7 days in healthcare (August 28th-September 3rd, 2023)
Summary
From the point of view of Biomedicine, it is worth highlighting how therapy with psychedelics is opening up among mental health professionals, especially for cases of depression, anxiety, post-traumatic stress, eating disorders and addictions.
As far as Global Health is concerned, a study of 18 clinical trials shows that screening for early detection of cancer does not make this population live longer than those who do not undergo this type of testing. WHO concern about blindness and vision disorders. More than 2.2 billion people globally have vision disorders, generally attributable to refractory disorders and cataracts.
In terms of International Health Policy, the expected bomb exploded from the application of the “Inflation Reduction Law”, approved in the USA in August 2022, which included something prohibited until now: price negotiation between pharmaceutical companies and Medicare. . The American government made public the 10 drugs that will be negotiated in 2023 and affects the main companies: Pfizer, Lilly, Novartis, AstraZeneca, J&J, etc. Although the established system is very gradual, since 10 drugs will be negotiated each year for the next four, the truth is that this breaks the status quo of the pharmaceutical industry not only in the USA (the largest drug market) but in the world. It is difficult to counter Biden’s argument, which he plans to use in the 2024 campaign, that Americans do not have to pay two to three times more for medicines than the rest of the developed countries, such as in Europe. However, The Economist, which recognizes the need for this price negotiation, nevertheless sees problems in its application due to the appeals filed by large pharmaceutical companies and the risk that these companies will distance themselves from the necessary medicines and concentrate on others unrelated to price control. He also says that if R&D expenses are taken into account, the profitability of pharmaceutical companies is not extraordinary, when compared to the companies in the S&P 500.
If we talk about National Health Policy (Spain), the incidence of covid shoots up by 70% in just one week. The Ministry of Health recommends the fifth dose to selected groups: over 60 years of age, health personnel and the vulnerable. The Supreme Court faces a complex issue: the ruling on thousands of compensation payments to businessmen due to the pandemic. These are property claims to the State due to Covid-19 from businessmen and self-employed workers, who are awaiting compensation for the damage caused by the restrictions during the states of alarm that were later cancelled.
In the field of Companies, on an international level, the most notable is the abandonment of CENTENE from the United Kingdom, where it had a chain of primary care centers and the CIRCLE hospital network. The movement follows his departure from Spain with the sale of Ribera. A concentration in the American market, difficulties with the anti-privatisation movements of healthcare in Europe and problems with hospital integration may be at the origin of the problems, to which perhaps we should also add an underdeveloped growth strategy for this American company in Europe. In any case, a shame, since CENTENE is a great American insurance company, with a lot to teach in the European world. As far as national news is concerned, Spain is the only country that has purchased (31 million euros) several million vaccines from HIPRA, which is not updated for the new strains. Big problem for the Ministry if it decides to use it.
Biomedicine
- Psychedelic therapy. A new paradigm of mental health care, in which there are more and more interested parties, to treat depression, anxiety, post-traumatic stress, eating disorders and addictions (https://jamanetwork.com/journals/jama/fullarticle/2808951#:~:text=The%20psychedelic%20allows%20feelings%20such,seem%20to%20be%20mitigated%20by)
- Some forms of chronic pain are particularly mysterious. Compared to acute pain, chronic pain is persistent and is usually accompanied by psychological effects. There are some indications that an effective treatment could begin to be known (https://www.economist.com/science-and-technology/2023/08/30/some-forms-of-chronic-pain-are-particularly-mysterious )
- They manage to transform aggressive cancer cells into healthy cells. It has been achieved in rhabdomyosarcoma, a particularly aggressive tumor (https://www.alimente.elconfidencial.com/bienestar/2023-09-02/trasformar-celulas-cancerosas-agresivas-en-sanas_3727388/#:~:text=This%20type%20of%20sarcoma%2C%20that,muscle%20cells%20healthy%20and%20normal.). Access to the original article: https://www.pnas.org/doi/10.1073/pnas.2303859120
- Discovered a new mechanism to improve cancer resistance. The team of Spanish biochemist Miguel Reina, who works at the University of California San Diego, has identified white blood cells that destroy cancer cells (https://elpais.com/ciencia/2023-08-31/despósito-un-nuevo-mechanism-to-improve-cancer-resistance.html). Original article in Nature: https://www.nature.com/articles/s41586-023-06483-w.epdf?sharing_token=kW_BNW6LGN7naGCXnVLtAtRgN0jAjWel9jnR3ZoTv0MTEd–5SaRkbA_yTrhU4O0rJh5BNxOSJBs_xQ2osSnqJOoa3bZpSu84aDjPLhR9bkuVsjUrfUcYK4oMFY-z4NKLJnmm7-kneX15gf3GRgyv05lsDpjwO-SelyslaSLXo27ufwpTjYdGmFwb
Global Health
- A mega study finds that cancer screening tests hardly save lives. The analysis of 18 clinical trials showed that the population subjected to screening, in general, does not live longer than those who are not tested (https://www.elespanol.com/ciencia/salud/20230829/mega-estudio-concludes-massive-tests-detect-cancer-barely-save-lives/790171341_0.html)
- WHO’s new vision of traditional medicine (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01841-X/fulltext#:~:text=Evidence%2Dbased%20integration %20is%20the,first%20Traditional%20Medicine%20Global%20Summit.)
