Posts

7 days in healthcare (February 19th-25th, 2024)

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Summary

From the point of view of Biomedicine, the mega-study of 250,000 genomes made public by the National Health Institutes of the USA stands out. This is in line with carrying out genome studies combining it with electronic medical record data from very large groups initiated in the United Kingdom by Genomics England and also developed in Iceland and Japan. A very promising way to improve knowledge of many diseases. New treatments for type 1 diabetes, based on the transplant of insulin-producing beta cells, obtained from stem cells, neutralizing the immune reaction. Gene therapy is the great promise for many rare diseases, currently without treatment. The problem to be solved is the high price of the treatments. At the present time, saying breast or prostate cancer is almost saying nothing. The treatment of tumors is no longer based on their anatomical origin, but rather on their molecular characterization. Bispecific antibodies that act on two targets at the same time, useful in hematological and solid tumors. The FDA approves a drug to prevent the amputation of fingers and limbs.

As far as Global Health is concerned, long covid was understood as a sequel to covid, but an article in The Economist states that covid is not the only infectious disease that leaves pathological conditions that are difficult to label. An article in Health Affairs places the solution to the obesity epidemic as a joint effort of prevention and treatment.

In terms of International Health Policy, more than half of USA’s rural hospitals do not offer childbirth services, which means that pregnant women have to be treated in centers located 30-40 minutes from their home, sometimes more. This is related to the high maternal and infant mortality in the USA, higher than that of most developed countries. The 4th anniversary of Brexit encourages the debate about whether it was good or bad for the National Health Service. The truth is that the NHS is worse now than before Brexit (waiting lists, professional strikes, etc.) and the difficulty of recruiting health professionals from the EU has increased. The investigation was also damaged. Increasing funding for the NHS was one of the arguments used by Brexiteers. France addresses the carbon footprint in the health system, within the general “France Nation Verte” program. Germany legalizes recreational cannabis, with one of the most liberal laws in Europe, after Malta and Luxembourg. More than controversial attempt in Germany to take control of non-communicable diseases from the Robert Koch Institute, one of the most prestigious organizations in German health, to give it to another organization, created as a result of covid. The European Medicines Agency recommends approving a drug against ALS.

If we talk about National Health Policy (Spain), as a result of a specific scandal, the entire problem of purchasing masks and other materials during covid is introduced into the national debate. Precisely everything related to the purchase of these materials was somewhat overlooked by the report “Evaluation of the Performance of the Spanish National Health System in the face of the covid-19 pandemic”, dated April 30, 2023, although published by the Ministry of Health in December of that year. It is already serious that an issue such as the problems of purchasing materials are not analyzed in the report, as if this had not been one of the most serious problems in the management of covid. The PNV requests the return of the text of the Public Health Agency law. That this law was going to have problems with the nationalist parties, always opposed to the creation of cohesion bodies in the National Health System, was something known. Surely this will mean delays in the appearance of the law and, what may be more serious, affect its content and functions. There is a risk that the announced Agency will be little more than an empty shell. The government creates the Extreme Temperature Observatory to analyze the health impact of climate change. The Basque Country approves a new Mental Health Plan 2023-2028. The EU denounces the high level of interim contracts in the Spanish public health system. At the current time, 43% of contracts are interim.

As for Companies, internationally, AstraZeneca reveals successes in the treatment of lung cancer. Indian drugmakers make versions of Novo Nordisk’s anti-obesity drug. At the national level, Sanitas intends to open a new hospital in Barcelona. Fever of construction of private hospitals in Valencia: Vithas, Quirón, IMED and Ascires in that race.

Biomedicine

Global Health

International health policy

  • United Kingdom and the National Health Service
    • Brexit and health. January 31, 2024 was celebrated as the 4th anniversary of the United Kingdom’s effective departure from the European Union. The Lancet asks whether or not that was good for the NHS, with two possible answers: the easy one, which says there is no evidence; and the difficult one, which confirms that the NHS is in fact worse now than before, as demonstrated by the long waiting lists and the continuous strikes by health professionals. What is certain is that it has become difficult to recruit doctors from the EU. At present, the majority of foreign doctors hired in the NHS are from outside the EU. Research plans were also negatively altered. (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00157-0/abstract)
    • The government changes its policy and plans to double the number of medical students in 2031 (https://ground.news/article/government-u-turn-on-plans-to-double-number-of-medical-students-in-england)

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 (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 (April 25-May 1, 2022)

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Summary

From the point of view of biomedicine, to highlight the evolution of acute hepatitis in children; Lilly’s announcement of a drug to tackle obesity that could compete with bariatric surgery; and the analysis of the New England Journal of Medicine on the “boosters” for covid.

