7 days in healthcare (January 10-16, 2022)

 

SUMMARY

From the international point of view, several issues stand out. In the first place, the agreement of the French Assembly taken on Sunday, January 16, to prevent the access of the unvaccinated to leisure and restaurant premises; also Quebec’s initiative to introduce special taxes on the unvaccinated; the WHO’s opinion that it is too early for COVID “flu” policies, as proposed by Spain; the calculation by ISGlobal (Barcelona) that COVID has already left 17 million deaths globally; and the big push for research on neurodegenerative diseases.

As for national news, the SEMFYC (one of the Primary Care medical societies) editorial had a great impact defending the “flu” policies of COVID and, therefore, the minimization of measures, encouraging, consciously or unconsciously, the “light” negationism. This position was quickly adopted by the central government and certain authorities of the Community of Madrid. The central government even tried to lead this position at the international level. Rejection of this idea by other Primary Care societies, a large number of experts, the WHO and the EU. Meanwhile, the incidence of COVID continues to rise to figures never seen in other waves (2,923 cases per 100,000 inhabitants). The price of antigen tests is regulated, after multiple requests from various groups. It is agreed to extend the third and fourth doses. Serious problems regarding sick leave, for which solutions are articulated about the legality of which is in doubt. The purchase of COVID medicines is announced. Ayuso Plan to stimulate the birth rate in Madrid.

As far as companies and other actors are concerned, a group of scientists in Texas announce a vaccine against COVID, which, according to them, it will be cheaper, easier to make and patent-free. Pfizer announces that it will have a new vaccine against the “ómicron” variant ready in March

INTERNATIONAL NEWS

  • France: the Assembly approves by 215 votes against 58 the law that prevents the access of the unvaccinated to leisure and restaurant venues (Le Monde, Jan 16, 22)
  • Quebec’s plan on special taxes on the unvaccinated is well received in Europe. the argument is: “10% of the population cannot overload 90%”. Cold reception at the federal level in Canada and in other provinces. However, in Europe it is not receiving a bad reception: Greece and Austria already fine the unvaccinated, Italy is studying it, France extends the “covid passport” (BMJ, Jan 14, 22)
  • Fourth dose in Israel, which had already been announced for the immunosuppressed, is now being extended to health professionals and those over 60 years of age (Lancet Respir Med, Jan 11, 22)
  • The WHO considers that it is too early to treat COVID-19 as endemic, contradicting the Spanish government’s proposal, and predicts that half of Europeans can be infected (FT, Jan 11, 22)
  • COVID-19 pushed millions of Indians into poverty (The Economist, January 12,22)
  • Some experts predict a new COVID wave at the beginning of the summer (The Guardian, Jan 14, 22)
  • China’s zero COVID policy is creating problems for the manufacturing and distribution chain sectors (FT, Jan 16, 22)
  • Beijing reports the first case of the “ómicron” variant (The Guardian, Jan 15, 22)
  • COVID would have already left 17 million dead in the world (the official figures are 5.5 million), according to a study by the Barcelona Institute for Global Health, sponsored by the La Caixa Foundation (Diario Médico, Jan 15, 22)
  • The Epstein-Barr virus may play a role in the development of multiple sclerosis (NYT, Jan 13, 22)
  • The Economist looks at how healthcare is evolving into a consumer product (The Economist, Jan 15, 22)
  • Great boost to research on neurodegenerative diseases, with 260 drugs under development: Alzheimer’s, Amyotrophic Lateral Sclerosis (ALS), Huntington’s, multiple sclerosis, multiple systemic atrophy, Parkinson’s and others (Diariofarma, Jan 14, 22)

NATIONAL NEWS

  • Incidence of COVID and evolution of the sixth wave

o As of January 13, 2022, the 14-day cumulative incidence of COVID amounts to 2,923 cases/100,000 inhabitants. It is not clear if the peak of the wave has been reached or if we are still going up. In any case, the figures are very high (Official data Ministry of Health, update to  Jan 13, 22)

o Almost half of the Spanish provinces have ICUs at very high risk (El País, Jan 12, 22)

o The debate on those hospitalized “for” COVID and “with” COVID is introduced (El Independiente, Jan 10, 22)

  • “Influenzaization of the pandemic”

o An editorial in a journal of the SEMFYC (Spanish Society of Primary and Community Care Physicians), one of the three scientific societies of Primary Care, advocates the “influenza” approach  of the COVID, avoiding counting individual cases and omitting general measures of protection (AMF-SEMFYC, Towards the end of the exceptionality, Jan 10, 22)

o The other scientific societies of Primary Care, as well as most of the experts, took a stand against the previous proposal, at least until the sixth wave was passed.

o Notwithstanding the foregoing, both the President of the Government and Minister Darias, and certain representatives of the Community of Madrid, expressed their agreement with the approach as “influenza”

o Not only that, but that approach was taken to the WHO, which showed its disagreement. Spain wants to lead this debate in the EU (El Periódico de España, Jan 12, 22)

  • Regulation of the price of antigen tests

o The government (Interministerial Commission on the Price of Medicines) limits the price of antigen tests to 2.94 euros and they will continue to be sold only in pharmacies, with entry into force on Saturday, January 15, 2022. The price is 50% more expensive than in France and Germany (El País, Jan 13, 22)

o During the free sale period, the gross margin for pharmacies was 25-50% (El Economista, Jan 13, 22)

o FEFE expresses its “deep discomfort” at having to sell the tests at a loss (diariofarma, Jan 14, 22)

  • The third and fourth doses are extended

o The Ministry of Health announces a fourth dose for patients at risk and will extend the third to those over 18 years of age (La Razón, Jan 13, 22)

  • Purchase of COVID medications

o Spain closes an agreement with Pfizer to buy 344,000 doses of its drug against COVID

o The regions were unaware of this and ask for an equitable distribution (El Español, Jan 11, 22)

  • Serious problem with sick leave

o COVID causes more than 10,000 sick leaves per day in Spain (El Independiente, Jan 11, 22)

o This situation collapses health centers

o A system is put in place so that discharge and discharge (after 7 days) take place in the same act. Madrid calls for a regulatory change, to which the Government does not seem willing (El Economista Jan 12, 22)

  • Ayuso Plan to stimulate the birth rate in Madrid

o It is intended to go from 50,000 to 70,000 births/year in the region. The plan consists of aid of 500 euros, flexible working hours, deductions and support for assisted reproduction (La Razón, Jam 10, 22)

  • Other themes

o FACME disagrees with the recertification plan of the Ministry of Health, which launched a tender to hire a consultant (Official note from FACME,  Jan 13, 22)

o Teachers facing the return to classes, doubts with the new protocol and fears (El País, Jan 10, 22)

o A court condemns the Generalitat Valenciana to compensate the toilets for not giving them the means of protection (El País, Jan 11, 22)

o Ingesa attempts an agreement on biosimilars, which does not have the agreement of BIOSIM (diariofarma, Jan 9, 22)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

  • A group of scientists in Texas announce a vaccine (CORBEVAX) that is cheaper, easier to make and patent-free (The Guardian, Jan 15, 22)
  • GSK rejects UNILEVER’s offer of 50,000 million pounds for its consumer division (FT, Jan 15, 22)
  • Medicare introduces major restrictions on the use of Biogen’s drug against Alzheimer’s (NYT, Jan 11, 22)
  • Adeslas will enter 1,655 million euros for MUFACE and ASISA 1,268 (PlantaDoce, Jan 12, 22)
  • Vivanta adjusts its network of centers, putting its beauty business up for sale (PlantaDoce, Jan 12, 22)
  • Pfizer says that it will have a new vaccine against “ómicron” ready in March (Redacción Médica, Jan 10, 22)
  • Merck acquires the US company EXELEAD for 789 million dollars (PlantaDoce, Jan 7, 22)
  • Medtronic reaches an agreement to acquire Affera (ConSalud, Jan 14, 22)
  • Eugin acquires the Delaware Institute of Reproductive Medicine (PlantaDoce, Jan 10, 22)
  • Caser Residencial acquires a new social health center in Laguna de Duero (PlantaDoce, Jan 13, 22)

7 days in healthcare (January 3-9, 2022)

 

SUMMARY

From an international point of view, perhaps the most striking thing is the great global expansion of COVID, particularly of the “omicron” variant, with a record number of infections in the United States, of more than one million a day.

