7 days in healthcare (January 2nd-8th, 2023)
Summary
From the point of view of Biomedicine, it is important to highlight significant advances in the treatment of some diseases, such as Alzheimer’s, breast cancer (a project inspired in its day by José Baselga), brain tumors, including the dreaded glioblastoma multiforme, and resistant tuberculosis.
With regard to Global Health, the WHO warns of global health threats in 2023: the Ebola outbreak in Uganda, which fortunately already seems to be in recession; the drought in the Horn of Africa; cholera, endemic in 69 countries; non-communicable diseases (particularly cardiovascular, diabetes, respiratory diseases and cancer), as well as the global stagnation due to the pandemic in the fight against various diseases: HIV, malaria and tuberculosis. Science reminds us that wastewater analysis has proven to be extremely useful for monitoring infectious diseases.
As for International Health Policy, with regard to covid, global concern is not so much for the cases that may come from China (which seem to correspond to the omicron that we already know) but for the new variant (Kraken) of United States, much more contagious than omicron and already affects a high percentage of cases in that country. The serious problems of the end of covid zero in China continue, with the opening of the country on January 8, which has been closed for three years. An editorial in The Economist looks at how the grand reopening may affect the global economy. Once again, the WHO says that mortality from covid in China is underestimated, if official figures are taken into account. Big change in the United States, where the abortion pill can be purchased in ordinary pharmacies. The large pharmacy chains, willing to participate in this sale. It must be remembered that a high percentage of abortions in the United States are already pharmacological. Serious crisis in the British National Health Service, with staff strikes, long waiting lists, saturation of emergencies and statements by unions and the Prime Minister. Labor wants to pass NHS employees to GPs (primary physicians), something that is in contradiction with the founding political pact of 1948 for the creation of the National Health Service, in which Aneurin Bevan participated. In France, health is also at the center of the political debate, with some statements on January 6 by President Macron, who considered among the solutions nothing less than ending fees per act, which in France are big words.
If we talk about National Health Policy (Spain), the year opens with the prospect of regional elections in 12 autonomous communities (May 28) and general elections at the end of the year, as well as a change in the head of the Ministry of Health. Several laws have been announced, including some advanced (new framework personnel statute, abortion, equity law), others more delayed (Public Health Agency, law of guarantees, possible reform of the dependency law). The Platform of Patient Organizations (POP) makes 10 proposals for chronic patients. As for professionals, some health insurance companies (DKV) have reacted quickly and announced increases in rates for doctors, which is undoubtedly a response to the criticism they had received from some medical associations, which even have raised certain protest actions. A piece of news says that the Zendal hospital has only 56 patients, which speaks of the fact that it has not yet found its place in Madrid’s health system, not surprising, since it seems that this hospital was established without the corresponding and obligatory Functional Plan (which defines the service portfolio, the population to be served, the incardination in the rest of the system, technology, personnel needs and other basic issues). Biosimilars, under the leadership of BIOSIM and starting in Extremadura, delve into the experience of shared benefit.
In the business sphere, in the international arena, Moderna acquires a genomics company. On the other hand, the completion of the Da Vinci robot patent will change the prospects for robotic surgery. At the national level, Ribera assumes the management of the Cascais hospital in Portugal, which is good news for public/private collaboration in our country.
