Posts

7 days in healthcare (March 11th-17th, 2024)

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Summary

From the point of view of Biomedicine, a revolutionary blood test stands out that manages to detect colon cancer in early stages and, consequently, reduce the number of deaths. Early diagnosis of this cancer can prevent most deaths, possibly 73% of them. But this requires regular screening in adults. There are two options: colonoscopy every ten years or fecal test every three. Both are unpleasant procedures, the first involving the introduction of a tube into the rectum and the second manipulating the stool itself. But something much simpler is on the horizon: a simple blood test. AI can revolutionize clinical trials, a fundamental basis for the progress of medicine. Just as Moore’s law was known in computing (the information capacity in a circuit grew every two years and at a lower price), in clinical trials in 2012 Eroom’s law was defined, which is just the opposite, since in the 60s In previous years, the number of drugs placed on the market per 1 billion invested was reduced by half every nine years. Half of this time and money was dedicated to clinical trials. AI can disrupt this law by helping to manage clinical trials, including developing protocols, recruiting patients, and analyzing data.

As far as Global Health is concerned, alterations of the nervous system are the most frequent cause of poor health. Neurological diseases such as stroke, dementia and migraine constitute the largest global cause of disease burden. This is related to increased life expectancy. However, if we adjust the data with age, we see that between 1990 and 2021, the number of neurological problems decreased by 27% and the number of deaths by 34%, in that 31-year period. Impressive Egypt success story with hepatitis. In Egypt at the beginning of the 20th century, most of the population worked on farms in contact with the Nile, a source of schistosomiasis, which affected 60% of the population. A treatment was implemented, but without single-use needles. This generated a very high prevalence of hepatitis C, which was reduced in just a decade from 2014. The secret was the free tests and treatment for everyone, with Gilead medication, after having negotiated the price with this company.

In terms of International Health Policy, the NEJM analyzes the effects of vertical integration in American medicine. Vertical integration (purchase of medical practices by hospitals) is unstoppable in the USA. We don’t know the consequences well. In theory it should improve coordination, facilitate the exchange of information and develop economies of scale. But, in practice, what has been seen is an increase in prices. It is urgent to study the consequences of this phenomenon. Macron, after a broad national debate, which included a citizens’ convention, supports the law on the end of life, which must still be approved in Parliament. An impressive debate took place in France on this topic for several months, just the opposite of what happened in Spain where such a transcendental issue was processed as a bill (avoiding the opinions required by the bills) and with hardly any national debate, as if it were a question of modifying the VAT on some product. Agreement in the EU for the regulations on the European Health Data Space, which will allow access to clinical information to any EU patient in all the countries of the Union, as well as the use of this information for research. A great step that, however, will take time to implement, given the very different and heterogeneous development of healthcare digitalization in EU countries.

If we talk about National Health Policy (Spain), the debate continues on the purchase of masks during the pandemic, another example of the more than deficient management of Covid-19 that occurred in Spain. The Minister of Health presents her plans in the Senate. Ambitious battery of health measures: mental health; Public Health Agency; climate change; smoking, sexually transmitted diseases; waiting lists, among other issues. We will see how this agenda progresses, since changes in healthcare are never easy. The health insurers involved in MUFACE (Adeslas, Asisa and DKV) request a renewal of the contract admitting 20% less of the public sector capital without pharmacy, which would mean an increase of 50% on the current capital. They also ask for some system of indexing the capital to the evolution of the public sector. Possibly the extension of the budgets represents an obstacle to the renegotiation of the agreement. Interesting initiative: the Council of Ministers approves a commercial pioneer of advanced therapies with public/private capital, whose promoter and shareholder is the CDTI (50% of the shares), as well as Insud and Rovi (25% each of them). The goal is to develop advanced therapies. It is included in the PERTE and, together, will mobilize 74 million euros.

As for Companies, internationally, recovery of mergers in the pharmaceutical industry in 2023. Psychedelic therapies, in the focus of investors. At the national level, AstraZeneca’s big commitment to Catalonia, where it will invest 1.3 billion until 2027.

