7 days in healthcare (July 3rd-9th, 2023)

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Summary

From the point of view of Biomedicine, the contribution of Artificial Intelligence to medical diagnosis is reviewed by JAMA magazine. It seems clear that AI is not going to replace the so-called Narrative Medicine, that ability of the doctor to communicate and to listen and interpret the history of the patients. Interesting advances in the field of  a simple way to diagnose pre-eclampsia and Parkinson’s.

With regard to Global Health, more and more importance is given to loneliness and its consequences on health, according to an editorial in The Lancet. Hunger and famine as a product of human activity, especially armed conflicts, is treated by Nature. Concern regarding the AIDS situation in sub-Saharan Africa, where anti-retroviral therapy has barely reached.

Regarding International Health Policy, in the United States, the FDA approves the first drug to slow down the progression of Alzheimer’s. In the UK, three health think tanks (King’s Fund, Nuffield Trust and The Health Foundation) are addressing both the government and the opposition calling for solutions to the critical situation of the NHS. They denounce a decade of underfunding, which has led the UK to have far fewer human and material resources than most European countries. An interesting subscription model for antibiotics is being considered in the United Kingdom. Pharmaceutical companies will receive 20 million pounds per antibiotic put on the market, regardless of the prescription. In France, the Cour des comptes publishes documents to promote home palliative care and the development of advanced practice nursing. An interesting WHO-Europe document on hospitals and their challenges is published.

If we talk about National Health Policy (Spain), the beginning of the general elections on July 23, has made the different parties have made their programs public, including the health ones. The PP dedicates 24 measures to health. The strong points are: the Primary Care Shock Plan (although the title on emergencies is debatable); the State Public Health Agency; the Agency for Innovation and Quality (similar to NICE); digitization; palliative care; and, the mental health strategy. A new General Health Law is announced. Although the current law has many obsolete points, the legal technique of addressing a new law (instead of partial reforms in relation to different issues) is debatable. There is a risk of opening a very large melon, of generating long delays and of putting health into the same dynamic as education (a law for each new government). Conspicuous absences: nothing about financing, no mention of waiting lists (one of the most serious problems in the system), dental care (an area in which we are very far from Europe) and nothing about public/private collaboration. The PSOE program continues to identify public service with public management, thus distancing itself from any form of public/private collaboration. Many measures are contemplated, seeming more like a government plan than an electoral program, so the priorities are difficult to identify. The star measure seems to be announcing a law on waiting lists. Laws on waiting lists have never been effective in any autonomous community. The solution to the waiting lists does not go through a time guarantee law but rather resources and productivity of the public system and an updated and agile system of collaboration with the private sector. SUMAR incorporates the Podemos program: creation of a public pharmaceutical company; end of the MUFACE model; deprivatization plan, including cleaning, catering and laundry; progressive elimination of the pharmaceutical co-payment; they also announce a law on waiting lists. The Vox program represents an amendment to the whole: recentralization of health, recovering powers in health matters; approach waiting lists; repeal of the euthanasia and abortion law; strong criticism of the WHO, which they accuse of dependence on China. At the national level, the other great news is the alarm given by the insurers involved in the MUFACE model (Adeslas, Asisa and DKV) regarding the fact that its financing is generating large losses, unaffordable in the long term.

In the field of Companies, internationally, large pharmaceutical companies (Merck, BMS) are suing the American government for what they consider lowering prices, as a consequence of the anti-inflation law. In Spain, Ribera continues to bet on public/private collaboration, but this time in Portugal.

Biomedicine

Global Health

  • Editorial of The Lancet: Loneliness as a health problem. In the UK and Japan there are loneliness ministers. The health damages are clear: cardiovascular disease, hypertension, diabetes, infectious diseases, depression and anxiety. Loneliness is not the same as being alone and can affect all ages (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01411-3/fulltext)
  • Hunger and famines are not accidents, but facts created by human action. Around 200 million people experience acute food insecurity. Especially Afghanistan, Burkina Faso, Ethiopia, Mali, Sudan and Syria. Hunger and conflict are connected (https://www.nature.com/articles/d41586-023-02207-2)
  • HIV in Africa. Antiretroviral therapy has transformed AIDS into a chronic disease. But in sub-Saharan Africa, where 70% of AIDS patients live, few have access to this therapy, which greatly decreases life expectancy in the area (https://www.nejm.org/doi/full/10.1056/NEJMp2304600)

