7 days in healthcare (July 8th-14th, 2024)

Summary

Biomedicine

• Four decades of orphan drugs. The Orphan Drug Act (ODA) was approved in the USA in 1983, due to the lack of commercial interest in the development of these drugs. The law that developed incentives for production, the duration of patents and research was a success and more than 800 indications have already been approved. However, many rare diseases remain untreated and prices are unsustainable. This is why a new strategy is proposed for the next four decades.
• Gene therapy offers hope for autoimmune diseases. Use of CAR-T, originally intended for cancers, in lupus. The initial findings offer hope to millions of patients with autoimmune diseases, four in five of which are women.

Global Health

• Vaccines save lives. The measles vaccine alone is estimated to have prevented 23 million deaths between 2000 and 2018. Globally, the vaccination rate has increased for many diseases. However, in 2022 (the latest figure available) there were still 14.3 million children with zero doses. A lack of access and high production and cost costs among the reasons for this situation. New strategies are needed to boost utilization.
• Counting the dead in Gaza. According to a letter published in The Lancet, as of June 24, 37,396 people had been killed in the Gaza Strip since the Hamas attack and the Israeli response, according to the Gaza Ministry of Health, figures not accepted by Israeli authorities, although they are by the United Nations and the WHO. If we take into account that the indirect deaths are estimated to be between three and fifteen the number of direct deaths, a conservative estimate with a multiple of four gives 186,000 deaths attributable to the current conflict. This is why an immediate ceasefire is advocated.

International health policy

• The NHS is broken: In his first official statement released on July 5, the new UK Health Minister (Wes Streeting) says that his department’s official position is that “the NHS is broken.” . He is surprised by this clarity regarding the recognition of problems, which is to be expected to be followed by profound reforms.
• Official statement from the Labor Party on preparing the NHS for the future: cutting waiting lists with 40,000 more appointments each week; double the number of cancer scans; a new Dental Plan; 8,500 more mental health professionals; back to the family doctor.
• Starmer turns to Alan Milburn, former Minister of Health, close to Tony Blair, to fix the problems of the NHS, which is interpreted as meaning that the private sector and consumer choice will be at the center of the plans.
• The first official report on Covid management in the United Kingdom is published. After multiple surveys, it will be published next Thursday and promises to reveal serious deficiencies in the management of Covid. It will be interesting to compare this report with the disappointing and incomplete one published in Spain, carried out by three experts selected by the government.
• European hospitals lose more than 170,000 beds in a decade, but Spain increases them, despite continuing to be one of the European countries with the fewest beds per 100,000 inhabitants.

National Health Policy (Spain)

• The State Public Health Agency, in limbo. The creation of this Agency takes forever. It’s a bit frustrating, says Eduardo Satué, president of the Spanish Society of Public Health and Health Administration (SESPAS).
• Various communities offer bonuses and incentives to doctors: to cover the deficit in Primary Care (Andalusia) or to cover the wings of the region (Asturias).
• AESEG requests a price difference between generics and brands, which Farmaindustria opposes, a measure that is already applied throughout Europe except in Spain. The sector has 21 production plants in Spain and generates more than 40,000 direct and indirect jobs.
• Private healthcare runs the risk of dying of success. Waiting lists are exploding for private health insurance (which 1 in every four citizens already have), but, due to low premiums, reaching up to 20 or 30 euros per month, it is not possible to provide a good service. A giant is being built with feet of clay.
• Serious management problems in the health sector, according to FEDEA. Despite the significant increase in resources in the health field, since the level of spending has grown from 13.2% in 1999 to the current 14.5% of the total spending of Public Administrations. Real public spending per inhabitant has grown by 48% since 2003. This reality contrasts with the idea that healthcare has experienced significant cuts in recent decades, when the only falls in real spending per inhabitant only occurred between 2010 and 2013.

