Posts

7 days in healthcare (August 21st-27th, 2023)

 

Summary

From the point of view of Biomedicine, to highlight the results of the devices that read the brain and allow certain people to speak using their thoughts. In September the Human Brain Project will be presented, the most ambitious research project financed by the European Union. The British NICE recommends stool tests to be carried out at home for colorectal cancer screening.

As regards Global Health, the journal Science analyzes how climate change can amplify epidemics and give rise to new pandemics.

Regarding International Health Policy, important developments in the USA: the CDC establishes new standards for the approach to sepsis in hospitals; large increase in sex change surgeries in recent years; AstraZeneca is suing the American government for its plans to negotiate the price of medicines, which reflects the great tension between the pharmaceutical industry and the American government, which next week will reveal the 10 medicines on which the price is going to be negotiated; and, a large increase in mental health spending after the pandemic, something that is not expected to change. The British Nuffield Trust analyze the income of English doctors in the various categories. The WHO launches an interesting digital health initiative.

If we talk about National Health Policy (Spain), the Ministry of Public Health publish in the BOE the call for specialized health training with places for doctors, pharmacists, nurses, psychologists, chemists, biologists and physicists. The Ministry also publishes a very complete analysis on the relevance of lung cancer screening. Although it has been said that the Ministry refuses to implement this screening, the truth is that it has limited itself to publishing the report, which will be analyzed by the Interterritorial Council. In Europe there is no public system that has programs of this type in place. The positions of the Scientific Societies must be heard, but they are not the only ones to consider, taking into account that these Societies usually support everything that favors the activity of the respective specialty. But in these types of decisions, many circumstances must be weighed, including cost/effectiveness. Important confrontation between doctors and health insurers in Seville, which will take place throughout September. Some complaints from physicians have been made public in relation to the SELENE computer program, which is widely implemented in the hospital public sector. A subject on which it is difficult to pronounce, but clearly to follow, due to its importance. Having a user-friendly, fast computer application with innovative features is essential for medical practice.

In the field of Companies, internationally, it seems that Roche and MSD will lead the billing of pharmaceutical companies in the next five years. As far as national news is concerned, Europe is not opposed for competition reasons to the agreement between Esteve and Lubea.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (May 22nd-28th, 2023)

 

Summary

From the point of view of Biomedicine, to point out the cerebral signs in the orbito-frontal cortex detected in chronic pain, which opens the possibility of implanting devices to alleviate pain. An AI-based digital bridge enables paraplegics to walk, raising hope that neurotechnology can help overcome numerous disabilities. The contribution of AI in the interpretation of radiological images is the subject of an extensive review in the New England Journal Medicine. Science magazine publishes advances in regenerative medicine, which helps to recover tissues damaged in many diseases.

With regard to Global Health, The Economist shows with its model that global deaths are 5% above the pre-pandemic era, speculating about whether the stress on health systems due to the covid could have left many people without treatment, which would have increased mortality. Child labor, so present even in developed countries, is the subject of an analysis by The Lancet. The WHO, for its part, warns that the next pandemic may be even deadlier than covid.

As for International Health Policy, the most striking thing is both the editorial and the article that The Economist dedicates to the National Health Service. He goes on to say that although the NHS may need more money, money alone would not solve its problems, calling for “a radical change of focus”, but not like those that some are calling for to move closer to social insurance-type models such as in Germany and France, which he considers unnecessary. He believes that the change consists of orienting the system more towards health, as its name indicates, and less towards disease. Less focus on hospitals and more on community health; from treatment to prevention; and valuing the results more than the activity inputs.