Biomedicine
- The United States approves a drug that slows cognitive decline in Alzheimer’s, one of the first treatments for this disease in decades. The drug is expensive: $26,500 per year, which will limit potential users (https://www.ft.com/content/0e9f7ce6-9dc9-4eb7-ae19-4e82f88e24cb)
- A pharmaceutical partnership (Daiichi Sankyo and AstraZeneca) creates Enhertu, which enables a breakthrough in the treatment of breast cancer. The foundations of this advance were laid by the late Spanish José Baselga (https://www.ft.com/content/37edd17b-145c-42ef-a725-c16c4f8861b0)
- Ancient viruses embedded in human DNA revive and promote aging. Interesting statements by the scientist Juan Carlos Izpisua. (https://elpais.com/ciencia/2023-01-06/virus-ancestrales-integrados-en-el-adn-humano-resucitan-y-promueven-el-envejecimiento.html)
- Harvard scientists create a vaccine to prevent and cure brain cancer, including glioblastoma (https://www.alimente.elconfidencial.com/bienestar/2023-01-04/vacuna-harvard-para-evitar-y- cure-brain-cancer_3552201/)
- A new treatment cures 90% of patients with resistant tuberculosis. The trial, promoted by Doctors Without Borders, has been published in the New England Journal of Medicine (https://www.epe.es/es/sanidad/20230103/nuevo-tratamiento-cura-pacientes-tuberculosis-resistente-medicamentos -80648021)
Global Health
- Humanitarian concern grows in 2023. The GHO 2023 program includes programs in 10 countries: Afghanistan, DR Congo, Ethiopia, Nigeria, Somalia, South Sudan, Syria, Ukraine and Yemen (https://www.thelancet.com/journals /lancet/article/PIIS0140-6736(22)02587-9/fulltext)
- The WHO warns of possible global health crises in 2023. Main problems: Ebola outbreak in Uganda; drought in the Horn of Africa; cholera, endemic in 69 countries; non-communicable diseases (cardiovascular, diabetes, respiratory diseases and cancer); stagnation in the global fight against HIV, malaria and tuberculosis (https://www.consalud.es/pacientes/crisis-sanitarias-2023_124559_102.html)
- Article in Science: The analysis of wastewater is useful in public health. Initially used for fecal-oral transmitted pathogens, but is now a clear component of any infectious disease monitoring (https://www.science.org/doi/10.1126/science.ade2503)
- A new Chinese mRNA vaccine shows promising initial results (https://www.ft.com/content/30de6f9b-af46-4d05-99d9-afc5d221e05d)
- Alphabet’s company Verily (Google) willing to eradicate dengue in Singapore. It would be the first country in the tropics without this disease, which affects 300 million victims, with 90 million serious cases and hundreds of thousands of victims, most of them children (https://www.ft.com/content/9ee5a38f-9f5e -4434-89ec-309f6d2513ca)
International Health Policy
- COVID19
- We can enter the most unpredictable year of the covid (https://www.ft.com/content/75148fa6-689b-4a97-b4e2-7991cef81ded)
- Experts are cautiously contemplating the new variant in the USA: XBB.1.5 (Kraken), much more contagious than the omicron (https://www.nytimes.com/2023/01/07/science/covid-omicron-variants-xbb .html)
- The European Union, prepared to require vaccination tests for travelers from China (https://www.ft.com/content/f718f87a-a544-4cca-b7ca-d4f3458de5bb)
- The variant of covid that most threatens Europe does not come from China, but from the United States (https://www.lavanguardia.com/ciencia/20230103/8666601/variante-covid-bxx-1-5-nueva-york- threat-europe.html)
- The European Center for Disease Control (ECDC) says that the variants circulating in China are already in the EU and do not pose any challenge (https://www-elmundo-es.nproxy.org/ciencia-y-salud/ health/2023/01/03/63b41e64fc6c8382088b456e.html)
- Mpox (formerly “monkey pox”)
- Mpox cases in Europe: downward trend (https://www.consalud.es/pacientes/infecciones/casos-mpox-europa_124658_102.html)
- The crisis of the covid-zero policy in China
