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7 days in healthcare (October, 10th-16th, 2022)

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Summary

From the point of view of biomedicine, to review the advances in knowledge of the human organ that, to a large extent, remains a mystery, the brain: the implantation of human cells in mice, which can send signals and the creation of a kind of synthetic intelligence, by verifying that nerve cells in a dish can learn. In the United States, it is found that mortality from breast cancer has decreased a lot, due to early detection and better treatments. Something that is not exclusive to the United States and that surely also occurs in Spain.

As far as Global Health is concerned, the serious health problems, for very different reasons, in Pakistan, Somalia, Syria and Lebanon must be highlighted.

Regarding international health policy, there is great concern in the WHO and other organizations about the effects of persistent covid. Threat of hospitals in Germany by covid. The Economist introduces the debate on the legalization of cocaine, which it strongly defends, considering that the problems of an illegal market far outweigh those that could arise in a controlled market. Put the simile of whiskey and cigarettes.

If we talk about national health policy (Spain), the rise in the incidence of covid continues, although in Spain without notably affecting hospitals. Promising launch of the Neurotechnology Center in Madrid.

In the field of companies, at the international level, the WTO (World Trade Organization) continues with its efforts to free the patents of medicines related to covid. As far as Spain is concerned, HIPRA suffers a new delay in the approval of its vaccine by the EMA, which practically excludes it from the fourth dose vaccination campaign.

Biomedicine

Global Health

International health policy

  • European Union
    • A step forward towards a Europe of health. The reinforcement of the ECDC (European Center for Disease Prevention and Control), the EMA (European Medicines Agency) and the creation of the Health Emergency Preparedness and Response Authority, constitute important steps towards a European policy of health, something not contemplated in the founding European treaties (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01980-8/fulltext)
  • The debate on the legalization of cocaine
  • New Code of Medical Ethics
    • Approved the new International Code of Medical Ethics of the World Medical Association. After the initial version of this Code in 1949, a new wording has been approved at the General Assembly of the World Medical Association, held in Berlin in October 2022 (https://jamanetwork.com/journals/jama/fullarticle/2797507)

National health policy

Companies

 

 

7 days in healthcare (February 7-13, 2022)

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SUMMARY

From the point of view of biomedicine, to highlight the advances that allow paraplegics to walk, through spinal implants.

Regarding Global Health, it is worth mentioning the WHO warning that the pandemic has threatened the health systems of 90% of the countries; as well as the health problems in Burkina Faso and Afghanistan.

In relation to international health policy, the WHO statement that the pandemic is not over and that more variants are expected should be highlighted. In some countries the restrictions are lifted (United Kingdom, Norway) while in others (Germany) they continue. HERA (the new European Authority for Preparedness and Response to Health Emergencies) begins its steps and will receive a budget of 1,300 million euros in 2022.

In national health policy, we are witnessing a relaxation of the restriction measures, as a consequence of the decrease in the figures of the pandemic (less than 1,500 per 100,000 inhabitants), although these figures are still high and are accompanied by high mortality. Nor is the appearance of new variants ruled out. On the other hand, in the face of loud announcements by the Government, the incorporation of Paxlovid, Pfizer’s medication against serious cases of COVID, is delayed. Work begins for the creation of the State Public Health Surveillance Network, one of the conclusions of the work of the Commission for Social and Economic Reconstruction of the Congress of Deputies of July 3, 2020 (point 19.2), although in the conclusions of the commission there was talk of “urgently implementing” this issue. It is addressed two years after the first death from covid. Also noteworthy is the great concern and mobilizations carried out by the nursing sector. The General Council of Nursing Colleges publishes a Decalogue, whose first point is “Spain without nurses” and the last “Enough of ignoring us”. Spain leads the consumption of anxiolytics, which does not seem like a minor problem.

As far as company news is concerned, mention should be made of the FDA’s delay in approving Pfizer’s vaccine for children under 5 years of age. Also the entry of Nestlé in the field of health, positioning itself in weight control.