Biomedicine

Global Health

International health policy

  • USA
    • The unknown health of the candidates for President in the USA. Everything is based on speculation. There is no official system to know the real health situation of either the presidents or the candidates. An attempt to create an expert body on the topic failed as recently as 2017 (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00528-2/fulltext?rss=yes)
    • The Lancet analyzes Biden’s health priorities in the State of the Union address. Commitment to women’s reproductive health; lowering drug prices, expanding Obamacare, preventing gun violence, among the most important priorities (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00529-4/abstract?rss=yes)
    • The effects of vertical integration in American medicine. Vertical integration (purchase of medical practices by hospitals) is unstoppable in the USA. We don’t know the consequences well. In theory it should improve coordination, facilitate the exchange of information and develop economies of scale. But, in practice, what has been seen is an increase in prices. It is urgent to study the consequences of this phenomenon (https://www.nejm.org/doi/full/10.1056/NEJMp2313406)
  • France
    • Macron supports the “end of life” bill, which will be discussed by Parliament in May. The term “assisted in dying” is used, rather than euthanasia or assisted suicide, which are considered more controversial. If approved, France will join the few European countries (Switzerland, Holland, Belgium, Spain) that have regulated this issue (https://www.ft.com/content/8129ad50-ae82-4cf9-8b06-cdd196cc57ef)

National health policy

  • Advanced therapies trading company

Companies

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 (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 (October 9th-15th, 2023)

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Summary

From the point of view of Biomedicine, after years of research, scientists have published an atlas of the brain, the most unknown organ and whose knowledge will allow great advances in biomedicine. This week 21 articles have appeared about the brain and its cells. The work is done under the BRAIN Initiative Census Network project. The objectives of this effort were three: first, to understand the cellular components of the brain; second, to know which cells are affected in neurological and psychiatric diseases; and, third, what makes the brain of Homo sapiens different from that of other animals. The brain is the most complex object in the universe and contains around 3,000 types of cells. Until recently it was believed that the human body, including the brain, had only 300 types of cells. Artificial intelligence, new therapeutic vaccines, xenotransplantations and quantum computing, in the focus of monitoring progress in medical sciences.

Regarding Global Health, The Lancet asks in several articles the impact on health of a world with a shortage of work, since until now a job in good conditions was considered important for health. The malaria community welcomes the WHO approval of the new vaccine. Malaria kills half a million children a year, mainly under five years old. This decision is expected to improve access to doses of the vaccine, especially in Africa. 28 African countries are going to introduce this vaccine as part of their immunization program.

Regarding International Health Policy, in the United States pharmaceutical companies agree to negotiate the price of medicines with Medicare, despite the fact that some maintain lawsuits against the American government. In the European Union, the shortage of amoxicillin, a widely used antibiotic, persists. There is also in the EU an increase in deaths due to mental disorders.

If we talk about National Health Policy (Spain), the government puts out to public consultation the draft Royal Decree for the evaluation of health technologies which, among other things, rethinks the economic evaluation of medicines, incorporating the participation of professionals and patients and attempting predictability and transparency in decision-making times.

In the field of Companies, at the international level, it is worth highlighting that the global cannabis market will reach 100 billion in 2030. At the national level, Sanitas is launching an educational experience, which is an example of the importance they give healthcare companies to the issue of training, aware that attracting and retaining talent will be the most important competitive advantage.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

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

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Summary

From the point of view of Biomedicine, it is worth highlighting that the famous doctor and communicator Eric Topol publishes an article in the magazine Science about the multiplication of medical applications of artificial intelligence. The number of variables of each individual person (anatomical, genomic, metabolomics, epigenomics, etc.) can only be captured and used in diagnosis and treatment through the use of artificial intelligence. Clinicians must become familiar with these new tools and possibilities.

Regarding Global Health, The Lancet comments on what happened with the mpox pandemic (previously called monkeypox), which triggered a global alarm from the WHO and which today has decreased significantly. UN high-level meeting on tuberculosis, whose mortality has increased recently, after years of decline. The Gates Foundation proposes simple and cheap measures to improve the health of women who give birth, since 800 women globally die in childbirth every day.