As for national news, official policy continues to trust everything to vaccination, avoiding other measures that may have certain political costs. The problem is the number of deaths, the collapse of the health system (which affects not only COVID cases, but the rest of the patients) and the large number of sick leave. The only measure at the national level is the obligation of the mask outdoors (about whose effectiveness many doubt), without addressing the need to control the aeration of premises based on CO2 meters; the avoidance of crowds; considering the mandatory nature of the vaccine for certain groups (health workers, teachers, etc.); the more agile activation of the third dose; ensuring the existence of antigen tests and regulating their price; the management of sick leaves in another more agile way, in such a way that Primary Care no longer completely collapses; and, ensuring the purchase and accessibility of new drugs against COVID.

Regarding company news, to highlight the record sale of 7 million antigen tests by pharmacies in the week of Christmas; and the great news that the Spanish HIPRA vaccine may be present in the second quarter of year 22.

INTERNATIONAL

  • 5 key articles published in JAMA on January 6: 1. A National Strategy for the New Normal of Life with Covid; 2. A National Strategy for COVID-19: Testing, Surveillance and Mitigation Strategies; 3. A National Strategy for COVID-19 Medical Countermeasures: Vaccines and Therapeutics; 4. The First 2 Years of COVID-19: Lessons to Improve Preparedness for the Next Pandemic; 5. The Pandemic Preparedness Program: Reimagining Public Health (JAMA, 6 at 22)
  • Deloitte publishes a document with the six major topics that will be present in health in 2022: 1. Health equity; 2. Corporate Social Responsibility: 3. Mental health and well-being; 4. Digital transformation and impact on delivery models; 4. The future of medical science; 5. Public Health, reimagined (Deloitte, https://www2.deloitte.com/content/dam/Deloitte/global/Documents/Life-Sciences-Health-Care/gx-health-care-outlook-Final.pdf)
  • The Lancet identifies humanitarian needs by 2022, the number of people in need of humanitarian assistance will rise in 2022 to 274 million, from 235 million in 2021 (The Lancet, Jan 8, 22)
  • Peter Singer, possibly the most famous bioethicist in the world, says that, in the face of a shortage of ICU beds, according to him, vaccinated people would have a preference (Project Syndicate, 5 at 22)
  • The USA reports a record number of infections throughout the pandemic, more than a million a day (FT, 4 in 22)
  • Italy declares COVID vaccination mandatory for those over 50 (The Guardian, 5 at 22)
  • A Chinese city of 1.2 million inhabitants, in confinement, before the appearance of three cases (The Guardian, 4 in 22)
  • Israel announces vaccination with a fourth dose for those over 60 years (Vozpópuli, 2 in 22)
  • The WHO follows the new IHU variant identified in France but states that it is not circulating very actively (El Mundo, 6 in 21)
  • More patients and fewer professionals push New York hospitals to the limit (NYT, 7 at 22)
  • Military deployed to London hospitals, to compensate for the absence of personnel (The Guardian, 7 at 22)
  • The French presidency of the European Union (first semester of 2022), intends to take steps in promoting the “European Health Union”, strengthening the ECDC, EMA and HERA (ConSalud, Jan 9, 22)

NATIONAL NEWS

  • “Spain, sick, resigned and incredulous”, hard and accurate article by José Antonio Zarzalejos, on the absence of a strategy against COVID-19. He accuses of attempts to trivialize the attitude of the Spanish authorities (both national and regional), trusting everything to vaccination, but not adopting other measures, as in other countries. It has not even debureaucratized sick leave. The government gets out of the way, individualizing the response to the pandemic. (El Confidencial, 8 at 22)
  • The number of cases in Spain reaches record figures throughout the pandemic (2,722 per 100,000 inhabitants in the last 14 days). The numbers of admitted and patients in ICU are somewhat lower than in other waves, but also worrying (Ministry of Health, Update no 537. Coronavirus disease (COVID-19). 01.07.2022)
  • Between the need to care for COVID, the administrative role for sick leaves and the personnel’s own dismissals, the «omicron» variant pushes Primary Care to the limit (El País, Jan 3, 22)
  • ICUs are as full as a year ago, with 10 times more incidence (El Español, 6 in 22)
  • More than a million children between 5 and 11 years old already have the first dose of the vaccine (El Confidencial, 4 in 22)
  • Spain is late in the purchase of new anti-COVID drugs, while other European countries already have reservations, but in Spain this was delegated to the autonomous regions (La Razón, 7 at 22)
  • The return to classes will be face-to-face at all stages from January 10, agreement of the Interterritorial Council (Sanitary Act, 4 at 22)
  • Health and communities say that at the school level, entire groups will only quarantine if there are five or more cases (El País, 7 out of 22)
  • Raise to five the positives in a classroom to confine them, something without scientific evidence, says the Spanish Association of Pediatrics (7 in 21)
  • Flurona, first cases of simultaneous influenza and covid infections in Spain (Expansión, 3 in 22)
  • December closes with 240,000 sick leave due to COVID, three times more than in November (CincoDías, 4 in 22)
  • A CIS study shows (?) That 55% of Spaniards are not being greatly affected by the pandemic (Vozpópuli, 3 in 22)
  • Great step back from smoking in Spain, they start smoking again like a decade ago (El Periódico de España, 4 at 22)
  • Almost forty organizations reject the Madrid Omnibus Law, published on December 23 and with a 7-day hearing procedure, between Christmas Eve and New Year’s Eve, modifying 33 laws and 5 decrees in force in the Community of Madrid (Acta Sanitaria, 4 Jan 22)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

  • Pharmacies sold a record 7 million antigen tests in the week of Christmas (CincoDías, 4 in 22) and in six months they have sold more than 21 million tests (El Debate, 6 in 22)
  • According to the Minister of Health, antigen tests will only be sold in pharmacies, contrary to what happens in other European countries (Diariofarma, 4 in 22)
  • Private hospitals denounce the Xunta for not compensating for its intervention during the state of alarm (La Voz de Galicia, 4 at 22)
  • HIPRA, the Spanish vaccine, already has a release date in the second quarter of 2022 (La Razón, 4 at 22)
  • The vaccine triggers the value of Novavax, Moderna, BioNTech and Pfizer on the stock market (Expansión, 6 Jan 22)
  • Pfizer and BioNTech will search for a vaccine against herpes zoster (CincoDías, 5 en 22)
  • The German Synlab buys the Valencian company Sistemas Genónicos, belonging to the Ascires group (Expansión, 7 at 22)
  • Rovi, newcomer and favorite among IBEX stocks (CincoDías, 9 at 22)
  • Telefónica has more than 50,000 clients in its telemedicine service (The Objective, 6 in 22)

7 days in healthcare (December 27, 2021-January 2, 2022)

 

 

SUMMARY

 

From an international point of view, to highlight the 50th anniversary of “Médecins sans Frontières”; also the impressive success of vaccines that saved hundreds of thousands of lives globally; the great expansion of COVID by the “omicron” variant, which is leading to the record of infections in many countries; as well as the strengthening of three important institutions linked to health in the European Union: the ECDC, the EMA and the HERA. To verify that COVID produced more deaths globally in 2021 than in 2020.

With regard to national news, it should be noted that Spain leads the number of infections in Europe, in the midst of a collapse of Primary Care and pressure on hospital emergencies and, little by little, also on hospitalization areas and ICUs. Antigen tests are scarce and, in addition, they are very expensive. The government submits the MUFACE model to AIReF’s evaluation, which is good news, if that evaluation is done rigorously. The Community of Madrid is tackling a very difficult project: the creation of a health purchasing center. Once again, it is necessary to do it very well, obtain the synergies of the large public buyer, without altering the autonomy of the centers and without evaluating exclusively the price of the items, but other elements (quality, safety for the patient, technical service, etc.)

In relation to companies, it should be noted that this year we will probably see the first Spanish vaccine (HIPRA) in operation, also that El Corte Inglés, Carrefour and Alcampo offer to sell COVID tests in their establishments, something until now reserved for pharmacies.

