7 days in healthcare (January 8th-14th, 2024)

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Summary

From the point of view of Biomedicine, it is worth highlighting the first results of the genomic studies of tumors carried out by the British public company, created in Cameron’s time, Genomics England, which will allow new therapeutic orientations in tumors. Certain hopes for patients with schizophrenia, a disease with a limited therapeutic arsenal. A Phase III trial gives promising results. It is expected that the drug can be approved in 2024 by the FDA. The WHO organizes a World Forum on Clinical Trials, establishing the four pillars for their development, which is of special interest to Spain, which is a power in clinical trials, a leader in Europe and only surpassed globally by the United States, China, India and Iran.

As far as Global Health is concerned, the WHO warns that a new pandemic will arrive and it will be more deadly.

In terms of International Health Policy, the growth of total health expenditures in the USA returns to pre-pandemic levels. They rose 4.1% in 2022, while in 2020 they had risen 10.6%. The New England Journal of Medicine publishes an interesting article on the “financialization” (non-financing) of health in the United States, distinguishing this from “corporatization” (the role of large corporations) or “privatization” (greater role of the private sector). “Financialization” refers to the greater role of financial or private equity companies in the healthcare world, in many cases as direct owners of healthcare companies, especially pharmaceutical and insurance companies. The effects of this phenomenon are not yet well analyzed. The FDA approves 55 drugs in 2023, up 48% from the previous year. Of those 55, 28 were intended for rare diseases. The Economist analyzes in an article that the British health system is acquiring a shape similar to that of the 1930s, with a large role of private companies and charities, when Aneurin Bevan created the NHS. It should be noted that the so-called generation Z (between 18 and 24 years old) are the largest users of private healthcare. The EU, through HERA, the body created as a result of Covid, will launch a vaccine development center.

If we talk about National Health Policy (Spain), the Ministry of Health agreed, in the face of the growth of the tripledemic, two measures: the first, the so-called “auto-sick leaves” (sick leaves of up to three days without prior medical report, by the exclusive decision of the worker); and, the second, the mandatory nature of masks in health centers. Both very controversial measures. The first was due to disagreements with the unions, employers and within the government itself, which speaks of improvisation on a very sensitive issue and which forced it to be postponed indefinitely. The second, with opposition from several communities and legal problems in its design. Measures continue to be taken to address problems such as pandemics without the expert advice of an organization such as the Public Health Agency, which has not yet been created, which could possibly have avoided or mitigated some of the problems that the Ministry has encountered. The Catalan government, faced with a growth in pharmaceutical spending, intends to control it with several measures. One of the requests is the transfer of the powers of the Interministerial Price Commission, in order to be able to negotiate the price of medicines with the laboratories at the community level. An issue that could threaten the necessary cohesion of the National Health System. Budgeted public health spending amounts to 89 billion in 2023, 29% more than in 2019, before the pandemic. The unions propose to the Ministry changes in the human resources policy and in the Framework Statute. Given the well-known aversion of unions to differentiation and individual and collective recognition, basic needs of the system, surely the approaches will not be very innovative.

In the field of Companies, on an international level, Goldman Sachs is making its debut in health, with a fund of 650 million dollars, in a line that seems to reinforce the idea of the “financialization” of health, discussed in the article this week from the New England Journal of Medicine. When it comes to national news, the highlight is the upheaval at Grifols, which has lost 3.2 billion euros in five days. After the Gotham Research City report, the company has not been able to convince shareholders of its reliability.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

7 days in healthcare (January 1st-7th, 2024)

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Summary

From the point of view of Biomedicine, scientists celebrate a new antibiotic, currently undergoing Phase 1 clinical trials, that can kill resistant bacteria. The magazine Nature publishes precisely an editorial in relation to the need to encourage the appearance of new antibiotics against resistant bacteria. The problem is that the current business model in the pharmaceutical industry does not introduce incentives to companies for investments in this field. This is why it proposes “push” solutions (strategies to reduce the cost that may include government aid for the initial stages of research) and “pull” (compensating companies that develop successful antibiotics).

