Pakistan police arrest key suspect in Zainab murder case

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Zainab murder suspect Imran Ali has been arrested.
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The child, Zainab Ansari, was brutally assaulted and her body was thrown in a garbage dump. (File photo by AP)
Updated 24 January 2018
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Pakistan police arrest key suspect in Zainab murder case

LAHORE: Pakistani authorities in Punjab have arrested the prime suspect in the sexual assault and murder of seven-year-old Zainab Ansari.
Malik Ahmed Khan, a spokesperson for the Punjab government, told Arab News that the suspect was arrested in the central Punjab district of Pakpattan.
“We have found some initial evidence and we have reason to believe that he is the one we were looking for,” Khan said.
He added that it was a difficult job to track down the suspect because he had moved around a lot and disguised his appearance.
“He modified his look,” Khan told Arab News. “Sometimes he wore glasses, other times he shaved his beard.”
Zainab went missing in her hometown of Kasur on January 4. Her body was found in a rubbish dump on January 9.
Khan said further details about the suspect would be available once forensic tests were completed; adding that other suspects had been released after DNA tests cleared them of any involvement in the child’s murder.
The suspect has been named in various media outlets as Imran Ali, and he had reportedly been arrested earlier in the investigation, but was released after Zainab’s family said he was a “trusted” acquaintance.
“His appearance is similar to that of the person last seen with Zainab in CCTV footage,” a senior police officer in Lahore told Arab News.
Zainab’s murder caused a huge public outcry in Pakistan. She was reportedly the 12th child to have been murdered in the last year in, or around, Kasur.
The Punjab government formed a joint investigation team that interviewed around 1,100 people, many of whom had their DNA tested.
Punjab Chief Minister Shehbaz Sharif also offered a reward of 10 million rupees for anyone who provided information about Zainab’s killer.
Sharif was expected to formally announce Ali’s arrest on Tuesday.


As medical costs mount, Japan to weigh cost-effectiveness in setting drug prices

A staff member of the National Cancer Center Hospital shows the immune system-boosting cancer drug Opdivo during a photo opportunity at the hospital in Tokyo, Japan December 26, 2018. (REUTERS)
Updated 5 min 44 sec ago
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As medical costs mount, Japan to weigh cost-effectiveness in setting drug prices

  • The Japanese government estimates that public medical spending could surge 75 percent to 68.5 trillion yen ($624 billion) by 2040

TOKYO: Japanese doctor Yasushi Goto remembers prescribing the cancer drug Opdivo to an octogenarian and wondering whether taxpayers might object to helping fund treatment, which at the time cost hundreds of thousands of dollars, for patients in their twilight years.
Japanese have easy access to new medicines, whose prices are decided by the government and subsidised by the country’s public health insurance system.
But that may change. Japan, confronted with the ballooning cost of caring for an aging population, is introducing a cost-effectiveness test for drugs as a means of capping prices.
There are no plans to deny care for patients of any age. But limiting the prices of innovative but costly treatments might chase new drugs out of the $86 billion Japanese market, drugmakers say.
“If you ask whether it’s worth prescribing an 85-year-old patient Opdivo, a lot of people will say no. But patients and family members are going to say yes,” said Goto, who works at the National Cancer Center Hospital.
Patients also fear more drastic changes, such as denying access to new medicines; Prime Minister Shinzo Abe’s economic council in December proposed considering cost in determining whether to approve treatments.
“For cancer patients like us, it’s not acceptable if the government applies a cost-effective analysis in determining whether to approve treatments,” said Yoshiyuki Majima, a director of patient advocacy group Rare Cancers Japan.

SUSTAINABILITY OR ACCESS
The Japanese government estimates that public medical spending could surge 75 percent to 68.5 trillion yen ($624 billion) by 2040.
“It is obvious that Japan will face difficulties in providing social security service,” said a government official involved in the discussions, declining to be named because he is not authorized to speak to media. “The cost-effectiveness analysis is a means to secure sustainability.”
The system that will be adopted in April, according to a draft published on the health ministry’s website, compares the cost to the effectiveness of new treatments using an “incremental cost-effectiveness ratio,” or ICER.
ICER, already used in countries such as Britain, considers how much it costs to give a patient one additional year of healthy life compared with existing alternatives. If that exceeds 5 million yen, for example, the government may insist on a lower price, according the policy draft.
There has been little public discussion; weekly meetings so far have involved mostly Health Ministry officials, doctors, academics and drugmaker executives.
“If I have rheumatoid arthritis and I can’t write or type, but then I get a treatment that enables me to go back to work, pay taxes, and take care of my family, that benefit is not going to be captured by the ICER,” said Kevin Haninger, a vice president of Pharmaceutical Research and Manufacturers of America, a lobbying group.
In an interview with Reuters, he insisted Japan should carefully consider an impact on the industry when introducing such analysis to reduce drug prices.
“If Japan is going to cut prices so much, I think Japan will really run a risk of losing its current position,” he said.

LUCRATIVE MARKET NO MORE?
Drugmakers have been complaining about price cuts since 2017, when the government decided to review costs more frequently.
Japan has slashed the price of Opdivo, developed by Ono Pharmaceutical Co. Ltd. and Bristol-Myers Squibb, by more than 75 percent in the last two years. It has also lowered Gilead Science’s hepatitis C drug Sovaldi by 32 percent since 2016.
But while drugmakers threaten to pull back from Japan, the government is prepared to call the industry’s bluff, saying Japan is too lucrative a market for companies to ignore, according to two government officials, who declined to be named because they are not authorized to speak to the media.
Unlike the United States, where insurers may deny claims, or the UK, where patients can be denied costly drugs, Japan is seen as a relatively predictable market because of its social insurance system.
For example, Novartis’ Kymriah, a type of therapy in which a patient’s T-cells are modified to attack cancer cells, is expected to be approved in Japan this year.
The price for paediatric leukaemia patients, to be set by a government panel after approval, is expected to start at about $475,000, similar to US prices. With an estimated 250 Japanese eligible for treatment with Kymriah, sales in Japan are a potentially lucrative addition to Novartis’ bottom line.
Novartis declined to comment on potential effects of a new pricing policy.
Goto said the government should focus on reducing prescriptions for illnesses that are not serious, rather than costly but possibly life-saving treatments for a small number of patients.
“Flu medicines, for example, can be seen to have very low cost-effectiveness because they don’t save people’s lives, except those of infants or pregnant women, compared with cancer drugs that are critical for some patients,” he said. ($1 = 109.6800 yen)