INTERNATIONAL NEWS

 

  • Eight medical advances (not related to COVID) in 2021: 1. The structure of proteins, within reach of an algorithm; 2. Live CRISPR; 3. Closer to the chimera (monkey-human chimeras); 4. New and controversial drug against Alzheimer’s: 5. Neuroprosthesis to communicate; 6. Avoid relapses into depression; 7. Impact of salt on strokes; and 8. Triple “jump” in child transplantation (Diario Médico, Dec 31 21)
  • 50 years after the creation of “Médecins sans Frontières” (Doctors without Borders), founded in 1971, as an independent non-governmental association, currently formed by 25 national or regional associations, which works in more than 70 countries and employs in around 45,000 people (The Lancet, 1 Jan 22)
  • One year of COVID vaccines. In the USA alone there are more than 200 million vaccinated, and the vaccine has prevented millions of COVID-19 cases, thousands of hospitalizations and saved hundreds of thousands of lives. An unprecedented success. Experience indicates that vaccines alone do not save lives, it is the vaccination process that saves them (including manufacturing, distribution and administration), which requires robust organizations (JAMA, Dec 21, 21)
  • The Wellcome’s Global Monitor 2020, which assesses trust in science and scientists, is released. The survey covers 113 countries. Although with large regional differences, it is detected that confidence in science grew during the pandemic (The Lancet, 1 Jan 22)
  • COVID leaves more deaths in the world in 2021 than in the year of its outbreak (El Confidencial, 1 Jan 22)
  • The “omicron” variant produces records of infections in 20 countries, among which are Australia, Canada, Denmark, Ireland, Italy, Spain, Switzerland, the United Kingdom and the United States (FT, Dec 31 21)
  • The United States reduces the period of isolation due to COVID to 5 days (FT, Dec 28 21)
  • The WHO warns of a “tsunami of cases” due to the “omicron” and Delta variants (FT, Dec 29 21)
  • WHO says the pandemic may overwhelm health systems, as cases reach records in Europe (FT, The Guardian, Dec 29 21)
  • Shortage of COVID tests in the UK, as cases rise (FT, Dec 29 21)
  • Europe: promoting the “European Health Union”, reinforcing the ECDC (European Center for Disease Prevention and Control) and the EMA (European Medicines Agency) and activating the creation of the HERA (European Preparedness and Response to Health Emergencies Agency), which is expected to start operating in early 2022, with an initial budget of 6,000 million euros, although it is expected to reach 30,000 million, with contributions from the States and the private sector (ConSalud, 30 Dec 21)
  • Persistent COVID and its more than 200 sequels already have an official definition (El País, Dec 28 21)
  • According to a survey, one in four Britons do not believe that the NHS can serve them well, which is surprising given the extraordinary prestige of the NHS so far in the UK (The Guardian, 26 Dec 21)

NATIONAL NEWS

  • “Redacción Médica” analyzes the 10 highlights of 2021: 1. COVID has not abandoned us; 2. Filomena tests the capacity for healing; 3. Relief in the Ministry of Health: Darias instead of Illa; 4. Euthanasia, regulated by Law; 5. Spanish stamp for the first public CART therapy in Europe; 6. Controversial choice of MIR places; 7. Industry is ahead of the virus, with an arsenal of vaccines and treatments; 8. Muface “illuminates” the future of health mutualism; 9. Several strategies in Spanish health: Cancer, Mental Health and Primary Care; and, 10. Various variants of COVID (Redacción Médica, Dec 31 21)
  • Elements that are considered essential for 2022: COVID, Primary Care and Mental Health. The Center for Public Health and improvements for professionals is also expected (ConSalud, 1 Jan 22)
  • Spain closes 2021 at the head of infections in Europe (Diario Médico, Dec 31 21)
  • On December 30, 21, the COVID rate reached 1,775 cases per 100,000 inhabitants. Despite everything, no new official information on the number of cases will be published until January 3 (El Español, Dec 31 21)
  • The collapse in primary care due to COVID leads to hospital emergencies (eldiario.es, Dec 26 21)
  • Health and communities agree to reduce the COVID quarantine period to 7 days (La Razón, Dec 29, 21)
  • Antigen tests in Spain: scarcity and high prices, while in other countries (France and the United Kingdom) they are free (El Debate, 1 Jan 22)
  • The Spanish Medicines Agency advises not to buy antigen tests online (El Debate, Dec 28 21)
  • The Council of Ministers endorses the Plan to improve Primary Care (Health Act, Dec 28 21)
  • Numerous unions and scientific societies (especially those linked to Primary Care) demonstrate against the approved Plan (Consalud, Dec 31 21)
  • The MUFACE model will be subject to review, the government instructs AIReF to evaluate it (El Español, Dec 28 21)
  • Very important draft bill of the Community of Madrid: “Draft Bill of urgent measures to promote economic activity and modernization of the Administration of the Community of Madrid”. Article 44 of the preliminary draft develops the Sanitary Contracting Agency of the Community of Madrid, which becomes a health purchasing center for Madrid. It is more than foreseeable that this is a controversial law with suppliers. (Draft project disseminated by the Community of Madrid: https://www.comunidad.madrid/transparencia/sites/default/files/2._anteproyecto_ley_omnibus_texto_completo_21-12-2021_0.pdf)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

 

  • 2022: the year in which the first Spanish vaccine will reach patients (El Español, Dec 30 21)
  • Private healthcare, years ahead of the SNS in telemedicine (Redacción Médica, Dec 29 21)
  • J&J (Janssen) Vaccine Protects Against Severe “Omicron”, Study Says (NYT, Dec 30, 21)
  • Teva found liable in the US opioid trial (NYT, Dec 30 21)
  • HM acquires a plot of land in Tres Cantos, for the construction of a university hospital (Acta Sanitaria, 23 Dec 21)
  • HM buys the Dr. Gálvez clinic in Malaga, the fourth clinic that the HM group buys in the region (Málagahoy, Dec 31 21)
  • Atrys has 100 million to buy health companies (El Economista, Dec 29 21)
  • Antigen test manufacturers (such as Abbott, Siemens Healthineers and Roche groups) end the year skyrocketing on the stock market (CincoDías, Dec 28, 21)
  • El Corte Inglés, Carrefour or Alcampo offer to sell antigen tests at their centers, according to their employer Anged (CincoDías, Dec 30 21)
  • Magnum Capital starts the international leap of its Miranza ophthalmology clinics: Portugal and Andorra (CincoDías, Dec 27 21)
  • The Jiménez Díaz Foundation leads for the sixth consecutive year the Hospital Excellence Index of the Coordinates Institute (ABC, Dec 27 21)

7 days in healthcare (December 20-26, 2021)

 

 

Summary

From an international point of view, possibly the most interesting is the summary of the year 2021 by The Lancet; also the studies that seem to show that the “omicron” variant is not only more contagious (which was already known), but that it produces a milder form of disease; the NEJM analyzes Amazon’s health offering; and finally, Israel’s attempts to move forward with the fourth dose.

As for national news, the most relevant thing is the great increase in the pandemic in Spain, which fundamentally translates into pressure on Primary Care and Emergencies, not so much in hospitals; the attitude of the central government in the Conference of Presidents of not imposing restrictive measures, in contrast to what is being done in other European countries; and the failures of the strategic reserve in health, which is causing a great shortage of antigen tests at this time.

With regard to companies and other agents in the sector, it is important to highlight that Europe approves the Novavax vaccine, which would already be the fifth vaccine approved in Europe. Also the authorization of the Merck pill by the FDA for high risk covid. From the point of view of corporate movements, perhaps the most relevant is the purchase of CERNER by Oracle, which may revolutionize the field of hospital informatics.

International

 

  • Farhat Yaqub summarizes for The Lancet the most notable events of 2021 in health: the COVID-19 pandemic, which had produced 3.3 million deaths globally as of December 10, 21, more than in 2020; COVID vaccination, with more than 8.4 billion doses administered through December 11; Biden instead of Trump, one of Biden’s first actions was to sign the executive order for the US to return to the WHO; the health impact of the conflict in Ethiopia; the effects of the decline in UK development aid; the COP 26 meeting in Glascow, which put climate change on the health agenda; the crisis in Afghanistan, the most serious current humanitarian crisis; abortion laws: legal in Argentina, banned in Honduras, severe restrictions in Texas; restrictions also in China; the approved malaria vaccine; severe shortage of midwives (The Lancet, Dec 18 21)
  • Three studies (England, Scotland and South Africa) show that the “omicron” variant produces milder COVID, with much less chance of being admitted to hospital (British Medical Journal, 23 Dec 21)
  • A NEJM article looks at Amazon’s healthcare offering: a combination of telemedicine and home care. Three main actions: mobile app; home assessment by a nurse; distribution of medication at home in two hours. A hybrid experience online and in person (NEJM, 23 Dec 21)
  • COVID vaccines are less effective against the “omicron” variant, says the EMA (FT, Dec 20 21)
  • Israel May Give Fourth Vaccine Dose, Despite Expert Reservations (NYT, Dec 23 21)
  • The “omicron” variant responsible for 75% of the cases in the USA (FT, Dec 21, 21)
  • The “omicron” variant has revealed a world not yet prepared for pandemics (FT, Dec 22 21)
  • US military announce SpFN, a valid vaccine against all variants of the coronavirus, including “omicron” (La Razón, Dec 22 21)
  • The “omicron” variant causes the cancellation of almost 5,000 flights around the world during the days of Christmas Eve and Christmas (CincoDías, 25 Dec 21)