Companies

• International
  • Pfizer wants to enter the anti-obesity drug market, having an advanced trial with a daily pill, with which it intends to enter the obesity market that promises to be worth 100 billion dollars a year.

• National
  • It is possible that Grifols will cease to be a listed company. The Grifols family in talks with the Brookfield fund to take the company private.

Biomedicine

• NEJM review: Four decades of orphan drugs. The Orphan Drug Act (ODA) was approved in the USA in 1983, due to the lack of commercial interest in the development of these drugs. The law that developed incentives for production, the duration of patents and research was a success and more than 800 indications have already been approved. However, many rare diseases remain untreated and prices are unsustainable. This is why a new strategy is proposed for the next four decades (https://www.nejm.org/doi/full/10.1056/NEJMp2401487)
• Non-communicable diseases in reproductive care. New approach to gestational diabetes (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01298-4/fulltext)
• Gene therapy offers hope for autoimmune diseases. Use of CAR-T, originally intended for cancers, in lupus. Initial findings offer hope to millions of patients with autoimmune diseases, four in five of whom are women (https://www.ft.com/content/a974f4c1-bb8a-4a1b-9d88-a2cf14be5c6e)

Global Health

• Article in Nature: Vaccines save lives, how their use can be increased. The measles vaccine alone is estimated to have prevented 23 million deaths between 2000 and 2018. Globally, the vaccination rate has increased for many diseases. However, in 2022 (the latest figure available) there were still 14.3 million children with zero doses. A lack of access and high production and cost costs among the reasons for this situation. New strategies are needed to boost utilization (https://www.nature.com/articles/d41586-024-02224-9#:~:text=In%20low%2Dincome%20countries%2C%20research,there%20exceeds%20their%20weekly%20wage.)
• Counting the dead in Gaza. According to a letter published in The Lancet, as of June 24, 37,396 people had been killed in the Gaza Strip since the Hamas attack and the Israeli response, according to the Gaza Ministry of Health, figures not accepted by Israeli authorities, although they are by the United Nations and the WHO. If we take into account that the indirect deaths are estimated to be between three and fifteen the number of direct deaths, a conservative estimate with a multiple of four gives 186,000 deaths attributable to the current conflict. This is why an immediate ceasefire is advocated (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01169-3/fulltext)
• A Russian missile hits a children’s hospital in the center of kyiv. At the time of impact there were 600 patients admitted. The evacuation began almost immediately, with the 100 most seriously ill immediately transported to other hospitals in Ukraine (https://www.economist.com/europe/2024/07/11/a-russian-missile-hits-a-childrens-hospital-in-central-kyiv)
• Article in Science: Avian flu is here to stay. Three months after the first outbreak of H5N1 bird flu on an American dairy farm, some researchers are beginning to wonder if the virus is here to stay (https://www.science.org/content/article/cow-flu-here-stay-three-months-after-it-emerged-fears-are-growing)
• The avian flu virus is transmitted between mammals through contaminated milk (https://www.abc.es/salud/enfermedades/virus-h5n1-gripe-aviar-transmite-mamiferos-traves-20240708134609-nt.html)
• Small improvements in nutrition could make the world smarter. Many pregnant women and newborns are malnourished and not only in poor countries, leading to problems with brain development (https://www.economist.com/briefing/2024/07/11/small-investments-in-nutrition-could-make-the-world-brainier)
• BMJ review: patient access to their medical history around the world. Although this right is generally recognized, complications with infrastructure and laws mean that access varies greatly from country to country. This review analyzes the situation of this problem in Australia, Brazil, Canada, Chile, China, Estonia, France , Germany, India, Japan, Kenya, Nigeria, Singapore, South Africa, South Korea, Sweden, United Kingdom and United States (https://www.bmj.com/content/386/bmj.q1481)
• Covid still kills around 1,700 people per week, according to the WHO (https://www.lemonde.fr/sante/article/2024/07/12/le-covid-19-tue-encore-environ-1-700-personnes-par-semaine-dans-le-monde-selon-l-oms_6248869_1651302.html)

International health policy

• USA
  • West Nile virus in the USA. After 25 years of the appearance of this disease (which causes encephalitis) in the USA, experts defend the need for an effective vaccine (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01435-1/abstract#:~:text=Infected%20mosquitoes%20are%20picked%20up,deaths%20from%20West%20Nile%20virus.)