As far as Global Health is concerned, we should mention an interesting article in The New York Times about the need to set up a kind of global immune system against multiple health threats. It would consist of a system of detection and immediate action. Great progress towards the objectives in relation to HIV, almost reaching the aspiration of achieving 95-95-95 (95% of patients with HIV, diagnosed; 95% with antiretroviral treatment; and, 95% with viral suppression).

In terms of International Health Policy, Case and Deaton’s theory in the United States of deaths due to despair (alcohol, drugs and suicide) seems to be dismantled, which would affect mainly white American men without university studies and who had reached relate even to Trump’s victory. Recent studies show that these deaths are not limited to this population, but affect all social classes. Also in the United States, the authorization by the FDA of the importation of medicines from Canada by the State of Florida is of great significance. The price is substantially cheaper for these medications than the one currently in force in the USA. Pharmaceutical companies have cried foul, since this is the first time this has happened in the USA. Litigation is more than assured. The tripledemic (respiratory infections of influenza A, covid and RSV in children) is spreading throughout Europe, with Spain and Italy being precisely the most affected countries.

If we talk about National Health Policy (Spain), the Interterritorial Council of the SNS will address next Monday (January 8) the measures against the tripledemic, in particular the possible mandatory nature of masks in health centers, something already imposed by some communities . The overcrowding in hospital emergencies highlights the absence of demand management: more role for Primary Care; less face-to-face activity  and online attention; and more paper for nursing. The El Español Health Observatory makes public a document of proposals for the health system, the result of the symposium held between October 2-5, 2023, with the participation of more than 150 speakers. The common genetics portfolio of the SNS will be presented on January 23, in what appears to be a great advance for the system. The Ministry of Health of Andalusia announces measures against waiting lists, based on what they call “restructuring the bases of activity.” Without a specific budget, trying to act on productivity without adequate management tools and avoiding agreements with the private sector, we dare say that the measures are doomed to failure.

In the field of Companies, on an international level, what stands out as a novelty is that Lilly is entering B2C, launching in the United States a website for direct sales of medicines to the public and even with a direct home delivery service. A very innovative experience, of which we will have to see the results. As far as Spain is concerned, Domus Vi sells five residences.

Biomedicine

Global Health

International health policy

  • USA
    • The theory of “deaths of despair” (Case and Deaton) no longer holds. This theory, which caused a lot of impact, said that in the USA deaths due to despair (alcohol, drugs and suicide) mainly affected whites without university education. This has changed and today it is known that they affect practically all social classes, without special predominance of the groups indicated by Case and Deaton (https://www.economist.com/united-states/2023/12/23/the-deaths-of-despair-narrative-is-out-of-date)
    • The FDA approves the first mass importation of medicines from Canada to Florida. The price is much lower than that of medicines in the USA, pharmaceutical companies are opposed and it is believed that the PhRMA (representative of American pharmaceutical companies) will file an appeal. Florida says it will save $150 million with the program in the first year alone. It is the first time that something like this has happened in the USA (https://www.nytimes.com/2024/01/05/health/drug-imports-canada-florida.html)
    • The rise in rates and costs drives the bankruptcy of healthcare companies. 18 healthcare companies went bankrupt in the last year. (https://www.ft.com/content/65dfbc81-2641-48fa-a40a-647076943194)
  • Europe
    • Europe fights against the tripledemic of respiratory infections. Tripledemic is the coexistence of covid, influenza A and RSV in children. Spain and Italy, the most affected countries. Also Germany and France. The term means that all three infections coexist, not that individuals have more than one disease. In fact, there are few cases of co-infection (https://www.ft.com/content/449c4748-ef63-4f0a-b26e-4e528889fac4)

National health policy

  • Recruitment of doctors in the Basque Country
    • After requiring Basque from doctors, it is now proposed to hire foreigners without requiring it (https://www.eldebate.com/sociedad/20240105/pais-vasco-queda-medicos-imponerles-euskera-ahora-contratara-extranjeros-exigirselo_164608. html – :~:text=The Government of the Basque Country, first time to non-EU personnel.)