International Health Policy

  • COVID19
    • Weekly covid report published by the WHO, July 6, 2023. The African region has shown a slight increase in deaths with a decrease in cases. The remaining five WHO regions show a decrease in both the number of cases and deaths (https://apps.who.int/iris/handle/10665/370545)
  • United Kingdom and National Health Service
    • Three health think tanks (King’s Fund, Nuffield Trust and The Health Foundation) address government and opposition on NHS issues. They are betting that the next election will end short-term politics in the NHS. The recovery of NHS services and waiting lists must be a priority. They denounce a decade of underfunding. They welcome the long-term plan on personnel, published last week. They point out that life expectancy is the second worst (before only the USA) of the 19 health systems analyzed in the King’s Fund report (https://www.health.org.uk/news-and-comment/news/joint-letter-to-political-leaders-in-england-on-future-of-nhs)
    • The NHS intends to roll out the subscription model for antibiotics. Under the new proposal pharmaceutical companies would receive £20m for their new antibiotics, regardless of how many may be prescribed (https://www.ft.com/content/a0b5a2ad-06a4-499d-8195-b4d6a3f65f7a)

National health policy

  • 23 J elections: the health program of the PP
    • The PP dedicates 24 measures to health. The strong points are: the Primary Care Shock Plan (although the title urgent and emergencies is debatable); the State Public Health Agency; the Agency for Innovation and Quality (similar to NICE); digitization; palliative care; and, the mental health strategy. A new General Health Law is announced. Although the current law has many obsolete points, the legal technique of addressing a new law (instead of partial reforms in relation to different issues) is debatable. There is a risk of opening a very large melon, of generating long delays and of putting health into the same dynamic as education (a law for each new government). Conspicuous absences: nothing about funding, no mention of waiting lists (one of the most serious problems in the system), dental care (an area in which we are very far from Europe) and nothing about public/private collaboration (https://www.pp.es/sites/default/files/documentos/programa_electoral_pp_23j_feijoo_2023.pdf)
  • 23 J elections: the health program of the PSOE
    • The PSOE program continues to identify public service with public management, thus distancing itself from any form of public/private collaboration. Many measures are contemplated, seeming more like a government plan than an electoral program, so the priorities do not look good. The star measure seems to be announcing a law on waiting lists. Laws on waiting lists have never been effective in any autonomous community. The solution to waiting lists does not go through a time guarantee law but resources and productivity of the public system and an updated and agile system of collaboration with the private sector (https://www.psoe.es/media-content/2023/07/PROGRAMA_ELECTORAL-GENERALES-2023.pdf)
  • 23 J Elections: SUMAR’s health program

Companies

 

7 days in healthcare (June 26th-July 2nd, 2023)

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Summary

From the point of view of Biomedicine, clinical trials in humans begin with drugs developed by artificial intelligence, such as one for idiopathic pulmonary fibrosis. Álvaro Pascual-Leone, a prestigious Spanish neuroscientist based in the United States, announces that in about ten years the brain will be able to be manipulated . Surely at that time the manipulation of the brain will be something as normal as today the replacement of the crystalline lens for the cataract. A new world is coming.

In Global Health, two charities (the Gates Foundation and the Wellcome Foundation) set to fund a TB vaccine, which could save 8.5 million lives over the next quarter century. Gavi, the organization that provides vaccines to developing countries, approves a vaccine that protects against polio and five other diseases.

Regarding International Health Policy, the editor of the American Journal Medicine publishes in the last issue an article with the five great challenges of the American health system in the 21st century. However, from a reporting point of view, the most interesting news comes from the UK. The King’s Fund, a major British health think tank, publishes a comparative analysis of that country’s health system, which it analyzes together with 19 health systems, including the Spanish one. The analysis is very interesting, and the conclusion is that the NHS is efficient, but with big problems, not only with waiting lists, but also with results. It seems to imply a chronic underfunding of the NHS, when compared to systems in other countries. For its part, the NHS publishes for the first time a long-term plan on personnel. It basically deals with three things: training, retention and reform. The Guardian hails the report but says it is years overdue. For their part, both The Lancet and the British Medical Journal publish editorials on the 75th anniversary of the NHS, which coincides with its deep crisis. In both positions, political consensus is claimed as a key piece to fix the serious problems of the NHS. The WHO-Europe publishes a document with architectural recommendations on the hospitals of the future.

