Posts

7 days in healthcare (December 19th-25th, 2022)

Summary

From the point of view of Biomedicine, it should be noted that 2022 has been an extraordinarily productive year from the point of view of the appearance of effective drugs, among others against obesity or different forms of cancer. mRNA vaccines open the way to new therapeutic approaches

With regard to Global Health, the British Medical Journal summarizes the human and health damage caused by the floods in Pakistan.

Regarding International Health Policy, discussions continue about the origin of the covid. President Biden is accused of complacency in saying as early as September that “the pandemic is over”, while the mortality continues. Everything seems to indicate that the end of the covid-zero policy in China is producing a large number of cases (millions in just one day), which is putting maximum pressure on the health system and, probably, since there are no reliable figures, with a high mortality. UK nurses and ambulance strike.

If we talk about National Health Policy (Spain), the incidence of covid has risen slightly in the last week, with a high death toll (241). The strike of Primary Care doctors in Madrid is paralyzed until January 11, to analyze the administration proposals. The Government undertakes to launch the working group for the elaboration of the Strategic Plan on the pharmaceutical industry, after the promises of investments in the next three years made by the heads of the most important pharmaceutical companies in a meeting in La Moncloa . Government and Community of Madrid launch the Neurotechnology Center.

In the field of Companies, internationally, it seems that private equity companies are oriented in the USA towards hospital emergencies. In Spain, Warren Buffet acquired the largest medical error insurance.

Biomedicine

Global Health

International Health Policy

National health policy

  • Pharmaceutical policy

Companies

 

 

7 days in healthcare (September 12th-18th, 2022)

 

Summary

From the point of view of biomedicine, immunotherapy (in colon cancer) and CAR-T therapies (in lupus) continue to expand their therapeutic possibilities. Advances against infections for resistant bacteria. Will there ever come a time when cancer can be diagnosed by a simple blood test? This possibility does not seem very remote, according to papers presented at the meeting of the European Society of Medical Oncology.

Regarding Global Health, an important work directed by Jeffrey Sachs and published by The Lancet on the delays and errors of both governments and the WHO in dealing with the covid pandemic, which could have produced 17.7 million of  deaths, many of them preventable.

Regarding international health policy, the WHO says that the end of the covid pandemic may be in sight, although at the same time a new variant (BJ.1) of covid is evident in Europe. Important debate in Europe (Scotland and France) on euthanasia and assisted death. The French Ethics Committee opens the door to this possibility. The financing of the American FDA was questioned, due to its great economic dependence on the pharmaceutical industry. Biden launches a speech commemorating Kennedy’s in 1962 when he decided to go to the Moon, but this time oriented towards the fight against cancer.

If we talk about national health policy (Spain), the PDeCAT presents an amendment to the entire equity law, which it accuses of interfering in regional powers and of confusing agreement with privatization. Surprising statements from the Ministry of Health in a parliamentary response, saying that its functions in relation to the waiting lists are only to inform and monitor, as if it did not have the possibility of signing agreements with the communities to address this problem or of launching other actions. Concern, there are even demonstrations in the street, of the relatives of the elderly admitted to residences. The Community of Madrid announces that it will reduce the waiting lists by half. Although we would like it not to be the case this time, this announcement is preceded by other similar ones from different governments, which always came to nothing in terms of effectiveness. The search for solutions by the Ministry of Finance to the MUFACE model, highly impacted by inflation, seems to recognize its underfinancing.

In the field of companies, from the international point of view, important success for Sanofi, with its new vaccine against bronchiolitis. In Spain, important corporate movements in Korian, HM Hospitales, Miranza and Ribera.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (1st-7th August 2022)

 

 

Summary

From the point of view of biomedicine, to highlight the use of monoclonal antibodies to combat malaria; also the return to life of cells and tissues in dead pigs, which may be important in transplants; and, the fact that the genomic map of chronic lymphatic leukemia has been completed, which, sooner or later, will have consequences in the treatment of this disease.

As far as Global Health is concerned, the poor preparation of most countries in the face of the increasingly frequent heat waves is confirmed, according to The Lancet.

