Posts

7 days in healthcare (January 16th-22nd, 2023)

/in /by

 

Summary

From the point of view of Biomedicine, it is worth highlighting, as the Science article does, the celebration of a decade of CRISPR gene editing technology, whose impact on medicine is only just beginning. Janssen withdraws from the HIV vaccine, a new failure in the attempt to discover a vaccine against this disease. Moderna, on the other hand, presents positive results with a vaccine against bronchiolitis. A new report points to wastewater analysis as fundamental to monitoring threats from a wide variety of diseases, not just covid.

As regards Global Health, The Lancet in an editorial underlines the importance of the One Health concept, this idea of the interdependence between human, animal and ecosystem health. The Economist publishes an editorial and an article on the problems of health systems that are in crisis everywhere in the post-covid era (even in Switzerland!), which is making mortality in Europe have been in the last year 10% higher than in a normal year.

Regarding International Health Policy, in the USA the opponents of abortion are manifested. Problems continue in the NHS, with Sajid Javid, former health secretary, proposing something as unusual in the UK as a co-pay in Primary Care and Emergency. He says an overly religious view of the NHS prevents reforms. Important debate and tensions about the price of medicines in the European continent (UK and EU) in relation to prices in the USA. Pharmaceutical companies, very reluctant to price controls, when they are also in the USA with the application of the Inflation Act, which gradually imposes a negotiation of the price of medicines between the Medicare Administration and pharmaceutical companies.

If we talk about National Health Policy (Spain), the incidence of covid continues to drop. Medical conflicts extend to various autonomous communities (Madrid, Catalonia, Navarra, etc.). The agreement in Aragon should be highlighted, which indicates that it is possible to reach agreements, possibly when they are well negotiated. The Ministry, completely absent from this problem. As for the public system, the statements by Lasquetty, Madrid’s Treasury Councilor, who points to “my own place” as one of the great rigidities of the public system, are very interesting. Conflict also in private health between doctors and insurers, raised in Seville. Abortion enters the national debate, following the picturesque proposals of Vox in Castilla y León, never applied. The Constitutional Court opens its new session with the debate on the recourse to the Law of deadlines presented in its day by the PP. The CIS survey presents health as the second problem that worries the Spanish.

In the field of Companies, internationally, Pfizer’s initiative to sell medicines at cost prices in 45 poor countries must be highlighted. At the national level, the launch by DKV of an insurance product that allows choosing a family doctor is notable. In a context in which insurers actually forget about Primary Care, this is something that deserves to be highlighted.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies

7 days in healthcare (January 9th-15th, 2023)

/in /by

 

Summary

From the point of view of Biomedicine, everything seems to indicate that important advances in the diagnosis and treatment of certain diseases are coming in the not too distant future, with cancer vaccines, the new FLASH radiotherapy, the diagnostic revolution of virtual biopsies and the incorporation of certain devices (such as smart watches) in the prevention and monitoring of certain pathologies.

With regard to Global Health, it should be noted that climate change seriously threatens our health, according to The Lancet. Another important article in this magazine refers to the fact that the covid has revealed the inequalities between social groups and countries in dealing with the pandemic, as well as the absence of a global health architecture.

As for International Health Policy, with regard to covid, an editorial in The Lancet says that far from being overcome, 2023 brings new concerns, such as the impact of the situation in China or the new form XBB.1.5 in the United States. In China, the post-covid zero situation continues, officially acknowledging almost 60,000 deaths in the last month, despite the fact that the WHO insists on the request for more transparency in that country. In the United States, the abortion pill, according to the FDA, can already be purchased in pharmacies and by mail order, even in states where abortion is totally prohibited, which indicates the difficulty of shortcuts and of wanting to close doors to the field. In the United Kingdom the serious crisis of the NHS continues. The health minister of the shadow Labor cabinet publishes in the Financial Times an article with a long-term approach to reforms, something that, regardless of its content, we miss in Spain by all parties. An important editorial in The Economist where it says that part of the solution to the NHS’s problems involves solving the problems of Primary Care, proposing several changes, but without losing perspective that a large part of the problems are in hospitals, with the situation of waiting lists and emergencies. He also opposes the Labor Party’s proposal, made last week, to end the independent mini-company character of Primary Care in the UK, in order to make primary care physicians salaried. The Economist carries out a study that says that in the United Kingdom there are 260 deaths a week (more than 12,000 a year) as a result of delays in the emergency room. The British are turning more and more to private healthcare, as increase problems in the public sector. The EU devises plans to avoid medicine shortages and dependence on China.