If we talk about National Health Policy (Spain), to highlight the change of political sign, with the departure of the PSOE and the arrival of the PP, in the governments of the Valencian Community, Cantabria, the Balearic Islands, Extremadura and Aragon. This is going to have health consequences. Although it is early to tell, it will surely give continuity to the concession model in the Valencian Community. The latest weekly report from the WHO on covid shows that Spain is currently the country in Europe with the highest mortality per 100,000 inhabitants from this disease. The Community of Madrid has a serious problem attracting professionals, leaving many positions for primary care doctors and paediatricians vacant. Debate on training in the SNS, for important professional associations, such as FACME, the SNS by itself will not be able to maintain teaching professionals without collaboration with the industry. The Government of Navarra is investigating several doctors for breach of exclusivity, apparently only in force in Navarra, Galicia and Asturias. It is surprising that the form of application of a national law depends on the political sign of the autonomous governments.

At the Business level, internationally, Pfizer reaches an agreement with the EU to reduce the supply of covid vaccines. At the national level, it should be noted that HIPRA, after two months of approval of its vaccine, only sells it in Spain.

Biomedicine

Global Health

International Health Policy

National health policy

  • AIDS
    • According to the report of the Carlos III Health Institute, 92.5% of people living with HIV in Spain would know their infection diagnosis; 96.6 are receiving antiretroviral treatment and 90.4 have suppressed viral load. The decrease in the undiagnosed fraction is the data that presents the greatest evolution in this report (https://www.isciii.es/Paginas/Inicio.aspx)

Companies

7 days in healthcare (May 15th-21st, 2023)

 

Summary

From the point of view of Biomedicine, to point out certain warnings about the use of blood tests for the detection of cancer, an area with great growth, since in some cases there may be errors in diagnosis, over diagnosis and over treatment . Researchers are trying to improve Nuclear Resonance imaging, through fMRI, which will be able to detect brain activity on the millisecond scale. The WHO warns about the use of sweeteners for weight control and ChatGPT in health, without careful prior examination.

With regard to Global Health, The Lancet denounces in an editorial the continuation of the practice of the death penalty in some countries, but most fundamentally in China. The International Treaty on Pandemics, which may be one of the positive consequences of the covid, seems to be ready in May 2024.

Regarding International Health Policy, very interesting statements by the Director General of the WHO to The Economist magazine, following the lifting of the global alarm due to the covid. Trying to explain why the covid affected developed countries (such as the USA) in many cases more than developing countries, he comments that possibly a certain self sufficiency about the strength of their health systems and a concentration towards investments in specialized hospitals and high technology, in instead of public health, is at the origin of this situation. The crisis in the NHS continues, Starmer (Labor Party leader) says the system cannot be fixed without fixing the “fundamentals”. He seems to understand by “fundamentals” the need for reforms and not just more funding. EMA 2022 annual report, which greets that year as very positive due to the rapid development of new vaccines and new drugs.

If we talk about National Health Policy (Spain), apart from the rise in the incidence of covid, possibly the most far-reaching news is the shortage of certain medicines in pharmacies. It seems that the causes can be multiple, but basically three: the dependence on certain raw materials that are manufactured in India and China; parallel exports due to the lower price of medicines in Spain compared to other European countries; and the very low price of some drugs that discourages their production. In Primary Care, the real problems far exceed the weekend promises to give more money, apparently already committed. In-depth reforms and increased funding is what Primary Care needs, after a deep negotiation and consensus. The PP of Asturias promises to end, if it wins, with the exclusivity of doctors in that region, apparently already the only one in Spain that rigorously applies this regulation. The project of the new Hospital Clinic (Barcelona) of more than 1,500 million surprises by its grandeur. It is to be assumed that such a large investment is fully justified and explained very well to the population.

In the field of Companies, at the international level, a large fine was imposed on the pharmaceutical chain Walgreens in San Francisco for promoting the use of opiates. In Spain, the construction of a new hospital in Alicante by IMED stands out (is there a real boom in new private hospitals?); the sale to a German fund of 26% of ESTEVE; and, as unusual, the denunciation by the hospital employer ASPE of the agreement between Sanitas and Generali. It seems that the discrepancy is that Sanitas extends the advantageous rates that it had negotiated with suppliers, which are more favorable than those of Generali, to Generali customers in this way.

