7 days in healthcare (July 29th-August 4th, 2024)
Summary
Biomedicine
- 14 critical risk factors for developing dementia identified. High cholesterol and hearing problems are associated with the development of dementia, according to a large study, which also identifies 14 critical risk factors that, if reduced, can prevent or delay half of the cases.
- The FDA approves a test for the detection of colon cancer. Although it is not a perfect alternative to colonoscopy, experts believe that this test will allow many people to be screened for colorectal cancers.
- Is Ozempic good for everything? Ozempic is back in the spotlight: diabetes, obesity, reducing alcohol consumption and now also for quitting smoking. According to a study published in the Annals of Internal Medicine, people who use this drug have fewer problems not using tobacco.
Global Health
- The WHO Pandemic Hub, threatened. The WHO Pandemic Hub was founded in the wake of the Covid-19 pandemic in Berlin on 1 September 2021 by Angela Merkel and the Director-General of the WHO. It is an intelligence tool that gives hope for better monitoring of all pandemics, but it has significant challenges, as it is based on reliable information systems in countries, which do not exist.
International health policy
- Review of the past, present and future of primary care in the USA. Robust primary care is considered essential for any health system. In 2024, only 24% of American doctors were dedicated to primary care, when the ideal ratio is considered 50%. The reasons are insufficient financial compensation, heavy administrative burdens and poor job satisfaction. It is proposed that care be provided by a team, with doctors focused on complex tasks: diagnosis and management of patients with multiple problems. Documentation should be kept by administrators or by artificial intelligence. Routine issues with good guidelines, such as hypertension or diabetes, should be handled by nurses, advanced practice nurses or physician assistants.
- Why so many Americans choose not to have children. It is not considered just a problem of hedonism, and, on the other hand, fertility is falling throughout the developed world. There are other more complex factors, such as the rising costs of raising children, housing problems and less optimism about the future.
- Screening rates in Europe. Northern Europe leads the rate of screening for breast, cervical and colorectal cancers.
National Health Policy (Spain)
- Various legislative initiatives on health, stuck. The first semester in Congress leaves several legislative initiatives in relation to health in the pipeline: the law of equity and cohesion of the SNS; law of universality of the SNS; and, the one that creates the State Agency of Public Health.
- The PSC-ERC agreement, a threat to the entire National Health System? In the same way that during the pandemic it was impossible not to refer to covid-19, in the current situation, speaking of health, it is impossible not to mention the PSC-ERC agreement to invest Salvador Illa, as president of the Generalitat. Therefore, although it is a controversial issue, we will only make some general considerations. The agreement document entitled “Acord d’investidura entre el Partit dels Socialistes de Catalunya i Esquerra Republicana de Catalunya” has been published. It is 25 pages that are worth reading, since everything is very well explained.
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- General assessment: It seems that the PSC – and, according to statements, the PSOE leadership itself – assumes the pro-independence postulates and the entire ERC discourse. This is a very clear deduction from the document.
- Topics covered: the document deals with many topics, but fundamentally three: the financing model, the linguistic policy and Catalonia’s foreign relations.
- Healthcare in Catalonia: in this aspect the document commits to maintaining and consolidating the commitments made with professionals; it makes a broad list of the investments that are intended to be addressed (new Hospital Clínic, new health campus in Girona, expansion of the Hospital del Mar, etc.); it talks about implementing territorial centres for oral health; and, deploying the Mental Health pact. Likewise, among the legislative commitments, there is talk of a law for an integrated Social and Health Agency.
- Impact on the National Health System. According to preliminary analysis by FEDEA, the impact on state coffers will be 30,000 million. This could mean a significant financial impact on the entire National Health System outside Catalonia, which would lead to either a deterioration in quality or the need to raise taxes.
- Assessment of the candidate Illa. Given his status as former Minister of Health in the initial phase of the pandemic, Salvador Illa is well known in the health sector. His management has been considered to be an erratic policy, with little transparency and few contacts with the sector. This is the assessment conveyed by Rafael Matesanz in a must-read statement (https://www.larazon.es/sociedad/20210314/dnjfplptrbhtlfaelt6jx5f6au.html)
- Difficulties in complying with the agreement. The difficulties of all kinds – legal, economic, political, etc. – are of such a formidable calibre that it is very doubtful that the agreements can be fulfilled, at least as they appear in the document.
- More than 100,000 foreign health professionals without homologation. It seems that we have to wait up to three years. The Ministry of Universities is in charge of this procedure.
Companies
- International
- Roche wants to enter the obesity market. Roche intends to quickly launch a weight loss pill to compete with rivals. According to the CEO, Roche’s first anti-obesity drug is expected to appear in 2028.