If we talk about National Health Policy (Spain), the drop in the incidence of covid continues, despite the situation in China and the American variant called Kraken. The Primary Care strike in the Community of Madrid is reactivated and a strike is on the brink in 8 autonomous communities, while the emergencies are collapsed. Despite the plans, recent studies show that almost half of public health workers are temporary. In relation to the Strategic Plan of the pharmaceutical industry, both BIOSIM and AESEG, as well as the representatives of orphan drugs, position themselves with requests, in a clear attempt not to leave this plan only in the hands of large innovative companies, as suggested by the photo of La Moncloa, with Sánchez meeting with the main leaders of pharmaceutical multinationals.

In the field of Companies, internationally, relevant news for Pfizer, BioNTech and AstraZeneca. In our country, it is worth noting the steps taken by Viamed (new hospital in Tarragona), Ribera (great growth in turnover in 2022), Miranza (which continues its growth), Korian (which is preparing to integrate Group 5) and the CUN (which has just renovated part of its hospitalization area). For its part, KKR has completed the acquisition of IVI, an important in vitro fertilization company of Spanish origin.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (December 5th-11th, 2022)

/in /by

 

Summary

From the point of view of Biomedicine, an emotional farewell in the New York Times of the “young” (81 years old), Anthony Fauci, who had such a presence in our homes throughout the years of the pandemic. Without a doubt, his scientific contributions are notable, but it is not a minor merit that he has contradicted President Trump on several occasions in the honest exercise of his office, something unusual in our environment. A new type of biomarkers seems to open the doors to the possible diagnosis of different types of cancer at an early stage with a simple blood test.

With regard to Global Health, to highlight the serious problems of diabetes, which continues to grow; and suicide, which is increasing markedly among young Americans, although, as the WHO says, it is in Africa where there are the highest suicide rates in the world.

Regarding International Health Policy, China continues to distance itself from the covid-zero policy, although we will see the increasing consequences of covid mortality. Labor problems continue in the NHS, with several strikes announced. Macron promises free condoms for minors and young people up to 25 years of age. Several initiatives in the field of health of the European Union, which makes health more and more a European Union policy, without prejudice to the fact that the management of national health services is the responsibility of the Member States.

If we talk about National Health Policy (Spain), in terms of covid, the incidence continues to decrease, what has not completely decreased is mortality (314 deaths in the last week). The strikes continue in the Primary Care of Madrid, without it seeming that the negotiations are progressing. The results of the Third Wave (2022) of the Health Barometer appear, which well deserves a careful analysis. Spain is the European Union country that performs the most instrumental deliveries, according to the “European Perinatal Health Report” (2015-2019).

In the field of Companies, at the international level, an important initiative by Pfizer to increase production in Europe, something necessary as seen during the pandemic and the difficulties for Europe to fully depend on production in Asia. Spin off of GE Healthcare from General Electric. Regarding national news, it should be noted that Blackrock increases its stake in Grifols.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (14th-20th November, 2022)

/in /by

 

 

Summary

From the point of view of Biomedicine, the promising advances in the clinical trial of monoclonal antibodies against malaria are noteworthy. Although malaria has declined remarkably in the last 20 years, progress stopped in 2014. 6 African countries suffer 55% of global malaria cases. There is no doubt that the world would be much better without this disease.

As regards Global Health, the COP27 summit approves what was a general demand: the creation of a fund to help countries vulnerable to warming, although it does not agree to end fossil fuels. Faced with the opinion of the Director General of the WHO to hail the Qatar soccer championship as good for health, The Lancet is more skeptical, pointing out, among other things, that it had already shown in 2021 that the Olympic Games do not contribute to the generalization of the practice of physical exercise among the population.

Regarding International Health Policy, it seems that China is beginning to soften the covid-zero policy with regulations that are not as draconian as up to now. The American CDC initiates the changes, after the report that was made that demonstrated notable failures during the pandemic. The pharmaceutical industry warns in the United States and the United Kingdom that a change in price conditions in the first country and an increase in taxes in the second, could harm investments and, consequently, innovations in medicines.