National News

  • The incidence of COVID shoots up to 911 cases per 100,000 inhabitants in the last 14 days (El País, 23 Dec 21)
  • Germany declares Spain as a high-risk territory due to COVID (El País, 23 Dec 21)
  • Sánchez prioritizes the economy in the sixth wave and avoids any restrictive measure in the Conference of Presidents, apart from the mandatory nature of outdoor masks and certain possibilities of hiring professionals without recognized degrees (La Razón, Dec 24 21)
  • Feijóo, Moreno, Urkullu and Aragonés consider that the mask on the street is not enough (El Confidencial, Dec 22 21)
  • Harsh criticism from the General Council of Medical Associations in the absence of measures against COVID: “they seek formulas to avoid the burden of responsibility and fear to implement measures that contradict or further anger citizen-voters” (La Vanguardia, Dec 24 21 )
  • The ICUs of ten communities are already at “high risk” due to patient occupation (Aragon, Asturias, Balearic Islands, Cantabria, Castilla y León, Catalonia, Valencian Community, Navarra, Basque Country and La Rioja) (Vozpópuli, Dec 24 21)
  • The sixth wave will leave 9,000 dead in Spain, according to a study by the University of Washington (IHME, Covid 19 Results Briefing, Spain, December 23, 21)
  • The strategic health reserve falls short and does not alleviate the shortage of tests (El Periódico de España, Dec 25 21)
  • Spain has practiced a hundred euthanasias since the approval of the new law (The Objective, Dec 18 21)
  • Strong statements by President Díaz-Ayuso: “In some health centers, not everyone wants to work and pitch in” (El País, Dec 21, 21)
  • SEMERGEN demands that Díaz-Ayuso reconsider her statements about primary care (ConSalud, Dec 22 21)

Companies, employers and main health actors

 

  • Europe approves the Novavax vaccine. It would be the fifth COVID vaccine approved in Europe, after those of Pfizer-BioNTech, Moderna, AstraZeneca and Janssen (FT, Dec 20 21)
  • Biogen cuts the price of its Alzheimer’s drug in half, due to low sales and divisions by experts about its benefits (FT, Dec 20 21)
  • Merck’s COVID pill is FDA cleared for high-risk adults (NYT, Dec 23, 21)
  • FENIN report on the hospital technological profile, with data updated to December 2020. FENIN has been conducting this study since 2009 (FENIN, Dec 21)
  • “MiQuirónsalud”, the portal that the hospital group makes available to its patients, exceeds four million users (ConSalud, Dec 21 21)
  • Oracle buys CERNER for more than 28,000 million euros to grow in health (PlantaDoce, Dec 22 21)
  • Atrys Health acquires 100% of Simm Molecular, which is dedicated to medical diagnosis in nuclear medicine (PlantaDoce, Dec 17 21)
  • Health in code and the Portuguese Algarve Biomedical Center sign an agreement for genetic diagnosis (PlantaDoce, Dec 22 21)
  • MBA (a medical technology company very oriented to orthopedics-traumatology and based in Asturias), until now owned by Alantra, is acquired by the Swedish group Addlife for 111 million euros (Medical Writing, 23 Dec 21)
  • Viamed, owned by the Macquarie fund, acquires the Fuensanta hospital in Madrid, until now owned by the Merina family. With this, Viamed now reaches 12 hospitals in Spain (PlantaDoce, 23 Dec 21)

7 days in healthcare (13-19 December, 2021)

Summary

From an international point of view, perhaps the most striking thing is the great growth worldwide of the “omicron” variant, already present in 89 countries. Although it is clear that it is much more transmissible than the Delta variant, it is not clear that the disease is milder. Some countries in Europe decree confinements. The effectiveness of COVID passports is demonstrated, in terms of increased vaccinations. Figures for healthcare spending in the United States are released in 2020, spending increased significantly, especially federal spending, related to COVID. It reaches 19.7% of GDP (which is said soon). It is also striking that for the first time in the history of the United States, public health spending exceeds private spending.

Regarding national news, great concern about the rapid expansion of the pandemic, which forces the President of the government to convene a Conference of Presidents, for two days before Christmas Eve, which prevents measures from being adopted for Christmas. The plenary session of the Interterritorial Council approves the “Primary and Community Care Plan 2022-2023”, a set of good intentions and the announcement of measures that, where appropriate, would have to be implemented by the autonomous communities. Once again you see how difficult “co-governance” without good governance.

In relation to the activity of companies and other agents in the sector, the activity of vaccine manufacturing companies continues. Two things are difficult to understand: the letter from the President of the Madrid Medical Association to the President of ASISA and the launch by DKV-Yoigo of a medical insurance for 20 euros. We believed, on the one hand, that health insurance companies were free to hire their medical staff; and, on the other hand, that it was difficult to continue lowering the price of health insurance in our country. It is true that in the United States and other countries online insurance, Oscar type, is emerging with cheaper policies than conventional insurance. But in Spain the policies are already very cheap and I do not think that it is about making policies for young and healthy people, who hardly consume health care.

International

  • The “omicron” variant advances at an incredible speed (The Economist, 18 Dec 21)
  • The ECDC warns that vaccination alone is not enough and calls for drastic measures (La Razón, Dec 15 21)
  • The “omicron” variant grows 70 times faster than the Delta in bronchial tissue (The Guardian, Dec 15 21)
  • The “omicron” variant is already present in 89 countries and is growing rapidly, according to the WHO (The Guardian, 18 Dec 21)
  • There is no evidence that the “omicron” variant is more benign than the delta (FT, Dec 17 21)
  • Seven people die in the United Kingdom from the “omicron” variant (El Independiente, 18 Dec 21)
  • The Netherlands decrees a new strict confinement until January 14 (El Periódico de España, Dec 18 21)
  • COVID passports have a positive effect on the number of vaccinated, according to an international study carried out in six countries (Denmark, Israel, Italy, France, Germany and Switzerland), (The Lancet, Dec 13 21)
  • The United States exceeds 800,000 deaths from COVID, the country with the highest mortality (The Guardian, Dec 15 21)
  • The scientific advances of 2021, according to the journal Science (the ease of identifying the structure of proteins, the most significant advance. In relation to medicine, several advances: treatments for COVID-19; psychedelic drugs versus some psychiatric disorders; artificial antibodies to infectious diseases; CRISP tools to modify genes within the body; Alzheimer’s medication, despite doubts about its efficacy) (Science, Dec 17, 219
  • The figures for healthcare spending in the USA in 2020 are published. The growth was 9.7% over the previous year, which had grown by 4.3%. The acceleration is due to the increase in federal spending, which grew 36%, especially in relation to COVID. The percentage of GDP dedicated to health reached 19.7%. The number of uninsured decreased. For the first time in US history, public health spending surpasses private spending (51% vs 49%) (Health Affairs, January, 22)
  • The repetition of epidemics due to different types of coronavirus (SARS, 2002 and 2003; MERS, since 2012 and COVID-19, since 2019) leads some to demand a kind of universal vaccine against coronaviruses. The article is signed, among others, by Fauci (New England Journal of Medicine, Dec 15, 2021)
  • Medicare Advantage for All, a potential pathway to universal coverage in the USA. Against Medicare for All, it would keep private insurers (JAMA, Dec 16 21)

Nationals

  • Spain is at a very high risk of contagion, after exceeding an incidence of 500 per 100,000 in the last fourteen days (El País, 17 Dec 21)
  • Sánchez calls the conference of presidents for next week, given the worsening of the pandemic (El País, 18 Dec 21)
  • Announcement on TV on Sunday, December 19, by Sánchez of the presidents’ conference for Wednesday, December 22, without advancing any measures. Logically, due to the date, there is no possibility of organizing measures for Christmas (El Mundo, 19 Dec 21)
  • Navarra and the Basque Country among the five regions with the most COVID in Europe (El Español, Dec 16 21)
  • Third dose for people over 40 and vaccinated with AstraZeneca (El Confidencial, Dec 16 21)
  • Spain is at the forefront of Europe in excess of mortality, according to the EuroMoMo (The Objective, 19 Dec 21)
  • On December 15, the plenary session of the Interterritorial Council approved the “Plan for Primary and Community Care 2022-2023”, continuation of the “Strategic Framework for Primary and Community Care”, approved in 2019 and never implemented. The plan is a set of promises, which to a large extent have to be implemented by the autonomous communities (such as the finalist budget, telemedicine and others). The plan is strongly criticized by SEMERGEN (Spanish Society of Primary Care Physicians and by FADSP (Federation of Associations for the Defense of Public Health) (Infolibre, Dec 16 21)
  • Antigen test: pharmacies appear to be short of supplies (El País, 19 Dec 21)
  • The Government (Ministry of Social Affairs and Agenda 2030) proposes to limit the residences for the elderly to a maximum of 50 places, as well as some ratios of staff per resident. The text must be consensual, which seems difficult (Infolibre, Dec 17 21)

