7 days in healthcare (September 4th-10th, 2023)
Summary
From the point of view of Biomedicine, in an editorial article, the Financial Times comments on the promise of anti-obesity drugs. Despite the clear benefits of the new drugs, there are unresolved issues: first, the limited knowledge of long-term effects; second, the drug is initially expensive. Private patients in the UK are expected to pay £300 a month; and, third, medications should be a complement rather than a substitute for general lifestyle measures. The first human organ created in an animal opens the door to manufacturing spare parts for people.
With regard to Global Health, the new director of Africa CDC publishes in Nature magazine the new policy guidelines of this body, aimed at addressing public health problems in Africa.
Regarding International Health Policy, it is confirmed that the latest versions of the vaccines are prepared for the new variants. Profound administrative reform of healthcare in Portugal, driven by the socialist government and, specifically, by the SNS administrator appointed about a year ago, Fernando Araujo. 31 management units (ULS, local health units) are created, which will be public business entities, with a board of directors, and a financing model in which money follows the patient. All hospitals will be assigned to one of these units. Strong criticism for the government’s secrecy in this reform, which has been carried out without prior consultation. The doctors’ order says that the reform will be a “complete disaster.” Despite what has been said, the reform has nothing to do with an implementation of the Spanish Alzira model in Portugal, but it is a public reform. Although some of the measures (business configuration of the management units, board of directors, new financing model in which money follows the patient) “sound good”, the truth is that a reform of this caliber carried out no longer without consensus political but without even public debate it is more than doubtful that it can be successful. He also questions the government’s idea of “getting out of the way” of healthcare by delegating changes to an “administrator.”
If we talk about National Health Policy (Spain), commitment of the Ministry of Health with the measures agreed with the pharmaceutical industry, with the participation even of President Sánchez, to ensure the investment of 8 billion euros. It seems that the conditions are to improve access to medicines; enhance R&D; increase industrial capacities and create supply chains for resilient drugs. Although it is logical and desirable for the government to be “business friendly” with companies in general and with pharmaceutical companies in particular, it is doubtful that such an explicit agreement is the best path for both parties. On the other hand, it must not be forgotten, in view of the government’s commitments, that we are in full discussion of European pharmaceutical policy. Certain relevant changes in the Community of Madrid: possibility of requesting any test from Primary Care and facility for non-EU doctors to work in Madrid. The Royal Decree approving the specialty of emergencies comes out in public hearing, something long awaited and promised, but no less controversial and debatable. The general director of Pharmacy, César Hernández, says that “we do not have a general problem of access to medicines”, which can also be controversial in certain environments.
In the field of Companies, at the international level, Novonordisk becomes the most valuable company in Europe according to market capitalization. Lilly tries to get ahead of Novordisk in the obesity market. Regarding national news, HM Hospitales expands its offer in Madrid with a new polyclinic in an area of intense growth such as Vadebebas.
Biomedicine
- FT Editorial: The promise of anti-obesity drugs. Obesity affects 1 billion people in the world, according to the WHO. Despite the clear benefits of the new drugs, there are unresolved issues: first, limited knowledge of long-term effects; second, the drug is initially expensive. Private patients in the UK are expected to pay £300 a month; and, third, medications should be a complement rather than a substitute for general lifestyle measures (https://www.ft.com/content/a6e0ccbd-66b4-4e5d-9a9a-002b95b0d19f)
- An RNA-based therapy, developed by researchers at Purdue University, slows the growth of tumors by naturally blocking cell division (https://www.elmundo.es/ciencia-y-salud/salud/2023/09/04/64f5ef0ee4d4d8a6308b458a.html)
- The first human organ created inside an animal opens the door to manufacturing “spare parts” for people. It is about introducing pluripotent human cells into pig embryos of a few days, genetically modified before so that they do not develop porcine kidneys (https://elpais.com/ciencia/2023-09-07/el-primer-organo-humano-creado-inside-an-animal-opens-the-door-to-manufacture-spare-parts-for-people.html#)
- Article in Science: degenerative diseases enter the era of functional genomics. Until now there is no cure for the most common neurodegenerative diseases, such as Alzheimer’s and Parkinson’s. Functional genomics and CRISPR techniques seem to open up new perspectives (https://www.science.org/doi/10.1126/science.adk5693#:~:text=The%20era%20of%20functional%20genomics%20in%20neurodegenerative%20disease %20research%20has,the%20discovery%20of%20disease%20mechanisms.)