Companies

 

 

7 days in healthcare (December 25th-31st, 2023). Happy New Year

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Summary

From the point of view of Biomedicine, 2023 definitely seems to be the year where the great impact of artificial intelligence on health has become completely clear. The example of a stethoscope that incorporates AI and substantially modifies the one invented 200 years ago is nothing more than an example of this great change. Scientific journals explore what 2023 has represented (anti-obesity medications and awareness of the impact of climate change on health, among others), as well as analyze the advances that are foreseen for 2024 (surely the HIV vaccine and the cure cholesterol, among many others).

Regarding Global Health, The Lancet dedicates its last issue of 2023 to exposing a series of photos related to health experiences in Nigeria.

Regarding International Health Policy, an interesting article in JAMA magazine that will cause controversy: it relates the increase in medical errors in American hospitals to their acquisition by private equity companies. It is one year since the end of the covid-zero policy in China and the Financial Times analyzes how that experience is remembered in that society.

If we talk about National Health Policy (Spain), our country says goodbye to 2023 with the experience of three different Ministers of Health (Darias, Miñones and now García). It is evident that this dance of ministers (in 45 years there have been 28 Ministers of Health) can guarantee, in the best of cases, the continuity of the “ordinary administration”, but not the promotion of large renewing projects of change. SESPAS asks the Ministry to launch the Public Health Agency in 2024. The Ministry of Health of the Regional Government of Andalusia has experienced a serious crisis that led to the resignation of both the Vice-Minister and the Manager of the SAS. It seems that the underlying issue was the approach to addressing the waiting list and the involvement or not of the private sector in that resolution. If so, regardless of the anecdote of this moment, what it reflects is a very deep problem: the absence of a clear policy towards the private health sector on the part of the Popular Party. Madrid wants to promote a pharmaceutical hub, an issue in which Catalonia is by far in the lead.

In the field of Companies, on an international level, the great growth of the hair transplant market stands out, which already moves 8.7 billion euros annually. It seems that it is a nascent industry, but on the rise. The fever of anti-obesity drugs has meant that there are now 188 candidates, of which 25 are in advanced phase (III or IV). When it comes to national news, the fever of corporate operations in hospitals continues. Ribera, Quirón, Viamed and Vithas, the great protagonists.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (December 18th-24th, 2023)

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Summary

From the point of view of Biomedicine, among the “star drugs” of 2023, the first drug based on CRISPR technology, from the North American company Vertex Pharmaceuticals, stands out.

Regarding Global Health, the WHO classifies a new variant of covid which it calls JN.1, which is characterized by its wide spread, although low risk.

Regarding International Health Policy, the New York Times summarizes the measures proposed in the United States to avoid drug shortages in pharmacies, after extensive discussion in Congress. Among the many measures, manufacturing by the government is considered, something that is also being considered in our country.

If we talk about National Health Policy (Spain), the news of the week was the appearance of the report on the management of covid, after months of waiting, after the commission in October 2021. The conclusion reflected by the press, which is a summary of the report, is that Spain was not prepared for the pandemic and the success of the vaccination campaign. However, and regardless of the prestige of the selected experts, it could be questionable that they were appointed by the government, compared to the possibility of having institutions (SESPAS, FACME, etc.) to appoint their own experts. Some comments on the report: although it is said that Spain had more mortality than other countries, there are no figures, no tables, nor is it specified which countries we are referring to; insufficient attention is given to the flagrant legal breaches, which led the Constitutional Court to declare the confinements illegal; at no time is there talk of serious problems and corruption in the purchase of materials; mortality among professionals is not quantified or given sufficient importance; although mortality in residences is discussed, the problem is not explained in detail or analyzed and a table comparing mortality in the different autonomous communities is not presented; although the need for the Public Health Agency is insisted upon, it is not specified what that Agency should have so that it would be comparable to others in other countries (Robert Koch, in Germany, for example) and avoid a “watered down” formula, such as which seems to be underway; finally, it is very striking that, among the proposals, there is none related to the production of materials (equipment and medicines) in Spain, precisely to achieve the “extended strategic autonomy”, of which the EU speaks.