- Water as a fundamental right (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01430-7/fulltext#:~:text=Similarly%2C%2019%20independent%20UN %20Human,and%20not%20as%20a%20commodity.&text=Water%20is%20a%20common%20good%20not%20a%20commodity%3A%20UN%20experts.)
- The health of the oceans (https://www.science.org/doi/10.1126/science.adk5309)
- Countless lives at risk in Afghanistan as the healthcare system collapses (https://www.bmj.com/content/382/bmj.p1961#:~:text=“The%20situation%20in%20Afghanistan%20is, donors%20to%20support%20the%20mission.)
- The WHO releases (August 10, 23) a document on blindness and vision disorders. 2.2 billion people have impaired near or distance vision. The main problems are refractive alterations or cataracts (https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment)
- South Africa fights against blindness (https://www.theguacom/global-development/2023/aug/28/many-patients-are-dying-blind-south-africas-struggle-to-save-eyesight#:~: text=In%202000%2C%20South%20Africa%20joined,care%20coordinator%20has%20been%20appointed.)
International health policy
- COVID 19
- Weekly covid report published by the WHO, September 1, 2023. Three of the five WHO regions (Western Pacific, Europe and Eastern Mediterranean) showed an increase in the number of cases, while the other two had decreases. (https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19—1-september-2023)
- A group of experts show that confinements and masks help stop the transmission of covid (https://www.bmj.com/content/382/bmj.p1959)
- USA
- The American government reveals the 10 drugs on which price negotiations will take place with Medicare. Under the proposed reform the minimum price decrease will be 25%. According to the Congressional Budget Office, the savings to the public coffers will be $100 billion over a decade. The affected companies are BMS, Pfizer, Boeheringer, Lilly, J&J, Merck, AstraZeneca, Novartis, Amgen, AbbVie, Novonordisk (https://www.ft.com/content/fa9b0422-6f93-4703-9358-6396660f63b6)
- The Economist, critical of the American government’s measure, although it recognizes that price negotiation was obligatory. He says that the prohibition on negotiation was nonsense, but the proposed negotiation system could have perverse effects. If R&D expenses are taken into account, pharmaceutical companies do not have extraordinary profits, compared to those of the S&P 500 (https://www.ecocom/leaders/2023/08/30/americas-new-drug-pricing-rules-have-perverse-consequences)
- Biden makes the negotiation of drug prices one of the central axes of his campaign for 2024, despite the fact that the price reduction will not begin until 2026 and that is if the law resists all judicial attacks (https://www.nytimes.com/2023/08/30/us/politics/biden-medicare-drug-prices-2024-campaign.html)
- Opinion article in FT: “The world needs to stop depending on the American pharmaceutical industry.” Americans pay up to three times more than other developed countries for medications. The American market is the main market for pharmaceutical companies. This policy is popular among Americans, but it may affect drug R&D globally. Pharmaceutical companies can orient themselves from the most needed medicines to those that escape price control (https://www.ft.com/content/0c20c518-60a8-4dd0-87be-f03adc8ec0e1)
- China
- An old health insurance scheme in China may have saved millions of lives (https://www.economist.com/china/2023/08/31/an-old-health-insurance-scheme-in-china-may-have-saved-millions#)
- United Kingdom and National Health Service
- Junior and senior doctors go on joint strike for the first time in NHS history (https://www.theguardian.com/society/2023/aug/31/junior-doctors-nhs-england-vote-to-continue-strikes-through-winter)
- Two-thirds of Britons support legalizing assisted dying, chg(https://www.theguardian.com/society/2023/aug/28/two-thirds-of-britons-support-legalising-assisted-dying- poll-shows#:~:text=Sixty%2Done%20per%20cent%20of%20members%20supported%20a%20law%20change,profession%20at%20the%20last%20vote.)