- Nature article: Global leaders in cancer research. Health centers: MD Anderson Cancer Center and Memorial Sloan Kettering Cancer Center; academic centers: Stanford and Harvard Universities; Government institutions: National Health Institutes (USA) and Chinese Academy of Sciences (https://www.nature.com/articles/d41586-023-02608-3)
Global Health
- New public health model in Africa. Article in Nature by Jean Kaseya, the new director of Africa CDC. 6 proposals: local manufacture of vaccines; improved tracking system; integrated health systems; laboratory network; emergency response design; robust national institutes of public health (https://www.nature.com/articles/d41586-023-02749-5)
- Cancers in young people (under 50) have risen by 80% in the last three decades, including breast, lung, stomach and colorectal cancers. (https://www.ft.com/content/b3140954-3cd0-4a3e-b554-92efa7ed7538). Original article in the BMJ: https://bmjoncology.bmj.com/content/2/1/e000049#
International Health Policy
- COVID-19
- The latest versions of the covid vaccines, prepared for the new variants (https://www.ft.com/content/336459ce-4c73-42f5-b913-50225f5ceb20)
- USA
- Long Covid presents threats to seniors. Approximately 11% of Americans have developed long covid (https://www.nytimes.com/2023/09/03/health/long-covid-seniors.html#:~:text=Long%20Covid%20can%20also%20exacerbate,mobility%20and%20increasing%20fall%20risks.)
- Covid continues to grow, but experts remain optimistic. There is an increase in hospitalizations and deaths but the numbers are relatively low and new vaccines are just around the corner (https://www.nytimes.com/2023/09/07/health/covid-deaths-hospitalizations-vaccines.html)
- Portugal
- Deep administrative reform of healthcare, promoted by the socialist government. 31 management units (ULS, local health units) are created, which will be public business entities, with a board of directors, and a financing model in which money follows the patient. All hospitals will be assigned to one of these units. Strong criticism for the government’s secrecy in this reform, which has been carried out without prior consultation. The doctors’ order says that the reform will be a “complete disaster.” The reform is attributed to Fernando Araujo, the SNS administrator appointed by the government last year (https://www.portugal.gov.pt/pt/gc23/comunicacao/noticia?i=nova-organizacao-dos-cuidados-de-saude-conheca-a-grande-reforma-do-sns-para-2024)
- Germany
- They try to avoid barriers between hospitals and outpatient care. Among the measures, the possibility for hospital patients to spend the night at home, and equal remuneration for procedures in hospitals and out-of-hospital specialists (https://eurohealthobservatory.who.int/monitors/health-systems-monitor/analyses/hspm/germany-2020/two-additional-instruments-to-overcome-sector-boundaries-between-inpatient-and-outpatient-care-are-to-be-introduced)
- Israel
- In Israel, waiting lists are not yet made public (https://eurohealthobservatory.who.int/monitors/health-systems-monitor/updates/hspm/israel-2015/waiting-times-for-elective-surgery-are-still-not-publicly-available)
- Croatia
- Effort to reduce the administrative burden of primary physicians (https://eurohealthobservatory.who.int/monitors/health-systems-monitor/updates/hspm/croatia-2022/reducing-the-administrative-burden-of-primary-healthcare-doctors)
- European Union
- The EU takes an important step in the fight against hepatitis D, the most serious of liver infections (https://elpais.com/sociedad/2023-02-11/la-incierta-lucha-contra-la-hepatitis-d-the-rare-infection-that-could-jump-from-plants-to-human.html)
- Avilés (Asturias, Spain) will host a European summit on mental health on November 14 (https://www.lne.es/aviles/2023/09/08/aviles-acogera-14-noviembre-cumbre-91847663.html)
- WTO (World Trade Organization)
- The WTO resumes negotiations on patents for covid treatments in October (https://www.elespanol.com/invertia/observatorios/sanidad/20230905/omc-retoma-negociacion-exencion-patentes-tratamientos-covid-octubre/791921020_0.html#:~:text=Será%20el%20próximo%209%20de,octubre%20tendrán%20lugar%20dos%20reuniones.