In the field of Companies, on an international level, there is a change of leadership in the best-selling drug, Abbie with Humira, passes the baton to Keytruda, from MSD. In terms of national news, Abanca is preparing to launch its own health insurance, which highlights the attractiveness of this market.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

7 days in healthcare (December 11th-17th, 2023)

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Summary

From the point of view of Biomedicine, CRISPR therapy, which begins with sickle cell anemia, is great hope. In the end, the FDA approves two gene therapies for this disease, which affects 7.7 million people globally and is a chronic, debilitating disease that causes pain and reduces the quality and expectancy of life. New approved therapies include extraction, genetic modification and reinfusion into patients of their own hematopoietic stem cells. The problem is that these patients live mainly in sub-Saharan Africa and India, which are far from having the infrastructure to apply this therapy. The price of these therapies is about 2 million euros per patient, which again raises the problem of the problems of universalization of precision medicine. Ozempic, Alzheimer’s drugs and malaria vaccines among the scientific milestones of 2023 for Science magazine. For its part, Nature magazine chooses a non-human among its scientists of the year: ChatGPT.

As far as Global Health is concerned, in the end, an international agreement is reached on the end of fossil fuels. COP28 was the first global conference on the subject after the Paris agreement in 2015 (COP21) in which a global limit to temperature growth was established at 1.5º. On December 13, 2023, the agreement on net zero emissions by 2050 will be reached. Fossil fuels generate a lot of wealth, but they are also the bulk of CO2 emissions. The problem is that there is no system that forces governments to meet that objective. A global treaty on plastics is proposed by the United Nations General Assembly (March, 2022). Plastic pollution is a global threat, since plastic is persistent and less than 10% is recycled, almost 6 billion tons now pollute the planet. This contains more than 10,500 chemicals, which includes carcinogens, neurotoxicants, etc.

Regarding International Health Policy, design by the European Union of a Plan to avoid shortages of more than 260 critical medicines, which includes storage and incentives for production

If we talk about National Health Policy (Spain), one in ten Spaniards on the waiting list, record numbers in health. At this moment there are 820,000 people to undergo surgery, a figure never reached. The Ministry of Health wants to raise this problem with the communities at the in-person meeting of the Interterritorial Council in Asturias on December 21. In theory there are two solutions: either self-concertation (the disdainfully called “peonadas”) or agreements with the private sector. In both cases money is needed. It is also necessary to review the indications, circuits and priorities. The CIS Barometer is released (3rd wave, October 2023). 57.5% value positively the functioning of the National Health System, which means a great setback with respect to previous editions. In an article in El País whose first signatory is Félix Lobo, it is proposed to strengthen the Ministry of Health. In 45 years there have been 28 ministers. And organizations with a clear health component have been separated from the Ministry, such as the Carlos III Health Institute, the Government Delegation for the National Drug Plan and the Food Safety and Nutrition Agency (AESAN). Although this reinforcement is necessary, it must surely be complemented with what we could call “cohesion bodies”, among which could be HISPANICE, also proposed by FUNCAS.

In the field of Companies, on an international level, Cigna renounces creating a health insurance giant in the USA, by becoming part of Humana. AstraZeneca enters the world of vaccines. Regarding national news, Quirón advances in the construction of its hospital in Gijón (Asturias) and receives from the Ministry of Defense the management of the hospital on Isaac Peral Street (former Generalísimo Franco), closed for more than 30 years. Good results from Miranza and Ribera, the latter contemplating three new projects.

Biomedicine

Global Health

International health policy

National health policy

  • Waiting lists
    • One in ten Spaniards on the waiting list, record figures in healthcare. At this moment there are 820,000 people to undergo surgery, a figure never reached. The Ministry of Health wants to raise this problem with the communities at the in-person meeting of the Interterritorial Council in Asturias on December 21. In theory there are two solutions: either self-concertion (the so-called “peonadas”) or conciliation with the private sector. In both cases money is needed. It is also necessary to review the indications, circuits and priorities (https://www.eldiario.es/sociedad/diez-espanoles-lista-espera-cifras-record-sanidad-quiere-atajar_1_10708957.html)
  • It is proposed to strengthen the Ministry of Health
    • In an article in El País whose first signatory is Félix Lobo, it is proposed to strengthen the Ministry of Health. In 45 years there have been 28 ministers. And organizations with a clear health component have been separated from the Ministry, such as the Carlos III Health Institute, the Government Delegation for the National Drug Plan and the Food Safety and Nutrition Agency (AESAN) (https://elpais.com/society/2023-12-11/potenciar-el-ministerio-de-sanidad.html)