If we talk about National Health Policy (Spain), there are several news of interest: the Audit Office of Catalonia publishes an interesting report on waiting lists. It seems that 9% of the cases on the waiting list in Catalonia were not counted on the Department of Health website, which leads some to use the word makeup. With regard to private healthcare, the IDIS is starting a very interesting project to share the patient’s clinical history among various provider and insurer entities, only an initial but very important step in what is to come. In the course of the pre-election debate, the President of the Popular Party announces a new General Health Law and a State Pact on Health if it reaches La Moncloa. Interesting announcements since, as The Lancet says for the NHS, only a certain political consensus and a new partnership, will be able to solve the problems of the health system in our country.

At the Corporate level, internationally, GSK completes the acquisition of Bellus Health. As far as national news is concerned, we must highlight Roche’s investment in Sant Cugat.

Biomedicine

Global Health

International Health Policy

  • USA
    • The challenges of the American healthcare system in the 21st century, according to the editor of the American Journal Medicine. Five big challenges: 1. Insufficient insurance coverage; 2. Low health education among the population; 3. Prevention and management of chronic diseases; 4. Great disparities in quality and results; and. 5. Trust in doctors? (https://www.amjmed.com/article/S0002-9343(23)00035-9/fulltext)

National Health Policy

Companies

 

 

 

 

 

7 days in healthcare (June, 19th-25th, 2023)

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Summary

From the point of view of Biomedicine, ethical problems continue to be discussed as a consequence of the creation of embryos without eggs or sperm. Until now, an embryo required an egg and a sperm, but this new approach would allow, in hypothesis, to solve problems of infertility or pregnancy loss, but it is a matter to regulate very carefully. Two studies in Nature seem to show that the Y chromosome makes men more vulnerable to tumors.

With regard to Global Health, The Lancet focuses on the great threat of diabetes, since it is estimated that in 2050 there will be 1.3 billion diabetics, a disease related to obesity, diet, tobacco, alcohol and sedentary lifestyle. Inequalities in access to morphine are denounced, with the United States and Europe almost completely monopolizing its use. An important issue, since this drug has a relevant role in the treatment of pain and in palliative care.

Regarding International Health Policy, according to the weekly WHO report, covid is declining in both the number of cases and deaths in all WHO regions of the world. Only in the African region is there a slight increase in the number of deaths, with a decrease in the number of new cases. In the United States, the commercialization of meat grown in the laboratory is approved. One of the authorized establishments belongs to the Spanish philanthropist José Andrés. Also in the United States, not minor problems continue as a result of the annulment of the Roe v Wade ruling that transfers the authorization of abortion to the states. In the United Kingdom, the problems with the emergency services continue and a strike of resident doctors is called. New health insurance law in South Africa, which appears to represent progress towards universal coverage in that country.

If we talk about National Health Policy (Spain), according to the WHO weekly bulletin, Spain is the country in Europe with the highest mortality from covid. The government and the communities agree to abolish the mandatory nature of masks in health centers and pharmacies. Ayuso, proclaimed President of the Community of Madrid, after the last elections. Absence of great news in the announcements of health measures for this legislature. As was already known, Spain is consolidating itself as a world power in clinical trials, an achievement no less.

In the field of Companies, internationally, Walmart (the largest supermarket chain in the USA) enters the primary care business, with 32 centers in 5 states. Walmart was already in healthcare, but it was with small clinics for minor care. Significant company purchases by Merck MSD and Lilly, which seems to confirm that M&A activity in pharmaceutical companies is reviving. In the Spanish national arena, ASEBIO announces an increase in investment in R&D by biotech companies in 2022.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (June 12th-18th, 2023)

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Summary

From the point of view of Biomedicine, to point out that human embryos have been produced without eggs or sperm, using stem cells, which raises far-reaching ethical questions. Joseph Alpert, editor of the American Journal of Medicine, recounts the 10 advances in clinical medicine he has seen since he was an intern in 1969-70. A whole different world, from the mortality of myocardial infarction, the evolution of HIV, the approach to leukemia, the possibilities offered by ICUs, the treatment of tuberculosis, etc. From that point of view, there is no doubt that the world is better than fifty years ago.