If we talk about National Health Policy (Spain), the incidence of covid has risen in the last week, after two weeks of decline. With the announced change of the Minister of Health, Spain will have the sad record of having five Ministers of Health (Montón, Carcedo, Illa, Darias and the new one) in five years. Not surprisingly, the Ministry of Health has become a contingency management ministry, rather than the driver of transformative system change. If any of those ministers, which is quite doubtful, had had any transformation approach, he would not have had time to even raise it. It is not surprising that, in these circumstances, the Ministry of Health has not had the opportunity to rule on the conflict between Primary Care doctors, as if it did not affect it, when local circumstances aside, the working and professional conditions of healthcare personnel at Primary Care are a national problem. It confirms what was already known: that Spain is among the countries with the most doctors per 1,000 inhabitants in the world. Important and necessary organizational revolution at the Vall d’Hebrón hospital in Barcelona, ​​creating 32 areas of knowledge. The approach will be presented at the next meeting of the European University Hospitals Alliance (EUHA).

In the field of Companies, at the international level, obesity is seen as the expected Eldorado of Big Pharma. In Spain, Sanitas acquires a hospital in Mexico; Ribera buys a hospital group in Murcia; and, Imed considers the construction of three new hospitals: Valencia, Alicante and Barcelona.

Biomedicine

Global Health

International Health Policy

National health policy

  • Other themes
    • Francesc Moréu, a well-known health manager, updates his document published in 2020 entitled: “A new health model for a new society” to November 2022. The fundamental thesis is that the health sector was created for another society and the fact that in-depth reforms have not been carried out for more than 40 years is creating problems for patients and professionals (https://drive.google.com/ uc?export=download&id=1W3l4Lz6gH3s-cG7rlKX_2kqKlsorkCy0)

Companies

 

7 days in healthcare (November 7th-13th, 2022)

/in /by

 

Summary

From the point of view of biomedicine, to highlight the blood transfusion with cells generated in the laboratory from donor stem cells, carried out in the United Kingdom, which opens up possibilities for what has been pursued for years: the so-called “artificial blood”. Likewise, two advances that originate in Spain: the discovery of a genetic variant that favors thinness (CNIO) and the fact that malignant cells break off from cancer and cause deaths by metastasis (Institute of Medical Research of Barcelona).

As regards Global Health, Nature insists in an editorial, following the COP27 meeting, that rich countries must advance compensation for polluting. Important challenges for the new Brazilian President in health matters, particularly in primary care.

Regarding International Health Policy, debate on the covid-zero policy in China, on the one hand, there seem to be signs that China is easing quarantines, on the other hand, according to José Luis Puerta in an article, this policy is a death trap , since its abandonment may mean assuming a high number of deaths, given the low percentage of vaccination in China. In the United Kingdom (NHS) a nurses’ strike for salary demands is raised for the first time, which. according to the Government, they are unaffordable.

If we talk about National Health Policy (Spain), it seems that the crisis of Primary Care, long incubated, has exploded. Although the problems of low wages, poor working conditions for doctors and flight or refusal to go to Primary Care is a national problem, the crisis has broken out above all, although not only, in Madrid, which has some peculiarities that aggravate the situation: 1. the closure of out-of-hospital emergencies for two years; 2. the low funding of the health system in Madrid and of Primary Care; and, 3. some confrontation practice. The truth is that the “white tide” has been activated, with a large demonstration in defense of public healthcare in the center of Madrid, which was a great success for the organizers. As always in these cases, the defense of public healthcare is mixed with the rejection of any form of public/private collaboration. Tensions in primary care also in the rest of Spain. Highly recommendable is the video on YouTube entitled “Doctors are lacking in Spain”?

In the field of companies, at the international level Bavarian Nordic increases its growth due to the monkeypox vaccine, while BioNTech’s revenues fall, due to the drop in sales of the covid vaccine. In Spain, changes in the CEO of Quirón, to whom Víctor Madera, the company’s founder, returns to executive positions. Success for Ribera, which is awarded an important contract for a hospital concession in Cascais (Portugal). New delays in the approval by the EMA of the HIPRA vaccine.

