Posts

7 days in healthcare (January 29th-February 4th, 2024)

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Summary

From the point of view of Biomedicine, the use of gene therapy based on CRISPR for the treatment of hereditary angioedema should be highlighted. Great debate regarding Elon Musk’s brain chip, in general the scientific community has expressed serious reservations about this initiative. Beginning of the first trials with mRNA-based therapy in cancers of different types in the United Kingdom.

As far as Global Health is concerned, the beginning of routine malaria vaccination can without exaggeration be considered a historic event, given the high mortality of this disease in children in Africa. The WHO warns about the prospects for great growth in cancer globally and the notable differences in its prognosis, especially in breast and cervical cancer.

In terms of International Health Policy, the NHS England initiative is especially interesting, allowing pharmacies to prescribe certain medications and carry out some care practices, which is expected to result in a decrease of 10 million primary care consultations. The results of this experience deserve to be followed, since it could be part of the solution to Primary Care also in Spain. EU document on cancer in Europe, highlighting inequities in its approach.

If we talk about National Health Policy (Spain), it is worth continuing to comment on the intervention of the Minister of Health in the Health Commission of Congress. Although now it seems that nothing is important, the truth is that this intervention is one of the most relevant of any minister who reaches her position. The intervention has some lights and many shadows. Lights: recovery of a certain will for strategic direction of the SNS and decision to address the great problem of waiting lists (this is notable, since it contrasts with other ministers, who used to rather assume that everything was transferred and , therefore, the role of the Ministry was minimal). Shadows: very negative, offensive and unacceptable mentions of private healthcare, with arguments and quotes that are intellectually inconsistent and lacking rigor; staunch defense of direct public management, compared to other forms of public management; Public Health Agency, apart from doubts about its real content (no one hides the fact that the Agency does not make the influential nationalist parties very happy), the Ministry of Health gets out of the way to decide the location, handing over the baton to the Ministry of Territorial Policy and Democratic Memory, as if it were not also a health decision; Framework Statute, where are the negotiations with professionals?; medicines, no mention of the Strategic Plan of the pharmaceutical industry (in which the President of the Government himself had committed himself); Oral health, where is the economic memory? What care model will be followed? Is the inclusion of glasses in public provision, given the financial strains of the system, a reasonable priority? Is there prior consensus with other agents on this measure? In another order of things, in the Valencian Community the reversion to the public sector of the Denia concession has been completed and that of Manises will soon be granted, something to which the Administration has every right, once the concession contract has ended. The mentions of the concept of “expropriation”, used by some concessionaire company, are extemporaneous. Now, the official press release from the Ministry announces a very notable increase in staff in that hospital in Denia. Logically, uncontrolled growth in health spending, if it is not justified, cannot be the public alternative to concessions. Notable growth in the price of health insurance premiums in Spain, although its price must probably continue to be low, compared to other European countries. Something to analyze.

As for Companies, on an international level, Novo Nordisk was surprised by the great demand in Europe for medicines against obesity. In terms of national news, the pharmaceutical distributor HEFAME has experienced great growth in recent years and is considering expanding throughout Spain. At Grifols, the board is considering excluding the family from the company’s strategic decisions.

Biomedicine

Global Health

International health policy

  • European Union
    • Document on inequalities in the EU regarding cancer: “Beating cancer inequalities in the EU” Emphasis on prevention and early detection (https://www.oecd.org/health/beating-cancer-inequalities-in-the-eu -14fdc89a-en.htm)
    • The EU fined the pharmaceutical industry 780 million for anti-competitive practices between 2018 and 2022 (https://www.elespanol.com/invertia/observatorios/sanidad/20240130/ue-multo-millones-industria-farmaceutica-practicas-anticompetitivas /828667294_0.html#:~:text=The%20European%20Commission%20investigated%20one, euros%20for%20the%20laboratories%20involved.)
    • Brussels calls to promote vaccines against human papillomavirus (HPV) and hepatitis B throughout the EU (https://elpais.com/sociedad/2024-01-31/bruselas-llama-a-impulsar-las -vaccines-against-human-papillomavirus-hpv-and-hepatitis-b-across-the-eu.html#:~:text=Brussels%20has%20launched%20this%20Wednesday, the%20Hepatitis%20B%20(HBV).)