- China reopens its borders, which have been closed for three years, on January 8 as a final goodbye to the covid zero policy (https://www.reuters.com/world/china/china-reopens-borders-final- farewell-zero-covid-2023-01-08/)
- Editorial from The Economist: How China’s grand reopening may affect the world economy (https://www.economist.com/leaders/2023/01/05/how-chinas-reopening-will-disrupt-the-world -economy)
- Deaths in China are underestimated, says WHO (https://www.ft.com/content/6e45f53b-d9f2-452e-b4ad-e3a2c82a3aa5)
- Changes in the United States
- Abortion pills may be offered at pharmacies, says the FDA. Until now it could only be offered at some mail order pharmacies or by certified clinicians or physicians. From now on it can be done in normal pharmacies and with ordinary medical prescription (https://www.nytimes.com/2023/01/03/health/abortion-pill-cvs-walgreens-pharmacies.html)
- CVS and Walgreens willing to offer abortion pill where abortion is legal (https://www.nytimes.com/2023/01/05/health/abortion-pills-cvs-walgreens.html)
- Serious NHS crisis in the UK
- Some trusts (public hospitals) recommend going to the private one, in order to skip the waiting list. The public hospitals themselves offer hip replacements for 10,000 pounds; cataract surgery for £2,200; £2,500 hernia repair (https://www.theguardian.com/society/2023/jan/07/revealed-nhs-trusts-tell-patients-they-can-go-private-and-jump-hospital-queues )
- From the Prime Minister’s office (No 10), it is said that it will be very difficult for some patients to access the NHS this winter (https://www.theguardian.com/society/2023/jan/03/no-10-very -difficult-some-people-access-nhs-winter-england)
- NHS unions say promised 2% rise will lead to more strikes (https://www.theguardian.com/society/2023/jan/01/nhs-unions-2-pay-rise-next-year-could -mean-more-strikes)
- Labor say they will end agreements with GPs to make them NHS employees (https://www.theguardian.com/society/2023/jan/07/labour-would-tear-up-contract- with-gps-and-make-them-salaried-nhs-staff)
- The NHS crisis will continue until April, warn NHS leaders (https://www.theguardian.com/society/2023/jan/02/intolerable-nhs-crisis-to-continue-until-april-health-leaders- warn)
- Prime Minister Sunak willing to negotiate salary conditions with nurses (https://www.theguardian.com/society/2023/jan/08/rishi-sunak-signals-he-is-open-to-discussing-this -years-pay-with-nurses)
- Health, at the center of politics in France
- Macron’s plan to get out of an “endless crisis”. In a speech on January 6, the President advanced some “solutions”, such as ending the fees per act and putting an administrative and medical tandem in charge of the hospitals (https://www.lemonde.fr/societe/article/ 2023/01/07/devant-les-professionnels-de-sante-emmanuel-macron-promet-d-aller-beaucoup-plus-vite_6156951_3224.html)
- Black January in the French health system: emergencies overwhelmed, medical cabinets closed and laboratories mobilized (https://www.lemonde.fr/societe/article/2023/01/06/urgences-debordees-cabinets-medicaux-fermes- ou-engorges-laboratoires-mobilises-un-janvier-noir-pour-le-systeme-de-sante_6156806_3224.html)
- Europe
- Public health in Europe, a time bomb. Serious problems at least in the United Kingdom, France, Germany, Spain, Portugal, Belgium, Italy and other countries (https://www.epe.es/es/sanidad/20230105/sanidad-publica-europa-bomba-relojeria- 80755286)
National health policy
- COVID
- The AI drops to 129 points. Deaths in a week 196. 3,530 patients admitted for covid, of which 231 are in ICU beds (https://www.consalud.es/pacientes/especial-coronavirus/covid-espana-notifica-casos_124703_102.html)
- Regulatory and political framework for 2023
- These are the laws that 2023 will bring. Advanced: new statute-framework, the abortion law and the equity law; more delayed that of the National Agency of Public Health, reform of the Law of Guarantees and Rational Use of Medicines, possible reform of the Dependency Law (https://www.diariomedico.com/medicina/politica/estas-son-las -sanitary-laws-that-2023-will-bring-and-those-that-will-not-give-time-to-approve.html)