As for international health policy, the United States declares monkeypox a public health emergency, the Administration covering itself up against certain accusations of slowness in dealing with this problem; global decline in the number of covid cases, particularly in Europe. Problems continue in the United States due to restrictions on abortion. Three news to highlight in the United States: the number of uninsured reaches the record low figure of 8%; the American Democrats have a majority in Congress within reach to approve the law that tries to reduce the price of medicines, by way of allowing Medicare to negotiate prices; and, finally, for the first time in decades, health spending in the United States fell in the first quarter of 2022, although it is doubtful that this will continue.

If we talk about national health policy (Spain), monkeypox continues with a very high number of infected people and a shortage of vaccines; large drop in the incidence of covid. Great and difficult to justify delay in the report commissioned by the Ministry of Health from experts on the management of the covid pandemic. Surely there will be more than technical analysis problems in the cause of this delay. The doctors of the private health, threaten with the copayment, before what they consider low rates of the insurers.

In the field of companies, Pfizer continues with its aggressive policy of buying companies, while the growth of Quirónsalud, which already exceeds 2 billion euros in turnover, should be highlighted.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

7 days in healthcare (July 4th-10th, 2022)

Summary

From the point of view of biomedicine, to highlight the finding that cancer drugs significantly reduce the mortality of patients hospitalized for covid.

With regard to Global Health, an important WHO report on mental health, the last of said organization on the same subject dates back to 2001. The Lancet publishes an interesting article on road safety: no less than 1.35 million deaths a year and 50 million injuries depend on that security. Compared to what was usual in the years before covid and the war in Ukraine, hunger has grown in the world, moving us away from the Sustainable Development Goals. The development of health systems in Africa collides with the shortage of professionals.

Regarding international health policy, it should be noted that the USA has just bought 2.5 million vaccines against monkeypox. The WHO and the EMA warn of the new wave of covid. New “centaurus” subvariant of covid, originating in India, but already widely disseminated. Biden signs an executive order, in order to protect abortion rights. The United States doubles the use of telehealth since the outbreak of the pandemic.

If we talk about national health policy (Spain), the wave of covid continues to grow, with an increased impact on hospitals. New approved version of the Framework Statute of Health Personnel, which tries to avoid prolonged temporary periods, which was necessary, but consolidating the statutory regime, which we believe is not good news and in line with what the public health system needs , although perhaps the unions. First regulation in relation to nursing prescription, long awaited. Important report from the Platform of Patient Organizations, showing how chronic patients suspend the health care they receive. Javier Murillo, the undisputed leader in the health insurance sector, warns about the risk of disappearance of administrative mutualism (MUFACE model), since it continuously produces losses. The CAPFF, chaired by the prestigious economist Félix Lobo, releases his report, demanding changes in the regulation of the price of medicines in the SNS, to reinforce “legal certainty.”

In the field of companies, FEFE gives us the news that the pharmaceutical industry already sells more in hospitals than in primary care, a great change. The ASEBIO Report highlights the growth of the sector both in business volume and in investments. It seems that HIPRA, the Spanish vaccine against covid, is getting closer to being approved by the EMA.

Biomedicine

Global health

International health policy

National health policy

Companies

 

7 days in healthcare (March 21-27, 2022)

 

SUMMARY

From the point of view of biomedicine, the progress in the treatment of breast cancer should be highlighted, according to the article published by the NEJM, with a brake of around 80% of this advanced cancer and makes it disappear in 16%. .

As far as Global Health is concerned, there are undiagnosed cases of tuberculosis (the missing tuberculosis), a disease that continues to have 10 million new cases a year and causes 1.5 million deaths. The Lancet report on what needs to be done to meet target 3.4 of (on non-communicable diseases) of the Sustainable Development Goals. Inequality in covid vaccination and its possible ways to solve it are the subject of an analysis by the NEJM. Concern for the health of the 3.5 million refugees from Ukraine. The low mortality of covid in Africa, a continent that was thought could be devastated by this disease, remains a mystery.

