1 December 2025 and described as a “landmark” deal that would “safeguard medicines access and drive vital investment for UK patients and businesses” through strengthening UK-US cooperation in sectors like life sciences and pharmaceuticals.

The agreement secured a 0% tariff on UK pharmaceutical and medical device exports to the US for three years, but also committed the NHS to substantially higher expenditure on new branded medicines over the next decade through changes to drug pricing arrangements and health technology assessment.

From April 2026 the government instructed the National Institute for Health and Care Excellence (NICE) to increase its cost-effectiveness threshold for new medicines from £20,000-£30,000 per quality adjusted life year (QALY) to £25,000-£35,000 per QALY for the same health benefits.

Changes in the way health benefits are measured by NICE’s assessments will also give more weight to benefits offered by new medicines. QALYs combine gains in survival and quality of life into a single measure and NICE has generally required a cost-effectiveness threshold of £20,000-£30,000 per QALY to balance the health gains offered by new medicines against the detrimental impact on health if NHS resources were displaced from other services.

An agreement between the pharmaceutical industry and the UK government (the voluntary scheme for branded medicines pricing, access, and growth; VPAG) designed to limit growth in NHS expenditure on branded medicines through industry rebate payments has also been watered down. In 2025 the rebate rate was 23% but under the new agreement this has been cut to 14.5%.

Overall, under the deal, the government has committed to more than double spending on new medicines from 0.3% of gross domestic profit (GDP) to at least 0.6% by 2036, with interim targets of 0.35% of GDP in 2028 and 0.4% of GDP in 2030.

The Department of Health and Social Care has undertaken an impact assessment on the wider costs of this trade deal, but this document has not been made publicly available.

The authors are calling for the full details of the deal and its impact assessment to be made public so the deal can receive parliamentary scrutiny. They also emphasise that many of the suggested benefits of the deal, such as claims that higher UK medicine prices will stimulate pharmaceutical innovation and investment in the UK, are uncertain.

Assuming these GDP targets are met and GDP rises by 1.5% annually, as predicted by the Office for Budgetary Responsibility (OBR), the additional annual costs to the English NHS will be at least £1.3bn in 2028 (£25m per week), and £8.8bn in 2036 (£170m per week). The cumulative additional cost will be £2.6bn by the end of 2028 and £44.7bn by the end of 2036.

Modelling of English local authority data suggests that every £1bn the NHS must find to fund this deal will increase the costs of publicly funded adult social care by £118m because of increases in morbidity and mortality.

NICE estimates that increasing cost effectiveness thresholds will result in only two to five additional medicines being approved annually. NICE already approves more than 90% of medicines it evaluates, suggesting that the agreement is more likely to increase the prices paid for medicines already entering the NHS rather than substantially expand access.

While the agreement establishes zero tariffs on UK pharmaceutical and medical device exports to the US for three years, the UK remains a net importer of medicines. The economic benefits of securing zero tariffs for UK pharmaceutical exports has also been substantially diminished since a US Supreme Court ruling reduced the proposed tariffs from 100% to 10%. The projected costs of the agreement are expected to exceed the total annual value of UK medical exports to the United States (£5bn) before 2031.

The authors say, “The government’s willingness to accommodate industry pressure while the NHS absorbs the resulting costs raises important questions about transparency and accountability.”

They add, “More importantly, it emphasises a broader structural problem at the heart of a health system conceived with the intention of delivering equitable, patient centred care, now reduced to underwriting risk in global pharmaceutical markets.”

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The strongest increase in consultations for anxiety and depression was observed for symptoms, such as feeling depressed or anxious, rather than anxiety or depressive disorders, the findings indicate.

Mental health problems have reportedly increased in many high-income countries, particularly among teens and young adults, raising concerns about deteriorating population mental health, note the researchers.

But it’s not clear if rising service use might reflect greater underlying mental ill health or changes in help seeking behaviour and diagnostic practice, they add.

In a bid to find out, the researchers studied all 10–46 year olds in Norway between 2010 and 2024—a total of 3,728,002 people.

They analysed administrative registers of general practitioner (GP) data to estimate the annual sex- and age-specific prevalence of any mental health consultation.

In the Norwegian primary care reimbursement system doctors code the reasons for contact as either symptoms or disorders.

Analysis of the data showed that the proportion of 10–46 year olds with any mental health consultation recorded by a GP rose from just under 10% in 2010 to 16% in 2024.