BIOMEDICINE

  • Spinal implants allow paraplegics to walk, swim and ride a bike. Breakthrough driven by Grégoire Courtine, a neuroscientist at the Federal Institute of Technology in Lausanne, and Jocelyne Bloch, a neurosurgeon at Lausanne University Hospital. The rupture of the cord prevents the transmission of electrical signals from the brain, which allows the implanted device (The Economist, 12 February 22)
  • There is a lack of evidence that current covid vaccines will produce herd immunity (American Journal of Medicine, February 6, 22)
  • A study analyzes the prevalence of loneliness in 113 countries, as a major health and social problem (BMJ, February 9, 22

GLOBAL HEALTH

  • The WHO warns that more than 90% of the countries have seen their health system threatened by the pandemic (interruptions in services, difficulties in accessing care, problems with emergency care) (La Razón, February 7, 22)
  • The WHO denounces actions by the pharmaceutical industry that make it difficult to bring covid vaccines to Africa. The declaration affects a foundation (kENUP) linked to BioNTech (BMJ, February 9, 22)
  • The armed conflict in the Sahel region (Burkina Faso) endangers the already weak health system (The Lancet, February 12, 22)
  • Afghanistan’s health system is collapsing under stress (NYT, February 6, 22)
  • Ukraine, fears that a health system that had made great progress in recent times is going into crisis due to the possible conflict (The Lancet 12 February 22)

INTERNATIONAL HEALTH POLICY

  • COVID

o The WHO warns that the pandemic is not over and that more variants are expected (ABC, February 12, 22)

o Covid levels remain high in many parts of Europe, but restrictions tend to be lifted (FT, February 11, 22)

o The 1918 flu had devastating effects the third year (Washington Post, February 6, 22)

o Protests against covid restrictions in France and the Netherlands (The Guardian, February 12, 22)

o Waiting lists in England exceed 6 million for the first time (FT, 10 February 22)

o Boris Johnson plans to end the restrictions due to covid a month earlier than planned (The Guardian, February 9, 22)

o China, ready to impose greater confinements in Hong Kong (FT, February 11, 22)

o A study detects that NYC deer are infected by covid (NYT, February 7, 22)

o Seven out of ten vaccines administered in the EU are from Pfizer (El Español, February 11, 22)

o Norway lifts all restrictions against the pandemic (El País, February 13, 22)

o Germany will not lift the restrictions against covid (El Mundo, February 10, 22)

  • Other issues

o HERA (the new European Authority for Preparedness and Response to Health Emergencies) will have a total budget of 1,300 million in 2022 (diariofarma, February 10, 22)

o The EFPIA publishes a white paper on the effectiveness of public procurement of medicines in the EU (EFPIA, February 22)

o It seems that the attempts of the United States government to lower the price of medicines by allowing the negotiation of their prices in Medicare are failing (NEJM, February 9, 22)

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o The low incidence of 1,500 cases per 100,000 inhabitants in Spain, although with 389 deaths on the last day with official information (La Vanguardia, February 11, 22)

o Delays in the incorporation of Paxlovid, Pfizer’s medication against severe COVID (El Periódico de España, February 11, 22)

  • Political announcements

o Spain begins to create the pandemic alert network, creating the State Public Health Surveillance Network (El Español, 13 February 22)

  • Other issues

o The nursing sector stars in demonstrations throughout Spain (La Razón, February 9, 22)

o Decalogue published by the General Council of Nursing Colleges (CGCE, February, 2022)

o Spain leads the consumption of anxiolytics in Europe, according to the latest report from the Narcotics Control Board (INCB), more than 2.5 million people consume psychotropic drugs daily (La Razón, February 12, 22)

o Spain doubles the number of leprosy cases in 2021 (The Objective, February 7, 22)

o The OMC (Collegiate Medical Organization), against Montero’s campaign on “obstetric violence” (El Español, February 10, 22)

o The Ombudsman intervenes in response to complaints of health cuts to MUFACE officials (La Razón, February 10, 22)

o In a meeting convened by the IMAS Foundation, specialists demand a digital health strategy (Health Act, February 9, 22)

o Cantabria wants to turn Valdecilla into a reference in precision medicine (Sanitary Act, February 10, 22)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

  • Important medical bet by Amazon that is revolutionizing the health system in the USA (El Economista, February 12, 22)
  • The FDA puts a brake on the approval of Pfizer’s covid vaccine below 5 years (The Guardian, February 11, 22)
  • Novavax, the fifth vaccine, arrives in Europe the last week of February (diariofarma, February 10, 22)
  • China conditionally approves Pfizer’s treatment Paxlovid (The Guardian, 12 February 22)
  • CEOE: Adriana Bonezzi, new head of the health area (Medical Writing, February 7, 22)
  • Wivi vision. company that evaluates the capabilities of the visual system: agreement with General Óptica to implement it in its network of stores (PlantaDoce, February 8, 22)
  • Vithas joins forces with Genesis Care to launch a cancer center in Madrid (PlantaDoce, February 4, 22)
  • Pfizer more than doubles its profits in 2021, up to 22,000 million dollars (PlantaDoce, February 8, 22)
  • Nestlé Health Science buys Pronokal, positioning itself in the weight loss and control products sector (Diario Médico, February 7, 22)
  • J&J suspends the manufacture of its vaccine (Consalud, February 11, 22)
  • Dependency insurance grows 96% and closes 2021 with 128,000 insured (PlantaDoce, February 7, 22)
  • Durcal relies on Movistar to break into the elderly care segment (PlantaDoce, February 10, 22)
  • Nordic Cap and Amulet enter the bid for the IVI group, Morgan Stanley will receive the non-binding offers before February 23 (CincoDías, February 12, 22)

 

 

Which Country Has The World’s Best Health Care?