In terms of International Health Policy, there is an emphasis on measures not learned during Covid, as global politicians seem to move away from fundamental concerns such as equitable access to vaccines and greater transparency. Alcoholism is a serious and very common disease in the USA, causing around 140,000 alcohol-related deaths each year in that country. It seems that the new medications (Ozempic, Wegovby) now used for obesity may also be useful in alcoholism, by curbing consumption. In the NHS the waiting list continues to grow, reaching historic record levels, which contrasts with Prime Minister Sunak’s promises. Serious problem for the Nigerian government to retain its doctors, since six out of ten intend to emigrate in search of better opportunities. Eurostat publishes the most frequent surgical interventions in Europe. Caesarean sections and cataracts, the most frequent interventions.

If we talk about National Health Policy (Spain), covid infections skyrocket due to the drop in immunity. Spain has 100 million vaccines not adapted to the new strains. However, the public health commission recommends the use of adapted vaccines. Problem for Spain, since these vaccines not prepared for the new strains cannot be sold or donated. Spain takes 780 days to supply the new medications. Apart from the 629 days recognized in the WAIT report, from the time the drug is approved by the EMA until the price and public financing are approved in Spain, another five months must be added for approval by the autonomous communities and it would even be necessary to add delays due to approval by hospital commissions. Cosmetic surgery operations have increased rapidly in Spain in recent years.

In the field of Companies, at the international level, the Strasbourg plenary session supports the plasma law that favors Grifols. At the national level, private hospitals (ASPE) take the Sanitas and Generali alliance to court. Ferrer and Almirall, with very good prospects.

Biomedicine

Global Health

International health policy

  • Mexico
    • Abortion, not criminalized in Mexico. The decision of the Supreme Court to reject the law that criminalized abortion opens the door to its legalization, increasing the liberalization of abortion in Latin America (https://www.bmj.com/content/382/bmj.p2060)

National health policy

Companies

 

 

 

 

7 days in healthcare (July 24th-30th, 2023)

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Summary

From the point of view of Biomedicine, the mRNA vaccine for cancer and regenerative medicine seem to be the great promises in medical advances.

As regards Global Health, The Lancet dedicates an editorial to the need for a broader vision of women’s health, beyond maternal health. The most prevalent disease problems in women are the same as in men, but need insight into specific, poorly understood risks.

As for International Health Policy, the battle continues in the United States for the application of the new pharmaceutical policy that allows Medicare to negotiate the price of drugs, something that until now had been banned. This negotiation will begin in 2024 and it is expected that on September 1, 2023 the medicines on which it will be negotiated will be known. In a movement that seems to be ahead of events, several pharmaceutical companies (Janssen, Merck, Astellas Pharma and BMS) file a lawsuit against the American government. Apart from other possible considerations, it seems difficult to maintain that the price of medicines is much higher in the United States than in other countries, and not only in developing countries, but also in Europe. In the United Kingdom, the British Medical Journal focuses on the financing of pharmaceutical and medical technology companies to British scientific societies. For this, more transparency is required.

If we talk about National Health Policy (Spain), the political changes derived from the regional elections establish a new configuration of the Interterritorial Council, which will be numerically dominated by the PP (which will count, including the Canary Islands Coalition) 12 seats in the Council, by 3 of the PSOE (Castilla-La Mancha, Navarra, Asturias), 1 from the PNV (Basque Country) and 1 from ERC (Catalonia). The Radar Healthcare organization publishes a new ranking of healthcare systems and awards Spain a very favorable position in terms of quality. In general, these types of rankings must be looked at with a magnifying glass and consider the type of indicators analyzed and another series of circumstances. A biased and unprofessional interpretation of the international rankings on the Spanish health system has meant, in practice, a brake on the reforms. If we are so well, why reform anything? It is known that Spain is one of the OECD countries that devotes less public funding to dental care. What we did not know and what is now clear is that it has even dropped very significantly in the last decade, going from 5,245 million euros in 2010 to 3,681 in 2020. It seems clear that Spain, which globally has organized vaccination against covid very well However, it has failed to develop a vaccine: the HIPRA vaccine was delayed much longer than expected and the announced intranasal vaccine no longer even has a release date. It is difficult to compete with vaccines that appear less than a year after the onset of the disease, as has happened in the case of covid, with long development of vaccines that take years.