As far as Global Health is concerned, we again quote Bill Gates, who is publishing a new book on pandemic prevention. Great concern about the resurgence of measles, yellow fever and polio in Africa, due to the low levels of vaccination against these diseases, given that resources have been largely diverted to covid.

As for international health policy, the problems of the “zero-covid” policy in China continue, which threatens the global economy, due to the closure of the largest port in the world: Shanghai. It seems increasingly clear that for political reasons this “zero-covid” approach will not change until the approval of a third term for its leader Xi. Also noteworthy is the very serious discrediting of the National Health Service in the United Kingdom, which until now had been the object of almost religious veneration.

If we talk about national health policy (Spain), the incidence of covid continues to increase, particularly in some regions (Galicia, Navarra, Asturias and Castilla y León). The Health Advertising Law was not approved by Parliament, which is not necessarily bad news, since it was largely part of the confrontation between the College of Dentists and the dental care networks. The announced strike of doctors in Madrid, regardless of its results, has its origin in a very serious problem: the very high rate of temporary employment (more than 50% of doctors in the public system in Madrid). Very interesting statements by José Ramón Repullo, proposing national accreditation and hiring at the local level.

In the field of companies, from the international point of view, certain possible disruptive changes for the pharmaceutical industry should be highlighted: 3D printing, which would allow the “manufacturing” of medicines in a clinical environment; and the movements of Amazon for the sale of prescription drugs.

Biomedicine

Global Health

International health policy

  • COVID-19

o Serious problems continue in China with the “zero-covid” policy. The general impression is that the rhetoric of war does not help to defeat covid (https://www.economist.com/leaders/2022/04/30/chinas-martial-rhetoric-will-not-help-it-defeat- covid), while the global economic implications of the closure of Shanghai persist, the largest port in the world (https://www.epe.es/es/internacional/20220429/estrategia-covid-cero-china-dessolucion-inflacion-13586353)

o The “zero-covid” policy in China, a great personal bet of the leader Xi and difficult to be modified before his re-election for a third term (https://www.ft.com/content/33b7fcb2-bc88- 4a76-9b81-d561deaabc5c)

o Covid cases on the rise in virtually all of the United States (https://www.nytimes.com/2022/04/29/world/coronavirus-cases-us.html)

  • Other issues

o The FDA, about to ban menthol cigarettes. They are the most used among the black population (https://www.nytimes.com/2022/04/28/health/menthol-ban-fda.html)

o Very serious loss of prestige of the National Health Service, which is ending an almost religious adoration of this body in the United Kingdom. A survey says that global satisfaction dropped to 36%, something never known. Poor staff planning among major problems (https://www.economist.com/britain/2022/04/28/the-nhs-is-in-seriously-poor-shape)

National health policy (Spain)

  • COVID

o The cumulative incidence among people over 60 years of age continues to rise, reaching (April 29) 676.43 cases per 100,000 inhabitants in the last 14 days, an increase of almost 70 points compared to the previous measurement. Occupation rate due to covid: 5.12% in the ward and 3.66% in the ICU (https://www.consalud.es/pacientes/especial-coronavirus/covid-19-espana-notifica-62695-casos-229- deceased-ia-exceeds-676-points_113987_102.html)

o The Ministry of Health reports almost 2,000 deaths in April, the first full month of “flu” from covid (https://www.elespanol.com/ciencia/salud/20220430/sanidad-notifica-muertes-primer-completo- flu-covid/668683313_0.html)

o Increase in the incidence of covid grows by 35% after Easter and there are already four regions with the unbridled incidence (Galicia, Navarra, Asturias and Castilla y León) (https://www.elespanol.com/ciencia/salud/20220428 /revenues-covid-semana-santa-ccaa-incident-runaway/668183406_0.html)

o The Ministry of Health will authorize the fourth dose for those over 80 years of age and those who live in residences, a total of about 3 million people (https://www.lavanguardia.com/vida/20220425/8219507/sanidad-autorizara- fourth-dose-vaccine-covid-older-80.html)

  • Regulatory announcements

o The Health Advertising Law presented by the PP fails, which is regretted by the professional associations, in particular that of dentists. Apparently, the Government is preparing a Royal Decree on the subject (https://www.diariofarma.com/2022/04/28/el-congreso-desestima-la-ley-de-publicidad-sanitaria-del-pp)