As for international health policy, the debate continues on the covid-zero policy in China, which has achieved great results so far (both in terms of mortality and economics), but it is not known if it will be able to continue with the variant “omicron”. The WHO judges the lifting of COVID measures in Europe too premature, considering that cases are growing, among other countries, in the United Kingdom, Ireland, Greece, France, Italy and Germany.

If we talk about national health policy (Spain), we are witnessing a relaxation of the measures against covid, despite its upward trend in recent days. Arrival of Paxlovid, Pfizer’s treatment for severe cases of covid. The important report published by the Catalan Society of Health Management, with an exceptional team led by Jordi Varela, on the forms of contracting health services from the point of view of value, is very noteworthy. The deans of Medicine react to the Ministry’s announcement of the increase in the “numerus clausus” in medicine by 10%.

In the field of companies, it is worth highlighting the evolution of the purchase of the fertility company IVI, the largest operation carried out by private equity companies in healthcare in Spain and with a company valuation of around 2,500 million euros.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

NATIONAL HEALTH POLICY (SPAIN)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

 

 

7 days in healthcare (February 28-Mars 6, 2022)

 

SUMMARY

From the point of view of biomedicine, the approach (apparently possible) of obtaining a vaccine for the next pandemic in 100 days stands out, compared to 10 years of previous situations and the year of COVID 19. Concern, according to an editorial in The Lancet, for depression, which is estimated to affect one billion people in the world. The WHO warns about the high figures of obesity: 650 million adults, 340 million adolescents and 39 million children. Great hopes in the combination of gene therapy and xenotransplantation, with great impact on the future of transplants.

Regarding global health, the great concern is the health consequences of the war in Ukraine and the WHO calls for the creation of a safe corridor to carry medical supplies. Pharmaceutical companies plan to manufacture 2.9 billion COVID vaccines in Africa.

Regarding international health policy, it should be noted that, according to experts, billions of dollars are needed to prevent the next pandemic.

As far as national health policy is concerned, it should be noted that the incidence of COVID is falling, although more slowly than a few weeks ago, and the mortality rate remains high (more than 150 deaths per day). The (official) deaths from COVID already exceed 100,000 in Spain. The Ministry plans to give the COVID data twice a week, instead of the current daily frequency (except weekends). Great collaboration in medical supplies and supply of beds by Spain in the face of the tragedy in Ukraine.

If we talk about companies, we would highlight the information from FENIN that Catalonia manufactures more than 35% of the health technology produced in Spain. Also the important investment in Barcelona by Novartis in an antibiotic center.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o The incidence of COVID drops to 463 per 100,000 inhabitants, but the decreases are smaller than in previous weeks and the figure of more than 150 deaths per day continues (https://www.consalud.es/pacientes/especial-coronavirus/covid-19-espana-registra-22400-casos-174-muertes-ia-desciende-463-puntos_111057_102.html)

o 100,000 (official) deaths from COVID in Spain (https://www.redaccionmedica.com/secciones/sanidad-hoy/espana-supera-los-100-000-muertos-por-covid-desde-el-inicio-de-la-pandemia-7926)

o The Ministry of Health will give COVID data twice a week instead of daily (https://www.elconfidencial.com/espana/2022-03-02/sanidad-pasara-dar-datos-covid-dos-veces-por-semana-en-lugar-de-a-diario_3384902/)

  • Political announcements

o The bill project amending the National Security Law is published (https://www.congreso.es/public_oficiales/L14/CONG/BOCG/A/BOCG-14-A-91-1.PDF)

o The bill project amending the Law on Science, Technology and Innovation is published (https://www.congreso.es/public_oficiales/L14/CONG/BOCG/A/BOCG-14-A-92-1.PDF)