Companies, employers and other agents in the sector

 

  • María Vila, elected President of FENIN (El Español, Dec 14 21)
  • Ana Polanco, reelected President of ASEBIO (Planta Doce, 16 Dec 21)
  • Letter from the President of the College of Physicians of Madrid to ASISA, reproaching him for the dismissal of doctors for the MUFACE system (Sanifax, Dec 15 21)
  • Spain has already manufactured 380 million vaccines for COVID (CincoDías, Dec 17, 21)
  • Catalonia creates a venture capital fund to promote scientific entrepreneurship (PlantaDoce, Dec 16 21)
  • The European Medicines Agency approves Pfizer’s anti-COVID pill (El Debate, 16 Dec 21)
  • Pfizer’s (Paxlovid) anti-COVID pill works well against the “omicron” variant, the company confirms (NYT, Dec 14 21)
  • The WHO and the EMA could approve the American vaccine NOVAVAX next week (FT, Dec 16 21)
  • Oracle, about to buy CERNER for US $ 30,000 million (FT, Dec 17 21)
  • The CDC discourages the use of the J&J vaccine, due to some clot problems (NYT, Dec 16 21)
  • Sanofi intends to request approval of its vaccine again (FT, Dec 15 21)
  • The IMED healthcare group invoices 12% more and its profit almost doubles, reaching 6 million (Valencia Plaza, Dec 15, 21)
  • The CEU and ASISA sign an agreement for the training of students at the HLA Moncloa hospital (El Debate, 18 Dec 21)
  • Venture capital is pushing for the formation of MIRs. The CVC fund studies buying MIR Asturias (El Periódico de España, 19 Dec 21)
  • Vivanta requests a ransom of 40 million euros from SEPI (PlantaDoce, Dec 16 21)
  • Quirón proton therapy successfully treats its first 100 children (ConSalud, Dec 14 21)
  • Philips expands its portfolio with the purchase of Vesper Medical (PlantaDoce, Dec 15 21)
  • Modern: agreement to bring a mRNA vaccine factory to Australia (PlantaDoce, Dec 14 21)
  • Company health insurance will become more expensive by 7.2% in 2022 (PlantaDoce, Dec 14 21)
  • Grifols sells VCN Biosciences for 66 million euros (PlantaDoce, Dec 15 21)
  • CSL acquires Vitor Pharma for 11.7 billion dollars (PlantaDoce, Dec 16 21)
  • Asistensi and Clínica de Navarra, agreement to export health insurance to immigrants (PlantaDoce, Dec 16 21)
  • Ysios enters the Dutch Northsea leading a round of 77 million euros (El Economista, Dec 17 21)
  • Biontech investors are studying buying Sandoz (El Economista, Dec 14 21)
  • Atrys Health acquires Simm molecular (Expansión, Dec 17 21)
  • DKV and the telephone company Yoigo launch a family health insurance for less than twenty euros (El Economista, 9 Dec 21)
  • The Savana company, founded in 2014, with an ecosystem of 160 hospitals in Europe and America, intends to lead the “healthcare data lake” (El Economista, 18 Dec 21)
  • Rovi receives the European recommendation for its own research antipsychotic (CincoDías, 17 Dec 21)
  • Almirall wins the rights to a drug against autoimmune diseases (CincoDías, Dec 14 21)

7 days in healthcare (6-12 December, 2021)

 

 

SUMMARY

At the international level, the Israeli study published in the New England Journal of Medicine stands out, which showed, in a large sample of cases, a 90% decrease in mortality with the third dose. Also that the “omicron” variant extends to 57 countries. In the United Kingdom, plan B is activated, given the growth of the pandemic: teleworking, masks and COVID passport. The COVID pandemic is found to have exacerbated social inequalities globally.

Regarding national news, to highlight the accelerated growth of the pandemic, with figures that are already very worrying, although lower than other European countries. The government seems to trust everything to vaccines. Six communities are already at high risk. The Ministry advances a new strategy against smoking. COVID vaccination begins for children between 5 and 11 years old.

As for companies, many of them cancel Christmas celebrations, given the advance of the pandemic.

 INTERNATIONAL

  • An Israeli study of 758,118 people who had received a third dose, after a full course with two doses of the Pfizer-BioNTech vaccine, showed that mortality was 90% lower than that of participants who had not received the third dose (NEJM , 8 Dec 21)
  • Afghanistan: collapse of the health system, WHO predicts that one million children will die of starvation this winter (BMJ, Dec 8, 21)
  • Health played a leading role in the COP26 climate conference (BMJ, Dec 7 21)
  • The “omicron” variant extends to 57 countries (The Guardian, 9 Dec 21)
  • Johnson activates plan B: teleworking, masks and COVID passports (The Guardian, 8 Dec 21)
  • COVID: More than 200 million Americans fully vaccinated (NYT, Dec 8, 219
  • The ‘omicron’ variant may produce 75,000 deaths by the end of April in the UK (The Guardian, Dec 11 21)
  • The COVID pandemic has exacerbated global inequalities, according to the “Global Inequality Report 2022” (Le Monde, 7 Dec 21)
  • Public Health expert Karl Lauterbach appointed Minister of Health in Germany (FT, Dec 6 21)
  • According to an article in the New York Times, the number of hospitalizations is now a better indicator of the evolution of COVID than the number of cases (NYT, Dec 11 21)
  • Fauci says that the “omicron” variant is more contagious but less serious (La Vanguardia, 7 Dec 21)

NATIONALS

  • Spain exceeds 320 cases per 100,000 inhabitants in the last 14 days (Germany, 929; United Kingdom, 963; France, 875; Italy, 331; Portugal, 466; United States, 464; Austria, 1,215; Belgium, 2,082) ( Expansion, 9 Dec 21)
  • Hard headline of La Razón: “Europe faces «omicron» and Spain does nothing”. It refers to measures from the central government, which seems to trust everything to vaccination. The article presents the measures in the United Kingdom (telework, mask and covid passport); Germany (severe restrictions on the unvaccinated); France (closing of nightclubs from December 10); Italy (closing of events for unvaccinated); Austria (confinement of the entire population); Denmark (closure of nightlife venues); Ireland (closing of discos and shows); Sweden (vaccination certificate): Holland (closing of all non-essential shops after 5:00 p.m.) (La Razón, 10 Dec 21)
  • Six communities are already at high risk, according to the new health traffic light (eldiario.es, Dec 11, 21)
  • The new Strategy of the Ministry of Health against tobacco is presented: more taxes, more smoke-free spaces and less advertising (El País, Dec 8, 2021)
  • Spain approves childhood vaccination and will begin vaccination of children between 5 and 11 years old on December 15 (El País, 7 Dec 21)
  • Different vaccination strategies for children by communities: vaccination courses, hospitals and health centers or schools (El País, 10 Dec 21)
  • The intensivists, worried. In three weeks the number of admissions to ICU has tripled (El Periódico de España, Dec 12 21)
  • The birth rate in Spain falls by 5.4% in 2020 (PlantaDoce, Dec 9 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

  • Companies cancel Christmas dinners and events and ask their staff to be prudent (El Confidencial, Dec 12 21)
  • Unilabs, until now from the Apax fund, acquired by the Danish family group A.P Moller Holding (Unilabs press release, 2 Dec 21)
  • Centene can sell its international businesses, in Spain Ribera (Forbes, Dec 10 21)
  • The alliance with Moderna bears fruit: Rovi enters the IBEX, instead of Viscofán (Valencia Plaza, 9 Dec 21)
  • Vivanta focuses its activity on dental to continue growing (PlantaDoce, 3 Dec 21)
  • Quirónsalud consolidates in Latin America (ConSalud, Dec 10 21)
  • The San Juan de Dios Hospital closes in Burgos (Medical Writing, Dec 10 21)
  • Ubikare, the healthcare start-up owned by Mutua, arrives in Madrid (10 Dec 219
  • Fertility moves more than 4,000 million in corporate operations (El Economista, Dec 11 21)
  • Otsu fuels its male sexual health business: ten new openings in 2022 (PlantaDoce, 9 Dec 21)

7 days in healthcare (November 29-December 5, 2021)

 

SUMMARY

From the international point of view, it is worth highlighting the beginning of the work of the WHO for the approval of a Treaty on pandemics. It seems that the alarm about the new “‘ ómicron “variant is lowered, after the WHO announcement that there had been no case of death. We must be attentive to the program of the new German coalition government, and its impact on the health system. It seems that its actions are concentrated in the pharmaceutical sector. The failure, for various reasons, of the COVAX platform for immunization of low- and middle-income countries is confirmed.