National health policy

  • Appearance of the Minister of Health before the health commission of the Congress of Deputies, on January 26, 2024
    • Lights and shadows in the appearance. Lights: recovery of a certain will for strategic direction of the SNS and willingness to address the great problem of waiting lists. Shadows: very negative and unacceptable mentions of private healthcare, with intellectually inconsistent arguments and quotes; staunch defense of direct public management, compared to other forms of public management; Public Health Agency, the ministry gets out of the way to decide the location, as if it were not also a health decision; Framework Statute, where are the negotiations with professionals and patient associations?; medications, no mention of the Strategic Plan of the pharmaceutical industry; Oral health, where is the economic memory?; Is the inclusion of glasses in public provision, given the financial strains of the system, a reasonable priority? Is there prior consensus with other agents on this measure? (https://www.youtube.com/watch?v=xlGfsMiuQDo)

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 17th-23rd, 2023)

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Summary

From the point of view of Biomedicine, important editorial and several articles in The Economist on the problems of reproduction and in vitro fertilization. Since this technique began, 45 years ago, more than 12 million children have been born thanks to it. The issue is extremely important considering that one in six people suffer from infertility. IVF is experiencing an extraordinary “boom”. Important article from The New York Times on the demographic changes that will give rise to a whole new world in terms of population distribution. Some skepticism about the effects of Donamebad on the evolution of Alzheimer’s.

When it comes to Global Health, The Economist looks at why the malaria vaccine has taken so long to develop. This is apparently due to cycle changes of the Plasmodium parasite. Singapore is a world leader in the marketing of cultured meat, which is possibly called to change many things in our eating habits.

Regarding International Health Policy, the WHO in its weekly covid monitoring newsletter on covid warns that, although the number of new cases and mortality are falling, this disease continues to be a threat, which requires maintenance of surveillance systems and periodic reports. The National Health Service, despite its deep crisis, continues to be a benchmark in terms of reflections on health and health systems. This time the King’s Fund is publishing a report on the kind of participatory leadership needed in the healthcare system.

If we talk about National Health Policy (Spain), we want to highlight the interesting book “Conversations for better health”, which consists of deep and nuanced reflections on many topics, carried out by two consolidated values in Spanish healthcare arena (Jesús María Fernández Díaz and José Martínez Olmos): the importance of Public Health, the need for the Public Health Agency, the opacity of our system in terms of information on results and quality, financing, co-payment, the challenges of Primary Care, the necessary new care model, the contributions of digital health, etc. When improvisations and light comments abound, often made from advertising or simple communication, this conversation between two experienced experts, who treasure experience and knowledge, is a must read. It can be purchased on Amazon.

In the field of Companies, internationally, there are two great opportunities for the pharmaceutical industry, one in the short term, such as all medications against obesity and Alzheimer’s, and another in the longer term, such as anti-aging therapies.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

7 days in healthcare (December 19th-25th, 2022)

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Summary

From the point of view of Biomedicine, it should be noted that 2022 has been an extraordinarily productive year from the point of view of the appearance of effective drugs, among others against obesity or different forms of cancer. mRNA vaccines open the way to new therapeutic approaches

With regard to Global Health, the British Medical Journal summarizes the human and health damage caused by the floods in Pakistan.

Regarding International Health Policy, discussions continue about the origin of the covid. President Biden is accused of complacency in saying as early as September that “the pandemic is over”, while the mortality continues. Everything seems to indicate that the end of the covid-zero policy in China is producing a large number of cases (millions in just one day), which is putting maximum pressure on the health system and, probably, since there are no reliable figures, with a high mortality. UK nurses and ambulance strike.

If we talk about National Health Policy (Spain), the incidence of covid has risen slightly in the last week, with a high death toll (241). The strike of Primary Care doctors in Madrid is paralyzed until January 11, to analyze the administration proposals. The Government undertakes to launch the working group for the elaboration of the Strategic Plan on the pharmaceutical industry, after the promises of investments in the next three years made by the heads of the most important pharmaceutical companies in a meeting in La Moncloa . Government and Community of Madrid launch the Neurotechnology Center.

In the field of Companies, internationally, it seems that private equity companies are oriented in the USA towards hospital emergencies. In Spain, Warren Buffet acquired the largest medical error insurance.

Biomedicine

Global Health

International Health Policy

National health policy

  • Pharmaceutical policy

Companies

 

 

7 days in healthcare (October 17th-23rd, 2022)

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Summary

From the point of view of biomedicine, the announced “vaccine against cancer” should be highlighted, which could be prepared before 2030. Although not strictly a vaccine, it represents a promising treatment against this disease based on mRNA technology, the same used for covid vaccine.

Regarding Global Health, an important announcement by the WHO about the dangers of a sedentary lifestyle, which could produce 500 million chronic patients in 2030. The WHO dedicates 2,600 million in its next strategy 2022-2026 for the eradication of polio .

Regarding international health policy, an important debate introduced by The Economist on the massive use of antidepressants, when only in 15% of cases do they have an effect other than placebo. Opioids in the United States and antidepressants worldwide are examples of the misuse of medications, which can lead to, and in many cases lead to, health problems. The post-pandemic horizon has generalized a hybrid work model (face-to-face and online) for office professionals.