As regards Global Health, an unexplained increase in the incidence of cancer has been detected in people under 50 years of age, with this trend particularly affecting the population between 25-29 years of age. The Lancet denounces what it considers pressure from the pharmaceutical industry in the pandemic treaty, currently under discussion at the initiative of the WHO, according to a draft that was leaked on May 22 and published. It would be good if this treaty corrected the major failures that occurred during the covid pandemic in access to vaccines in developing countries, particularly in Africa.

Regarding International Health Policy, according to the weekly WHO report, covid is declining in both the number of cases and deaths in all regions of the world. Forecasts of health spending in the USA are published. Although growth will be moderate in the coming years, it will reach 20% of GDP in 2023, more than any country in the world. The National Oncology Plan in Italy is published. The European Monitoring Center for Drugs publishes its report for 2023. Cannabis, followed by cocaine, are the most widely used illegal drugs in Europe.

If we talk about National Health Policy (Spain), the incidence of covid is decreasing, which makes the government consider removing the mandatory use of masks in pharmacies and health centers. Madrid, the autonomous community with the shortest waiting list for non-urgent surgery. Although our country has a low birth rate, the use of in vitro fertilization is skyrocketing.

At the Business level, internationally, Philips has serious problems with faulty respirators. A collective accuses this company of involuntary manslaughter. The 10 largest pharmaceutical companies have more than 110,000 million dollars available for operations to purchase other companies, a move that is undoubtedly spurred on by the loss of patents in many of them. Lobbyists linked to tobacco companies are accused of advertising vaping online, against the recommendations of the WHO, with many reservations about this practice, considering it harmful to health. On a national level, Quirón presents its new hospital project in Badalona. Grifols will refinance its debt after divesting from its business in China. Asterion, the largest Spanish fund, breaks into health, by buying a health transport company.

Biomedicine

Global Health

International Health Policy

  • Europe
    • The European Monitoring Center for Drugs publishes the report on Drugs 2023: Trends and development. Cannabis (marijuana or hashish) is the most widely used illicit drug in Europe, followed by cocaine. Heroin is the most widely used opioid and the one that causes the most health problems (https://www.emcdda.europa.eu/publications/european-drug-report/2023_en)

National Health Policy

Companies

7 days in healthcare (June 5th-11th, 2023)

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Summary

From the point of view of Biomedicine, to point out a new drug that gives hope to patients with certain brain tumors (low-grade gliomas). The amino acid taurine, related to the delay of aging. Biological drugs enter the treatment of COPD (chronic obstructive pulmonary disease).

As regards Global Health, the journal Nature publishes a set of articles on the effects of tobacco on health. Although the percentage of smokers has gone down from 1990 to 2019 (not the total number of smokers which has gone up, due to population growth), the battle against tobacco is not won. 14% of deaths globally in 2019 were due to tobacco. Whether nicotine is harmful to health is still being investigated. What is clear is that it is addictive, that is why it is said that you smoke because of the nicotine, but you die because of the tar. Difficult regulations against tobacco in Africa, due to the pressures of the industry and the lack of means. In Malaysia, suicide is going to be decriminalized, which is considered a good strategy for its prevention.

Regarding International Health Policy, regarding the covid, the weekly WHO report published on June 8 speaks of a decrease in new cases and mortality globally in the last 28 days, compared to the 28 days previous. The Lancet warns that this is not the time for complacency about the covid in Europe, since mortality continues to be unacceptably high. Interesting article from the New England Journal of Medicine on the origins of the covid, and the reasons that make it convenient to clarify that origin. In the United States, the debate on the negotiation of the price of medicines by Medicare continues, surely the most important health measure taken in the United States in recent years and which will have an impact not only in that country, but also in the pharmaceutical market, globally. Shortage of many medicines, some oncological in the USA. In the UK the difficult work continues for the report on the management of covid. The EU is discussing legislation to protect the health of sex workers.