Companies

 

7 days in healthcare (December 4th-10th, 2023)

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Summary

From the point of view of Biomedicine, Nature magazine analyzes the clinical trials that will shape medicine in 2024, including genetic editing for hypercholesterolemia; AI for early diagnosis of lung cancer; HIV vaccines; stem cells for Parkinson’s; the use of machine learning for patient triage; conjugated antibodies for brain metastases; and, computed tomography for lung cancer screening. The New England Journal of Medicine analyzes whether clinical trials with xenotransplants should be “liberalized” in the absence of human donors, especially in the United States.

Regarding Global Health, at COP28, 124 countries, including Spain, sign a Declaration on Climate and Health. It remains surprising, however, that the president of the COP28 meeting, held in Dubai, is the president of that country’s state oil company, which did not stop expressing its skepticism regarding decarbonization actions. On the other hand, populist leaders around the world (Wilders, Milei, Bolsonaro, Trump) have made climate change denial an electoral platform. Decline of AIDS worldwide, particularly in sub-Saharan Africa.

In terms of International Health Policy, the White House creates an Office for the Prevention of Firearm Violence. Large drop in state health insurance policyholders in China, the largest health insurance organization in the world. In the United Kingdom, the Tony Blair Institute for Global Change analyzes the high and increasing cost of being overweight. Many Britons, despite their adoration of the NHS, choose to pay for certain interventions and procedures, in order to avoid the waiting list. In that country, this form of payment for certain actions is more common than insurance, which is expensive in Britain. Germany announces a plan to strengthen the pharmaceutical industry. It seems that the promotion of research and production in the country will be the main axes. The European Union definitively approves the AI law, the first law in the world on this subject. Without a doubt, it will have a great impact on health.

If we talk about National Health Policy (Spain), after the constitution of the writing team appointed by the Ministry of Health in October 2021, 2023 is about to end without the official report on the management of the pandemic having been made public, which which puts us behind many countries that have already published analyzes and reports. On the other hand, it does not seem that, contrary to what was done in other countries, such as the United Kingdom, where even Boris Johnson had to appear, the Spanish commission has sought the opinion of many actors. Surely the delay in publication could come from the problems of managing the pandemic in our country: two confinements declared unconstitutional by the Constitutional Court, delay in decision-making, high mortality figures at the beginning, high mortality among professionals, serious problems in purchasing supplies, etc. The Minister of Health takes her first steps, having to face in the coming weeks the problem of the lack of doctors in Primary Care. In Asturias, the autonomous community will dedicate 57 million extra hours for professionals to address the problem of waiting lists. A measure that seems reasonable and that overcomes the criticism of the so-called “peonadas”, as if activity in the public sector could not be controlled.

In the field of Companies, on an international level, Roche is jumping on the obesity bandwagon, following moves in this direction by NovoNordisk, Lilly and AstraZeneca. In our country, Ribera is finalizing the purchase of IMSKEN, an important trauma hospital in Valencia. The bankruptcy administrator and creditors are demanding the seizure of KKR, which they accuse of the bankruptcy of Dentix.

Biomedicine

Global Health

International health policy

  • China
    • The Chinese state health insurance, the largest in the world with 1.3 billion insured, loses tens of millions of members. In 2022, 19 million people were no longer covered, an unprecedented drop. It is blamed on the rise in premiums and co-payment increases and the decline in household income, https://www.ft.com/content/0ef68e30-bbe7-4b6e-8d17-479a552be994

National health policy

  • Lack of professionals in Primary Care

Companies

7 days in healthcare (November 27th-December 3rd, 2023)

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Summary

From the point of view of Biomedicine, the New England Journal of Medicine begins a series on the usefulness of wearable technology, the set of devices or instruments that are worn and transmit information about health, which could be useful in monitoring , diagnosis and treatment of various diseases or clinical situations. There is every impression that this technology will be part of the future and what the NEJM intends is to clarify its usefulness and indications in various diseases and specialties, starting with diabetes. Regarding CAR-T therapies, until now used in hematological processes, it is envisioned that they could also be useful in solid tumors.