- English cancer patients will be the first to benefit from 7-minute injections. The procedure replaces intravenous infusions that last 30 minutes (https://www.theguardian.com/society/2023/aug/29/patients-in-england-will-be-first-to-access-seven-minute-cancer-jab)
- European Union
- The EU approves the adaptation of the Pfizer-BioNTech vaccine against the XBB.15 variant of covid (https://www.elmundo.es/ciencia-y-salud/salud/2023/09/01/64f1a4bfe4d4d8d4678b4573.html#)
National health policy
- COVID
- The incidence of covid shoots up 70% in just one week (https://www.diariomedico.com/medicina/enfermedades-infecciosas/la-incidencia-de-covid-se-dispara-casi-un-70-in-spain-in-just-a-week.html)
- The Ministry of Health recommends a fifth dose for those over 60 years of age, healthy and vulnerable (https://www.larazon.es/sociedad/sanidad-recomienda-quinta-dosis-mayores-60-anos-sanitarios-vulnerables_2023082864ecab409598e3000199d29c.html#:~ :text=%20experts%20also%20advise%20it,for%20those%20with%20higher%20risk.)
- The rebound in covid multiplies the sale of antigen tests in pharmacies (https://www.elperiodico.com/es/sociedad/20230901/repunte-covid-venta-test-antigenos-91577347#)
- Waiting lists
- Madrid healthcare manages to significantly reduce waiting lists. It reduces the surgical waiting list by 10.5%, while launching a Comprehensive Plan to bring it to less than 45 days (https://www.larazon.es/madrid/sanidad-que-rompe-listas-espera_2023083164efd3429598e300019f5801 .html)
- The problems with the Zendal hospital continue
- The umpteenth function is being sought for the Zendal hospital, which costs 15 million euros per year (https://www.eldiario.es/madrid/ayuso-busca-enesima-funcion-zendal-cuesta-15-millones-ano-prepare-big-announcement-september_1_10465390.html)
- Organ donation
- One in four EU donors comes from Spain (https://www.consalud.es/pacientes/cada-4-donantes-union-europea-proviene-espana_133874_102.html)
- Private healthcare
- DKV refuses to negotiate collectively with the private healthcare doctors of Seville (https://theobjective.com/sanidad/2023-08-28/dkv-rechaza-negociar-medicos-privada-sevilla/)
- Judicial consequences of the pandemic
- The Supreme Court faces the sentencing of thousands of compensations to businessmen due to the pandemic. These are property claims to the State due to Covid-19 from businessmen and self-employed workers, who are awaiting compensation for the damage caused by the restrictions during the states of alarm that were later cancelled. About 9,000 resources are expected. The sentence is very complex, due, among other things, to the high economic amount that it could represent (https://www.expansion.com/juridico/sentencias/2023/09/01/64f1cc47e5fdea09658b45ba.html)
Companies
- International News
- Centene divests its UK business: sells its primary care and hospital network. The primary care network had 60 Operose practices and the Cicle hospital network was the largest private hospital network in the UK. A concentration of its activity in the USA, the recognition of the anti-health privatization movements in Europe and the difficulties of integrating hospitals seem to be at the heart of the operation (https://www.ft.com/content/4f2e1a38-27f5-4e38-9bd8-70f0ae6b206a)
- How Ozempic and Wegovy, Novonordisk’s weight loss drugs, are reshaping the Danish economy (https://www.nytimes.com/2023/08/28/business/denmark-ozempic-wegovy.html)
- Novonordisk eclipses LVMH as the most valuable European company (https://www.ft.com/content/97e89e94-38cb-4a22-9a17-c110e39958bc)
- Orphan drugs, small but very profitable markets (https://www-ft-com.ezp.lib.cam.ac.uk/content/cdb3fa57-0849-40ba-aece-720d55b4fe55)
- The business conglomerate 3M agrees to pay 6 billion to stop a lawsuit for its earplugs (https://www.elmundo.es/economia/empresas/2023/08/30/64ee6d0de85ecec6258b459a.html#)
- National
- Hipra only sells its vaccine in Spain and will arrive out of date with the new strains. Health spends 31 million on Hipra vaccines. Spain is the only country that has purchased this vaccine, which is already outdated, according to recommendations from international organizations (https://www.eleconomista.es/salud/noticias/12420343/08/23/hipra-solo-vende-su-vaccine-in-spain-and-it-will-be-outdated-to-the-new-strains.html)
- Grifols, the only national pharmaceutical company that is saved from the drop in profits (https://www.eleconomista.es/salud/noticias/12419012/08/23/grifols-la-unica-farmaceutica-que-se-salva-of-the-fall-of-profit-.html)
- Health closes the Serra Pàmies factory due to serious deficiencies (https://www.eleconomista.es/salud/noticias/12421552/08/23/sanidad-cierra-la-fabrica-de-serra-pmies-por-deficiencias-serious.html)
- Pharmamar’s new antitumor boosts its benefits in the USA by 7.8% (https://www.eleconomista.es/salud/noticias/12426033/08/23/el-nuevo-antitumoral-de-pharmamar-impulsa-sus -income-in-us-un-78.html)
This post is also available in: Spanish