Biomedicine

Global Health

International health policy

  • COVID-19
    • China eases quarantine rules, with Guangzhou close to lockdown. There is speculation that Beijing is considering a relaxation of the covid-zero policy (https://www.ft.com/content/709e95e6-cc63-4fe0-9c4a-5683c87f7e7b)
    • Interesting article by José Luis Puerta: “China: the deadly trap of the covid-zero policy”. If the government lifts the restrictions, which are sinking the economy, the country risks suffering a tsunami of infections, due to the low level of vaccination. It is estimated that this could cause 1.6 million deaths and a demand for intensive care that exceeds its current capacity by 15.6 times (https://theobjective.com/internacional/2022-11-12/china-covid-zero/ )

National health policy

Companies

 

7 days in healthcare (October, 3rd-9th, 2022)

/in /by

 

Summary

From the point of view of biomedicine, to review the Nobel Prize in Physiology and Medicine, won by Svante Pääbo, a scientist who is recognized for his studies on the DNA of human ancestors, which allows us to better understand genetic evolution towards the “homo sapiens”. It seems that a study with Artificial Intelligence of the eye will help predict coronary risk in minutes, without the need for blood tests or other studies.

As far as Global Health is concerned, it is believed that malaria could be definitively eradicated from the world, with the help of new vaccines.

As for international health policy, alerts in Europe about avian flu and diphtheria, brought by immigrants from Africa and Asia. To highlight the changes in Portugal, which incorporate an independent team to the management of the SNS.

If we talk about national health policy (Spain), the rise in covid cases prevents the Interterritorial Council from approving the abolition of masks on public transport. The health items in the General State Budgets are analyzed with a magnifying glass in the professional press, despite the low weight of the expenses of the Central Administration in the total health expenses. However, it allows to detect some priorities for the Ministry, although the economic items are usually below the challenges: primary care, genomic portfolio, mental health, dental care, primary care infrastructure, etc. The CEOE charges against the Equity Law, which it describes as “unprecedented risk”. The debates and controversies continue in relation to the delays in the incorporation of pharmaceutical innovation in Spain. However, these debates do not usually consider that the approval by the EMA of a medicine does not mean automatic public financing in Spain, according to article 92 of the Law on Guarantees and rational use of medicines, which establishes the “financing selective and not indiscriminate” according to a series of criteria, which are established. AESEG and BIOSIM no longer agree with the plan approved a couple of years ago on generics and biosimilars, but want the new approaches to be included in the Guarantees Law.

In the field of companies, in the international arena, BioNTech signs an agreement with Australia, for the establishment of research centers in that country. As for national news, the growing weight of online pharmacy (prescription drugs excluded by law). HM reinforces itself in Andalusia, incorporating four hospitals in Malaga into its network.

Biomedicine

Global Health

International health policy

National health policy

  • General State Budgets (impact on health)

Companies

 

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

/in /by

 

Summary

From the point of view of biomedicine, to review the articles in The Economist on advances in knowledge of the brain, which will have a great impact on the appearance of new drugs and pain therapy.

With regard to Global Health, the WHO report of September 21, which places cancers, cardiovascular conditions and diabetes as responsible for three quarters of global mortality.

In terms of international health policy, an important initiative in France to offer three preventive consultations free of charge by the public system: at 25, 45 and 65 years of age. The EU launches a plan for the elimination of tuberculosis in Europe.

If we talk about national health policy (Spain), great debate around the Equity Law. What should have been just a law to correct the access deficiencies of the Montón Law, is being flamboyantly called “Equity” (as if accessibility guaranteed equity, not having a single provision to improve equity), and It is used to introduce the aspirations of Unidas Podemos to annul Law 15/97, approved almost unanimously at the time. The IDIS Foundation has warned of the damage to assistance and, specifically, the waiting lists, if some precepts of the Law are approved. It seems that the Catalan consortiums are going to respect each other, which is important, but it is also important to preserve and reinforce public/private concerts throughout the national territory.

At the corporate level, from an international point of view, the shares of the large vaccine manufacturers (especially Moderna, BioNTech and Novavax) plummeted, as a result of President Biden’s announcement that “the pandemic has been feared”. In Spain, it should be noted that Moderna will install its first quality laboratory outside the United States in Madrid.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

7 days in healthcare (August 29th-September 4th, 2022)

/in /by

 

Summary

From the point of view of Biomedicine, the great impact of the study by scientists from the University of Oviedo, who have studied the genes of a species of jellyfish, which incorporates rejuvenation elements in its life cycle, should be highlighted.

With regard to Global Health, historical decline in life expectancy in the United States, which went to 76 years in 2021, compared to 79 in 2019. The covid, the main responsible, although not the only one. Presumably we will see a similar phenomenon in Europe and in Spain.

Regarding International health policy, both the FDA and the EMA approve the covid vaccine boosters, despite some questions that have been pointed out by the journal Science. In the UK, long waiting lists in the public sector are leading to a boom in direct payment systems for healthcare.