Biomedicine

Global Health

International Health Policy

  • China
    • What happened in China after the abandonment of the covid zero policy and the massive infection of omicron? The official figures for deaths are 87,475 between February 24 and March 16, 2023. Other estimates speak of between 1-1.5 million deaths. Surely the reality is somewhere in between (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2804631)

National health policy

Companies

 

 

7 days in healthcare (April 3rd-9th, 2023)

 

Summary

From the point of view of Biomedicine, vaccines against cancer and heart disease, based on mRNA technology, which are looming on the horizon 2030, seem to be the next great advance in medicine, potentially saving millions of lives. The Economist dedicates an article and an editorial to demonstrate the weak evidence for the therapy of gender transitions in adolescents, especially when they include pharmacological or surgical medication. Contrary to what had been a very popular assumption, moderate alcohol consumption does not produce health benefits, according to a study of more than 40 years published by the JAMA Network Open. Rather the opposite is true.

As regards Global Health, the WHO, born after the Second World War, is celebrating its 75th anniversary. He has emerged from the pandemic with injuries and issues, but acutely aware of his mission, purpose, and need for change. One of the problems it encounters is the discrepancies between countries in the discussion of a treaty on pandemics, which it intends to be approved in 2024. The Lancet publishes several articles on the commercial determinants of health, a subject of great interest. interest. Four industries – tobacco, unhealthy eating, oil and fossil fuels, and alcohol – are responsible for a third of deaths each year globally.

As for International Health Policy, in the United States, a federal judge in Texas has just banned the use of an abortion drug, which had been approved by the FDA more than 20 years ago. In France, the citizens’ convention, made up of 184 citizens chosen by lot, has just ruled in favor of euthanasia and assisted suicide, although with certain “red lines”. Macron wants to discuss the bill before the summer.

If we talk about National Health Policy (Spain), surgical waiting lists set a new record, according to the report made public by the Ministry of Health, with data as of December 31, 2022. Almost 900,000 people waiting for a surgical intervention. An absolutely delegitimizing element of the system. As is well known, the Ministry only makes public the waiting lists for surgical intervention or specialist consultations, but not for special tests (radiology, radiotherapy, ultrasound, etc.), on which there are no national data, although there are some autonomous communities. Interesting article published in Gaceta Sanitaria on the economic impact of including dental care in public coverage. This is an issue that the majority political parties have been pronouncing in favor of for several years, but nothing has been done on it. Spain is possibly the European country with the least percentage of its health spending devoted to dental care. The declarations of the Minister of Health of Catalonia are surprising, justifying the dismissal of the nurses who criticized the Catalan C1. Since this type of statement about specific dismissals is not common among regional ministers, it is to be assumed that there is an important political background. The decision of Navarra and Asturias to launch public companies, one for medical transport and another for a hospital laundry, is also surprising. Wouldn’t there have been the possibility of resorting to private initiative to solve these needs, perhaps more efficiently than through a public company?

In the field of Companies, internationally, agreement between Medtronic and Davita to launch Mozarc. At the national level, it is worth noting the start of work on the Viamed hospital in Tarragona, and the separation of the “pharmacy” and “chemistry” areas of the company Esteve.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies

 

 

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

 

 

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 (May 23th-29th, 2022)

 

 

Summary

From the point of view of biomedicine, the most important are the advances in the study of the microbiota, published in the journal Science.

As far as Global Health is concerned, the tragic mistake of the donation of vaccines by Europe should be highlighted, since many of those sent were close to expiration. Reappearance of polio in Africa, always worrying.

Regarding international health policy, the European health agency asks governments to be prepared against possible vaccination against monkeypox. Health bursts into the spotlight at the Davos Economic Forum.

If we talk about national health policy (Spain), Spain joins the European system for the purchase of vaccines against monkeypox. The MIR call leaves 200 vacancies for family doctors. An emergency situation is addressed, but not the underlying problem: the unattractive nature of these places.

In the field of companies, it should be noted that, according to Expansión, private insurance customers are dissatisfied with the massive use of the service. Between this and the unhappiness of both doctors and providers with the fees, it seems that significant changes are coming in this sector.