If we talk about National Health Policy (Spain), the Ministry of Health submits the emergency MIR to public consultation, a long-standing promise, which surprisingly is launched almost during the electoral period. Psychiatrists denounce the need for these professionals, as Spain is one of the countries in Europe with fewer psychiatrists per 100,000 inhabitants, which contrasts with the increase in demand for mental health. Dentists, on the other hand, denounce from their Professional College, the growth in the number of dentists (26% growth in the last 10 years), having a high number of graduates, due to the proliferation of Dentistry Schools. In this case, on the other hand, it coincides with low dental care activity in Spain, in relative terms with other countries. Oncologists warn of an explosion of cancer cases by 2040, both globally and in Spain.

In the field of Companies, at the international level, Pfizer proposes a change in the payment model for antibiotics, proposing a kind of “subscription payment”, separating the volume from the value. Regarding the national situation, CASER announces growth in dental clinics and Hospitén a considerable investment in the Dominican Republic, where this company of Canary origin is very active.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

7 days in healthcare (May 29th-June 4th, 2023)

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Summary

From the point of view of Biomedicine, it is worth noting the death of the virologist Harald sur Hausen, whose name will not mean anything to many, but who 50 years ago discovered the relationship between papillomavirus and cervical cancer, initiating studies of the relationship between viruses and cancer. Reading the DNA of a large and highly varied number of primates allows us to better understand what a human person is and the origin of some diseases. An international consortium discovers that the nucleus of cells is metabolically active.

As regards Global Health, The Economist focuses on the decline in global fertility, due to a decrease in births, not an increase in deaths, a fact with great consequences in our societies. The WHO puts a target by means of cheap vaccines to the global vaccination against cervical cancer, which still produces a large number of deaths. The UN warns about the great sources of hunger in the world: Haiti, Mali, Burkina Faso and Sudan.

Regarding International Health Policy, Canada is preparing a regulation that will make it mandatory to carry warnings of negative health effects on each cigarette. The EU finalizes a regulation to remunerate plasma donations. The WHO celebrates the 76th World Assembly in Switzerland, in which several topics were discussed, among others, the next UN High-Level meeting on universal health coverage, to be held on September 23.

If we talk about National Health Policy (Spain), the call for early elections for July 23 paralyzes the processing of more than 60 laws in relation to health, including some as important as the Equity Law, the Framework Statute, the Law of the National Agency of Public Health or the Law of Guarantees and Rational Use of Medicines. In the Valencian Community, Mazón (the winning candidate of the PP in that Community and foreseeable new president) announces the freezing of the reversal process of the concessions of Manises, Denia and Elche, which had already started or were planned by the Ximo Puig government. He also doesn’t rule out launching new concessions. The Princess of Asturias Award for International Cooperation, awarded to the non-profit initiative Medicines for Neglected Diseases, which focuses not on rare diseases, but on highly prevalent diseases, especially in underdeveloped countries, such as Chagas disease, dengue fever, kala-azar or river blindness and which are considered to affect around 1,000-1,500 million people in those countries, without any research, industry or commercial effort commensurate with their importance.

In the field of Companies, internationally, China breaks the veto on Western vaccines and will allow Moderna to settle in that country. For its part, AstraZeneca defies geopolitical challenges and intends to grow in China. At the national level, Zurich joins forces with Google and DKV to launch digital health insurance. Quirónsalud intends to grow in telemedicine and closes a contract to serve university students.