Regarding Global Health, great prominence of the issue of health in the COP28 meeting, from two perspectives: the reduction of CO2 emissions, which can be harmful to health; and the emissions from the health system itself, which is a major polluter. It is confirmed in a new and extensive study carried out in Australia that the younger generations have worse mental health.

Regarding International Health Policy, in the United States an executive order by President Biden on AI, not specifically directed at the health sector, will, however, have an impact on this sector and the Ministry of Health is already preparing specific regulations. In China, it seems to be ruled out that the increase in respiratory infections is due to a new virus, but rather to common bacteria and viruses. The United Kingdom’s genetic database, UK Biobank, is about to reveal results, which seem to have an impact on new therapies. In France the price of a pack of tobacco is rising, despite this country’s failures in the fight against smoking. The new conservative government of New Zealand annuls the 2022 law, which prohibited the sale of tobacco from 2027. Austria launches a new health reform, which reinforces the digital route as access to the health system. Concern of several health groups in Argentina, given the health announcements of the new president-elect, Javier Milei.

If we talk about National Health Policy (Spain), the government of the Generalitat of Catalonia reactivates the results center, a model initiative in terms of transparency in the health sector, which had been largely paralyzed since the “procés”. All the data until 2022 has already been presented. Biosim demands new forms of purchasing and management adapted to biosimilars. Problems in the last research institute recognized by the Carlos III Health Institute, that of Asturias. Strong tensions for months between the management of ISPA (the Health Research Institute of the Principality of Asturias) and FINBA, a Foundation with a majority of private companies, which seeks to exercise control over ISPA. Unusual proposal from the Catalan medical colleges, which aims to introduce a “quota” for non-Catalans who aspire to study medicine in Catalonia.

In the field of Companies, on an international level, AstraZeneca is allying itself with AI Biologics. The linking of pharmaceutical companies with AI companies seems to be a general trend. At the national level, Vivanta confirms an ERE.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

7 days in healthcare (November 20th-26th, 2023)

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Summary

From the point of view of Biomedicine, in the United Kingdom an initiative aims to be able to produce medicines for individual patients in less than a year. According to the National Bureau for Economic Research (NBER) of the United States, artificial intelligence, even with use cases already developed, will produce savings in healthcare expenses between 5-10%. This will offset the rise in other expenses in the sector, such as new medicines and medical technologies.

As far as Global Health is concerned, there is a relationship between the pattern of economic income and obesity, which occurs more in low-income workers, in relation to those with higher incomes. The fight against climate change has already produced some results. The COP28 conference, which will take place starting next week in Dubai, is expected to produce a declaration on climate and health. Polio is about to be eradicated in a few months, but the great challenge is that it does not return, since eradication is not the same as extinction.

Regarding International Health Policy, in its latest issue The Economist dedicates a supplement to forecasts for 2024. Among the 10 general forecasts, there is one that says that in an older world, health expenditures will grow to reach one tenth of global GDP. Among the specific health forecasts, it is noted that the pandemic has led to a growth in public spending on health (up to 80%, starting from 75%). Growth in private activity and an increase in the global pharmaceutical market is expected, with research efforts concentrating on medications against obesity and mRNA patents. In the United States, there is evidence of the inadequacy of private health insurance to provide financial security to the elderly for long-term care. Important agreement in the United Kingdom between the NHS and pharmaceutical companies, with which an annual growth in spending on medicines of 4% is agreed until 2027. Surely, an example for many countries, including Spain. Also in the United Kingdom, an agreement between the NHS and community pharmacies for the provision of a series of services, which will mean a large reduction in consultations in Primary Care. The health insurance boom in the United Kingdom, due to the problems of the NHS, is revealing certain limitations of private health insurance to meet demand. Something similar to what happens in Spain. Important document from the WHO (European region) and the Observatory on health systems, in which several governments participate, including the Spanish one, talking about the convenience of the participation of the private sector in the public health service, establishing the requirements for this to be successful. European countries warn of the health problems of climate change, since Europe is the continent in which temperatures have risen the most.