- Huge growth in the global implant market. According to a report, the global market for dental implants and prostheses has been valued at 11.64 billion dollars in 2024. It is expected to grow at a compound annual growth rate (CAGR) of 11.41%, to reach 34.3 billion dollars in 2034.
- National
- Edwards Lifesciences will open a heart valve factory in Valencia. It will create 1,200 jobs. This multinational company is dedicated to heart valves and hemodynamic monitoring. It is the sixth plant in the world and represents an investment of 150 million euros.
- Manufacturing medicines in Spain, a strategic asset. In Spain there are 174 factories distributed across 13 communities. Of the total number of plants, 106 are factories for human use medicines; 22 manufacture veterinary medicines; and 46 are factories for the production of active ingredients.
Biomedicine
- Science: Key trial may herald new era of HIV prevention. Presented at AIDS 2024 Conference, over 2,000 African women who had received two injections a year of antiviral lenacapavir as prophylaxis, none contracted AIDS (100% effective). The drug is produced by Gilead (https://www.science.org/content/article/landmark-trial-may-herald-new-era-hiv-prevention#:~:text=Another%20long%2Dacting%20injectable%20drug,by%2088%25%20compared%20with%20oral)
- How medical research is failing women. Over the years, the development and testing of new drugs has been done on men, to the detriment of female patients. The result is that women are sometimes given drugs that are not only less effective, but sometimes less safe (https://www.ft.com/content/ce9895f9-8ead-4b43-b473-874aebabc0e6)
- High cholesterol, a critical factor in the development of dementia. High cholesterol and hearing problems are associated with the development of dementia, according to a large study, which also identifies 14 critical risk factors that, if reduced, can prevent or delay half of cases (https://www.ft.com/content/20422086-56cb-4b53-ad36-dbc4797dbf59). Access to the original article in The Lancet: https://www.thelancet.com/commissions/dementia-prevention-intervention-care
- The FDA approves a test for the detection of colon cancer. Although not a perfect alternative to colonoscopy, experts believe the test will allow many people to be screened for colorectal cancers (https://www.nytimes.com/2024/07/29/health/colon-cancer-blood-test-shield.html)
- A graphene brain implant is set to begin a clinical trial in the UK. The material is believed to allow for better connections between the human brain and external computers. Potential beneficiaries include Parkinson’s and stroke patients (https://www.ft.com/content/4d50e3ac-013d-465a-b835-de67361ba40f)
- A blood test can diagnose Alzheimer’s in 90% of cases. The test is more accurate than cognitive tests and scanners (https://www.nytimes.com/2024/07/28/health/alzheimers-blood-test.html). Access to the original JAMA article: https://jamanetwork.com/journals/jama/fullarticle/2821669
- Ozempic is back in the spotlight: diabetes, obesity, reduced alcohol consumption and now also for quitting smoking. According to a study published in the journal Annals of Internal Medicine, people who use this drug have fewer problems not using tobacco (https://www.epe.es/es/sanidad/20240731/ozempic-ayuda-a-dejar-de-fumar-dv-106334595)
- The rate of heart attacks and strokes was lower after vaccination against covid-19. A study published in Nature Communications and carried out on 46 million adults shows that vaccination against covid-19 is associated with a decrease in the incidence of heart attacks and strokes. (https://www.elmundo.es/ciencia-y-salud/salud/2024/08/01/66ab481cfc6c838d7e8b459e.html#). Access to the original article: https://www.nature.com/articles/s41467-024-49634-x#:~:text=This%20England%2Dwide%20study%20offers,their%20known%20rare%20cardiovascular%20complications.
Global Health
- The WHO Pandemic Hub was founded in the wake of the Covid-19 pandemic in Berlin on 1 September 2021, by Angela Merkel and the WHO Director-General. It is an intelligence tool that gives hope for better monitoring of all pandemics, but it has significant challenges, as it is based on reliable country information systems, which do not exist (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01591-5/abstract)
- Russian attacks in Ukraine, impacting maternal and child health. Article in The Lancet following a Russian attack on a children’s hospital in kyiv (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01590-3/abstract)
- Medicalized genital mutilation must stop. Female genital mutilation is an oppressive and patriarchal practice aimed at controlling the sexual practices and bodies of women and girls. It is defined by the WHO as “any procedure involving the total or partial removal of the external female genitalia.” The UNICEF report says that more than 230 million women worldwide have undergone this practice, an increase of 15% over the last eight years. The practice has no medical benefit and carries the risk of pain, bleeding and even death. Although medicalized genital mutilation has fewer risks than that performed by non-professionals, both the WHO and the World Medical Association condemn this practice (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01592-7/fulltext#:~:text=FGM%20has%20no%20medical%20benefits,can%20continue%20throughout%20later%20life.)