Biomedicine

Global Health

International Health Policy

  • France
    • Tobacco use is stable in France, one in four adults smokes daily (https://www.lemonde.fr/sante/article/2023/05/31/avec-un-adulte-sur-quatre-qui-smoke-quotidiennement-le-tabagisme-reste-stable-en-france_6175491_1651302.html#:~:text=Tabac-,Tabac%20%3A%20avec%20un%20adulte%20sur%20quatre%20qui%20fume%20quotidiennement%2C% twenty)
  • Canada
    • Canada is going to require that a warning about the danger be printed on each cigarette, since it has been seen that young people start smoking when they receive the offer not of a pack, but of a cigarette (https://www.lemonde. fr/international/article/2023/05/31/le-canada-va-demiger-qu-un-avertissement-soit-imprime-sur-chaque-cigarette_6175630_3210.html)

National health policy

Companies

 

 

7 days in healthcare (May 22nd-28th, 2023)

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Summary

From the point of view of Biomedicine, to point out the cerebral signs in the orbito-frontal cortex detected in chronic pain, which opens the possibility of implanting devices to alleviate pain. An AI-based digital bridge enables paraplegics to walk, raising hope that neurotechnology can help overcome numerous disabilities. The contribution of AI in the interpretation of radiological images is the subject of an extensive review in the New England Journal Medicine. Science magazine publishes advances in regenerative medicine, which helps to recover tissues damaged in many diseases.

With regard to Global Health, The Economist shows with its model that global deaths are 5% above the pre-pandemic era, speculating about whether the stress on health systems due to the covid could have left many people without treatment, which would have increased mortality. Child labor, so present even in developed countries, is the subject of an analysis by The Lancet. The WHO, for its part, warns that the next pandemic may be even deadlier than covid.

As for International Health Policy, the most striking thing is both the editorial and the article that The Economist dedicates to the National Health Service. He goes on to say that although the NHS may need more money, money alone would not solve its problems, calling for “a radical change of focus”, but not like those that some are calling for to move closer to social insurance-type models such as in Germany and France, which he considers unnecessary. He believes that the change consists of orienting the system more towards health, as its name indicates, and less towards disease. Less focus on hospitals and more on community health; from treatment to prevention; and valuing the results more than the activity inputs.

If we talk about National Health Policy (Spain), to highlight the change of political sign, with the departure of the PSOE and the arrival of the PP, in the governments of the Valencian Community, Cantabria, the Balearic Islands, Extremadura and Aragon. This is going to have health consequences. Although it is early to tell, it will surely give continuity to the concession model in the Valencian Community. The latest weekly report from the WHO on covid shows that Spain is currently the country in Europe with the highest mortality per 100,000 inhabitants from this disease. The Community of Madrid has a serious problem attracting professionals, leaving many positions for primary care doctors and paediatricians vacant. Debate on training in the SNS, for important professional associations, such as FACME, the SNS by itself will not be able to maintain teaching professionals without collaboration with the industry. The Government of Navarra is investigating several doctors for breach of exclusivity, apparently only in force in Navarra, Galicia and Asturias. It is surprising that the form of application of a national law depends on the political sign of the autonomous governments.

At the Business level, internationally, Pfizer reaches an agreement with the EU to reduce the supply of covid vaccines. At the national level, it should be noted that HIPRA, after two months of approval of its vaccine, only sells it in Spain.

Biomedicine

Global Health

International Health Policy

National health policy

  • AIDS
    • According to the report of the Carlos III Health Institute, 92.5% of people living with HIV in Spain would know their infection diagnosis; 96.6 are receiving antiretroviral treatment and 90.4 have suppressed viral load. The decrease in the undiagnosed fraction is the data that presents the greatest evolution in this report (https://www.isciii.es/Paginas/Inicio.aspx)

Companies

7 days in healthcare (May 15th-21st, 2023)

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Summary

From the point of view of Biomedicine, to point out certain warnings about the use of blood tests for the detection of cancer, an area with great growth, since in some cases there may be errors in diagnosis, over diagnosis and over treatment . Researchers are trying to improve Nuclear Resonance imaging, through fMRI, which will be able to detect brain activity on the millisecond scale. The WHO warns about the use of sweeteners for weight control and ChatGPT in health, without careful prior examination.

With regard to Global Health, The Lancet denounces in an editorial the continuation of the practice of the death penalty in some countries, but most fundamentally in China. The International Treaty on Pandemics, which may be one of the positive consequences of the covid, seems to be ready in May 2024.