Among girls and women, it rose from nearly 12% to just over 19.5%, and from just over 8% to just over 12.5% among boys and men.

The steepest increases occurred among 21–30 year olds, with relative increases of 69% for women—from 13% to 22%—and 52% for men—from just under 9% to nearly 14%.

Among the youngest age group (10–15 year olds), the proportion of those with any mental health consultation rose from 3.5% of girls and just over 5% of boys in 2010 to around 9% for both sexes in 2024.

When consultations for anxiety and depression—two of the most common reasons for mental health consultations—were disaggregated, symptom codes showed notably steeper increases than disorder codes across all age groups.

The proportion of primary care consultations for anxiety or depressive symptoms increased substantially over the study period: 286% relative rise in those coded as anxiety symptoms (from 0.44% to 1.7%); 147% relative rise in those coded as depressive symptoms (from 0.73% to 1.8%).

By comparison, the proportion of consultations coded as anxiety or depressive disorders rose only slightly or remained stable: 46% relative increase for those coded as anxiety disorder (from 0.95% to 1.4%); 4% decrease for those coded as depressive disorder (from 2.8% to 2.7%).

The steepest increase in recorded anxiety symptoms was among 16–20 year old women, rising from 0.4% to 2.3%—a 475% relative increase—while the proportion recorded as anxiety disorder rose by a relative increase of 64%–from just under 1.5% to just over 2%.

The steepest increases in depressive symptom consultations were among 21–46 year old women, particularly after 2020, and particularly among 21-30 year olds.

By comparison, there was no comparable increase in the proportion of depressive disorder consultations in either sex at any age.

The researchers caution that their study relied only on primary care data, which didn’t include symptom severity, so can’t be used to provide conclusive evidence on the mechanisms underlying the changes in primary healthcare service use for mental health problems.

“The observed increases could reflect changes in underlying distress, but also changes in recognition, willingness to disclose symptoms, help-seeking and clinical recording practices,” they note.

“While the observed over-proportional increase in symptoms is consistent with changes in norms for help-seeking, it cannot exclude alternative explanations, such as an actual increase in lighter mental health problems among young people, for example, due to increased social media use, the pandemic experience, or other factors,” they add.

Nevertheless they conclude: “The findings suggest that changes in help-seeking behaviour and/or diagnostic recording, rather than worsening underlying morbidity, are key drivers of rising primary care mental health contacts.”

The findings also have implications for primary care, they point out.

“The growing volume of symptom-level presentations poses an organisational challenge for GPs, who face increasing demand that may be more appropriately managed through psychoeducation or brief digital interventions rather than traditional clinical pathways,” they suggest.

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Heart failure affects approximately 860,000 Canadians, is associated with reduced survival and quality of life, and is the third leading cause of hospitalization in the country. Heart failure with reduced ejection fraction (HFrEF) accounts for approximately half of these cases.

Despite high-quality evidence supporting the benefits of guideline-directed medical therapy (GDMT) for patients with HFrEF, which entails the rapid initiation of four distinct classes of medication collectively known as quadruple therapy, use of these medications remains suboptimal. This is in part due to inadequate access to heart failure specialists and clinics for many Canadian patients living with HFrEF. This high unmet need underscores the importance of alternative models that expand beyond physician-led GDMT management.

“Heart failure is a serious medical condition that has several effective medications that are underused across Canada,” says lead investigator Ricky Turgeon, BSc(Pharm), ACPR, PharmD, Faculty of Pharmaceutical Sciences, University of British Columbia. “Pharmacists and nurse practitioners are important members of the healthcare team who can help to improve medication use for heart failure.”

The researchers evaluated whether getting pharmacists and nurse practitioners to initiate and manage heart failure medications would be good value for money for the healthcare system by comparing two different scenarios using an economic model.

In the first scenario, patients with heart failure received the usual care currently experienced by most British Columbians with heart failure. In the second scenario, patients with heart failure received the usual care plus additional medication management from pharmacists and nurse practitioners. The investigators then modelled what would happen to these patients over time and tracked how long they would live, how often they would be hospitalized, and how much healthcare resources they would need.

It was estimated that within the first year of implementation, this added service would save approximately 10 lives and prevent 25 hospitalizations per every 1,000 patients who received the pharmacist- or nurse practitioner-led intervention.

