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

 

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

• Medication to prevent HIV: “Carbotegravir” can play a prominent role in the fight against HIV/AIDS, since globally there are 1.5 million people who become infected each year. Pricing issues (https://www.nature.com/articles/d41586-022-02136-6)
• Two biomarkers capable of predicting Alzheimer’s detected, study by a Spanish group published in Nature (https://www.diariomedico.com/medicina/neurologia/descubren-dos-biomarcadores-en-sangre-que-detectan-de-forma -early-alzheimer.html)
• How science is approaching a world without animal testing. Lift Biosciences replicates miniature human tumor in the lab (https://www.ft.com/content/7c35e08a-4931-4401-b27e-acabf974bff8)

Global health

• A new zoonosis (“Langya”) is identified in China, as published by the NEJM (https://www.nejm.org/doi/full/10.1056/NEJMc2202705)
• India at 75 years of independence, the opportunity for universal coverage (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01525-2/fulltext)
• Botwanna: an example in the fight against HIV/AIDS (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01523-9/fulltext)
• Tibetan cities, confined, after the first covid outbreak in two years (https://www.ft.com/content/eb85751c-6a3c-4a45-98a7-9ff64aab6a90)
• The polio virus reappears in rich economies, exposing immunization problems. The disease was thought to be eradicated (https://www.ft.com/content/c0c4c976-4482-4513-9d41-6ce83ee7a388)

International health policy

• The American Climate, Fiscal and Sanitary law (Inflation Reduction Act, IRA, of 2022)
  • These last two weeks the American Congress (Senate and House of Representatives, in this order) approved this important law. The provisions on health are very notable, as summarized by the NYT: Expenditures and tax deductions: Benefits for prescription drugs in Medicare ($ 34.2 B); Subsidies to purchase insurance under the Affordable Care Act ($64.1B); Savings and new income: Drug price negotiation ($99 B); Caps on drug price growth ($62.3B) (https://www.nytimes.com/interactive/2022/08/13/upshot/whats-in-the-democrats-climate-health-bill. html)
  • USA willing to negotiate the price of medicines, despite strong opposition from the pharmaceutical lobby. The negotiation process is scheduled to start with 10 drugs in 2026; 15 in 2027 and 2028; and 20 every year starting in 2029 (https://www.ft.com/content/b6b86a7d-79c2-46a0-a957-d39745260862)
  • Detailed analysis of the Health Affairs magazine on the pharmaceutical component of this Law (https://www.healthaffairs.org/content/forefront/understanding-democrats-drug-pricing-package)

• Monkeypox
  • JAMA publishes an update on the monkeypox outbreak (https://jamanetwork.com/journals/jama/fullarticle/2795359)
  • Don’t blame monkeys for monkeypox, says WHO. Despite the name, the risk of transmission is between humans, not animals (https://www.nytimes.com/2022/08/11/health/monkeypox-attacks-who.html)

• COVID-19
  • Globally, the number of cases remained in decline during the period August 1-7, 22 (published by the WHO on August 10), with new cases falling by -9%. In Europe the drop was -7%. The largest decrease in the number of cases occurred in Africa (-46%) (https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19—10 -august-2022)
  • The CDC softens the guidelines against covid “as the virus is here to stay” (https://www.nytimes.com/2022/08/11/health/virus-cdc-guidelines.html)
  • NEJM: Trying to understand vaccine efficacy over time (https://www.nejm.org/doi/full/10.1056/NEJMp2201084)
  • Why the world is still waiting for a treatment for long covid (https://www.nature.com/articles/d41586-022-02140-w)
  • Covid vaccination during pregnancy (https://www.bmj.com/content/378/bmj-2021-069741)
  • North Korea officially announces its “great victory” over the pandemic. Officially 4.8 million infected and only 74 dead (https://www.lemonde.fr/planete/article/2022/08/11/covid-19-la-coree-du-nord-annonce-en-avoir- fini-avec-la-pandemie_6137727_3244.html)

• Controversial ruling in the USA: annulment Roe v Wade
  • Nature: Analysis of the consequences of the annulment of Roe v Wade: although the long-term effects are unknown, it is likely to increase unsafe abortions and maternal mortality (https://www.nature.com/articles/d41586- 022-02139-3)
  • Some women are turning to self-managed abortion, as access declines, as abortion is currently prohibited in at least 10 American states. The system consists of obtaining information through the internet and accessing medication without medical supervision (https://www.nytimes.com/2022/08/07/health/abortion-self-managed-medication.html)