At the national level, the growth of COVID continues to figures that are already beginning to be worrying, despite the advantage over other European countries. The council of ministers approves the Mental Health Strategy, a plan that, unlike the one approved a few years ago on Primary Care, does have funding, despite having aroused reservations among experts. The council of ministers also approves the PERTE for health. As of December 13, the vaccines for children will be available.

Regarding companies, it should be noted that both Pfizer and Moderna are preparing to adapt their vaccines to the new COVID variant.

 

INTERNATIONAL

 

  • The WHO agrees on December 1, 2021 to begin negotiating an international agreement on how countries should prevent, prepare for and react to pandemics. The agreement is to hold a meeting before March 1, 2022 and discuss a draft before August 1, 2022 (British Medical Journal, Dec 2, 21)
  • A law to introduce dental care in Medicare is discussed in the American Congress (NEJM, 2 Dec 21)
  • An article is published that compares the evolution and behavior in 24 months of a large number of people from the Veterans Administration vaccinated with Moderna and Pfizer-BioNTech (NEJM, Dec 1 21)
  • The need for the health sector to contribute to decarbonization continues to be present (NEJM, Dec 2 21)
  • The WHO warns of a high risk due to the new “omicron” variant (FT Nov 29, 21)
  • WHO says there have been no deaths from the new “omicron” variant, despite its expansion (The Guardian, 4 Dec 21)
  • The “ómicron” variant, with a wide worldwide diffusion: apart from its origin in South Africa, and the expansion to 11 European countries, also present in Canada, Brazil, Australia and Saudi Arabia, among others (CNN Español, Dec 1 21)
  • Van der Leyden calls to discuss the mandatory nature of the vaccine (FT, Dec 1 21)
  • Analysts say that the economic impact of the “omicron” variant will not be important (FT, Nov 29, 21)
  • The program of the new German coalition government has an impact on the healthcare and pharmaceutical sector. Most important measures: price containment in medicines, push for healthcare digitization and use of medical data for research (Covington, Nov 29 21)
  • Biden rules out a new lockdown to tackle the new “omicron” variant (FT, Nov 29, 21)
  • The United Kingdom urgently calls a meeting of the G7 to discuss the problem of the new variant (La Razón, 28 Nov 21)
  • The new variant presents more than 50 mutations over the original from Wuhan (La Razón, Nov 29, 21)
  • COVAX has only distributed 26% of the promised covid vaccines for 2021. The most unanimous explanation is that rich countries have monopolized the market (El Español, Dec 4, 21)
  • The EMA would need three to four months to approve vaccines if they have to be modified by “omicron” (El Confidencial, Nov 30, 21)
  • Europe steps on the accelerator with the third doses in full uncertainty for the new variant (eldiario.es, Nov 29, 21)
  • The lack of vaccines, logistical limitations and the rejection of part of the population hinder immunization in Africa (El País, 28 Nov 21)
  • Germany imposes a de facto confinement to the unvaccinated: leisure and commerce will be banned (El País, 2 Dec 21)
  • Agreement between the Council and the European Parliament to strengthen the role of the ECDC (El Global, 30 Nov 21)

NATIONALS

 

  • COVID cases continue to rise, reaching an AI (cases per 100,000 in the last 14 days) of almost 250 (El Confidencial, Dec 3, 21)
  • Health advises limiting participants in social events during Christmas after the advance of COVID (La Razón 1 Dec 21)
  • The government does not have a “legal plan B” before the “omicron”, it trusts everything to vaccination and rejects restrictions that could affect the economy (La Razón, Dec 1 21)
  • The Government defends the need for an International Treaty on Pandemics, as stated by Minister Darias during the Extraordinary Assembly of the WHO in Geneva (ConSalud, 29 Nov 21)
  • The Council of Ministers approves the Mental Health Strategy 2022-2026, the last was of 2009. It is criticized by experts (Spanish Society of Psychiatry, Spanish Society of Dual Pathology) for its lack of ambition, although the effort of consensus. Among the criticisms is the lack of standards such as professional ratios, number of beds in children’s and adolescent hospitals, waiting lists, etc. It has financing of 100 million euros for the next three years, 30 million for 2022. Intervention in the workplace, the approach to suicide and the gender perspective, among the novelties of this Strategy (El Mundo, Dec 4, 21)
  • The council of ministers officially approves the PERTE for health. Investment of more than 1,400 million euros, between 2021 and 2023. These investment agendas are articulated through tenders, the creation of an investment, development and innovation (R + D + i) structure for advanced online therapies, launch of a public-private investment vehicle in advanced therapies (public-private commercial company) with the participation of companies with production capacity in Spain, elements of early coordination and identification of capacities and needs of the National Health System, public procurement innovative and pre-commercial, agreements with communities, private initiatives and co-programmed projects and public tenders (PlantaDoce, Nov 30 21)
  • The Interterritorial Council of December 2 addresses the Royal Decree of Specialties, so that it is approved before the end of 2021. It contemplates approving new specialties and reviewing access to specific training areas (ConSalud, Nov 30, 21)
  • Pfizer vaccines for children, available from December 13 (ConSalud, Dec 1 21)
  • AESEG presents a report “The sector of generic drugs in the economic and social reconstruction of Spain”, in which it advocates a differential price of generics in relation to brands (AESEG, Dec 1 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

 

  • Continuity of care, interoperability, innovation and the promotion of the SDGs (Sustainable Development Goals), among the objectives of the IDIS Foundation for 2022 (ConSalud, 2 Dec 21)
  • Teladoc Health grows 81% in the third quarter (PlantaDoce, Dec 1 21)
  • Pfizer and Moderna are preparing to adapt their vaccines to the new “omicron” variant (El Global, Nov 29, 29)
  • Merck’s COVID Treatment (Molnupiravir), Endorsed by FDA (NYT, Nov 30 21)
  • HM Hospitales will have a new space of 1,000 square meters in Valdedebas (PlantaDoce, Nov 30, 21)
  • HIPRA relies on its covid vaccine to grow 13% in 2021 (PlantaDoce, Dec 1 21)
  • The major private equity companies (CVC, Advent, Cinven, PAI, KKR,…) prepare offers for around 1,500 million for IVI (CincoDías, Nov 30, 21)

7 days in healthcare (22-28 November, 2021)

 

ABSTRACT

From the international point of view, the most outstanding thing is the great impact produced by the new variant of COVID called “omicron” and which originated in South Africa. Both the stock markets and the price of oil have collapsed and countries have established measures on flights from those countries, which does not prevent cases of the new strain having already been detected in Belgium, Germany, Italy, Austria, the Czech Republic and possibly Holland and Denmark. Globally, there is the impression that there has been a major failure of global vaccination, especially in low-income countries, which is providing a breeding ground for the emergence of new strains. As for the contagiousness and lethality of the new strain, it is not yet known.

At the national level, the growth of the pandemic continues (the figure of 171 cases per 100,000 inhabitants has been reached). Some communities have imposed COVID passports. but that is a legal chaos, in the absence of common guidelines.

As for companies, vaccine manufacturers have started a race to test their vaccine against the new strain. If a new vaccine is required, it is said that it would be ready in 100 days.

INTERNATIONAL

  • The stock market and the price of oil sink, in the face of the new variant of the coronavirus (FT, 26 Nov 21)
  • The new variant “omicron”, “of concern”, says the WHO (FT, Nov 26, 21)
  • Scientists warn of the new “omicron” variant of the coronavirus, with a large number of mutations (The Guardian, 24 Nov 21)
  • With three out of every 100 people vaccinated in some poor countries, the world situation is considered to be a powder keg and a breeding ground for new variants (El País, 28 Nov 21)
  • Rich countries could have avoided the crisis of the new variant, experts say (The Guardian, 26 Nov 21)
  • The WHO warns that before March 1, 700,000 more people could die in Europe from COVID (ABC, 23 Nov 21)
  • The growing phenomenon of “Virtual First” Primary Care grows in the USA. United Health, Humana, Aetna and many other insurers have already introduced it (JAMA, Nov 22 21)
  • Following the case of Belgium, new cases with the new “omicron” variant have been detected in the UK, Germany, Italy, Austria, the Czech Republic and possibly the Netherlands and Denmark (The Guardian, Nov 28, 21)
  • Portugal will impose a confinement after Christmas (El Mundo, 25 Nov 21)
  • The EMA approves the COVID vaccine for children between 5 and 11 years old (El Confidencial, 25 Nov 21)
  • German army planes transport COVID patients to decongest the ICUs (El País, 26 Nov 21)
  • Merkel warns that the crisis is “dramatic” and that current measures “will not be enough” (El País, 22 Nov 21)
  • The European Parliament requires countries to donate more vaccines to COVAX (La Vanguardia, 25 Nov 21)
  • Tobacco control works slowly globally. In 2021 there were an estimated 1.3 billion smokers worldwide, compared to 1.320 in 2015. Only a fraction of countries adopted the WHO Framework Convention on Tobacco Control (FCTC) (Lancet, 27 Nov 21)
  • An international treaty on pandemics is proposed at the next WHO World Assembly, which will take place between Nov 29 and Dec 1, 21. It is estimated that the current mechanisms are not sufficient to control the pandemic. A framework agreement is wanted, such as the tobacco one (Lancet, Nov 27 21)
  • The vaccination of children, necessary. In the USA when the pandemic began in 2020, infected children were 3% of cases, now they are in 25% (Science, 18 Nov 21)
  • Green light from the European Parliament to the Pharmaceutical Strategy for Europe (daily newspaper, Nov 24 21)