  • Other issues

o Catalonia wants to extend pharmacological abortion up to 14 weeks (https://elpais.com/espana/catalunya/2022-03-02/cataluna-quiere-ampliar-el-aborto-farmacologico-hasta-las-14-semanas.html)

o Spain will send more than 20 tons of medicines and medical supplies to Ukraine (https://www.elindependiente.com/espana/2022/02/26/espana-enviara-20-tonadas-de-medicinas-y-material-sanitario -to-ukraine/)

o The autonomous communities offer 3,000 beds to care for the victims of Ukraine (https://www.elespanol.com/espana/politica/20220227/ccaa-ofrecen-hospitalarias-acoger-victimas-invasion-ukrania/653434701_0.html)

o Spain joins the health PERTE at European level (https://www.lamoncloa.gob.es/serviciosdeprensa/notasprensa/industria/Paginas/2022/030322-ipceisalud.aspx)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

 

 

7 days in healthcare (February 14-20, 2022)

 

 

 

SUMMARY

In biomedicine, we have to highlight the studies that are confirming a modest association between an increased incidence of mental illness after COVID.

As far as Global Health is concerned, mention should be made of the book by Ed Miliband, a British parliamentarian, former leader of the Labor Party and minister with Gordon Brown, which amounts to a manifesto on public health in the wider sense, which, at the moment, is already beginning to be a literary genre, among which the books by Gordon Brown, Minouche Shafik, Fareed Zakaria and, soon, Bill Gates stand out.

Regarding international health policy, verifying that the calculation of excess mortality is the best way to assess mortality from COVID. The problem is that this may be valid for Europe and the Americas, but not for Asia and Africa, where the low mortality figures are hardly credible. Gordon Brown, former British Prime Minister, asks the G20 for a global financial solution to tackle the pandemic, similar to what was done in the 1960s with smallpox. The Economist highlights Africa’s low capacity for vaccine production, in contrast to its large population.

Regarding the national health policy, the first thing to mention is the drop in the incidence of COVID, which last Friday reached 919 per 100,000 inhabitants, which is compatible with the fact that mortality skyrockets in the sixth wave and there is a delay in receiving the new antivirals. The government approves the Science Law project, with controversial elements among researchers. The massive retirement of professionals (including doctors) is probably the most far-reaching problem of the SNS. The SEOM (Spanish Society of Medical Oncology) denounces the lack of equity in access to drugs and markers.

In business news, we must mention the FENIN declaration in favor of the manufacture of medical technology in Spain, to avoid dependency in the event of pandemics; also that the fifth vaccine approved in Europe (NOVAVAX) receives authorization to be manufactured in Galicia (Porriño); Rovi extends its alliance with Moderna for the manufacture of vaccines for ten years.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o The incidence of COVID drops to 919 cases per 100,000 inhabitants, with 7.8% occupancy of hospital beds due to COVID and 13.7% of ICU beds (https://www.consalud.es/pacientes/especial -coronavirus/covid-19-spain-records-30615-cases-288-deaths-ia-baja-919_110353_102.html)

o Deaths from covid skyrocket in the sixth wave (https://www.elindependiente.com/vida-sana/salud/2022/02/19/las-muertes-por-covid-se-disparan-en-febrero-con-4-365-fallecidos-y-elevan-a-11-081-las-de-la-sexta-ola/)

o Waiting for the antivirals that Sánchez promised in January (https://www.elespanol.com/ciencia/salud/20220214/omicron-mata-espera-antivirales-sanchez-prometio-enero/650185438_0.html)

o Public health detects an explosion of scabies cases related to the pandemic (https://elpais.com/sociedad/2022-02-19/la-sanidad-publica-detecta-una-explosion-de-casos-de- scabies-related-to-the-pandemic.html)

o Sports events capacity returns to 100% on March 4 (https://www.consalud.es/politica/consejo-interterritorial-decide-recuperar-aforos-deportivos-100-4-marzo_110196_102.html)

  • Political announcements

o The Government approves the Science Law project that the sector sees with room for improvement (https://www.diariomedico.com/investigacion/el-gobierno-aproba-una-ley-de-ciencia-que-los-investigadores-ven-muy -improveable.html?check_logged_in=1)

o Changes in the portfolio of services: more oral health and screening (https://www.redaccionmedica.com/secciones/ministerio-sanidad/la-nueva-cartera-comun-del-sns-contempla-mas-salud-bucodental- y-screened-6455)

o Spain adheres to the International Vaccine Institute (https://www.consalud.es/politica/gobierno-aprob-adhesion-espana-instituto-internacional-vacunas_110110_102.html)