  • Other issues

o Madrid hospital doctors go on strike over temporary contracts (https://www.epe.es/es/sanidad/20220429/medicos-hospitales-madrid-huelga-contratos-temporales-13587639)

o Interesting statements by José Ramón Repullo regarding the temporality of doctors and health professionals and their non-solution through the OPEs. He proposes national accreditation and contracting by centers, as exists in other countries (https://elpais.com/espana/madrid/2022-04-30/la-temporalidad-de-los-medicos-es-el-resultado -of-a-bad-system-worse-governed.html)

o Cases of severe hepatitis in children in Spain rise to 22 (https://www.lavanguardia.com/vida/20220429/8233030/hepatitis-aguda-ascienden-22-casos-espana.html)

o 700,000 Spaniards on the surgical waiting list, the worst figure in the history of public healthcare (https://www.elespanol.com/espana/20220501/espanoles-lista-espera-quirurgica-historia-sanidad-publica/668683270_0. html)

o Núñez Feijóo calls for the creation of the emergency specialty, with the argument of preventing primary care professionals from leaving (https://www.consalud.es/autonomias/galicia/feijoo-pide-creacion-urgencias_113617_102.html)

o Facme presents the Spanish recertification model (https://www.diariofarma.com/2022/04/22/facme-presenta-el-programa-espanol-de-recertificacion)

o Five communities (Extremadura, Aragón, Baleares, Comunidad Valenciana and Navarra) ask AIReF to evaluate their healthcare and pharmaceutical spending (https://www.diariofarma.com/2022/04/26/cinco-ccaa-piden-a- the-airef-assess-your-health-care-and-pharmaceutical-expenditure)

o Very interesting article by José Luis Puerta: “Data saves lives”, on the need to overcome the situation in which the custodians of the data are not capable of exploiting them, nor do they allow third parties to do so (https://www.diariomedico .com/opinion/data-saves-lives.html)

Companies

  • International News

o Possible disruptive changes for the pharmaceutical industry (http://gestionclinicavarela.blogspot.com/2022/04/aires-de-disrupcion-en-la-industria.html?utm_source=feedburner&utm_medium=email): volumetric 3D printing that would allow drugs to be “manufactured” in a clinical setting (https://www.sciencedirect.com/science/article/abs/pii/S2214860422000781) and Amazon Prime’s offer to facilitate basic drugs for $1 a month (https://www.reuters.com/business/healthcare-pharmaceuticals/amazon-pharmacy-offers-half-yearly-prescriptions-starting-6-2021-06-08/)

o Roche sales soar in the United States due to the demand for covid tests (https://www.ft.com/content/ed5f4f64-4fa6-4663-bc75-8860bb1ad997)

o Investors pressure Nestlé and Kraft Heinz to target health (https://www.ft.com/content/545651c2-c408-4cad-b724-698ed896ee89)

o Philips records losses of 151 million euros in the first quarter of 2022 (https://www.plantadoce.com/empresa/philips-registra-unas-perdidas-de-151-millones-de-euros-en-el -first-quarter-of-2022.html)

o Abbie strengthens its neurosciences portfolio and acquires Syndesis Therapeutics (https://www.plantadoce.com/empresa/abbvie-strengthens-its-neurosciences-portfolio-and-acquires-syndesi-therapeutics.html)

  • National News

o Lácer attracts the interest of venture capital funds (https://www.expansion.com/empresas/distribucion/2022/04/29/626afa0de5fdeaa9578b45a2.html)

o Grifols closes the purchase operation of its German rival Biotest (https://cincodias.elpais.com/cincodias/2022/04/25/companias/1650876940_315447.html)

o Faes Farma profit grows 24% thanks to licenses and the Latin American market (https://www.eleconomista.es/pais_vasco/noticias/11743403/04/22/El-beneficio-de-Faes-Farma-crece -a-24-thanks-to-the-licenses-and-the-latin-american-market.html)

o Senniors disembark in Abu Dhabi with the support of the country’s sovereign wealth fund (https://www.plantadoce.com/empresa/senniors-desembarca-en-abu-dabi-con-el-apoyo-del-fondo-soberano-del -country.html)

o Quirónsalud launches a new rehabilitation center in Ronda de Triana (https://www.plantadoce.com/empresa/quironsalud-pone-en-marcha-un-nuevo-centro-de-rehabilitacion-en-ronda-de -triana.html)

o Hospitales Parque (CASER) accelerates in 2021 and raises its income by 46%, up to 58 million euros (https://www.plantadoce.com/empresa/hospitales-parque-acelera-en-2021-y-eleva-un -46-your-income-up-to-58-million-euros.html)

o Asisa strengthens Otoaudio and opens its first center in Seville (https://www.plantadoce.com/empresa/asisa-refuerza-otoaudio-y-abre-su-primer-centro-en-sevilla.html)

o Asisa Dental opens its first own clinic in the Canary Islands in Las Palmas (https://www.consalud.es/ecsalud/nacional/asisa-dental-abre-palmas-clinica-canarias_113952_102.html)