NATIONAL

  • The new variant of COVID puts the economic recovery in check (CincoDías, 27 Nov 21)
  • The new variant scares the Spanish Stock Market, which falls 5% and loses 28,000 million (CincoDías, Expansión 27 Nov 21)
  • In Spain, COVID is growing rapidly and reaches 171 cases per 100,000 inhabitants (La Razón, Nov 26, 21)
  • Three indicators anticipate an explosion of infections in Spain (Rt or contagion rate, the incidence of cases diagnosed in the last 7 days, positive diagnostic tests) (La Razón, Nov 22, 21)
  • Health challenges communities to vaccinate with booster doses before Christmas to 16 million people, those over 60 years old (ABC, 24 Nov 21)
  • Galicia, Aragon, Balearic Islands, Murcia, Catalonia and Navarra already have the judicial endorsement to impose the COVID passport (eldiario.es, Nov 26 21)
  • Legal chaos with COVID passports due to the lack of common guidelines (El Mundo, 23 Nov 21)
  • Those not vaccinated against COVID have a 25 times higher risk of death in Spain (La Razón 24 Nov 21)
  • Vaccination is encouraged in Spain, after the increase in incidence and the possible imposition of the COVID passport (El País, 25 Nov 21)
  • The communities pressure Sánchez to address the covid fund in the next President’s conference (January, La Palma), which the government rejects (El Mundo, Nov 26, 21)
  • Health will approve the Mental Health Strategy on December 2 (ConSalud, Nov 26, 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

  • Vaccine manufacturers start a race to test their vaccine against the new variant (FT, Nov 26 21)
  • The vaccine against the new variant “omicron” will be ready in 100 days (ABC, 26 Nov 21)
  • An American jury finds that the pharmacy chains CVS, Walgreens and Walmart triggered the serious opioid crisis (NYT, 23 Nov 21)
  • Novavax expects to be approved as the fourth vaccine in the UK (The Guardian, 24 Nov 21)
  • Merck recognizes that its antiviral against COVID is less effective than it first thought (FT, 26 Nov 21)
  • Rise of private healthcare, policy record (El Debate, Nov 24 21)
  • The pandemic precipitates a “low cost” health insurance race with policies of up to 8 euros for young people (infolibre, 22 Nov 21)
  • The Swiss Vifor buys the Balearic Sanifit in the largest operation of a Spanish “biotech” (CincoDías, 22 Nov 21)
  • KKR wants to bypass the IVI auction and acquire the company for 1.8 billion (El Periódico de España, 23 Nov 21)
  • Almirall wants to be the new European leader in medical dermatology (Expansión, 27 Nov 21)
  • Fresenius grows in Latin America with the purchase of two centers in Colombia (PlantaDoce, 22 Nov 21)

7 days in healthcare (15-21 November, 2021)

 

ABSTRACT

From the international point of view, the plan of the American Democrats to negotiate the price of medicines and its possible impact on innovation continues to be discussed; Europe is once again the engine of the pandemic, with demonstrations in some European cities against confinements and COVID passport measures; and finally, the United States reach a peak in mortality from opioid as the covid pandemic continues.

At the national level, four elements of interest: 1. Spain exceeds 100 cases per 100,000 inhabitants, although the situation is worrying, nothing to do with that of other European countries; 2. The state-of-the-art health PERTE is presented, doubts regarding its reformist impact; 3. Publication of the draft law that aims to consolidate the universality and equity of our National Health System; 4. The waiting lists are published as of June 30, 2021.

In terms of company news, perhaps most relevant is that both Merck and Pfizer’s COVID therapies will be available in generics for low- and middle-income countries.

INTERNATIONAL

  • Request for action in Afghanistan, given the food emergency, by the director of the World Food Program. Disaster is the consequence of conflict, economic collapse and drought (The Lancet, Nov 20 21)
  • Intense debate in the USA about the consequences for pharmaceutical innovation of the regulatory framework on the price of drugs that the Biden Administration wants to approve (NEJM, Nov 18, 21)
  • Democrats in the USA have a plan to reduce the price of drugs, without harming innovation (The Economist, Nov 20 21)
  • A year after the decision of the British NHS to move towards zero carbon emissions by the health system, another 13 countries, including Spain, have joined this approach, which entails important changes, especially in supply chains (The Lancet, Nov 17 21)
  • Europe is once again the engine of the pandemic, with the extremely worrying situation in Austria, Germany, the Netherlands, Belgium, the United Kingdom, Ireland, Hungary, Romania and Russia, among others (Le Monde, 17 Nov 21)
  • Austria returns to lockdown (The Guardian, Nov 18 21)
  • Thousands of people protest in Vienna against confinement and mandatory vaccination (El País, 20 Nov 21)
  • Germany tightens restrictions on the unvaccinated and will force health workers and nursing home workers to be vaccinated (El País, 18 Nov 21)
  • Bavaria cancels Christmas markets, given the growth of the pandemic (The Guardian, 19 Nov 21)
  • The third dose can be extended to all adults, says British Health Minister Sajid Javid (The Guardian,
  • The majority of the European population, in favor of COVID passports (The Guardian, 19 Nov 21)
  • The use of masks reduces the incidence by 53%, according to an international study published in the British Medical Journal (The Guardian, 18 Nov 21)
  • In the USA, mortality from opioid overdose reaches record growth, while the pandemic continues (NYT, Nov 17, 21)
  • Fauci says the pandemic may be under control in 2022, with more third doses (The Guardian, Nov 17, 21)
  • Europe will prioritize the local manufacture of drugs to gain autonomy. This coming week the new EU pharmaceutical strategy will be approved (El Economista 21 Nov 21)

NATIONAL

  • Spain exceeds 100 cases per 100,000 inhabitants for the first time in two months (El País, 18 Nov 21). Comment: although the situation is worrying, it has nothing to do, however serious, with that of other parts of Europe. It seems that the high immunization, the fifth wave and the high percentage of vaccination are at the origin of this situation. However, we do not know if this differential is going to be maintained or we are heading towards a situation similar to that of most of the rest of Europe.
  • The autonomous communities denounce that they once again lack legal tools in the face of another wave of the pandemic (El Mundo, Nov 21, 21)
  • The state-of-the-art health PERTE is presented, which entails 1,489 million investment until 2023 (diariofarma, 15 Nov 21). Comment: there is no transformation in the sense of reforming the health system (which they consider good) and it is an investment aimed at the biotechnology industry. Mentions of primary care are imprecise. In summary: facing the transformation of the health system and to what extent European funds can help, including digitization, is an issue that remains to be seen
  • Published the Draft Law that modifies various regulations to consolidate equity, universality and cohesion of the National Health System, which seeks to prevent co-payments and promote direct management (Diario Médico, Nov 16 21)
  • Waiting lists published as of June 30, 2021: 121 days on average to undergo surgery and 75 days to visit a specialist. 661,162 people, waiting for an intervention. The lists are close to those in 2019 (La Vanguardia, Nov 26 21)
  • ASPE offers its collaboration to end the waiting lists (Medical Redaction, Nov 18 21)
  • Summer-22 is set as the limit to reform the Framework Statute in the summer of 2022, for which it is announced that there will be minor changes to adapt to the Basic Statute of Public Employees and the labour conditions of residents (Diario Médico, Nov 18, 21)
  • The Public Health Center will go to the Council of Ministers soon (Consalud, 19 Nov 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

