Posts

7 days in healthcare (October 24th-30th, 2022)

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Summary

From the point of view of Biomedicine, it is worth highlighting the studies that show that certain types of breast cancer, which respond to chemotherapy, will not require surgery. The link between Alzheimer’s and certain viruses is surprising. As for proton therapy, it seems that an increase in its indications (prostate, lung, etc.) is in sight.

As far as Global Health is concerned, the WHO study on a prioritized list of fungal threats should be noted. Cases of resistant tuberculosis, on the rise, which is a big problem with high mortality. Shortage of cholera vaccines. “Nature” magazine considers the possible second term of Bolsonaro in Brazil as a threat to science, democracy, the environment and the world. Said alarm had already been launched by this magazine as a result of his first term.

As for International Health Policy, monkeypox is in clear recession and covid is apparently less serious, possibly due to increased immunity. The truth is that mortality and cases requiring hospitalization are falling. Plan in the United Kingdom so that pharmacies can collaborate in the treatment of minor disorders (hypertension, high cholesterol, etc.)

If we talk about National Health Policy (Spain), a surprising proposal from ASPE to the Ministry of Health for the homologation of foreign doctors through a kind of two-year express MIR. The problem is surely more complex and it should be considered that we are one of the countries with the most doctors per 1,000 inhabitants and the most Faculties of Medicine. To analyze the shortage by areas and specialties, as well as the expansion of nursing work. It is doubtful that exporting quality doctors after an excellent MIR and importing foreign doctors with an express MIR is the solution. Perhaps the salary and working conditions of Spanish doctors should also be considered. Also striking is the new approach of the PSOE in terms of the Trans law, which tries to involve judges in changing sex between 12 and 15 years, compared to the bill approved by the Council of Ministers, which did not contemplate this possibility. AESEG, very willing to increase the use of generics, through regulatory and price changes.

In the field of Companies, at the international level, the extensive job cuts at Philips are striking, after its withdrawal of devices for sleep apnea. As for Spain, Sanitas publishes a study on mental health, which shows that the private health sector is agile in its response to a serious problem, which has become more evident after covid. Orange’s agreement with Mapfre confirms the great interest of telecommunications platforms in the world of health and their need to ally with traditional operators.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (September 26th-October 2nd, 2022)

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Summary

From the point of view of Biomedicine, to review the advances, still to be confirmed, in the treatment of two terrible diseases: ALS and Alzheimer’s.

Regarding Global Health, concerns continue about the evolution of polio, whose eradication was announced in 2019, but which is reappearing in several countries.

Regarding International health policy, it is worth noting the similarities between the covid-zero policy in China and the era of prohibition in the United States, something pointed out by The Economist. Very worrying is the “burnout” of doctors, a phenomenon highlighted by the New York Times in the United States, but which seems to be universal.

If we talk about National health policy (Spain), the debates on the Equity Law continue. The update of the RD on the minimum data set of the SNS leaves out the private sector, despite the opposition of the POP, IMAS Foundation, IDIS Foundation and ASPE. It is a modification of a 2010 RD, but in twelve years the private sector has developed a lot and it is no longer so easy to leave it out in certain decisions. The Senate rejects the PP’s motion to facilitate access to medicines and reduce the time it takes to join the SNS. Surely the motion of the PP was too vague and, at this point, it is necessary to explain very well the “what” and the “how” of any proposal.

At the corporate level, at the international level, big rise in Biogen shares, spurred by what appear to be hopeful results from its Alzheimer’s drug. At the national level, there are rumors that KKR and CVC could be trying to buy Quirónsalud, currently in the hands of the German group Fresenius, which has recently changed its CEO. The Murcian company Vócali develops the Inbox Medical software for transcription of medical reports.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (August 8th-14th, 2022)

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Summary

From the point of view of biomedicine, there seems to be a glimpse of a new drug to prevent the transmission of HIV/AIDS, for which there are problems in obtaining an affordable price. Animal testing is the basis for certain advances in medicine. This can be overcome with certain new discoveries, according to the company Lift Sciences.

Regarding Global Health, two key issues: a new zoonosis (“Langya”) appears in China, as published in the NEJM. In certain developed countries it seems that polio, which was considered eradicated, is making a comeback.

Regarding international health policy, the approval of the Inflation Reduction Act (IRA) of 2022 in the United States, about Climate, Fiscal and Health will have a very important impact. Aside from expanding access to insurance through the Affordable Care Act (Obamacare), surely the most far-reaching impact will be on the pharmaceutical industry. Gradually, Medicare will be able to negotiate the price of medicines with the pharmaceutical industry, something that until now it could not do. This radically changes the business model of the pharmaceutical industry, which was based on two things: the protection of intellectual property through patents; and the existence of free prices with high margins in the United States (the largest pharmaceutical market) and regulated prices and lower margins in the rest of the world. A substantial change that will most likely have a global impact. It may also curb the escalation of health care spending in the United States. We’ll see if this doesn’t upset the fast pace of drug innovation.

If we talk about national health policy (Spain), the good news is that, as in all of Europe, covid continues to decrease in incidence, although it is still a worrying disease, due to the number of hospitalized cases and mortality.

In the field of companies, trials for new covid variants begin by BioNTech and Pfizer. More than 2,300 Spanish pharmacies can now sell through the Glovo platform and soon Uber, although only parapharmacy products, not prescription drugs.

Biomedicine

Global health

International health policy

National health policy

Companies

 

 

 

 

 

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

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Summary

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

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

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

International

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

Nationals

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

Companies, employers and other agents in the sector

 

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

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

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ABSTRACT

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

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

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

INTERNATIONAL

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

NATIONAL

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

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

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