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The famous physician, health economist and bioethicist, Ezekiel J. Emanuel, has recently published a book (Public Affairs, New York, 2020) that tries to answer the famous question of what is the best healthcare system in the world. Obviously, after a long exploration, the answer is that there is no system that can be classified as the best in the world, but rather that they all have their strengths and weaknesses.

But the exploration is not without interest, since he analyzes with some detail, the systems of 11 countries: the United States, Canada, the United Kingdom, Norway, France, Germany, the Netherlands, Switzerland, Australia, Taiwan and China. Very much in the Anglo-Saxon tradition, Spain does not exist and, what is even more surprising, none of the Latin American and Caribbean countries.

The book analyzes the 7 challenges that healthcare systems usually face:

  1. Cost pressure
  2. The price of medicines
  3. Inefficiency in the provision of services
  4. Coordination of patients with chronic diseases
  5. Mismatch between the organization of provision services and the needs of chronic patients
  6. Provision of mental care
  7. Long-term care

The book has very interesting graphs that analyze: a) the different types of coverage in each country; b) financing and origin of funds; c) the system of payment to hospitals and doctors; d) organization of provision (including hospital care, outpatient care, mental care, long-term care and prevention); e) pharmaceutical coverage and price control; and, finally, f) human resources.

The challenges of each country are analyzed objectively.

7 days in healthcare (8-14 November, 2021)

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ABSTRACT

 

From an international point of view, the appearance of two new drugs for COVID (Merck and Pfizer) is considered a milestone in the evolution of the pandemic. Both drugs are small molecule, easy to produce, and for oral use. The other great milestone of the pandemic was, at the time, the appearance of vaccines. Especially worrying are the high numbers of COVID in Europe, especially in the United Kingdom, Ireland, but also Germany and the Netherlands, without forgetting the special situation due to its seriousness in Romania and Bulgaria.

From the national point of view, the announced draft bill on Equity, Universality and Cohesion of the SNS is of great interest. Although the text of the preliminary draft is not known at the time of writing this note, from what was announced it could be said that the positive aspect is universality (provided that universality is not identified with equity) and the negative are the possible repeal of Law 15 / 97, on enabling new forms of management in the National Health System, the imposition of direct management compared to other more flexible forms of management and bad messages regarding co-payments. It seems that he wants to transfer the idea that “privatization” and “copayments” are the problems of the sector, which is absurd.

Regarding companies, the disappearance of large industrial business conglomerates, such as J&J and GE, is striking. It should be noted that in both operations one of the bets is health. This contrasts, instead, with the creation of tech giants (Google, Amazon, Apple, etc.).

 

INTERNATIONAL

 

  • The Economist forecast: COVID will most likely disappear by 2022. Success: vaccines and new drugs. Failure: immunity at terrible cost, 16.5 million deaths worldwide (The Economist, 8 Nov 21)
  • The Economist welcomes the extension of “assisted death” as a new and important right, started in 1995 in Australia and already legal in a dozen countries, most recently Portugal. It is not yet legal in the UK, but Parliament is discussing a law on the subject. In the Netherlands, 4% of deaths are assisted (The Economist, 13 Nov 21)
  • The new anti-COVID drugs represent a significant change in the pandemic (the first notable change was that of vaccines). The new drugs are malnupiravir (Merck) and paxlovid (Pfizer). Both are “small molecule” drugs, easy to produce and for oral use (The Economist, 12 Nov 21)
  • 100 Years of Insulin (Toronto, 1922), a therapeutic success, but a failure in its worldwide spread. The producing companies are Novo Nordisk, Eli Lilly and Sanofi. Now there is biosimilar (The Lancet, Nov 13, 21)
  • The 100,000 genomes project in the United Kingdom (Genomics England) has made it possible to catalog, and in some cases treat, many rare diseases (New England Journal of Medicine, 11 Nov 21)
  • The rise of the COVID epidemic in Germany (almost 500 cases in the last 14 days per 100,000 inhabitants), at the peak and rising, is considered an pandemic of the unvaccinated. Among the factors, the interim Merkel government is valued (NYT, 11 Nov 21). Merkel will meet with the “Länder” next week to take measures against the growth of the covid (El Mundo, 11 Nov 21)
  • The Netherlands imposes new restrictions, as COVID cases are very high (The Guardian, 12 Nov 21)
  • The governments of 42 countries (including the United States, the United Kingdom and Germany) ask to cut emissions from the healthcare sector. The sector’s emissions represent 5% of the total. If it were considered a country, the health sector would be the 5th emitter of CO2 pollution (NYT, 8 Nov 21)
  • The Economist analyzes the non-zero cost of China’s zero-COVID policy (The Economist, 13 Nov 21)
  • COVID vaccination will be mandatory for NHS staff starting next spring (FT, 9 Nov 21)
  • Waiting lists on the NHS soared. They grow by 100,000 people in a month. More than 5.8 million were waiting in September, with 12,500 awaiting treatment for more than two years (FT, Nov 11 21)