Biomedicine

Global health

International health policy

  • Monkeypox

o The European health agency asks governments to be prepared for vaccination against monkeypox (https://www.ft.com/content/11df80f5-32d5-4bb3-8215-420574f276c4)

o The monkeypox virus, what we know so far that alarms countries (https://www.ft.com/content/d951bd2b-0470-4d74-827d-0c06d9bf5056)

o Monkeypox, more than 180 cases outside Africa, countries prepare to vaccinate (https://www.lemonde.fr/planete/article/2022/05/25/variole-du-singe-plus-de- 180-cas-confirmes-hors-d-afrique-des-pays-se-preparent-a-vacciner_6127608_3244.html)

o A study published in The Lancet points to an antiviral as a possible treatment for monkeypox (https://www.eldiario.es/sociedad/estudio-publicado-the-lancet-senala-antiviral-posible-tratamiento-viruela- monkey_1_9018642.html)

  • COVID-19

o Lessons from Japan on dealing with covid, since this country had six waves and the number of cases and deaths per capita has been lower than other G7 countries, despite having an aging and highly concentrated population (https ://media.nature.com/original/magazine-assets/d41586-022-01385-9/d41586-022-01385-9.pdf)

o More than 1 in 5 COVID survivors may develop long covid in the United States (https://www.nytimes.com/2022/05/24/health/long-covid-infections.html)

o Pfizer warns of constant waves of covid-19, while complacency grows (https://www.ft.com/content/8244af52-26ba-4676-961a-c57f1d4892e8)

o What justifies the zero-covid policy in China?, an analysis by Zhang Jun, director of the China Center for Economic Studies in Shanghai (https://www.project-syndicate.org/commentary/shanghai-lockdown-why-china -keeps-its-zero-covid-strategy-by-zhang-jun-2022-05)

o A study suggests that women are twice as likely to suffer from persistent covid (https://www.ft.com/content/ea2d58c5-ae62-442c-b721-364c95852209)

  • Other themes

o Health bursts into the spotlight at the return of the Davos Economic Forum, with the presence of Bill Gates, the CEO of Pfizer and the president of AstraZeneca, among others (https://www.plantadoce.com/entorno/la- health-breaks-in-as-protagonist-in-the-return-of-the-davos-economic-forum.html)

o Tedros Adhanom Ghebreyesus re-elected as WHO Director General (https://www.ft.com/content/75de7a67-f850-4fe2-8911-8f6237f38514)

o Oklahoma Governor signs law strictly banning abortion (https://www.theguardian.com/us-news/2022/may/26/oklahoma-strictest-abortion-ban-law-us-governor)

National health policy (Spain)

  • Monkeypox

o At least six countries have detected cases of monkeypox in travelers from Spain (https://elpais.com/sociedad/2022-05-28/al-menos-seis-paises-han-detectado-casos-de- monkeypox-in-travelers-from-spain.html)

o 41% of monkeypox cases are in Spain (https://www.larazon.es/sociedad/20220523/6t2hw3xhhveq3e7oho5hnj3zxa.html)

o Spain will enter the European system for the purchase of the monkeypox vaccine (https://www.diariofarma.com/2022/05/25/espana-entrara-en-la-compra-centralizada-de-la -eu-to-deal-with-monkeypox)

  • COVID

o The cumulative incidence, down (728.2 cases in the last 14 days; there were 848 the previous Friday. Hospital occupancy due to covid: 5.6%; ICUs: 4.2%) (https://www.consalud .es/patients/special-coronavirus/covid-19-spain-coronavirus-data_115366_102.html)

  • Regulatory announcements

o New Framework Statute, at the table of the Advisory Council on June 2 (https://www.redaccionmedica.com/secciones/ministerio-sanidad/nuevo-estatuto-marco-y-10-puntos-mas-al-consejo- advisory-of-june-2-5764)

o A new draft of the Preliminary Draft Law is published, which modifies various regulations to consolidate the equity, universality and cohesion of the National Health System, after its approval in the Interterritorial Council of April 2022 (https://www.diariofarma .com/2022/04/06/el-cisns-da-luz-verde-a-la-ley-de-equidad), held in Toledo. In relation to the previous version of 11/15/2021, more requirements are introduced for agreement, incorporating the concept of “effective cost” previously established and reviewable by the Administration