“While this service would require additional funding, we demonstrated that this investment would be well justified given what the Canadian healthcare system is generally willing to pay,” notes Dr. Turgeon. “The size of this benefit was far beyond what was anticipated. As a pharmacist caring for people with heart failure, I find these results genuinely empowering. They show that we play an important role in improving patients’ lives while also easing pressure on the healthcare system. We have the evidence; now we need to implement this approach.”

By quantifying the clinical and economic impacts of these additional medication management services, this study provides healthcare system planners with the insights needed to effectively address persistent gaps in care for heart failure patients.

Co-lead investigator Kelly Mackay, MA, Cardiac Services BC, Provincial Health Services Authority, comments, “Our research offers a roadmap to improving patient outcomes while strengthening the sustainability of our health system. The research also provides Cardiac Services BC with the evidence and innovation needed to drive meaningful system change.”

“Expedited and increased access to quadruple therapy has the potential to save lives and reduce some of the pressures in British Columbia’s hospitals. We believe this model could also be successful in other Canadian provinces. We’re thrilled that this research presents such an effective—and feasible—way for more heart failure patients to receive this gold-standard treatment,” concludes co-investigator Nathaniel Hawkins, MBChB, MD, MPH, Cardiac Services BC, Provincial Health Services Authority, and Division of Cardiology, University of British Columbia.

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Meanwhile, traditional, in-person visits to the doctor’s office have rebounded since the pandemic. And although digital medicine has become a routine part of healthcare, it is supplementing rather than replacing in-person care. This evolution, researchers say, is reshaping how hospitals and clinics operate daily.

These are the main conclusions of the study, which was led by researchers at NYU Langone Health and represents the largest review ever performed on communications recorded by Epic electronic health records. The team’s analysis involved more than 140 million patient records from 2,067 hospitals and 47,100 health clinics in the US. As part of the study, the researchers evaluated over 8 billion patient-provider interactions that took place between January 2020 and December 2025.

Publishing in the Journal of the American Medical Association (JAMA) online June 22, the study team found that online portal messages more than doubled between 2020 and 2025 (by 153 percent). By contrast, total telephone calls decreased by 6 percent over the same period. The number of Americans with an active Epic health record went from 94 million in 2020 to 140 million in 2025. Thirty percent of active patients on Epic (42 million) sent a portal health app message to their clinician during the first three months of 2025.

Patient portal visits, however, are not replacing in-office visits, which have returned to an average of between two and three per year per patient. Messages from patients to healthcare providers have doubled since the pandemic, from an average pace of 2.2 per year in early 2020 to 5.4 per year in late 2025.

“Our study shows that use of patient portals, health apps, and messaging are now a routine part of everyday patient care across America, not simply side channels used occasionally,” said study senior investigator Michal A. Mankowski, PhD.

Dr. Mankowski, an assistant professor in the Department of Surgery at NYU Grossman School of Medicine, said the study demonstrates that patients now have much more direct access to physicians and other clinicians.

“Our findings reveal that while digital health tools have become a core part of healthcare, delivery is becoming more continuous, timeless, and no longer tied to scheduled appointments during routine work hours,” said Dr. Mankowski.

Among the study’s other findings was that since 2020, Americans have, as logged in Epic record systems, booked at least 1.77 billion in-person visits to health clinics, sent 1.34 billion messages to their healthcare providers, and received some 3.25 billion online portal messages from providers. Also documented in Epic were 1.59 billion telephone calls and 146 million virtual telehealth portal visits.

Study co-investigator Dorry L. Segev, MD, PhD, said that the digital delivery of healthcare does not replace the old ways of working; it just adds another layer of more steps to existing workflows. To manage this new patient reality, hospitals, clinics, and healthcare workers have to plan future staffing and support.

“Modern delivery of healthcare means increasingly that healthcare providers will have to balance their digital workload on top of their traditional clinical workload,” said Dr. Segev, a professor and vice chair in the Department of Surgery at NYU Grossman School of Medicine. “Clinical staff will need to be trained in mastering the tools of messaging in healthcare; in using AI support programs, including chatbots that can frame content to minimize its complexity; and in making the most effective use of clinician time needed for online billing and online counseling,” said Dr. Segev, who is also a profession in NYU Grossman’s Department of Population Health.

Already, he noted, NYU Langone uses AI support tools to speed up drafting of physician and provider notes.

Dr. Segev said the team next plans to look more specifically at digital-use trends within healthcare systems, including NYU Langone, to break down any regional and outpatient clinic-specific shifts that could affect operational planning.