  • Pfizer’s anticovid pill will be sold as a generic drug in 95 low- and middle-income countries, mainly in Africa and Asia, although the agreement excludes some countries hit hard by the pandemic. Previously, Merck had announced something similar (NYT, Nov 16 21)
  • European regulators, with serious doubts about Biogen’s Alzheimer’s drug (FT, Nov 17 21)
  • DKV remains in the MUFACE system (company declarations)
  • The EMA launches the emergency authorization process for the NOVAVAX vaccine, which would be the first vaccine with recombinant proteins developed in the European Union (Expansión, 18 Nov 21)
  • Quirónsalud launches two new phase I clinical trial units in Madrid and Barcelona, ​​following an agreement with Next Oncology (Diario Médico, 19 Nov 21)
  • Prim improves its profit by 90% in the first nine months of the year, to 12 million (PlantaDoce, Nov 15, 21)
  • Moderna appoints new general manager for Spain and Portugal, Juan Carlos Gil (PlantaDoce, Nov 16 21)
  • Miranza expands its presence in the Basque Country and opens a new center in Bilbao (PlantaDoce, 15 Nov 21)
  • The German biotechnology company CureVac will begin second-generation vaccine trials (ConSalud, 19 Nov 21)
  • Rovi expects to reach growth forecasts for 2023 this year (CincoDías, Nov 16, 21)
  • Pfizer, BioNTech and Moderna expect to bill 62,000 million euros in 2021 with their vaccines (CincoDías, 15 Nov 21)
  • The Spanish HIPRA vaccine will prove its effectiveness as a booster injection for Pfizer vaccinated (Expansión, 16 Nov 21)
  • USA will pay 4,650 million euros to Pfizer for 10 million anti-covid treatments (CincoDías, Nov 18, 21)
  • Almirall collapses on the stock market, after losing 40 million euros (Expansión, 15 Nov 21)

7 days in healthcare (8-14 November, 2021)

 

ABSTRACT

 

From an international point of view, the appearance of two new drugs for COVID (Merck and Pfizer) is considered a milestone in the evolution of the pandemic. Both drugs are small molecule, easy to produce, and for oral use. The other great milestone of the pandemic was, at the time, the appearance of vaccines. Especially worrying are the high numbers of COVID in Europe, especially in the United Kingdom, Ireland, but also Germany and the Netherlands, without forgetting the special situation due to its seriousness in Romania and Bulgaria.

From the national point of view, the announced draft bill on Equity, Universality and Cohesion of the SNS is of great interest. Although the text of the preliminary draft is not known at the time of writing this note, from what was announced it could be said that the positive aspect is universality (provided that universality is not identified with equity) and the negative are the possible repeal of Law 15 / 97, on enabling new forms of management in the National Health System, the imposition of direct management compared to other more flexible forms of management and bad messages regarding co-payments. It seems that he wants to transfer the idea that “privatization” and “copayments” are the problems of the sector, which is absurd.

Regarding companies, the disappearance of large industrial business conglomerates, such as J&J and GE, is striking. It should be noted that in both operations one of the bets is health. This contrasts, instead, with the creation of tech giants (Google, Amazon, Apple, etc.).

 

INTERNATIONAL

 

  • The Economist forecast: COVID will most likely disappear by 2022. Success: vaccines and new drugs. Failure: immunity at terrible cost, 16.5 million deaths worldwide (The Economist, 8 Nov 21)
  • The Economist welcomes the extension of “assisted death” as a new and important right, started in 1995 in Australia and already legal in a dozen countries, most recently Portugal. It is not yet legal in the UK, but Parliament is discussing a law on the subject. In the Netherlands, 4% of deaths are assisted (The Economist, 13 Nov 21)
  • The new anti-COVID drugs represent a significant change in the pandemic (the first notable change was that of vaccines). The new drugs are malnupiravir (Merck) and paxlovid (Pfizer). Both are “small molecule” drugs, easy to produce and for oral use (The Economist, 12 Nov 21)
  • 100 Years of Insulin (Toronto, 1922), a therapeutic success, but a failure in its worldwide spread. The producing companies are Novo Nordisk, Eli Lilly and Sanofi. Now there is biosimilar (The Lancet, Nov 13, 21)
  • The 100,000 genomes project in the United Kingdom (Genomics England) has made it possible to catalog, and in some cases treat, many rare diseases (New England Journal of Medicine, 11 Nov 21)
  • The rise of the COVID epidemic in Germany (almost 500 cases in the last 14 days per 100,000 inhabitants), at the peak and rising, is considered an pandemic of the unvaccinated. Among the factors, the interim Merkel government is valued (NYT, 11 Nov 21). Merkel will meet with the “Länder” next week to take measures against the growth of the covid (El Mundo, 11 Nov 21)
  • The Netherlands imposes new restrictions, as COVID cases are very high (The Guardian, 12 Nov 21)
  • The governments of 42 countries (including the United States, the United Kingdom and Germany) ask to cut emissions from the healthcare sector. The sector’s emissions represent 5% of the total. If it were considered a country, the health sector would be the 5th emitter of CO2 pollution (NYT, 8 Nov 21)
  • The Economist analyzes the non-zero cost of China’s zero-COVID policy (The Economist, 13 Nov 21)
  • COVID vaccination will be mandatory for NHS staff starting next spring (FT, 9 Nov 21)
  • Waiting lists on the NHS soared. They grow by 100,000 people in a month. More than 5.8 million were waiting in September, with 12,500 awaiting treatment for more than two years (FT, Nov 11 21)

NATIONAL

 

  • The government approves the “preliminary draft of the Law by which various norms are modified to consolidate the equity, universality and cohesion of the National Health System” (reference of the Council of Ministers 8 Nov 21)
  • The Secretary of State for Health publishes a prior consultation on the draft bill of measures for equity, universality and cohesion of the National Health System, establishing the November 19 deadline for submitting opinions.
  • The Minister of Health, in public statements, mentions the laws that are going to be repealed or modified. Among those that will be repealed, “explicitly and expressly”, she mentions Law 15/97, on enabling new forms of management in the National Health System (El Periódico de España, 8 Nov 21)
  • The BOE publishes the agreement between the Government, certain autonomous communities and the Amando Ortega Foundation, for the implementation of 10 proton therapy equipment in the public system. A monitoring commission is created on the subject (BOE, no. 267, 8 Nov 21)
  • The health PERTE is presented on November 15. It is integrated into the five PERTES that the government has devised: cutting-edge healthcare, electric vehicle, new language economy, aerospace and smart and sustainable food chain. It appears that the health PERTE will have three components: 1. Innovative techniques and technologies for the diagnosis and prevention of diseases; 2. Development of advanced therapies; and, 3. Platform for the design and industrial production of medicines and vaccines (ConSalud, 11 Nov 21)
  • The autonomies claim to maintain the covid funds for 2022 (El País, 9 Nov 21)
  • The University of Washington predicts a sixth wave of covid in Spain (Vozpópuli, 8 Nov 21)
  • The cumulative incidence of covid grows in Spain to 71.5 cases per 100,000 inhabitants in the last 14 days. It is not comparable to the figures of other European countries, but it continues to rise slowly (ConSalud, 12 Nov 21)
  • The waiting list grows. The latest data published is from December 31, 2020 and the waiting time had passed, in relation to the previous record, from 121 to 148 days for interventions. Pending publication of the data corresponding to June 2021 (ConSalud, 8 Nov 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

 

  • J&J (Johnson & Johnson) will be divided into two companies: one dedicated to consumer products and the other to drugs and medical devices (NYT, 12 Nov 21)
  • GE (General Electric) will be divided into three companies: health, energy and aviation (FT, 9 Nov 21)
  • The Spanish pharmaceutical industry proposes a plan of 1.7 billion to produce essential drugs (CincoDías, 10 Nov 21)
  • Moderna rejects the claims of the American government to appear as a co-inventor of vaccine technology (FT, 11 Nov 21)
  • BioNTech shoots its profit up to 7,126 million euros in the first nine months of the year. (Floor Twelve, Nov 9, 21)
  • The Zendal hospital in the post-pandemic: 400 personnel for 38 patients (Diario.es, Nov 7 21)
  • Fresenius is interested, along with other investors, in InsudPharma, specialized in biosimilars and valued at 1,000 million euros (El Periódico de España, Nov 9, 21)
  • Advent gives gas to Vitaldent, with the purchase of Smysecret (dental aesthetic treatments) (PlantaDoce, 12 Nov 21)
  • Acciona will build a hospital in Chile (PlantaDoce, 11 Nov 21)
  • KKR enters fertility with the purchase of GeneraLife from Invesindustrial (Expansión, 10 Nov 21)
  • HIPRA will imminently begin the new phase of clinical trials for its vaccine (El Economista, Nov 8, 21)
  • Grifols liquidates the blood bag business and closes production in Brazil and Murcia (Cinco Días, Nov 12, 21)