• China
  • The Economist publishes a report on opportunities and challenges of the medtech industry in China (https://www.clearstate.com/campaigns/opportunities-and-challenges-in-chinas-medtech-market/)

• United Kingdom and the National Health Service
  • The NHS is broken: in his first official statement published on July 5, the new UK Health Minister (Wes Streeting) says that his department’s official position is that “the NHS is broken” (https://www.gov.uk/government/speeches/statement-from-the-secretary-of-state-for-health-and-social-care)
  • King’s Fund analysis: what does the minister mean by saying the NHS is broken? The Kings’s Fund asks three questions in response to the minister’s statement: 1 What is broken?; 2. What does “broken” mean?; 3. What is the answer? (https://www.kingsfund.org.uk/insight-and-analysis/blogs/is-the-nhs-broken-what-does-that-mean)
  • Official statement from the Labor Party on preparing the NHS for the future: cutting waiting lists with 40,000 more appointments each week; double the number of cancer scans; a new Dental Plan: 8,500 more mental health professionals; return to the family doctor (https://labour.org.uk/change/build-an-nhs-fit-for-the-future/)
  • Starmer turns to Alan Milburn, former Minister of Health, close to Tony Blair, to fix the problems of the NHS, a sign that the private sector and consumer choice will be at the center of the plans (https://www.telegraph.co.uk/politics/2024/07/06/key-blairite-called-in-to-drive-through-nhs-reform/)
  • The new British health minister offers to shift billions from hospitals to GPs (less than 10% of the NHS budget in England goes to primary care) in order to fix the front door in the NHS. The new minister wants to turn towards GPs, reduce pressure on hospitals and reduce pay disputes (https://www.theguardian.com/society/article/2024/jul/08/wes-streeting-promises-to-divert-billions-to-gps-in-order-to-fix-front-door-of-nhs#:~:text=NHS-,Wes%20Streeting%20pledges%20billions%20to%20GPs%20in%20order,fix%20front%20door’%20of%20NHS&text=Minist)
  • The first official report on Covid management after multiple surveys will be published next Thursday and promises to reveal serious deficiencies in Covid management (https://www.theguardian.com/uk-news/article/2024/jul/14/first-covid-inquiry-report-to-set-out-appalling-failures-during-pandemic)

• France
  • The emergency crisis, a priority issue for the next Minister of Health. These services, the gateway to the hospital, where the number of patients has not stopped increasing for years, have become the symbol of the difficulties of the health system (https://www.lemonde.fr/societe/article/2024/07/12/la-crise-des-urgences-dossier-prioritaire-pour-le-prochain-ministre-de-la-sante_6249235_3224.html#:~:text=Augmentation%20de%20l’affluence&text=La%20pénurie%20de%20soignants%20touche,qui%20engendre…%20de%20.)

• WHO
  • WHO’s firm commitment to digital health (https://www.consalud.es/industria/apuesta-firme-oms-por-salud-digital-plataformas-tecnologicas-regulation-ia_146447_102.html). Key documents: Global Digital Strategy (2020-2025): https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf, Digital Strategy for Europe (2023-2030): https://www.who.int/europe/publications/i/item/EUR-RC72-5

• European Union
  • European hospitals lose more than 170,000 beds in a decade, but Spain increases them, despite continuing to be one of the European countries with the fewest beds per 100,000 inhabitants (https://www.plantadoce.com/entorno/la-ue-reduces-its-hospital-beds-in-2022-but-spain-increases-them#:~:text=Grifols%20Pfizer-,The%20UE%20reduces%20its%20hospital%20beds%20in%202022 %2C%20but,in%20long%20term%20in%202022.)
  • Europe calls for increased surveillance against avian flu (https://www.elmundo.es/ciencia-y-salud/salud/2024/07/08/668c091bfdddff574d8b4575.html#)