If we talk about national health policy (Spain), the pressure on hospitals due to covid remains low, despite a slight rise in this disease. Intense debate on the flight of Spanish doctors to other countries, attracted by better salary and professional conditions. No matter how much the number of MIR vacancies and Faculties of Medicine increases, the problem will not be solved if working conditions are not acted upon. Teleconsultations seem to consolidate in Primary Care, already being more than 50% of the visits. The Trans law is the subject of great controversy. Most psychiatrists and psychologists, against. Obviously, we are in favor of the position of the WHO by removing from the list of diseases already in 2018 these cases of having a gender identity other than biological sex and wanting to change the morphology of their body. We welcome that there is a law on the subject as in most Western civilized countries. But one thing is that and another that 14-year-olds can choose sex without a psychological evaluation carried out by experts, who can rule out cases. Irreversible problems may occur. There is a certain consensus that the current wording of the law does not sufficiently protect minors.

In the field of companies, at the international level, we must welcome the first agreement with a pharmaceutical company (Novartis) to produce an anticancer drug as a generic that is still protected by patent, for its production in developing countries. As far as Spain is concerned, the continuous growth of health insurance should be highlighted, which in 2022 until September grows considerably more than the insurance as a whole.

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 (June 20th-26th, 2022)

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Summary

From the point of view of biomedicine, to highlight the article in The Lancet that shows that the covid vaccine has saved 20 million lives in the first year of its use.

As far as Global Health is concerned, it is confirmed that covid 19 may be wreaking havoc in North Korea.

Regarding international health policy, it should be noted that the WHO has decided not to declare monkeypox an international health emergency. Strong rise in the incidence of COVID throughout Europe. Controversial annulment in the United States of the Roe v Wade ruling that declared abortion a constitutional right. Now abortion will have to be regulated by the States. Serious public health problems are expected, as in the pre-Roe v Wade era, although mitigated by the widespread use of the abortion pill, which can even be purchased online. For the first time in the history of the United States, an agreement is reached to limit, albeit in a very limited way, the use of weapons, with President Biden having signed a law in this regard. Instead, the Constitutional Court declared illegal any limitation on the display of weapons in public, as some States had legislated. More Americans are dying from drug overdoses than ever before. The European Medicines Agency approves the Valneva covid vaccine, the sixth covid vaccine approved in Europe (after Pfizer-BioNTech, Moderna, AstraZeneca, J&J and Novavax).

If we talk about national health policy (Spain), we are witnessing a growth in the incidence of covid, some speak of a seventh wave. Published in the Official Bulletin of the Congress of Deputies the project of equity law. Important statement from the Consorci Sanitari de Catalunya saying that more than the management model, we must focus on quality and results. The National Market and Competition Commission (CNMC) publishes a report on wholesale pharmaceutical distribution, which is considered a boost to the use of generics and biosimilars.

In the field of companies, it should be noted that Alphabet (Google’s parent company) is making a strong investment to become a powerhouse in health. Its fields of action will be: wearables, clinical records, artificial intelligence applied to health and extension of human longevity. The medical marijuana business is making its way.

Biomedicine

Global health

International health policy

National health policy

Companies

 

7 days in healthcare (March 28-April 3, 2022)

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SUMMARY

From the point of view of biomedicine, the publication in Science that completes the analysis of the human genome should be highlighted, which seems to open the door to the therapy of various diseases.

As far as Global Health is concerned, polio reappearance in Malawi is of concern.

As for international health policy, problems with the covid-zero policy in China continue, which has led to the confinement of millions of people in Shanghai. As it happens, many older Chinese are unvaccinated, apparently out of fear. The satisfaction of the British public with the NHS falls to the lowest levels in history. At this rate, the UK is going to lose faith in what is said to be their last remaining religion.

If we talk about national health policy (Spain), we are witnessing a new phase of the pandemic, with cases on the rise and hospitalizations on the decline. The Lancet shows that the consumption of opioid analgesics is higher in Spain than in the United States.

