7 days in healthcare (March 25th-31st, 2024)

 

Summary

From the point of view of Biomedicine, it should be noted that possibly the next “boom” will be everything related to anti-aging therapies, an aspect to which the Financial Times dedicates an article, following the appearance of three books on the subject. . The Economist dedicates a lot of space in its latest issue to the issue of AI in healthcare, no less than an editorial and four articles. The conclusion is that AI will have a great impact on healthcare. However, as Eric Topol, the well-known cardiologist and health publicist, comments in another article in the Financial Times, “AI is very transformational, but these things always take longer than you initially think.” Nature magazine analyzes the reasons for optimism about cancer vaccines. Vaccines to treat, not to prevent.

Regarding Global Health, the WHO focuses on the millions of undiagnosed cases of tuberculosis, which compromise efforts to combat this disease. The WHO estimates that in 2023 there will be three million new cases not known to health services. Problems continue between developed and developing countries, which do not agree on the Treaty on the prevention of pandemics, proposed by the WHO as a goal for 2024.

In terms of International Health Policy, the King’s Fund and the Nuffield Trust, two prestigious British think tanks on health, analyze satisfaction with the NHS, which is the lowest in the entire history of this institution. Only 24% of citizens in England, Scotland and Wales are happy with the service, with waiting lists being the most common complaint. In France, the Sorbonne Faculty of Medicine and a former health minister propose “strong measures” to, they say, prevent the degradation of the health system in France. Of the three measures they propose, one of them has to do with the preservation of “medical time” (through non-medical assistants in consultation); and the other with the promotion of advanced practice nursing.

If we talk about National Health Policy (Spain), based on Primary Care analysis that is on the Ministry’s website, it is observed that people treated in primary health centers who earn less than 18,000 euros per year are medicalized more frequently, have prescribed more chronic drugs and consume more pills for pain, anxiety or depression. The Ministry of Health is studying allowing price competition between medicines so that generics can gain market share. This would affect generics and biosimilars, which would be cheaper than brand-name ones and it would be the patient who, if they wanted, would assume the difference. The situation in Spain of the same price for generics as for branded ones is unique in Europe. The objective is to stimulate the development of the generic and biosimilar industry and, ultimately, reduce the pharmaceutical bill for these medicines, in order to allow the incorporation of innovations. If it is carried out, it will be great news. Of note is the agreement signed between the Colleges of Pharmacists of the Basque Country and the Department of Health of that community, with the idea of facilitating the integration of community pharmacies as health agents in the health system. More than interesting is the article published in Human Resources for Health, and whose first signatory is Sara Calderón-Larrañaga, and which analyzes the reasons why primary doctors leave Spain. The work consisted of a survey, focus groups and interviews with 158 primary doctors who had left Spain. The causes of their departure were, in order of importance: insufficient salary, temporary employment, excessive workload, poor governance of primary care, lack of flexibility in the workplace and personal circumstances. There are the keys to a reform of Primary Care.

As for Companies, internationally, a cancer drug (Keytruda, from Merck-MSD), the best-selling drug in the world. In Spain, the historic achievements of Rovi, with a business approach that goes beyond covid. We must also highlight Vithas’ hospital commitment in Barcelona, where construction is underway.