  • Other issues

o Health approves the new vaccination schedule for 2022 (https://www.larazon.es/sociedad/20220217/as5pmub735hwpmxosjjwlzapty.html)

o Strong mobilizations in the Andalusian health sector (https://www.elconfidencial.com/espana/andalucia/2022-02-19/sanidad-andalucia-manifestaciones-sindicatos-partidas_3378408/)

o Mass retirement of health workers: a drag on the SNS (https://www.consalud.es/profesionales/jubilacion-masiva-sanitarios-quebradero-cabeza-sistema-nacional-salud_110332_102.html)

o Private healthcare demands a clear legal framework in the National Security Law (https://www.redaccionmedica.com/secciones/privada/la-privada-reclama-un-marco-juridico-claro-en-la-nueva- security-law-8788)

o Lack of equity in access to drugs and markers (https://cincodias.elpais.com/cincodias/2022/02/16/companias/1645013239_112550.html)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

7 days in healthcare (November 29-December 5, 2021)

 

SUMMARY

From the international point of view, it is worth highlighting the beginning of the work of the WHO for the approval of a Treaty on pandemics. It seems that the alarm about the new “‘ ómicron “variant is lowered, after the WHO announcement that there had been no case of death. We must be attentive to the program of the new German coalition government, and its impact on the health system. It seems that its actions are concentrated in the pharmaceutical sector. The failure, for various reasons, of the COVAX platform for immunization of low- and middle-income countries is confirmed.

At the national level, the growth of COVID continues to figures that are already beginning to be worrying, despite the advantage over other European countries. The council of ministers approves the Mental Health Strategy, a plan that, unlike the one approved a few years ago on Primary Care, does have funding, despite having aroused reservations among experts. The council of ministers also approves the PERTE for health. As of December 13, the vaccines for children will be available.

Regarding companies, it should be noted that both Pfizer and Moderna are preparing to adapt their vaccines to the new COVID variant.

 

INTERNATIONAL

 

  • The WHO agrees on December 1, 2021 to begin negotiating an international agreement on how countries should prevent, prepare for and react to pandemics. The agreement is to hold a meeting before March 1, 2022 and discuss a draft before August 1, 2022 (British Medical Journal, Dec 2, 21)
  • A law to introduce dental care in Medicare is discussed in the American Congress (NEJM, 2 Dec 21)
  • An article is published that compares the evolution and behavior in 24 months of a large number of people from the Veterans Administration vaccinated with Moderna and Pfizer-BioNTech (NEJM, Dec 1 21)
  • The need for the health sector to contribute to decarbonization continues to be present (NEJM, Dec 2 21)
  • The WHO warns of a high risk due to the new “omicron” variant (FT Nov 29, 21)
  • WHO says there have been no deaths from the new “omicron” variant, despite its expansion (The Guardian, 4 Dec 21)
  • The “ómicron” variant, with a wide worldwide diffusion: apart from its origin in South Africa, and the expansion to 11 European countries, also present in Canada, Brazil, Australia and Saudi Arabia, among others (CNN Español, Dec 1 21)
  • Van der Leyden calls to discuss the mandatory nature of the vaccine (FT, Dec 1 21)
  • Analysts say that the economic impact of the “omicron” variant will not be important (FT, Nov 29, 21)
  • The program of the new German coalition government has an impact on the healthcare and pharmaceutical sector. Most important measures: price containment in medicines, push for healthcare digitization and use of medical data for research (Covington, Nov 29 21)
  • Biden rules out a new lockdown to tackle the new “omicron” variant (FT, Nov 29, 21)
  • The United Kingdom urgently calls a meeting of the G7 to discuss the problem of the new variant (La Razón, 28 Nov 21)
  • The new variant presents more than 50 mutations over the original from Wuhan (La Razón, Nov 29, 21)
  • COVAX has only distributed 26% of the promised covid vaccines for 2021. The most unanimous explanation is that rich countries have monopolized the market (El Español, Dec 4, 21)
  • The EMA would need three to four months to approve vaccines if they have to be modified by “omicron” (El Confidencial, Nov 30, 21)
  • Europe steps on the accelerator with the third doses in full uncertainty for the new variant (eldiario.es, Nov 29, 21)
  • The lack of vaccines, logistical limitations and the rejection of part of the population hinder immunization in Africa (El País, 28 Nov 21)
  • Germany imposes a de facto confinement to the unvaccinated: leisure and commerce will be banned (El País, 2 Dec 21)
  • Agreement between the Council and the European Parliament to strengthen the role of the ECDC (El Global, 30 Nov 21)