National health policy

• Central government initiatives
  • The creation of the State Public Health Agency is eternal. It’s a bit frustrating, says Eduardo Satué, president of the Spanish Society of Public Health and Health Administration (SESPAS) (https://www.elperiodico.com/es/sociedad/20240708/creacion-agencia-estatal-salud-publica-eternalizes-105323135)

• Initiatives and news from the autonomous communities
  • Advanced telecare with artificial intelligence will provide service to 100,000 Madrid residents (https://www.abc.es/espana/madrid/teleasistencia-avanzada-inteligencia-artificial-dara-servicio-cien-20240711183907-nt.html)
  • Galicia advances an anti-bureaucracy plan in Primary Care (https://www.consalud.es/autonomias/galicia/galicia-avanza-plan-antiburocracia-en-atencion-primaria-este-mismo-ano_146322_102.html)
  • Andalusia offers daily bonuses to doctors who agree to cover the deficit in primary care this summer (https://www.eldiario.es/andalucia/andalucia-ofrece-pluses-543-euros-dia-medicos-especialistas-cubran-deficit-atencion-primaria-summer_1_11507435.html#:~:text=The%20ofrecimiento%20of%20Salud%20a, to%20who%20want%20to attend%20voluntarily.)
  • Asturias: incentives for doctors to go to the wings (https://www.lne.es/asturias/2024/07/12/incentivos-medicos-vayan-trabajar-alas-105529445.html)
  • The first children’s palliative care hospital is born in Madrid with the help of the Amancio Ortega Foundation (https://www.abc.es/espana/madrid/nace-madrid-primer-hospital-infantil-cuidados-paliativos-20240713162400-nt.html#:~:text=Twelve%20mothers%20have%20left%20a,in%20the%20Community%20of%20Madrid&text=14%2F07%2F2024%20a%20them,arrived%20at%20the%20age%20adult.)

• Health professions
  • Doctors are leaving Spain, there is a 40% increase in those who decide to practice abroad (https://www.vozpopuli.com/espana/politica/voladura-controlada-agrieta-vox-rebelion-extremadura-castilla-leon-fear-balearic.html)

• AESEG
  • AESEG requests a price difference between generics and brands, which Farmaindustria opposes, a measure that is already applied throughout Europe except in Spain. The sector has 21 production plants in Spain and generates more than 40,000 direct and indirect jobs (https://www.redaccionmedica.com/secciones/industria/los-genericos-piden-didifferentiar-su-precio-frente-al-de-brand-7973)

• Private healthcare
  • Report in El País: private healthcare runs the risk of dying of success. Waiting lists are exploding for private health insurance (which 1 in every four citizens already have), but, due to low premiums, reaching up to 20 or 30 euros per month, it is not possible to provide a good service (https://elpais.com/economia/negocios/2024-07-13/when-health-is-a-question-of-money-because-private-healthcare-runs-the-risk-of-dying-de-success.html)

• FEDEA
  • Serious management program in the health sector, despite the significant increase in resources in the health field, since the level of spending has grown from 13.2% in 1999 to the current 14.5% of total spending of Public Administrations. Real public spending per inhabitant has grown by 48% since 2003. This reality contrasts with the idea that healthcare has experienced significant cuts in recent decades, when the only falls in real spending per inhabitant occurred between 2010 and 2013 (https://www.redaccionmedica.com/secciones/sanidad-hoy/-problemas-graves-de-gestion-tras-el-descontento-hacia-la-sanidad-publica-4807). Original FEDEA document: Citizens before the Administration (https://documentos.fedea.net/pubs/dt/2024/dt2024-05.pdf?utm_source=wordpress&utm_medium=actualidad&utm_campaign=estudio&_gl=1*lsig2h*_ga*MTMwNzY5NTcyMS4xNzIwOTc0MzI0*_ga_K71EGLC8 J.C. *MTcyMDk3NDMyNC4xLjAuMTcyMDk3NDMyNC4wLjAuMA..)