International health policy
- USA
- A review in the American Journal of Medicine on the past, present and future of primary care in the USA. Robust primary care is considered essential for any health system. In 2024 only 24% of American physicians were dedicated to primary care, when the ideal ratio is considered to be 50%. The reasons are insufficient financial compensation, high administrative burdens and poor job satisfaction. It is proposed that care be delivered by a team, with physicians focused on complex tasks: diagnosis and management of patients with multiple problems. Documentation should be handled by administrative staff or by artificial intelligence. Routine issues with good guidelines, such as hypertension or diabetes, should be handled by nurses, advanced practice nurses, or physician assistants (https://www.amjmed.com/article/S0002-9343(24)00163-3/fulltext)
- Why so many Americans choose not to have children. It is considered that it is not just a problem of hedonism and, on the other hand, fertility is falling throughout the developed world. There are considered to be other more complex factors, such as the increasing costs of raising children, housing problems and less optimism about the future (https://www.nytimes.com/2024/07/31/health/fertility-births-vance.html)
- United Kingdom and the National Health Service
- GPs (primary doctors) in the United Kingdom want to limit appointments per day, in their latest protest action. NHS England has warned of the serious consequences of this action, since many patients will choose to go to other levels of care (https://www.ft.com/content/19b731eb-703d-4afe-9dd8-c493eb56982e)
- Nigeria
- A fleet of motorbike-ambulances to save the lives of pregnant women. In rural areas of the center-north of the country it is difficult to get to the health center in time to give birth. The African state accounts for 12% of maternal and infant deaths and stillbirths worldwide. Home births are still a common practice in most low-income communities in Nigeria (https://elpais.com/planeta-futuro/2024-07-30/una-flota-de-motocarros-ambulancia-para-salvar-la-vida-de-las-embarazadas-en-nigeria.html)
- European Union
- Northern Europe leads the rate of screening for breast, cervical and colorectal cancers (https://www.consalud.es/pacientes/cancer-norte-europa-tasas-cribados_147006_102.html#)
National health policy
- Central government initiatives
- The first semester in Congress leaves several legislative initiatives in the pipeline in relation to health: the law of equity and cohesion of the SNS; law of universality of the SNS; and the one that creates the State Agency of Public Health (https://www.consalud.es/politica/primer-semestre-congreso-deja-en-tintero-iniciativas-sanitarias_146857_102.html)
- Health will resume the negotiation of the Framework Statute of professionals in September (https://www.elespanol.com/invertia/observatorios/sanidad/20240802/sanidad-retomara-negociacion-estatuto-marco-profesionales-sanitarios-septiembre/874662887_0.html)
- The School of Occupational Medicine will not close, according to the Ministry of Health (https://www.redaccionmedica.com/secciones/ministerio-sanidad/sanidad-se-niega-a-dejar-caer-la-escuela-nacional-de-medicina-del-trabajo-2237#:~:text=El%20Ministerio%20de%20Sanidad%20no,que%20hacía%20inviable%20su%20continuidad)
- The inter-ministerial committee on childhood obesity approved by Royal Decree (http://diariomedico.com/medicina/politica/aprobado-real-decreto-comite-interministerial-obesidad-infantil.html)
- Initiatives and news from the autonomous communities
- Diariofarma: Outcry against the “destruction” that the PSOE and ERC tax agreement would cause in Spain. Although there are no concrete estimates yet, a calculation made public by FEDEA says that the agreement could mean 30 billion for the state coffers, which, translated to the National Health System, could mean either a deterioration of services or significant tax increases. (https://diariofarma.com/2024/07/30/clamor-contra-el-destrozo-fiscal-que-puede-provocar-el-acuerdo-psc-y-erc-en-la-financiacion). Access to the PSC-ERC agreement document (25 pages in Catalan): https://static1.ara.cat/ara/public/content/file/original/2024/0730/11/preacord-psc-erc-pdf.pdf
- Catalonia will invest 38 million in the creation of a new proton therapy centre (https://gacetamedica.com/politica/cataluna-invertira-38-millones-de-euros-en-la-creacion-de-un-nuevo-centro-de-protonterapia/)
- The Generalitat protects the use of Catalan in healthcare. The provision appeared in the Official Journal of the Generalitat on 30 July. The objective is to achieve full training of both professionals and users in Catalan and in the “rest of the official languages in Catalonia”. According to surveys, 52% of doctors do not use Catalan to communicate with patients in consultations and it is less frequent among the younger generations (https://theobjective.com/sanidad/2024-08-03/generalitat-blinda-catalan-sanidad/#:~:text=En%20febrero%20de%202024%2C%20la,laboral%20hasta%20noviembre%20de%202024.)