In the field of Companies, internationally, the president of Novartis (company of European origin) says that the price reform in the United States of medicines represents a threat to Public Health. At the national level, it is worth noting that spending on biosimilars has exceeded 1 billion euros in 2022, due to the fact that the patent for several biological drug molecules has expired and biosimilars have appeared.

Biomedicine

Global Health

International Health Policy

National health policy

  • Changes in the Interterritorial Council
    • Changes in the political sign of the autonomous communities completely modify the political weights in the Interterritorial Council. The popular ones will have 12 seats (with the Canary Islands Coalition), compared to 3 for the socialists (Castilla-La Mancha, Navarra and Asturias), 1 for the PNV (Basque Country) and 1 ERC (Catalonia) (https://gacetamedica.com/opinion/a-new-territorial-council-of-the-sns/)

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 (March 13th-19th, 2023)

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Summary

From the point of view of Biomedicine, the debate on the governance, supervision and ethical limits of human genome editing is increasingly present, precisely when it seems that many medicines based on this technique are in advanced development, to treat many sicknesses. Nature publishes a novel approach to disseminate Magnetic Resonance, which fifty years after its birth is still a very expensive technique and not accessible to many countries. The mapping of the brain of a larva, after decades of research, heralds advances in the knowledge of more complex brains.

As regards Global Health, the WHO has drawn up the first draft of a treaty on pandemics, precisely to avoid what happened during the covid, the great differences in mortality, morbidity and access to treatment between the different countries.

Regarding International Health Policy, in the United States, the New York Times denounces that aggressive medical behavior continues to be common at the end of life. This same newspaper echoes in its editorial section the serious crisis of the British National Health Service, where several strikes are coexisting at this moment: nurses, consultants, junior doctors and ambulance drivers. The prestige of the NHS among the population plummets. Le Monde publishes in France a report on the change of pharmacies: from drug stores to health “hubs”. BCG releases a report on the scope and benefits of the metaverse in health.

If we talk about National Health Policy (Spain), the incidence of covid continues to increase. It is estimated that 1 million people in Spain may have persistent covid. The conflict between the Primary Care doctors in Madrid ends (it was about time). The SNS will address the problem of the carbon footprint of hospitals. The low remuneration of consultations by healthcare insurance companies is denounced, it is urgent in this sector to move from a model of payment by activity to another of payment by value.

At the Corporate level, internationally, Pfizer is addressing the purchase of Seagen, a biotech-oriented biotech company. As far as national news is concerned, it should be noted that HM Hospitales opens (in Rivas) its eighth hospital in Madrid.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies

7 days in healthcare (January 16th-22nd, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting, as the Science article does, the celebration of a decade of CRISPR gene editing technology, whose impact on medicine is only just beginning. Janssen withdraws from the HIV vaccine, a new failure in the attempt to discover a vaccine against this disease. Moderna, on the other hand, presents positive results with a vaccine against bronchiolitis. A new report points to wastewater analysis as fundamental to monitoring threats from a wide variety of diseases, not just covid.

As regards Global Health, The Lancet in an editorial underlines the importance of the One Health concept, this idea of the interdependence between human, animal and ecosystem health. The Economist publishes an editorial and an article on the problems of health systems that are in crisis everywhere in the post-covid era (even in Switzerland!), which is making mortality in Europe have been in the last year 10% higher than in a normal year.

Regarding International Health Policy, in the USA the opponents of abortion are manifested. Problems continue in the NHS, with Sajid Javid, former health secretary, proposing something as unusual in the UK as a co-pay in Primary Care and Emergency. He says an overly religious view of the NHS prevents reforms. Important debate and tensions about the price of medicines in the European continent (UK and EU) in relation to prices in the USA. Pharmaceutical companies, very reluctant to price controls, when they are also in the USA with the application of the Inflation Act, which gradually imposes a negotiation of the price of medicines between the Medicare Administration and pharmaceutical companies.