• Other themes
  • Turkish doctors emigrate due to low wages and rising violence (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01524-0/fulltext)
  • The PaRIS study of results perceived by patients is underway. It is promoted by the OECD, it is carried out in more than 20 countries and in Spain it is coordinated by the Ministry of Health (https://diariofarma.com/2022/08/09/en-marcha-el-estudio-paris-de-resultados -perceived-by-patients)
  • The United Kingdom, willing to urgently offer a second dose of polio vaccine to children between 1 and 9 years of age in London (https://www.ft.com/content/0af50308-b845-4dd0-b07b-cc2e382aca56), confined, after the first covid outbreak in two years (https://www.ft.com/content/eb85751c-6a3c-4a45-98a7-9ff64aab6a90)

National health policy

• Monkeypox
  • Vaccines against monkeypox are lacking, only 18,500 doses are guaranteed for the whole year (https://elpais.com/sociedad/2022-08-12/faltan-vacunas-para-la-viruela-del-mono-espana -you-only-have-guaranteed-18500-doses-for-the-whole-year.html)
  • Evolution of cases in Spain: 5,162, according to the last update. The first country in Europe and the second in the world, only surpassed by the USA (https://www.larazon.es/sociedad/20220809/fsfluqstmjdypckjrklvw3pxha.html)
  • Spain only has 24 treatments of the only antiviral available against monkeypox (https://www.elespanol.com/ciencia/salud/20220809/espana-solo-tratamientos-unico-antiviral-disponible-viruela/693930940_0.html)

• COVID
  • The incidence of COVID continues to decline, reaching 283.38 cases per 100,000 inhabitants in people over 60 years of age in the last 14 days. However, this disease continues to be a problem, with 5,402 patients admitted and 369 in the ICU (https://amp.redaccionmedica.com/directo/coronavirus-ultimas-noticias/20220502

• Heat wave
  • Mortality skyrockets in heat waves (https://www.eldiario.es/sociedad/calor-mata-mortalidad-dispara-olas-vez-extremas_1_9217920.html)

• Other themes
  • More than 230 million for the digital transformation of Primary Care, within the cutting-edge health PERTE (https://diariofarma.com/2022/08/12/mas-de-230-millones-para-la-transformacion-digital -de-ap)
  • Hospitals gave less than 600,000 discharges in 2020, when the pandemic broke out, than in the previous year (https://www.redaccionmedica.com/secciones/sanidad-hoy/los-hospitales-dieron-620-000-altas-menos-el- year-that-covid-19-2894-exploded)
  • Eight hospitals test a pilot plan to prevent suicide in adolescents (https://elpais.com/sociedad/2022-08-12/ocho-hospitales-essayan-el-primer-plan-para-reductor-el-intento -of-suicide-in-teenagers-is-alarming-the-peak-in-girls.html)

Companies

• International News
  • Pharmaceutical groups lose 30 billion pounds in market capitalization, due to concerns about legal problems. Great concern about Zantac, which the FDA said in 2020 was causing unacceptable levels of cancer (https://www.ft.com/content/6cb2bc93-fc61-4559-a876-2cf1b78fa756)
  • Cars, health and metaverse, Apple’s bets on the future (https://elpais.com/tecnologia/2022-08-12/coches-salud-y-metaverso-los- Negocios-de-futuro-de-apple. html)
  • Pfizer and BioNTech begin clinical trials of vaccines for new covid variants (https://www.ft.com/content/b6825ee8-3631-4f1c-a4e0-119802c7bb7d)
  • Pfizer surpasses J&J and becomes a leader in the pharmaceutical field (https://www.expansion.com/empresas/industria/2022/08/12/62f69a12e5fdeae81d8b465e.html)
  • Novavax sinks on the stock market after cutting its sales forecasts (https://www.consalud.es/ecsalud/economia/novavax-se-hunde-en-bolsa-recortar-50-su-prevision-ventas-anuales_118945_102.html )
  • The parapharmaceutical company Haleon leaves GSK (https://cincodias.elpais.com/cincodias/2022/08/11/opinion/1660221769_440972.html)
  • J&J withdraws its talcum powder for babies from the global market, after receiving accusations that the product causes cancer (https://cincodias.elpais.com/cincodias/2022/08/12/companias/1660292161_479904.html)

• National News
  • More than 2,300 pharmacies will be able to sell through the Glovo app and soon through Uber. It is parapharmacy, since in the case of prescription drugs it is prohibited by law (https://cincodias.elpais.com/cincodias/2022/08/05/companias/1659701442_479876.html)
  • Almirall will open a subsidiary in the Czech Republic, in full European expansion (https://www.eleconomista.es/salud/noticias/11898007/08/22/Almirall-abrira-una-filial-en-la-Republica-Checa -in-full-european-expansion.html)