National health policy
- COVID
- The sale of antigen tests has skyrocketed by 556% since the beginning of summer (https://www.eleconomista.es/salud/noticias/12437145/09/23/la-venta-de-test-de-antigenos-para-covid-a-556-is-triggered-since-the-beginning-of-summer.html)
- Strategic plan of the pharmaceutical industry
- Commitment from the Ministry of Health to the pharmaceutical industry so as not to lose the promised investment of 8,000 million, 4,500 young jobs and 48,000 million in exports in the next three years. It seems that the conditions are: improve access to medicines, enhance R&D; increase industrial capacities and create resilient drug supply chains (https://www.diariomedico.com/farmacia/industria/compromiso-de-sanidad-con-el-plan-estrategico-de-la-industria-farmaceutica-para-no-(lose-8000-million-euro.html)
- Almirall requests economic incentives only for responsible companies with Spain (https://www.eleconomista.es/salud/noticias/12436273/09/23/almirall-pide-incentivos-economicos-solo-para-las-companias-responsables-with-spain.html)
- Changes in the Community of Madrid
- Madrid will allow all tests to be requested from primary care before going to the hospital (https://www.consalud.es/autonomias/c-madrid/medicos-primaria-madrid-podran-pedir-todas-pruebas-antes-derivar-hospital_134050_102 .html)
- Non-EU doctors will be able to work in Madrid without having Spanish nationality to alleviate the lack of professionals (https://elpais.com/espana/madrid/2023-09-07/los-medicos-extracomunitarios-podran-trabajar-ya-in-madrid-without-having-Spanish-nationality-to-paliar.html)
- Basque Country
- The Basque Country presents its new 2030 Health Plan (https://www.consalud.es/autonomias/pais-vasco/pais-vasco-presenta-nuevo-plan-salud-2030-aspira-combatir-desigualdad_134033_102.html) . Access to the original document: https://www.euskadi.eus/contenidos/informacion/publicaciones_departamento/es_def/adjuntos/plan-salud-2030.pdf
- Health professions
- The Royal Decree that creates the emergency specialty is put out for hearing and public information. A long-requested and promised topic, but very controversial (https://www.sanidad.gob.es/normativa/audiencia/home.htm)
- Health big data
- Spain offers 45 million euros to the firm that manages healthcare big data (https://www.eleconomista.es/salud/noticias/12432151/09/23/espana-ofrece-45-millones-a-la-firma-let-manage-the-big-health-data.html)
- Access to medicines
- “We do not have a general problem of access to medicines”, says César Hernández (General Director of the Common Portfolio of the SNS and Pharmacy) (https://elglobal.es/industria/no-tenemos-un-problema-de-widespread-access-to-medicines-like-other-countries-but-there-are-stumbling blocks/)tratamientos-covid-octubre/ 791921020_0.html#:~:text=It will be%20the next%20%20%20of October%20they will have%20place%20two%20meetings.)
Companies
- International News
- Novonordisk becomes the most valuable company in Europe according to market capitalization (https://www.ft.com/content/19357584-62e0-452f-a06f-7cda1d8cd0e3)
- The FDA will report Amazon for the sale of unapproved medications (https://www.consalud.es/salud35/internacional/fda-denunciara-amazon-venta-medicamentos_134012_102.html)
- Amgen obtains the green light to complete the acquisition of Horizon Therapeutics (https://www.plantadoce.com/empresa/amgen-obtiene-luz-verde-para-completer-la-adquisicion-de-horizon-therapeutics.html)
- Lilly takes impulse to overtake Novornordisk in the obesity market (https://www.eleconomista.es/salud/noticias/12433974/09/23/lilly-toma-impulso-para-adelantar-a-novo-nordisk-and-conquer-the-obesity-market.html)
- GSK invests 250 million to build a new vaccine plant in Belgium (https://www.eleconomista.es/salud/noticias/12430326/09/23/gsk-invierte-mas-de-250-millones-para-construir-a-vaccine-plant.html)
- National
- The Spanish company Werfen launches We Venture Capital to invest in diagnostic companies (https://www.plantadoce.com/empresa/werfen-lanza-we-venture-capital-para-invertir-en-empresas-de-diagnostico.html )
- Virtus and CVC bid for control of the Eugin fertility clinics (https://www.plantadoce.com/empresa/virtus-y-cvc-pujan-por-el-control-de-las-clinicas-de-fertilidad-eugin.html)
- HM Hospitales expands its offer in Madrid with a new polyclinic in Valdebebas (https://www.plantadoce.com/empresa/hm-hospitales-amplia-su-oferta-en-madrid-con-un-nuevo-policlinico-en-valdebebas.html)
- Sanitas continues with its dental expansion plan and surpasses 40 clinics in Catalonia (https://www.plantadoce.com/empresa/sanitas-continua-con-su-plan-de-expansion-en-dental-y-supera-40-clinics-in-cataluna.html)
- Donte plans to purchase five new dentistry clinics (https://www.plantadoce.com/empresa/donte-preve-cinco-nuevas-compras-para-maex-y-apunta-a-mas-de-420-clinics-in-2023.html)
- Bayer proposes an ERE in its Spanish division that will affect 135 workers (https://cincodias.elpais.com/companias/2023-09-05/bayer-plantea-un-ere-en-su-division-espanola-que -will-affect-135-workers-on-6-of-the-staff.html)
This post is also available in: Spanish