- What will happen to health policy in 2023?: Change in the Ministry and 12 autonomous communities will have elections (https://www.redaccionmedica.com/secciones/sanidad-hoy/-mudanza-en-el-ministerio- of-health-for-a-2023-of-tidal-regulation-1956)
- Regulatory framework
- The worker will no longer be obliged to deliver his medical leave to his company. Doctors will only issue a copy of the report to the employee, which the company will have to access electronically (https://cincodias.elpais.com/cincodias/2023/01/02/economia/1672685082_780185.html)
- Patients
- The Platform of Patient Organizations (POP) advances 10 proposals for chronic patients (https://www.consalud.es/pacientes/10-deseos-pacientes-cronicos-cambio-atencion-nuevo-modelo-financiacion_124479_102.html)
- Health professions
- January 21, 2023, will be the date for the FSE (Specialized Health Training) exam: Medicine, Pharmacy, Nursing, Psychology, Chemists, Biologists and Physicists (https://www.actasanitaria.com/politica-y-sociedad /ministry-health-ratifies-21-january-as-date-exam-mir-2023_2004516_102.html). See BOE resolution: https://www.boe.es/boe/dias/2023/01/04/pdfs/BOE-A-2023-128.pdf
- Insurance companies increase the remuneration of their professionals from 7% to 14%. MUFACE exception, due to the shortage of the premium (https://www.consalud.es/industria/companias-aseguradoras-profesionales-aumenta-su-retribucion-hasta-14_124654_102.html)
- Public healthcare
- The Zendal hospital, with only 56 patients (https://www.eldiario.es/madrid/zendal-hospital-estrella-ayuso-53-pacientes-acumula-2022-contratos-dedo-suman-15-millones_1_9842159.html)
- Pharmaceutical policy
- Biosimilars launch benefit sharing (https://www.redaccionmedica.com/secciones/industria/el-sns-estrena-los-acuerdos-de-beneficio-compartido-con-los-biosimilares-7897)
Companies
- International News
- Moderna acquires OriCiro Genomics for 85 million dollars (https://www.plantadoce.com/empresa/moderna-se-va-de-compras-y-acquiere-oriciro-genomics-por-85-millones-de-dolares .html)
- The expiration of Da Vinci’s patents encourages the showcase of robotic surgery (https://www.diariomedico.com/medicina/cirugia-general/la-expiracion-de-las-patentes-del-da-vinci-anima- the-showcase-of-robotic-surgery.html)
- The Advent International fund finalizes the purchase of India’s Suven Pharmaceuticals (https://www.plantadoce.com/empresa/el-fondo-advent-international-ultima-la-compra-de-la-india-suven-pharmaceuticals.html)
- GE Healthcare becomes independent from GE as a medical technology, diagnosis and digital solutions company (https://www.diariomedico.com/medicina/empresas/ge-healthcare-se-independiza-de-ge-como-compania-de-tecnologia -medical-diagnosis-and-digital-solutions.html)
- National News
- Smysecret grows with two new openings in Spain and aims to double revenue by 2023 (https://www.plantadoce.com/empresa/smysecret-crece-con-dos-nuevas-aperturas-en-espana-y-apunta-a -double-income-in-2023.html)
- Ribera enters Portugal with the management of the Cascais public hospital (https://www.plantadoce.com/empresa/ribera-entra-en-portugal-con-la-gestion-del-hospital-publico-de-cascais.html)
- Healthcare activos purchases two new hospitals in Portugal from FSG Saúde (https://www.plantadoce.com/empresa/healthcare-activos-compra-dos-nuevos-hospitales-en-portugal-a-fsg-saude.html)
- Atrys buys the Spanish Initia and the Chilean Chilerad for more than ten million euros (https://www.plantadoce.com/empresa/atrys-compra-la-espanola-initia-y-la-chilena-chilerad-por- more-than-ten-million-euros.html)
- Generali will offer its clients Sanitas health services for ten years (https://www.plantadoce.com/empresa/generali-ofrecera-a-sus-clientes-los-servicios-de-salud-de-sanitas- for-ten-years.html)
- Adeslas leads online health insurance contracts, ahead of Asisa, Sanitas, DKV and AXA (https://www.expansion.com/empresas/banca/2023/01/04/63a5a9cfe5fdeaaa478b45e5.html)
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