Biomedicine

• On the eve of a significant advance in anti-aging therapies. The Financial Times analyzes this phenomenon, following the appearance of three books on aging, that of Venki Ramakrishnan, that of Coleen T. Murphy and that of Andrew J. Scott (https://www.ft.com/content/95480867-9ae2-4100-a56c-c69eb8c36254)
• The Economist dedicates a large part of its latest issue to AI in healthcare, with an editorial, in which it highlights the great potential of AI, as well as the barriers to its introduction, and regulatory problems (https://www.economist.com/leaders/2024/03/27/the-ai-doctor-will-see-youeventually) and four articles, one on the possibility of AI making the healthcare system more efficient, which is a big change, since until now health technologies, unlike in other sectors, increased spending (https://www.economist.com/technology-quarterly/2024/03/27/can-artificial-intelligence-make-health-care-more-efficient); another on the possibilities of accelerating the appearance of new drugs (https://www.economist.com/technology-quarterly/2024/03/27/artificial-intelligence-is-taking-over-drug-development#); a third on how to improve diagnostics with AI (https://www.economist.com/technology-quarterly/2024/03/27/artificial-intelligence-has-long-been-improving-diagnoses); and a quarter on its contribution to making health care safer and better (https://www.economist.com/technology-quarterly/2024/03/27/ais-will-make-health-care-safer-and-better?utm_medium=cpc.adword.pd&utm_source=google&ppccampaignID=18151738051&ppcadID=&utm_campaign=a.22brand_pmax&utm_content=conversion.direct-response.anonymous)
• Despite all of the above, healthcare professionals show a certain immunity to AI, according to an article in the Financial Times. Despite the advances in AI, human intervention remains essential. Eric Topol says: “AI is very transformational, but these things always take longer than you initially think” (https://www.ft.com/content/c89c2e01-330e-45f3-bdd2-b860cbe8d056)
• Nature magazine publishes an article analyzing the reasons for optimism about cancer vaccines. Most people consider immunization as a way to prevent infectious diseases. Vaccines contain proteins that the immune system can use to identify a pathogen. But just as pathogens carry certain proteins, known as antigens, cancer cells do the same, which is used with cancer, not to prevent it, but to treat it. Vaccines to treat, not to prevent (https://www.nature.com/articles/d41586-024-00840-z)
• Obese children are twice as likely to develop multiple sclerosis, suggests a study, originally from the Karolinska Institute in Stockholm (https://www.theguardian.com/society/2024/mar/28/obese-children-multiple-sclerosis-study)
• New hope for HIV cure with a single injection. There are 39 million infected. Researchers from Canada and the United Kingdom find a molecule that could permanently eliminate the virus from the body (https://www.larazon.es/sociedad/nueva-esperanza-cura-vih-asequible-sola-inyeccion_2024032766040aca17c56e0001d7ab52.html). Access to the original article: https://www.tandfonline.com/doi/full/10.1080/22221751.2024.2327371
• New studies analyze the strengths and weaknesses of liquid biopsy for the detection of colorectal cancer. Due to false positives and negatives, they cannot be recommended to replace established effective detection methods (https://www.diariomedico.com/medicina/oncologia/nuevos-estudios-analizan-luces-sombras-biopsia-liquida-deteccion-early-cancer-colorectal.html)
• Colon cancer is increasing in young people: causes and symptoms. The report published by the American Cancer Society shows that this tumor is growing among people aged 20, 30 and 40, while the incidence declines in those over 65 (https://www.nytimes.com/2024/03/27/well/colon-cancer-symptoms-treatment.html)
• The controversy continues over the excessive use of statins, following a NICE report, which seems to reinforce their use (https://www.bmj.com/content/384/bmj.q758)

Global Health

• The Gambia aims to reverse the ban on female genital mutilation. Globally, according to UNICEF, there has been a 15% increase in the number of girls and women survivors of genital mutilation in the last 8 years. Although female mutilation is not in the Quran, many religious leaders are convinced of its necessity (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00625-1/abstract#:~:text=The%20Gambia%20could%20become%20the,report%20before%20a%20final%20vote.)
• Insufficient progress against female genital mutilation (https://www.lemonde.fr/planete/article/2024/03/26/contre-les-mutilations-genitales-feminines-des-progres-insuffisants_6224195_3244.html)
• Tuberculosis, the millions of undiagnosed cases, compromise efforts to combat this disease. The WHO estimates that in 2023 there will be 3 million new cases not known to health services (https://www.lemonde.fr/planete/article/2024/03/24/tuberculose-les-millions-de-cas-non-diagnostiques-compromettent-les-efforts-de-lutte_6223844_3244.html#:~:text=Santé-,Tuberculose%20%3A%20les%20millions%20de%20cas%20non%20diagnostiqués%20compromettent%20l)
• WHO member countries are failing to reach an international agreement on pandemic prevention (https://www.lemonde.fr/sante/article/2024/03/29/prevention-des-pandemies-les-pays-memberes-de-l-oms-n-ont-pas-reussi-a-conclure-un-accord-international_6224810_1651302.html#:~:text=Après%20deux%20ans%20de%20discussions,monde%20à%20une%20future%20pandemie.)
• South and Central America and the Caribbean, hard hit by dengue (https://www.lemonde.fr/planete/article/2024/03/28/l-amerique-du-sud-l-amerique-centrale-et-les-caraibes-durement-touchees-par-la-dengue_6224717_3244.html#:~:text=La%20région%20a%20enregistré%20en,pas%20été%20identifiée%20jusqu’alors.)
• Sweden, the first smoke-free country in the world, meaning a smoking rate of less than 5% (https://www.elperiodico.com/es/sociedad/20240325/suecia-primer-pais-mundo-libre-99900451 )