  • Other themes

o The Ministry of Health marks November for the new palliative strategy (https://www.redaccionmedica.com/secciones/ministerio-sanidad/sanidad-marca-noviembre-para-activar-la-nueva-estrategia-de-paliativos- 6597)

o The public debt to suppliers amounts to 2,000 million (https://www.diariofarma.com/2022/05/23/la-deuda-publica-a-proveedores-sanitarios-asciende-a-2-000-millones)

o Warning from Brussels to Spain due to the “shortage” of health professionals and primary care financing (https://www.consalud.es/politica/toque-bruselas-espana-por-escasez-sanitarios-finacion-primaria_115145_102.html)

o Podemos takes the “deprivatization” of the SNS to Congress (https://www.redaccionmedica.com/secciones/parlamentarios/podemos-aprieta-al-psoe-llevando-al-congreso-la-desprivatizacion-del-sns-1224)

o The lack of family doctors worsens as the MIR call leaves 200 places vacant (https://elpais.com/sociedad/2022-05-24/la-falta-de-medicos-de-familia-se-agrava- la-convocatoria-de-mir-deja-200-plazas-vacantes.html), for which it is agreed to increase the number of MIR vacancies for non-EU people to fill the vacancies (https://www.elmundo.es/ciencia- y-salud/salud/2022/05/25/628e86d3e4d4d85f418b45e6.html

Companies

  • International News

o Pfizer intends to obtain approval in the USA for the covid vaccine for children under 5 years of age (https://www.ft.com/content/48c88652-502c-4b33-9866-589eeafcf302)

o Medtronic and DaVita announce the creation of a kidney health technology company (https://www.consalud.es/ecsalud/internacional/medtronic-davita-anuncian-creacion-empresa-tecnologia-salud-renal_115348_102.html)

o The USA will deploy the Bavarian Nordic monkeypox vaccine (https://www.consalud.es/ecsalud/internacional/eeuu-desplegara-vacuna-contra-viruela-mono-bavarian-nordic-entre-poblacion-vulnerable_115091_102. html)

o The IFPMA (global employers association of pharmaceutical manufacturers) proposes 10 measures to fight the next pandemic (https://www.diariofarma.com/2022/05/25/la-ifpma-propone-10-medidas-para-luchar- against-the-next-pandemic)

  • National News

o Grupo Juste, a Spanish pharmaceutical company that turns 100 (https://www.redaccionmedica.com/secciones/industria/una-farmaceutica-espanola-cumple-100-anos-7009)

o Esteve intends to double its turnover, reaching 1,000 million euros (https://cincodias.elpais.com/cincodias/2022/05/26/companias/1653591656_508050.html)

o Clients of private health insurance, disappointed by the mass use of the service (https://www.expansion.com/empresas/banca/2022/05/28/6290b63c468aebbe018b45d8.html)

o The private sector of assisted reproduction moves 500 million in 2021, 9% more than in 2020 (https://www.plantadoce.com/entorno/el-sector-privado-de-reproduccion-asistida-mueve-500-millones -in-2021-a-9-more-than-in-2020.html)

o FENIN registers a 27% decrease in investment in 2021 (https://www.actasanitaria.com/tecnologia/fenin-registra-descenso-27-en-inversion-tecnologia-sanitaria_2002610_102.html)

o Sanitas and the San Pablo CEU University sign an agreement for the training of health professionals (https://www.servimedia.es/noticias/sanitas-universidad-ceu-san-pablo-firman-acuerdo-para-formacion-profesionales- assistance-future/3406605)

o Malaga will have a new public hospital in 2023, after the agreement with the Pascual group (https://www.vidaeconomica.com/2022/05/hospital-malaga/)