In the field of companies, from the international point of view, the plan of the Cleveland Clinic to build a hospital in the center of London, with a large investment of 1 Billion pounds, should be highlighted, which could herald the landing of hospitals Americans in Europe. In our country, the private equity company KKR will pay almost 3 Billion euros for IVI, the largest fertility company in the world, in what is one of the largest operations of its kind in Spain. IMQ approves the sale of shares (50% of the insurer) to SegurCaixa Adeslas, which was already a minority shareholder in the company. Important announcement by Sanitas to launch its fifth hospital in Spain. It will be in Valdebebas, it will come into operation in 2025 and will have 100 beds, 23 of which are for mental health, which is a very innovative element in the Spanish hospital landscape.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

  • COVID

o Many older Chinese remain unvaccinated, many out of fear (https://www.economist.com/china/2022/04/02/why-so-many-elderly-chinese-are-unvaccinated)

o Lockdown in Shanghai, while covid cases rise throughout China (https://www.theguardian.com/world/2022/mar/28/shanghai-to-lock-down-millions-for-mass-testing-as -chinas-covid-cases-surge)

o The FDA allows a second “booster” for those over 50 (https://www.nytimes.com/2022/03/29/us/politics/second-coronavirus-booster-shot.html)

o The CDC lifts the order that prevented immigration during the pandemic (https://www.nytimes.com/2022/03/30/us/politics/immigration-cdc-biden.html)

  • Other themes

o British public satisfaction with the NHS drops to lowest levels since 1997 (https://www.theguardian.com/society/2022/mar/30/public-satisfaction-with-nhs-sinks-to-lowest- level-since-1997)

o The growth of health spending in the USA was reduced, after the pandemic. In 2021 it rose 4.2%, while in 2020 it had risen 9.7% (https://www.wsj.com/articles/us-healthcare-spending-slowed-in-2021-after-covid-19- surge-11648497601)

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o New phase of the pandemic: cases on the rise and hospitalizations on the decline (https://elpais.com/sociedad/2022-03-29/espana-entra-en-la-nueva-fase-de-control-de- the-pandemic-with-cases-on-the-rise-and-hospitalizations-on-the-low.html)

  • Other themes

o The flu gets out of control in Spring, it already supposes more hospitalizations than covid in several autonomous communities (https://www.elespanol.com/espana/20220331/descontrola-primavera-supone-ingresos-hospitalarios-covid-ccaa/660934368_0. html)

o The health plan against tobacco will raise its price and will prohibit smoking in cars and terraces, seeking a 25% drop in smoking (https://theobjective.com/sociedad/2022-03-30/sanidad-tabaco-precio- taxes/)

o Spain exceeds the United States in the consumption of opioid analgesics, according to The Lancet (https://www.elindependiente.com/vida-sana/salud/2022/03/31/espana-supera-a-eeuu-en-el -consumption-of-opioid-analgesics-according-to-the-lancet/)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

  • International News

o United Health buys home care firm LHC for $5.4 billion (https://www.wsj.com/articles/unitedhealth-to-buy-home-health-firm-lhc-group-for-5-4- billion-11648550701)

o Great bet by the Cleveland Clinic, to build a hospital in central London for 1 Billion pounds (https://www.ft.com/content/c42bc01c-346c-4ae7-a931-4bbf0605e3ec)

o BioNTech returns almost 2 Billion euros to shareholders after the success of the vaccine (https://www.ft.com/content/db1c6786-6707-4d22-bf43-9c7686cbe97b)

o Fresenius acquires mABxscience and Ivenix to accelerate “biopharma” and “medtech” (https://www.plantadoce.com/empresa/fresenius-acquires-mabcience-and-ivenix-to-accelerate-in-biopharma-and-medtech .html)

  • National News

o The EMA begins the evaluation of HIPRA, the Spanish vaccine against covid (https://www.eldiario.es/sociedad/ema-comienza-evaluacion-hipra-vacuna-espanola-covid-19_1_8871634.html)

o The private equity company KKR will pay almost 3 Billion euros for IVI, the Spanish company that is the largest fertility company in the world (https://www.elconfidencial.com/empresas/2022-03-28/kkr-ivi -rma-transition-fertility_3399221/)

o IMQ approves the sale of shares to SegurCaixa Adeslas (https://www.redaccionmedica.com/secciones/privada/los-medicos-de-imq-aproven-la-venta-del-grupo-a-segurcaixa-adeslas-1096 )

o IMED hospitals opens a new polyclinic in Alcoy (https://www.plantadoce.com/empresa/imed-hospitales-abre-una-nueva-policlinica-en-alcoy.html)

o Sanitas will open a new hospital in Madrid, in the Valdebebas neighbourhood, it will be its fifth hospital in Spain and it is expected to open in 2025. It will have 100 individual rooms, 22 dedicated to mental health. Sanitas will be the tenant, the property will be owned by Pryconsa (https://cincodias.elpais.com/cincodias/2022/04/01/companias/1648816602_273605.html)

o LetsGetChecked acquires the Spanish biotechnology company Veritas (https://www.europapress.es/corporate-y-ma/noticia-letsgetchecked-adquiere-100-biotecnologica-espanola-veritas-20220329123245.html)