NATIONAL

 

  • The government approves the “preliminary draft of the Law by which various norms are modified to consolidate the equity, universality and cohesion of the National Health System” (reference of the Council of Ministers 8 Nov 21)
  • The Secretary of State for Health publishes a prior consultation on the draft bill of measures for equity, universality and cohesion of the National Health System, establishing the November 19 deadline for submitting opinions.
  • The Minister of Health, in public statements, mentions the laws that are going to be repealed or modified. Among those that will be repealed, “explicitly and expressly”, she mentions Law 15/97, on enabling new forms of management in the National Health System (El Periódico de España, 8 Nov 21)
  • The BOE publishes the agreement between the Government, certain autonomous communities and the Amando Ortega Foundation, for the implementation of 10 proton therapy equipment in the public system. A monitoring commission is created on the subject (BOE, no. 267, 8 Nov 21)
  • The health PERTE is presented on November 15. It is integrated into the five PERTES that the government has devised: cutting-edge healthcare, electric vehicle, new language economy, aerospace and smart and sustainable food chain. It appears that the health PERTE will have three components: 1. Innovative techniques and technologies for the diagnosis and prevention of diseases; 2. Development of advanced therapies; and, 3. Platform for the design and industrial production of medicines and vaccines (ConSalud, 11 Nov 21)
  • The autonomies claim to maintain the covid funds for 2022 (El País, 9 Nov 21)
  • The University of Washington predicts a sixth wave of covid in Spain (Vozpópuli, 8 Nov 21)
  • The cumulative incidence of covid grows in Spain to 71.5 cases per 100,000 inhabitants in the last 14 days. It is not comparable to the figures of other European countries, but it continues to rise slowly (ConSalud, 12 Nov 21)
  • The waiting list grows. The latest data published is from December 31, 2020 and the waiting time had passed, in relation to the previous record, from 121 to 148 days for interventions. Pending publication of the data corresponding to June 2021 (ConSalud, 8 Nov 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

 

  • J&J (Johnson & Johnson) will be divided into two companies: one dedicated to consumer products and the other to drugs and medical devices (NYT, 12 Nov 21)
  • GE (General Electric) will be divided into three companies: health, energy and aviation (FT, 9 Nov 21)
  • The Spanish pharmaceutical industry proposes a plan of 1.7 billion to produce essential drugs (CincoDías, 10 Nov 21)
  • Moderna rejects the claims of the American government to appear as a co-inventor of vaccine technology (FT, 11 Nov 21)
  • BioNTech shoots its profit up to 7,126 million euros in the first nine months of the year. (Floor Twelve, Nov 9, 21)
  • The Zendal hospital in the post-pandemic: 400 personnel for 38 patients (Diario.es, Nov 7 21)
  • Fresenius is interested, along with other investors, in InsudPharma, specialized in biosimilars and valued at 1,000 million euros (El Periódico de España, Nov 9, 21)
  • Advent gives gas to Vitaldent, with the purchase of Smysecret (dental aesthetic treatments) (PlantaDoce, 12 Nov 21)
  • Acciona will build a hospital in Chile (PlantaDoce, 11 Nov 21)
  • KKR enters fertility with the purchase of GeneraLife from Invesindustrial (Expansión, 10 Nov 21)
  • HIPRA will imminently begin the new phase of clinical trials for its vaccine (El Economista, Nov 8, 21)
  • Grifols liquidates the blood bag business and closes production in Brazil and Murcia (Cinco Días, Nov 12, 21)