If we talk about national health policy (Spain), the two most relevant issues are the approval of the bill that creates the Spanish Public Health Agency, subject to hearing and public information; and the draft Law on Abortion, which has very controversial elements, such as abortion in women aged 16-18 without information or parental consent; conscientious objection for doctors (on whose regulation the WTO has ruled negatively); the obligation to carry out this practice in public centers; and the dispensing of the morning after pill. Surprising statements by the President of the Community of Madrid, who attributes the shortage of doctors to the lack of Faculties of Medicine, contrary to what had been the opinion of the State Confederation of Medical Students and the Conference of Deans of Faculties of Medicine, with the support of the Forum of the Medical Profession. And the fact that only South Korea surpasses Spain in the ratio of Faculties of Medicine per million inhabitants.

In the field of companies, health has jumped into the metaverse with a business of 5,060 million dollars, although we will have to be very attentive to what we call metatarsus. HIPRA starts a trial to study its covid vaccine as a fourth dose.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

7 days in healthcare (August 21st-28th, 2022)

/in /by

 

Summary

From the point of view of biomedicine, the very encouraging results of the polypill published by a Spanish group led by Valentin Fuster should be highlighted. The Economist underlines the great future of gene therapies in medicine, with a list of diseases for which there is a therapy or is in advanced study.

Regarding Global Health, The Lancet publishes a report with some conclusions and lessons regarding future pandemics.

As for International Health Policy, both monkeypox and covid are plummeting in Europe. The controversial annulment of the Roe v Wade ruling in the United States, which leaves the right to abortion to the criteria and regulation of the states, continues to be talked about. American companies, including Walmart, the largest American employer, introduce this benefit for women, regardless of the state where they work.

If we talk about National Health Policy (Spain), covid continues to drop and especially the number of cases in the ICU. The Government approves the bill that creates the Public Health Agency, probably the largest, if not the only, far-reaching measure after the pandemic. The text of the law is not yet public, and therefore important aspects such as governance and functions are not known. The location is not known either, although the Government has advanced that it would not be in Madrid, which is not without controversy either. Next week the government will approve the abortion law, according to a text promoted by Podemos.

In the field of companies, Moderna’s lawsuit against Pfizer and BioNTech has been shocked, which it accuses of plagiarism of its mRNA technology in the covid vaccine. Amazon closes its telecare service, which once again demonstrates the difficulties of the large technology platforms in finding an adequate strategy for health, a sector in which they want to be above all else. In Spain, the export of drugs manufactured in Spain grows by 60% in one year.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

 

7 days in healthcare (August 8th-14th, 2022)

/in /by

 

Summary

From the point of view of biomedicine, there seems to be a glimpse of a new drug to prevent the transmission of HIV/AIDS, for which there are problems in obtaining an affordable price. Animal testing is the basis for certain advances in medicine. This can be overcome with certain new discoveries, according to the company Lift Sciences.

Regarding Global Health, two key issues: a new zoonosis (“Langya”) appears in China, as published in the NEJM. In certain developed countries it seems that polio, which was considered eradicated, is making a comeback.

Regarding international health policy, the approval of the Inflation Reduction Act (IRA) of 2022 in the United States, about Climate, Fiscal and Health will have a very important impact. Aside from expanding access to insurance through the Affordable Care Act (Obamacare), surely the most far-reaching impact will be on the pharmaceutical industry. Gradually, Medicare will be able to negotiate the price of medicines with the pharmaceutical industry, something that until now it could not do. This radically changes the business model of the pharmaceutical industry, which was based on two things: the protection of intellectual property through patents; and the existence of free prices with high margins in the United States (the largest pharmaceutical market) and regulated prices and lower margins in the rest of the world. A substantial change that will most likely have a global impact. It may also curb the escalation of health care spending in the United States. We’ll see if this doesn’t upset the fast pace of drug innovation.

If we talk about national health policy (Spain), the good news is that, as in all of Europe, covid continues to decrease in incidence, although it is still a worrying disease, due to the number of hospitalized cases and mortality.

In the field of companies, trials for new covid variants begin by BioNTech and Pfizer. More than 2,300 Spanish pharmacies can now sell through the Glovo platform and soon Uber, although only parapharmacy products, not prescription drugs.

Biomedicine

Global health

International health policy

National health policy

Companies