7 days in healthcare (November 6th-12th, 2023)

Summary

From the point of view of Biomedicine, Victor R. Fuchs, a pioneer of health economics and possibly the most recognized and prestigious health economist in the world, dies. He always defended universal health coverage for the United States, although he was very aware of the difficulties of its implementation, due, among other circumstances that he explained, to the heterogeneity of American society. And it must be said that he was not wrong in that. The FDA has just approved an oral drug based on the intestinal microbiome, a new horizon in medicine.

As far as Global Health is concerned, although tuberculosis is preventable and treatable, it continues to be the infectious disease with the most mortality globally, after a short period of time in which it was covid. But 40% of the world’s population with tuberculosis is not treated.

In terms of International Health Policy, it seems that the covid pandemic did not damage developed economies as much as initially thought. This seems to be deduced from studies of initials from the United Kingdom and Italy. The EFPIA, the pharmaceutical industry’s association, continues to complain that the new European legislation could end incentives for innovation and put Europe in an even worse relative position than the one it already has with respect to the USA and China. The OECD has just published “Health at a Glance 2023”, a must-read.

If we talk about National Health Policy (Spain), the agreements of the PSOE and Junts (and also those signed with the PNV for the Basque Country and with the BNG for Galicia) contemplate the transfer of powers over the MIR (and in the case of the Basque Country also of the issuance of titles). Some say that constitutional values and democratic principles have been subordinated in the investiture agreements. Obviously, this does not happen with the MIR, but an important value is put at risk: the cohesion of the National Health System, based, among other issues, on the uniformity of the training system and recognition of titles and specialties, being , on the other hand, a highly recognized system. 11 public hospitals appear to be starting a lung cancer screening program. Since this procedure is not recognized in the SNS service portfolio, the innocent question is: who pays for this? Or is it simply a pilot program with special funding? The Community of Madrid proposes a modification of the current Law of Good Government, which required the appointment of managers of health centers by competition and which at the time was approved by broad consensus, to another system that allows the direct appointment of these positions by part of the SERMAS Board of Directors.

In relation to Companies, at the international level, the battle between pharmaceutical companies in relation to obesity continues (the main players are NovoNordisk, Lilly and AstraZeneca). Amazon is relaunching in health, providing health services through One Medical to its premium customers. At the national level, great growth in the 22nd year of dental, ophthalmological and aesthetic clinics. The purchase of the Eugin assisted reproduction clinics from Fresenius by KKR and GED is completed. The latter retains the business in Spain, while KKR will integrate the international business into IVI RMA.

Biomedicine

• Victor R. Fuchs, possibly the most recognized and prestigious health economist in the world, dies. He was a pioneer of health economics and always defended universal health coverage in the United States, although aware of the difficulty of its implementation (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02475-3/fulltext)
• Fecal transplants: the beginning of a new type of medicine. The FDA has just approved a product called SER-109, the first oral microbiome therapeutic, for use against C. difficile infection (https://www.economist.com/science-and-technology/2023/11/08/faecal-transplants-are-just-the-start-of-a-new-sort-of-medicine#)
• Blood tests for dementia are trialled on the NHS (https://www.theguardian.com/society/2023/nov/09/simple-blood-tests-for-dementia-to-be-trialled-in-nhs#:~:text=A%20team%20of%20researchers%20backed,a%20single%20drop%20of%20blood.)
• Trial shows NovoNordisk anti-obesity drugs reduce risk of death by 18% (https://www.ft.com/content/a204a830-4c54-4832-94d8-62b040e6fd48)
• The first vaccine against chikungunya, transmitted to humans by mosquitoes and which causes fevers and violent joint pain, approved in the United States (https://www.lemonde.fr/sante/article/2023/11/10/le-premier-vaccination-against-le-chikungunya-approuve-aux-etats-unis_6199241_1651302.html)
• Gonorrhea is becoming resistant (https://www.nytimes.com/2023/11/10/health/gonorrhea-treatment-zoliflodacin.html#:~:text=Becoming%20Drug%20Resistant.-,Scientists%20Just%20Found%20a%20Solution.,arrival%20of%20other%20needed%20antibiotics.)
• Algorithms are starting to decide who gets an organ transplant. Doubts about whether decisions are fair (https://www.ft.com/content/5125c83a-b82b-40c5-8b35-99579e087951)
• A chimeric monkey is born with two-thirds of its cells coming from another monkey embryo. The scientific community calls these hybrid organisms chimeras, in reference to the mythological monster. It is expected that the appearance of these creatures can help better understand certain human diseases such as Parkinson’s and Alzheimer’s (https://elpais.com/ciencia/2023-11-09/nace-un-mono-quimerico-con-dos-thirds-of-their-cells-from-another-monkey-embryo.html)

Global Health

• Ending tuberculosis is within reach, why are millions still dying? Tuberculosis, which is preventable and curable, has regained the title of the deadliest infectious disease after this title was taken away by Covid. But 40% of the world’s population with tuberculosis is not treated (https://www.nytimes.com/2023/11/06/health/tuberculosis-tb-treatment-vaccine-diagnosis.html#:~:text=Tuberculosis%20has%20passed%20Covid%20as,%2C%20Ghana.Credit…)
• Sudan: humanitarian crisis of epic proportions (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02515-1/fulltext)
• Healthcare in Gaza continues to worsen with the conflict (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02513-8/fulltext#:~:text=14%20of%2035 %20hospitals%20and,said%20WHO%20spokesperson%20Tarik%20Jasarevic.)