If we talk about National Health Policy (Spain), the incidence of covid continues to drop. Medical conflicts extend to various autonomous communities (Madrid, Catalonia, Navarra, etc.). The agreement in Aragon should be highlighted, which indicates that it is possible to reach agreements, possibly when they are well negotiated. The Ministry, completely absent from this problem. As for the public system, the statements by Lasquetty, Madrid’s Treasury Councilor, who points to “my own place” as one of the great rigidities of the public system, are very interesting. Conflict also in private health between doctors and insurers, raised in Seville. Abortion enters the national debate, following the picturesque proposals of Vox in Castilla y León, never applied. The Constitutional Court opens its new session with the debate on the recourse to the Law of deadlines presented in its day by the PP. The CIS survey presents health as the second problem that worries the Spanish.

In the field of Companies, internationally, Pfizer’s initiative to sell medicines at cost prices in 45 poor countries must be highlighted. At the national level, the launch by DKV of an insurance product that allows choosing a family doctor is notable. In a context in which insurers actually forget about Primary Care, this is something that deserves to be highlighted.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies

7 days in healthcare (November 7th-13th, 2022)

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Summary

From the point of view of biomedicine, to highlight the blood transfusion with cells generated in the laboratory from donor stem cells, carried out in the United Kingdom, which opens up possibilities for what has been pursued for years: the so-called “artificial blood”. Likewise, two advances that originate in Spain: the discovery of a genetic variant that favors thinness (CNIO) and the fact that malignant cells break off from cancer and cause deaths by metastasis (Institute of Medical Research of Barcelona).

As regards Global Health, Nature insists in an editorial, following the COP27 meeting, that rich countries must advance compensation for polluting. Important challenges for the new Brazilian President in health matters, particularly in primary care.

Regarding International Health Policy, debate on the covid-zero policy in China, on the one hand, there seem to be signs that China is easing quarantines, on the other hand, according to José Luis Puerta in an article, this policy is a death trap , since its abandonment may mean assuming a high number of deaths, given the low percentage of vaccination in China. In the United Kingdom (NHS) a nurses’ strike for salary demands is raised for the first time, which. according to the Government, they are unaffordable.

If we talk about National Health Policy (Spain), it seems that the crisis of Primary Care, long incubated, has exploded. Although the problems of low wages, poor working conditions for doctors and flight or refusal to go to Primary Care is a national problem, the crisis has broken out above all, although not only, in Madrid, which has some peculiarities that aggravate the situation: 1. the closure of out-of-hospital emergencies for two years; 2. the low funding of the health system in Madrid and of Primary Care; and, 3. some confrontation practice. The truth is that the “white tide” has been activated, with a large demonstration in defense of public healthcare in the center of Madrid, which was a great success for the organizers. As always in these cases, the defense of public healthcare is mixed with the rejection of any form of public/private collaboration. Tensions in primary care also in the rest of Spain. Highly recommendable is the video on YouTube entitled “Doctors are lacking in Spain”?

In the field of companies, at the international level Bavarian Nordic increases its growth due to the monkeypox vaccine, while BioNTech’s revenues fall, due to the drop in sales of the covid vaccine. In Spain, changes in the CEO of Quirón, to whom Víctor Madera, the company’s founder, returns to executive positions. Success for Ribera, which is awarded an important contract for a hospital concession in Cascais (Portugal). New delays in the approval by the EMA of the HIPRA vaccine.

Biomedicine

Global Health

International health policy

  • COVID-19
    • China eases quarantine rules, with Guangzhou close to lockdown. There is speculation that Beijing is considering a relaxation of the covid-zero policy (https://www.ft.com/content/709e95e6-cc63-4fe0-9c4a-5683c87f7e7b)
    • Interesting article by José Luis Puerta: “China: the deadly trap of the covid-zero policy”. If the government lifts the restrictions, which are sinking the economy, the country risks suffering a tsunami of infections, due to the low level of vaccination. It is estimated that this could cause 1.6 million deaths and a demand for intensive care that exceeds its current capacity by 15.6 times (https://theobjective.com/internacional/2022-11-12/china-covid-zero/ )

National health policy

Companies