International health policy

• USA
  • The use of abortion pills has grown greatly after the Supreme Court’s Roe ruling (https://www.nytimes.com/2024/03/25/health/abortion-pills.html#:~:text=Overall%2C%20the%20study%20found%20that,outside%20the%20formal%20health%20system.)
  • Republicans in the Senate block legislation in favor of in vitro fertilization, despite agreeing, they prefer that it remain the responsibility of the states (https://www.nytimes.com/2024/02/28/us/politics/senate-republicans-ivf-bill.html#:~:text=A%20Republican%20senator%20on%20Wednesday,embryos%20should%20be%20considered%20children.)
  • The Biden Administration ends short-term health insurance, launched by Trump (https://www.nytimes.com/2024/03/28/us/politics/biden-short-term-health-plans.html#:~:text=The%20Biden%20administration%20announced%20on,to%20cheaper%20but%20skimpier%20plans.)
  • According to Paul Krugman, in an article published in The New York Times, Obamacare is once again under threat. This law has allowed millions of Americans access to health insurance and is quite popular, despite the initial cost for Democrats (https://www.nytimes.com/2024/03/25/opinion/trump-obamacare.html?searchResultPosition=2)

• United Kingdom and the National Health Service
  • Public satisfaction with the NHS is the lowest it has ever been, according to a survey carried out jointly by the prestigious think tanks King’s Fund and NuffieldTrust. Only 24% of citizens in England, Scotland and Wales are happy with the service, with waiting lists being the most common complaint (https://www.theguardian.com/society/2024/mar/27/public-satisfaction-with-the-nhs-at-its-lowest-ever-level-poll-shows). Access to survey document: https://assets.kingsfund.org.uk/f/256914/x/48c40ea52b/public_satisfaction_nhs_social_care_2023_bsa_2024.pdf
  • Thousands of foreign nurses (about 9,000) leave the NHS each year to work in other countries. The destination countries are mainly the USA, New Zealand and Australia, where nurses are better paid than in the UK (https://www.theguardian.com/society/2024/mar/25/thousands-of-foreign-nurses-a-year-leave-uk-to-work-abroad)
  • NHS residents support six more months of strike over pay (https://www.bmj.com/content/384/bmj.q717#:~:text=Junior%20doctors%20in%20England%20have,of%20action%20short%20of%20striking.)

• France
  • Why the French drink less wine. Today only 10% of French people drink wine every day, down from 50% in 1980. One of the reasons is that they prefer beer (https://www.economist.com/europe/2024/03/27/why-the-french-are-drinking-less-wine?utm_medium=cpc.adword.pd&utm_source=google&ppccampaignID=18151738051&ppcadID=&utm_campaign=a.22brand_pmax&utm_content=conversion.direct-response.anonymous&gad_source=1&gclid)
  • “Strong measures” are proposed to improve the health system in France. Three measures: the first, make doctors practice what they are trained to do; the second, creating medical time, medical assistants in the consultation or hiring non-clinical personnel (administrative assistants, etc.); the third, promote the model of advanced practice nurses (https://www.lemonde.fr/idees/article/2024/03/28/des-mesures-fortes-sont-necessaires-pour-inverser-la-degradation-de-notre-systeme-de-sante-en-france_6224602_3232.html#:~:text=pour%20les%20soignants-,Des%20mesures%20fortes%20sont%20nécessaires%20pour%20inv)
  • Tensions in France between public and private hospital rates, since public rates are expected to grow by 4.3% compared to 0.3% for private ones (https://www.lemonde.fr/societe/article/2024/03/31/hopital-une-hausse-des-tarifs-qui-ravive-les-tensions-entre-public-et-prive_6225197_3224.html#:~:text=Santé-,Hôpital%20%3A%20une%20hausse%20des%20tarifs%20qui%20ravive%20les%20tensions%20entre,le%20ministè)