International health policy

• COVID
  • Covid 19 did not damage developed economies as much as initially thought. This seems to be deduced from initial data from the United Kingdom and Italy, which questions previous information (https://www.economist.com/the-economist-explains/2023/11/08/why-covid-19-did-not-harm-rich-economies-as-badly-as-first-thought)

• USA
  • Why sexually transmitted infections are rising in the USA (https://www.economist.com/united-states/2023/11/09/why-sexually-transmitted-infections-are-rising-in-america#)

• United Kingdom and the National Health Service
  • Harsh article from the British Medical Journal: the chaos in Whitehall during covid, which affected the response (https://www.bmj.com/content/383/bmj.p2576)

• European Union
  • The EFPIA (employer association of the European pharmaceutical industry) charges against the loss of incentives posed by the new pharmaceutical legislation (https://diariofarma.com/2023/11/06/la-efpia-carga-contra-la-perdida-of-incentives-posed-by-the-new-pharmaceutical-legislation/). Disseminates a study by the consulting firm Dolon, very critical of the new legislation project: https://efpia.eu/media/cm2jbsjx/revision-of-the-general-pharmaceutical-legislation-impact-assessment-of-european-commission-and-efpia-proposals.pdf

• OECD
  • The OECD publishes “Health at a glance 2023”. Main conclusions: healthcare systems are under severe financial pressure; there has been no complete recovery after covid; unhealthy lifestyles cause millions of deaths; Access barriers persist, despite universal coverage in most OECD countries; the quality of care is improving; digital health has immense potential (https://www.oecd.org/health/health-at-a-glance/)

National health policy

• MIR transfer
  • MIR transfer to Catalonia, included in the PSOE and Junts agreement (https://www.redaccionmedica.com/autonomias/cataluna/el-psoe-defendera-el-traspaso-del-mir-a-cataluna-recollected-en-el-statut-2039#:~:text=The%20Generalitat%20will assume%20the%20planning,held%20in%20August%20of%202021.&text=The%20Generalitat%20of%20Cata)

• 2022 annual report of the National Health System
  • Published the 2022 Annual Report of the National Health System (https://www.sanidad.gob.es/estadEstudios/estadisticas/sisInfSanSNS/tablasEstadisticas/InfAnSNS.htm)

• Lung cancer screening
  • First lung cancer screening in Spain in 11 hospitals (https://www.redaccionmedica.com/secciones/neumologia/once-hospitales-activan-el-primer-cribado-de-cancer-de-pulmon-de-espana-5068#:~:text=The%20hospitals%20that%20willbegin%20a,the%20Hospital%20San%20Carlos%2C%20el)

• SERMAS changes the manager selection system
  • A modification of the current law will allow the appointment of managers without a merit contest (https://www.redaccionmedica.com/autonomias/madrid/el-sermas-recupera-la-seleccion-de-gerentes-sin-concurso-de-merits-3691)

• Published the RESA report of the IDIS Foundation
  • The IDIS Foundation publishes a report on quality in private healthcare, in which a large number of centers and clinics participate (https://www.fundacionidis.com/informes/estudios-resa/estudio-resa-2023)

Companies

• International News
  • BioNTech cuts revenue forecast due to lower demand for the covid vaccine (https://www.ft.com/content/d5b1f377-a34d-4a7a-86b7-2c833d860110)
  • AstraZeneca signs deal on oral obesity drug and boosts profit forecast (https://www.ft.com/content/c96bafc8-0ba9-4a24-9239-c5d5ee0d5051)
  • Lilly’s obesity drug is approved to rival Novonordisk’s Wegovy (https://www.ft.com/content/66af86f2-547f-483e-adea-506373e00917)
  • Amazon expands its health push, offering One Medical benefits to prime members (https://www.ft.com/content/90fdcadf-7ec4-4fcc-9847-c6f96e445de2)

• National
  • Palex buys Burke&Burke and continues developing its business in Italy (https://www.plantadoce.com/empresa/palex-compra-burkeburke-y-sigue-desarrollando-su-negocio-en-italia.html#:~:text=Palex%20continues%20growing.,the%20statement%20of%20the%20company.)
  • Dental, ophthalmological and aesthetic clinics grew by 14% in 2022 (https://www.plantadoce.com/entorno/las-clinicas-dentales-oftalmologicas-y-de-cirugia-estetica-crevió-un-14-en-2022.html#:~:text=2023%20-%2012%3A00-)
  • A company co-founded by Ysios raises 57 million for mental health (https://www.expansion.com/catalunya/2023/11/07/654a0cb1468aebdf188b45b0.html#)
  • Rovi soars on the stock market after improving forecasts and earning 118.8 million euros until September (https://cincodias.elpais.com/companias/2023-11-08/rovi-gana-un-2-menos-hasta-September-but-improves-its-income-forecast-for-the-whole-year.html)
  • KKR and GED buy the Eugin assisted reproduction clinics from Fresenius. KKR will integrate the business outside Spain into IVI RMA and GED will retain the Spanish business (https://cincodias.elpais.com/companias/2023-11-08/kkr-y-ged-compran-a-fresenius-las-assisted-reproduction-clinics-eugin.html)
  • Venture capital goes after dental prostheses for 1,000 million (https://cincodias.elpais.com/companias/2023-11-08/el-capital-riesgo-se-lanza-a-por-las-protesis-dentals-with-1000-millions.html)