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Literacy is a luxury that many of us take for granted.  We depend on written communication for information, guidance, and access to heath care information That is why SADAG created SPEAKING BOOKS and revolutionized the way information is delivered to low literacy communities. It's exactly what it sounds like.a book that talks to the reader in his or her local  language, delivering critical information in an interactive, and educational way.

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Sat April 17, 2004 07:48 AM ET

By Susan Heavey

WASHINGTON (Reuters) - Patients with depression and diabetes may soon join those getting pain relief, birth control hormones and help quitting smoking through skin patches that can deliver medication for days at a time.

Advances in technology, the advantages of continuous drug delivery and rising patient acceptance are helping drive the growth of patches.

Drug makers may also be able to extend patent protection by delivering an existing drug through the skin. "It gives them a little bit more opportunity to profit from that drug," said George Perros, an analyst at Greystone Associates.

Prescription patches were a $5 billion to $8 billion global business in 2003 -- coming a long way since the U.S. Food and Drug Administration first approved a motion sickness patch in 1979.

The top-selling patch is Duragesic, by Johnson & Johnson, a narcotic with $1.63 billion in global sales last year.

Other top sellers include Novartis' Nitroderm for the heart pain of angina, and a number of hormone replacement patches by Novartis and Aventis, according to Kalorama Information, a market research company.

The FDA recently gave conditional approval to a depression-treating patch, expected to launch later this year.

The EmSam patch, by Mylan Laboratories Inc. unit Somerset Pharmaceuticals Inc. and Watson Pharmaceuticals Inc., is the first patch in the huge antidepressant market.

SpectRx Inc. is launching a patch this summer that uses tiny needles to deliver insulin from an attached pump, company spokesman Bill Wells said. SpectRx is also developing a pumpless patch, he said.

Developing patches for insulin and other large molecules is difficult. "The skin is a very tough barrier to get through," said Diane Burgess, a pharmaceutics professor at the University of Connecticut.

Researchers are working on a variety of technologies, including ultrasound and electrical charges, to force bigger molecules through the skin. These so-called "active patches" could pave the way for delivering insulin, as well as red-cell stimulating erythropoietin, to diabetics and anemia patients without injections.

"The next frontier for transdermal delivery is going to be ways to get more active substances and larger molecules ... through the skin," said Greystone's Perros.

Other companies, like Noven, Alza Corporation and Altea Therapeutics, are also working on making patches thinner, smaller and able to carry larger doses.

For patients with chronic conditions, patches can replace the need to take pills every day by providing a steady release of medication for longer periods of time.

"You don't have to remember if you took your pill. You can always see your patch," said Noven CEO Robert Strauss. Noven, in a joint venture with Novartis, makes an estrogen patch the size of a quarter, called Vivelle-Dot.

Skeptics warn that the convenience could make it easy to forget to replace a patch, and skin irritation may force some patients to rotate the patch to different parts of the body.

Some experts say patches are useful only in niche markets and will never surpass pills. "The public really prefers to take an oral tablet. That's the easiest thing to do," said Burgess.

Perros expects demand for medicated patches to grow worldwide by about 11 percent annually through 2007. Kalorama Information estimates 7 percent to 9 percent growth.

"There's going to be a lot more self-medication (and) self-administration of drugs in the future, especially with chronic conditions," said Perros. "You need a way for people to do that ... safely, conveniently and pretty much on a schedule."


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