• Ireland
  • • A Lancet editorial praises progress in health equity in Ireland (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00628-7/fulltext)

• European Union
  • The ACT (Accelerating Clinical Trials) EU initiative creates a multilateral platform to improve the clinical trials environment in the EU (https://elglobal.es/industria/act-eu-crea-una-plataforma-multilateral-para- improve-the-environment-of-clinical-trials-in-the-eu/)

National health policy

• Spain medicalizes poverty
  • People treated in health centers who earn less than 18,000 euros per year receive medical treatment more frequently, are prescribed more chronic drugs and consume more pills for pain, anxiety or depression (https://www.eldiario.es/sociedad/espana-medicaliza-pobreza_1_11233232.html). Access to the source: https://www.sanidad.gob.es/estadEstudios/estadisticas/estadisticas/estMinisterio/SIAP/home.htm

• Central government initiatives
  • The government refuses health transfers to Melilla, as proposed by the PP (https://diariofarma.com/2024/03/25/el-gobierno-no-preve-ceder-las-competencias-sanitarias-a-melilla-what-I-posed-the-pp)
  • The Platform of Patient Organizations considers urgent the approval of the Comprehensive Tobacco Plan (https://www.diariomedico.com/medicina/politica/plataforma-organizaciones-pacientes-considera-urgente-aprobacion-plan-integral-tabaquismo.html )
  • The Ministry of Health is studying allowing price competition between medicines so that generics can gain market share. This would affect generics and biosimilars, which would be cheaper than brand-name ones and it would be up to the patient to bear the difference if they wanted. The situation in Spain of the same price for generics as for branded ones is unique in Europe (https://elpais.com/sociedad/2024-03-27/sanidad-estudia-permita-la-competencia-de-precio-between-drugs-so-generics-gain-market-share.html)
  • The possibility of simpler oppositions in the “new” SNS is being studied (Escrivá, Ministry of Digital Transformation and Public Service) (https://www.redaccionmedica.com/secciones/parlamentarios/escriva-abre-el-sns-with-the-reorganization-of-templates-and-ope-simpler-1345)

• Initiatives and news from the autonomous communities
  • Waiting lists are increasing in Madrid, which are worse than those of a year ago (https://elpais.com/espana/madrid/2024-03-26/las-listas-de-espera-de-madrid-baten-a-new-record-with-116,000-more-patients-in-queue-than-last-year.html)
  • Many complaints to the institution of the Andalusian ombudsman about health (https://www.eldiario.es/andalucia/notable-aumento-quejas-atencion-sanitaria-andalucia-informe-anual-defensor-pueblo_1_11228115.html). Access to the report: https://www.defensordelpuebloandaluz.es/sites/default/files/informe-anual-2023/index.php
  • The colleges of pharmacists of the Basque Country sign a pharmaceutical provision agreement with the Basque Health Service (https://elglobal.es/farmacia/los-cofs-del-pais-vasco-firman-un-nuevo-convierte-de-pharmaceutical-provision-with-the-Basque-health-service/)
  • Asturias enters the battle for the location of the State Public Health Agency (https://www.lne.es/oviedo/2024/03/27/asturias-basara-candidatura-atraer-agencia-100014462.html)
  • The European electronic prescription is pending in three autonomous communities: Asturias, La Rioja and the Balearic Islands (https://www.consalud.es/autonomias/receta-electronica-europea-se-extiende-por-espana-solo-3-ccaa-your-application-is-pending-141941_102.html)