Companies

• International News
  • Investors behind Moderna provide $3.6 billion for new shares (https://www.ft.com/content/2e530667-49e0-4c8b-895b-d02c7984a6e4)
  • Pfizer wants to enter the anti-obesity drug market, having an advanced trial with a daily pill, with which it intends to enter the obesity market that promises to be worth 100 billion dollars a year (https://www.ft.com/content/865f8432-6c88-40ca-a48e-06b30a81f176)
  • Lilly buys the biotechnology company Morphic for 2.9 billion dollars (https://www.elconfidencial.com/empresas/2024-07-08/eli-lilly-compra-biotecnologica-morphic-2900-millones_3920071/#:~:text=The%20pharmaceutical%20Eli%20Lilly%20ha,quotation%20un%2074%2C97%25.)

• National
  • The Grifols family in talks with the Brookfield fund to take the company private (https://www.ft.com/content/87254b8d-1d3f-4c5d-b68a-0434f2a44da3)
  • Clinical analysis laboratories invoiced 1,550 million euros in 2023, 17.8% less, according to DBK. In 2023, the drop in diagnostic tests linked to covid was prolonged, which had already occurred in 2022 (https://www.plantadoce.com/entorno/los-laboratorios-de-analisis-clinicos-facturaron-1550-millones- in-2023-a-178-less#:~:text=Grifols%20Pfizer-,The%20laboratories%20of%20analysis%20clinics%20billed%201,550%20million%20in%202023,are%20another%20type%20)
  • Asepeyo increases its income by 8.1% in 2023, up to 3,254 million euros (https://www.plantadoce.com/empresa/asepeyo-eleva-sus-ingresos-un-81-en-2023-hasta-3254-millions-of-euros#:~:text=Grifols%20Pfizer-,Asepeyo%20eleva%20sus%20revenues%20un%208%2C1%25%20in%202023%2C,nuevo%20centro%20en%20Chamartín%2C%20Madrid .)
  • Cantabria Labs inaugurates a new R&D center in Madrid (https://www.plantadoce.com/empresa/cantabria-labs-inaugura-un-nuevo-centro-de-idi-en-madrid#:~ :text=The%20center%20will%20locate%20in,In%202022%20turnover%20293%20million.)
  • Edwards Lifesciences settles in Valencia with an investment of 317 million euros (https://www.plantadoce.com/empresa/edwards-lifesciences-se-instala-en-valencia-con-una-inversion-de-317- million#:~:text=Grifols%20Pfizer-,Edwards%20Lifesciences%20is%20installed%20in%20Valencia%20with%20an%20investment%20of,the%20locations%20es%20Moncada%)
  • The Peruvian AC Farma arrives in Spain (https://www.plantadoce.com/empresa/la-peruana-ac-farma-llega-a-espana-junto-a-un-vehiculo-societario-para-comprar-inmuebles )
  • Novartis closes one of its R&D centers (https://www.consalud.es/salud35/internacional/novartis-cierra-centro-san-diego-plan-reestructuracion_146450_102.html#)
  • Ribera incorporates the Assistens Clinic in A Coruña (https://www.consalud.es/salud35/nacional/ribera-incorpora-clinica-assistens-coruna-especialidades_146438_102.html)
  • Roche proposes an adjustment of 190 jobs in its diagnostic and diabetes divisions in Spain (https://www.plantadoce.com/empresa/roche-propone-190-despidos-en-sus-divisiones-de-diagnostico-y-diabetes-in-espana#:~:text=Roche%20aspires%20to%20a%20adjustment,of%20fifty%20%20%20job positions.)