For the study, the team used Epic Cosmos, a national dataset of the electronic health records of more than 300 million American patients. The dataset includes information from a majority of hospitals and clinics that use Epic, the nation’s largest vendor of electronic health record systems, which had no role in performing the study.

Funding support for the study was provided by NYU Langone.

Along with Drs. Mankowski and Segev, NYU Langone researchers involved in the study were lead investigator Jane J. Long, MD, and co-investigators Mara A. McAdams DeMarco, PhD; Mark D. Schwartz, MD; Joshua Chodosh, MD; and Eric K. Oermann, MD.

Dr. Mankowski was recently elected to serve on the governing board of Epic Cosmos. Dr. Schwartz reported being president-elect of the Society of General Internal Medicine. Dr. Segev has received consulting and/or speaking honoraria from Sanofi, CareDx, Moderna, AstraZeneca, Roche, Optum, OrganOx, Hansa, and Biosidus and is a journal editor for Springer. None of these activities are related to the current JAMA study. NYU Langone is managing the terms and conditions of these relationships in accordance with its policies and procedures.

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The population-based retrospective cohort study, which analysed data from more than 1.8 million Canadian adults, examined how initial prescribing patterns influence whether patients go on to use benzodiazepines over the long term. The findings highlight a critical window of opportunity at the point of first prescription, suggesting that the decisions clinicians make early on can have a significant bearing on a patient’s longer-term trajectory.

Benzodiazepines are widely prescribed for conditions including anxiety, insomnia, and seizure disorders, but long-term use carries well-documented risks including dependence, cognitive impairment, and difficulties with withdrawal. Concerns about overprescribing and the potential for harm have made identifying modifiable risk factors a priority for researchers and health systems alike.

The study – funded by a Womenmind Grant to co-principal investigators at the Centre for Addiction and Mental Health (CAMH) – found that three initial prescribing characteristics were associated with earlier discontinuation: keeping the initial course short, prescribing a single benzodiazepine rather than multiple agents, and opting for short-acting formulations over longer-acting ones.

The research team say the results could directly inform prescribing guidelines, offering clinicians practical, evidence-based levers for reducing the risk of patients transitioning from short-term to long-term use.

The full paper, Association between initial benzodiazepine prescribing patterns and time to benzodiazepine discontinuation: A population-based retrospective cohort study, is freely available at https://plos.io/4uxybkF.

Image: Researchers assess long-term benzodiazepine use in Canada.

Credit: Haley Lawrence, Unsplash (CC0, https://creativecommons.org/publicdomain/zero/1.0/)

The post Long-term benzodiazepine use is less likely when shorter courses, a single medication or short-acting agents are prescribed, per cohort study of more than 1.8 million Canadian adults which could inform prescribing practices appeared first on Pharmacy Update Online.

“Our study findings highlight opportunities to improve patient care and reduce inappropriate testosterone prescribing. Long-term, these findings can lead to quality-improvement efforts and clinical decision support tools that promote consistent, guideline-concordant testosterone prescribing,” said senior author Maria Papaleontiou, M.D., associate professor at the University of Michigan in Ann Arbor, Mich.

The retrospective chart review included a random sample of 200 males assigned at birth (mean age, 52.5 years) with at least one outpatient primary care visit at Michigan Medicine in the past year, who had a diagnosis of hypogonadism, and received an initial testosterone prescription during the study period (2020 to 2025).

The most common coexisting medical conditions in the study population included obesity (63%), hypertension (52%), depression (40%), diabetes (28%) and arthritis (28%).

That data show only 12% of men who received an initial testosterone prescription had two low morning testosterone levels (total testosterone < 300ng/dL), free testosterone < 70pg/mL, or low bioavailable testosterone, between 5 a.m. and 10 a.m.), had their LH and/or FSH measured, and had no contraindications to testosterone therapy.

More than half of the patients (62%) had a prostate-specific antigen (PSA), and 77% had a complete blood count measured in the year before the initial testosterone prescription.

Overall, 55% of the men had obstructive sleep apnea, 4% prostate cancer and 1.5% PSA >4 ng/mL before being prescribed testosterone.

Prescriptions were written by primary care physicians (45%), urologists (35.5%), endocrinologists (18%) and other specialists (1.5%). The most common testosterone prescription was a topical formulation (68.5%).

Sinha and Papaleontiou said improving guideline-concordant testosterone prescribing can help prevent avoidable risks in people who may not have a true clinical need for it.

“Future studies should evaluate whether targeted interventions are needed,” Papaleontiou said.

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