NATIONALS

 

  • COVID cases continue to rise, reaching an AI (cases per 100,000 in the last 14 days) of almost 250 (El Confidencial, Dec 3, 21)
  • Health advises limiting participants in social events during Christmas after the advance of COVID (La Razón 1 Dec 21)
  • The government does not have a “legal plan B” before the “omicron”, it trusts everything to vaccination and rejects restrictions that could affect the economy (La Razón, Dec 1 21)
  • The Government defends the need for an International Treaty on Pandemics, as stated by Minister Darias during the Extraordinary Assembly of the WHO in Geneva (ConSalud, 29 Nov 21)
  • The Council of Ministers approves the Mental Health Strategy 2022-2026, the last was of 2009. It is criticized by experts (Spanish Society of Psychiatry, Spanish Society of Dual Pathology) for its lack of ambition, although the effort of consensus. Among the criticisms is the lack of standards such as professional ratios, number of beds in children’s and adolescent hospitals, waiting lists, etc. It has financing of 100 million euros for the next three years, 30 million for 2022. Intervention in the workplace, the approach to suicide and the gender perspective, among the novelties of this Strategy (El Mundo, Dec 4, 21)
  • The council of ministers officially approves the PERTE for health. Investment of more than 1,400 million euros, between 2021 and 2023. These investment agendas are articulated through tenders, the creation of an investment, development and innovation (R + D + i) structure for advanced online therapies, launch of a public-private investment vehicle in advanced therapies (public-private commercial company) with the participation of companies with production capacity in Spain, elements of early coordination and identification of capacities and needs of the National Health System, public procurement innovative and pre-commercial, agreements with communities, private initiatives and co-programmed projects and public tenders (PlantaDoce, Nov 30 21)
  • The Interterritorial Council of December 2 addresses the Royal Decree of Specialties, so that it is approved before the end of 2021. It contemplates approving new specialties and reviewing access to specific training areas (ConSalud, Nov 30, 21)
  • Pfizer vaccines for children, available from December 13 (ConSalud, Dec 1 21)
  • AESEG presents a report “The sector of generic drugs in the economic and social reconstruction of Spain”, in which it advocates a differential price of generics in relation to brands (AESEG, Dec 1 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

 

  • Continuity of care, interoperability, innovation and the promotion of the SDGs (Sustainable Development Goals), among the objectives of the IDIS Foundation for 2022 (ConSalud, 2 Dec 21)
  • Teladoc Health grows 81% in the third quarter (PlantaDoce, Dec 1 21)
  • Pfizer and Moderna are preparing to adapt their vaccines to the new “omicron” variant (El Global, Nov 29, 29)
  • Merck’s COVID Treatment (Molnupiravir), Endorsed by FDA (NYT, Nov 30 21)
  • HM Hospitales will have a new space of 1,000 square meters in Valdedebas (PlantaDoce, Nov 30, 21)
  • HIPRA relies on its covid vaccine to grow 13% in 2021 (PlantaDoce, Dec 1 21)
  • The major private equity companies (CVC, Advent, Cinven, PAI, KKR,…) prepare offers for around 1,500 million for IVI (CincoDías, Nov 30, 21)