- The Community of Madrid launches a home oncology hospitalization program at the Gregorio Marañón (https://gacetamedica.com/politica/la-comunidad-de-madrid-lanza-un-programa-de-hospitalizacion-oncologica-domiciliaria-en-el-gregorio-maranon/#:~:text=Gaceta%20Médica-,La%20Comunidad%20de%20Madrid%20lanza%20un%20programa%20de,domiciliaria%20en%20el%20Grego)
- Health professions
- More than 100,000 foreign health professionals without homologation. It seems that you have to wait up to three years. The Ministry of Universities is in charge of this process (https://www.elespanol.com/invertia/observatorios/sanidad/20240803/titulos-sin-homologar-duro-proceso-sanitarios-extranjeros-ejercer-espana/874662930_0.html)
- Health insurers
- Insurance companies join the digitalization: the commitment to telemedicine and apps (https://www.consalud.es/salud35/rsc/aseguradoras-se-suman-digitalizacion-apuesta-por-telemedicina-apps_146977_102.html)
- Consequences of Maduro’s “victory” in Venezuela
- Mass medical migration is expected (https://www.redaccionmedica.com/secciones/sanidad-hoy/la-sanidad-espanola-notara-que-siga-maduro-habra-migracion-medica-masiva–6704)
- Advanced therapies
- The CNMC approves the creation of Terafront Farmatech, the commercial company for advanced therapies, whose promoter and sole shareholder is the Center for Technological Development and Innovation (CDTI), Rovi and Insud Pharma. (https://www.consalud.es/salud35/nacional/cnmc-aprueba-creacion-terafront-sociedad-mercantil-terapias-avanzadas_147035_102.html)
Companies
- International news
- Roche aims to quickly launch weight-loss pill to compete with rivals. Roche’s first anti-obesity drug is expected to appear in 2028, according to the CEO (https://www.ft.com/content/9c45008d-cd9d-478c-b925-fae180defa03)
- NHS blocks use of AstraZeneca breast cancer treatment (https://www.ft.com/content/d831c865-ae82-40f3-86a3-de43b53d25f0)
- GSK raises forecasts despite alarm over vaccine sales (https://www.ft.com/content/99172f0e-06de-4366-a3b9-9088b6a3851a)
- Roche completes purchase of Point of Care from LumiraDX (https://www.plantadoce.com/empresa/roche-completes-the-purchase-of-point-of-care-from-lumiradx#:~:text=The%20swiss%20pharmaceutical%20has%20closed,%20for%20the%20transaction.)
- Significant growth in the global implant market. According to a report, the global dental implants and prosthetics market has been valued at $11.64 billion in 2024. It is expected to grow at a compound annual growth rate (CAGR) of 11.41%, to reach $34.3 billion in 2034 (https://www.consalud.es/dentalia/tratamientos/demanda-odontologia-estetica-mercado-mundial_147162_102.html)
- National
- The multinational Edwards Lifesciences will open a heart valve factory in Valencia and will create 1,200 jobs. This multinational company is dedicated to heart valves and hemodynamic monitoring. It is the sixth plant in the world with an investment of 150 million euros (https://elpais.com/espana/comunidad-valenciana/2024-07-31/edwards-lifesciences-abrira-una-fabrica-de-valvulas-cardiacas-en-valencia-y-creara-1200-empleos.html)
- Article by the general director of Farmaindustria: Manufacturing medicines in Spain, a strategic asset. In Spain there are 174 factories distributed across up to 13 communities. Of the total number of plants, 106 are factories for human use medicines; 22 manufacture veterinary medicines; and 46 are factories for the production of active ingredients (https://www.larazon.es/sociedad/fabricar-medicamentos-espana-activo-estrategico_2024072666a2adb7b40b9c000189e6b5.html)
- Vithas will open a medical center in Majadahonda with cutting-edge technology in September (https://www.consalud.es/salud35/nacional/vithas-abrira-centro-medico-majadahonda-tecnologia-vanguardia_147099_102.html)
- Grifols receives authorization from the USA for clinical trials of its new therapy for hepatitis B (https://cincodias.elpais.com/companias/2024-07-31/grifols-recibe-autorizacion-de-ee-uu-para-ensayos-clinicos-de-su-nueva-terapia-para-hepatitis-b.html)
- Caser purchases three new dental clinics in Catalonia (https://www.plantadoce.com/empresa/caser-dental-adquiere-tres-nuevas-clinicas-en-cataluna#:~:text=Los%20tres%20nuevos%20centros%20de,aumentando%20su%20presencia%20durante%202024.)