• Hospital Clinic
  • The Clínic hospital begins to move private activity outside the center after years of complaints (https://elpais.com/espana/catalunya/2024-03-28/el-hospital-clinic-empieza-a-trasladar-la-private-activity-outside-the-center-after-years-of-complaints.html#:~:text=The%20private%20entity%20of%20center,the%20Clínic%2C%20according%20has%20able)

• Professionals
  • Analysis of the reasons why primary doctors leave Spain. An article published in Human Resources for Health, and whose first signatory is Sara Calderón-Larrañaga, analyzes the reasons why primary doctors leave Spain. The work consisted of a survey, focus groups and interviews with 158 primary doctors who had left Spain. The causes of their departure were, in order of importance: insufficient salary, temporary employment, excessive workload, poor governance of primary care, lack of flexibility in the workplace and personal circumstances (https://pubmed.ncbi.nlm.nih.gov/38263243/#:~:text=Conclusion%3A%20Efforts%20to%20improve%20GP,%2C%20professional%20development%2C%20and%20governance.)

• Proton therapy
  • Spain will be the country with the greatest public access to this technology in 2026 (https://www.epe.es/es/sanidad/20240328/protonterapia-2026-espana-pais-acceso-publico-tecnologia-99837869)

• Health permits for foreigners
  • 3,215 in 2023 (https://www.redaccionmedica.com/secciones/empleo/espana-concedio-3-215-permisos-de-trabajo-a-sanitarios-extranjeros-en-2023-5589#:~:text=The%20Government%20of%20Spain%20granted,to%20this%20sector%20240%20professionals.)

• Sale of medicines online
  • Limits, in Spain the online sale of prescription medications is not allowed. In cases where it is not required, it should always be done through pharmacy office websites (https://www.diariomedico.com/farmacia/comunitaria/venta-medicamentos-online-estan-limites.html)

Companies

• International News
  • Zealand wants its share in the anti-obesity drug business (https://cincodias.elpais.com/mercados-financieros/2024-03-31/zealand-quiere-su-parte-del-pastel-del-negocio-of-drugs-for-slimming.html)
  • An anti-cancer drug (Keytruda, from Merck-MSD), the best-selling drug in the world (https://www.expansion.com/empresas/industria/2024/03/30/660865e3468aeb761e8b459c.html)
  • NovoNordisk reaches $1 billion deal for mRNA therapies for heart disease (https://www.ft.com/content/07420e71-3bf9-43d0-bfe0-8043f51ad3cc)
  • Amazon hopes that demand for anti-obesity drugs will strengthen its pharmacy business (https://www.ft.com/content/91df6151-5594-49b3-9631-d65ccfe2f280)
  • Moderna receives 750 million from Blackstone for flu vaccines (https://www.plantadoce.com/empresa/moderna-recibe-750-millones-de-dolares-de-blackstone-para-vacunas-contra-la-gripe#:~:text=The%20American%20pharmaceutical%20signs%20a,of%20dollars%20in%20this%20bet.)

• National
  • Rovi achieves historical highs with a business vision beyond covid (https://cincodias.elpais.com/mercados-financieros/2024-03-31/rovi-logra-maximos-historicos-con-una-vision-of-business-beyond-covid.html#)
  • Vithas increases the investment in its new hospital in Barcelona to 101 million euros (https://www.elespanol.com/invertia/observatorios/sanidad/20240320/vithas-eleva-millones-euros-inversion-nuevo-hospital-barcelona/841416040_0.html)
  • Atrys doubles its losses to 45 million in 2023, but increases its income by 27.3% (https://www.expansion.com/catalunya/2024/03/27/6603f5cfe5fdeab3368b4578.html)
  • Ferrer buys a license from Verge Genómica to combat ALS (https://www.eleconomista.es/salud/noticias/12738120/03/24/ferrer-compra-una-licencia-a-verge-genomics-para-combatir-la-ela-.html#:~:text=In%20su%20turn%20towards%20treatments,in%20patients%20of%20lateral%20sclerosis)

This post is also available in: Spanish