Regarding International Health Policy, very interesting statements by the Director General of the WHO to The Economist magazine, following the lifting of the global alarm due to the covid. Trying to explain why the covid affected developed countries (such as the USA) in many cases more than developing countries, he comments that possibly a certain self sufficiency about the strength of their health systems and a concentration towards investments in specialized hospitals and high technology, in instead of public health, is at the origin of this situation. The crisis in the NHS continues, Starmer (Labor Party leader) says the system cannot be fixed without fixing the “fundamentals”. He seems to understand by “fundamentals” the need for reforms and not just more funding. EMA 2022 annual report, which greets that year as very positive due to the rapid development of new vaccines and new drugs.

If we talk about National Health Policy (Spain), apart from the rise in the incidence of covid, possibly the most far-reaching news is the shortage of certain medicines in pharmacies. It seems that the causes can be multiple, but basically three: the dependence on certain raw materials that are manufactured in India and China; parallel exports due to the lower price of medicines in Spain compared to other European countries; and the very low price of some drugs that discourages their production. In Primary Care, the real problems far exceed the weekend promises to give more money, apparently already committed. In-depth reforms and increased funding is what Primary Care needs, after a deep negotiation and consensus. The PP of Asturias promises to end, if it wins, with the exclusivity of doctors in that region, apparently already the only one in Spain that rigorously applies this regulation. The project of the new Hospital Clinic (Barcelona) of more than 1,500 million surprises by its grandeur. It is to be assumed that such a large investment is fully justified and explained very well to the population.

In the field of Companies, at the international level, a large fine was imposed on the pharmaceutical chain Walgreens in San Francisco for promoting the use of opiates. In Spain, the construction of a new hospital in Alicante by IMED stands out (is there a real boom in new private hospitals?); the sale to a German fund of 26% of ESTEVE; and, as unusual, the denunciation by the hospital employer ASPE of the agreement between Sanitas and Generali. It seems that the discrepancy is that Sanitas extends the advantageous rates that it had negotiated with suppliers, which are more favorable than those of Generali, to Generali customers in this way.

Biomedicine

Global Health

International Health Policy

  • China
    • What happened in China after the abandonment of the covid zero policy and the massive infection of omicron? The official figures for deaths are 87,475 between February 24 and March 16, 2023. Other estimates speak of between 1-1.5 million deaths. Surely the reality is somewhere in between (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2804631)

National health policy

Companies

 

 

7 days in healthcare (May 8th-14th, 2023(

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Summary

From the point of view of Biomedicine, it is worth pointing out the expanded “pan-genomic” base, which significantly increases the letters of the DNA, which, apparently, will make it possible to improve the typing and treatment of certain diseases. Promising results of mRNA technology in pancreatic cancer. Potential of stool transplants against some bacteria not sensitive to antibiotics.

As far as Global Health is concerned, although covid is no longer a global emergency, the truth is that, as the WHO itself shows, the disease continues to kill and change.

Regarding International Health Policy, it is worth highlighting the great news coming from the British government, which will allow pharmacies to prescribe certain medications, as well as the contraceptive pill. The objective of the measure is to significantly reduce the number of visits to the primary doctor. In France, patients, faced with overloaded doctors, turn to self-medication. Euthanasia is already legal in Portugal. Great battle in Chile between the Boric government and the Isapres (Chilean health insurers). In a bill, the government, in order to respond to an erga omnes ruling (of universal application) of the Courts, proposes the payment by insurers of alleged amounts for overpayments, which would make the model unfeasible. The Association of Isapres has reacted with a harsh note, answered no less harshly by government spokesmen. Health and specifically the role of the Isapres, at the center of the political debate in Chile.

If we talk about National Health Policy (Spain), the most important news is the proposals by various medical associations (IMAS Foundation, FACME, General Council of Medical Associations) for a decalogue of proposals to reform the SNS, which they consider in total crisis, before the next legislature. New governance; new management model; citizen/patient and professional participation; measurement of results and transparency; new care model; digital transformation according to the citizen’s digital clinical history model, are some of the most important measures. We only have to congratulate those responsible for this initiative, which contrasts so much with the limited and timid proposals put forward by the majority political parties. To those parties (PSOE and PP) the proposals were raised in a meeting. The only possible consideration is whether a reform of the public system is possible without mentioning a limited and selective co-payment, the absence of which we are the exception in Europe, as well as the non-consideration of the private sector in that reform. Looking the other way from the private sector has never produced good results. On the other hand, the document emphasizes its proposal for changes in the management and care model, governance, the participation of citizens/patients and professionals, and transparency. But he doesn’t mention financing at all. Although financing as an isolated reform (which is very common to consider) would not solve much, this issue has specific problems. Having made these qualifications, as a whole it is a splendid document, a must-read. The Constitutional Court publishes the ruling declaring the 2010 law on abortion deadlines legal. A study in Catalonia shows that the rich wait less on the lists of Catalan public hospitals than the rest of the population, something that had already been demonstrated in the UK on the NHS. The CEOE-union agreement includes the control of sick leave by Mutual Societies, something whose real scope will have to wait to see its effects. The truth is that absenteeism had increased a lot in recent times.

