While biologic originators’ patents are expiring, biosimilars are emerging to take their place, offering significant cost savings to healthcare systems. Many challenges still need to be addressed in the clinical practice of inflammatory bowel disease (IBD). A global survey was organized to highlight physicians’ current knowledge and beliefs and to gain insight about their practical management and remaining concerns and obstacles associated with starting a biosimilar, switching from an originator to a biosimilar, or switching from one biosimilar to another (multiple switches and reverse switching). Fifteen physicians with expertise in the field of IBD from 13 countries attended a virtual international consensus meeting to develop practical guidance regarding biosimilar adoption worldwide, considering the survey results. Consensus was reached on 10 statements regarding biosimilar effectiveness, safety, indications and rationale, multiple switches, therapeutic drug monitoring of biosimilars, non-medical switching and future perspectives.

Natural gas plays a significant role in Tunisia's energy mix. Tunisia imports 66% of natural gas (NG) from Algeria (ANG), and the rest is provided by local gas fields mainly Miskar gas (MNG). To counteract this deficit, the Power-to-Gas approach emerges as a promising solution, given Tunisia's abundant renewable energy resources. By blending green hydrogen into the NG network, it is possible to (i) address the current energy crisis, (ii) lower the carbon intensity of the gas grid, and (iii) encourage sector coupling through the use of various renewable energy sources. This study presents an overview of various interchangeability indicators and investigates accordingly the allowable ratios for hydrogen blending with two types of natural gas distributed in Tunisia (ANG and MNG). It also explores the impact of hydrogen injection on the energy content variation and various combustion parameters. The results confirm that both ANG and MNG can withstand a maximum hydrogen blend of up to 20%. The article concludes with recommendations for further experimental testing of the findings and emphasizes the need to look into infrastructure and safety requirements with regards to the Natural gas network in Tunisia. This research serves as a critical step towards harnessing the potential of green hydrogen in Tunisia.

Biological drugs are inaccessible to more than 80% of the world population due mainly to their high costs; this is a significant concern of the World Health Organization. Biosimilars are supposed to reduce the cost burden, but their approval process is complex, including expensive and irrelevant studies. While the Stringent Regulatory Authorities (SRAs) have adopted the guidance of the FDA or EMA, such adoptions are neither necessary nor practical for the rest of the world (ROW). We present a science-driven, rational approach to formulate regulatory guidelines that will enable faster biosimilars' entry into the ROW without compromising their safety and efficacy. The key recommendations include removing animal and safety efficacy testing, making analytical assessment more robust, and cGMP compliance assured through third-party audits. The ROW countries are also recommended to initiate a rapporteur system available in the EU, to overcome the biases and assure state-of-the-science evaluation as the common understanding of the critical quality attributes evolves. It is anticipated that stronger regional agencies like those in the MENA region, with the leadership of the Kingdom of Saudi Arabia, will help propel the idea faster across the globe.