If we talk about National Health Policy (Spain), new change in the Ministry of Health. Going to minister for a year or less does not seem like the best formula to address the long-term challenges of healthcare, without prejudice to the qualities of the new minister, which will have to be observed. Record in the waiting list, after the publication of the lists as of June 30 by the Ministry of Health. Important study on obesity in Spain published by the Carlos III Health Institute and AESAN, which demonstrates the relationship between the level of obesity and the postal district. A study by the Institute of Fiscal Studies shows that between the beginning of 2020 and the end of 2022, the number of doctors in the SNS has decreased by 17,000, despite the fact that the number of staff has increased globally. The Valencian Community launches a specific competition for positions that are difficult to fill. Aside from the approach of the tender, it is good that the specificities of this type of places are taken into account. There is no doubt that the standardizing approach to personnel policy does not allow us to solve certain problems, such as what are now called difficult-to-fill positions. Farmaindustria carries out, in collaboration with scientific societies, a study on clinical research in Primary Care. We are a powerhouse in clinical research in hospitals and there is no doubt that the bases of this success must be extended to other environments.

In the field of Companies, on an international level, problems in Bayer with a sharp drop in the stock, which the CEO of this company attributes to a limited pipeline, a consequence of a lack of effort in investment. At the national level, Vithas confirms its new hospital project in Valencia. For its part, Sanitas announces an investment to grow in nursing homes.

Biomedicine

Global Health

International health policy

  • European Union
    • European countries warn of the health problem of climate change. It is estimated that last summer there were 62,000 deaths in Europe due to heat, since this is the continent with the highest temperature rises. 18 member states ask the European Commission and ECDC for action (https://www.ft.com/content/52e71922-d9fc-49b6-98b5-3a4d37c21dbc)

National health policy

Companies

 

7 days in healthcare (November 13th-19th, 2023)

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Summary

From the point of view of Biomedicine, The Economist speculates in an article about whether certain regenerated neurons of the dentate gyrus could reverse Alzheimer’s, based on studies in mice. AI, useful in improving the detection of breast cancer.

Regarding Global Health, the WHO points out the rebound in measles worldwide. The number of cases and, above all, mortality are increasing a lot.

In terms of International Health Policy, the United Kingdom encourages the EU and the USA to join its “subscription model” for the development of antibiotics. In practice, it introduces a system of incentives for pharmaceutical companies not linked to the sale of the drug, which can be useful if new antibiotics against resistant bacteria are intended to be of low use. The King’s Fund (an important British health think tank) launches a study in which it analyzes in great detail the inequities in waiting lists. Without a doubt interesting reading in our country. In France, the SNCF (equivalent to our RENFE) launches an interesting initiative to alleviate the problem of medical deserts: build telemedicine centers near the stations.

If we talk about National Health Policy (Spain), the confrontation between private doctors and insurers continues. Without a doubt, the problems of personnel policy do not only occur, as some might think, in the public sector. They also occur in the private sector. The Ministry of Health calls the comments about the transfer of the MIR to certain communities hoaxes. The problem is that this issue appears in the investiture agreements. Success of the PRAN (the plan to reduce antibiotic consumption), obtaining good results in our country, despite continuing to be one of the countries with the highest consumption of antibiotics, both in humans and in veterinary medicine.

In the field of Companies, on an international level, the sale of obesity drugs could be a great boom and reach 100 billion dollars in 2030. On a national level, Quirón is advancing in the approach of building its new hospital in Gijón. Sanitas-BUPA buys a Turkish insurer. The bankruptcy administrator blames KKR for the bankruptcy of the dental company Dentix.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

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

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Summary

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

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

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

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

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

Biomedicine

Global Health

International health policy

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

National health policy

Companies