In the field of Companies, at the international level, drugs for weight loss point to an area of great economic interest for the pharmaceutical industry. In Spain, the most striking thing is Fresenius’s intention to get rid of the part of Quirón in Latin America, as well as the fertility company Eugin. Mutua Madrileña and El Corte Inglés launch medical insurance under the Adeslas brand.

Biomedicine

Global Health

International Health Policy

  • Chili
    • The Boric government against the Isapres (private health insurance companies in Chile). In a bill, the government, in order to respond to an erga omnes ruling (of universal application) of the Courts, proposes the payment by insurers of alleged amounts for overpayments, which would make the model unfeasible. Hard note from the Association of Isapres, which has obtained a no less harsh response from the Government. (http://www.isapre.cl/images/PDF/Declaracion_Prensa_19_abril_VFdocx_1.pdf)

National health policy

Companies

 

 

7 days in healthcare (May 1st-7th, 2023)

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Summary

From the point of view of Biomedicine, to point out the interest in certain therapies using viruses that engulf bacteria to address infections caused by antibiotic-resistant bacteria. Progress continues to be made in breaking the blood-brain barrier, which will make it possible to better treat certain brain tumors, which until now have not been reached by medication.

As regards Global Health, the WHO declares the end of the emergency due to the covid pandemic, although not the covid, which is still with us. Since its inception this disease has caused more than 20 million deaths globally. Gavi reveals his plans for a malaria vaccine, another major global plague.

As for International Health Policy, he has highlighted the rise in the price of tobacco in France (a good measure against smoking), and Australia wants to limit the use of electronic cigarettes. The ECDC brings out an interesting report with the lessons of the pandemic: “More investment, improvement of surveillance systems, improvement of risk communication, community participation and greater participation between countries” could be the summary.

If we talk about National Health Policy (Spain), in the update of the Stability Program 2023-2026, the % of GDP dedicated to public healthcare spending does not change, remaining at 6.9%. It is evident that only increasing spending does not solve the problems of our health system, but it is difficult to see how they can be solved without increasing spending, as the government proposes. The Spanish Association against Cancer, through the mouth of its president, denounces that Spain has the cheapest tobacco in Europe: “the tobacconist of Europe” calls for this situation. Interesting article by Juan Abarca Cidón, who presents a decalogue to avoid the collapse of our health system. The measurements are very clear and direct. It will be possible to qualify or even disagree with some, but there is no doubt that the problems are addressed. Not like the framework programs of the majority parties for the 28-M elections, which seem to try not to raise any suspicion, by saying nothing.

At the Corporate level, at the international level, Lilly presents a new drug that slows down the progression of Alzheimer’s. The birth of a large market linked to Artificial Intelligence in health is in sight, according to the report by Siemens Financial Services. As far as our country is concerned, Cofares reaches a sales record in 2022. Grifols enters the field of leukemia.

Biomedicine

Global Health

International Health Policy

National health policy

  • Interesting article with a decalogue of reforms in our health system
    • Article by Juan Abarca Cidón, the proposals range from a political agreement; increase general spending on health; finalist financing with certain objectives; reduce costs, considering the co-payment; new governance model at all levels; new care organization model with a greater role for nursing; deal with patient problems, such as waiting lists; address the problems of professionals; normalize the activity of the private sector; and promote the Public Health Agency (https://www.elespanol.com/edicion/20230430/decalogo-reformas-evitar-colapso-sanidad/760293970_12.html)

Companies