Posts

7 days in healthcare (July 10th-16th, 2023)

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Summary

From the point of view of Biomedicine, there is little doubt that Artificial Intelligence will revolutionize medicine: from diagnosis, to the robotic-AI combination for surgical procedures, rehabilitation aid, support in the fight against infectious diseases, development of new drugs, etc. There will be few areas of medicine that are not affected by the development of Artificial Intelligence.

As regards Global Health, The Lancet insists on the WHO-Europe notice on the need to decontaminate the air, since pollution contributes to the appearance of a large number of diseases and premature deaths. This time, 12 African countries are going to receive 18 million doses of the malaria vaccine. Now one can dream of the disappearance of malaria – that secular plague – from our planet.

Regarding International Health Policy, the American regulator approves the first contraceptive pill that will be dispatched (in pharmacies, supermarkets and online) without the need for a prescription. Although the “pill” could be used in the USA for 50 years, until now it was always under medical prescription. It is believed that this measure will contribute to reinforcing women’s reproductive rights, which were so affected by the US Supreme Court ruling that repealed the previous interpretation of the federal constitutional right to abortion, leaving this regulation in the hands of the states. Great controversy as a result of the WHO declaration of the possible carcinogenic effects of aspartame, a sugar substitute widely used in many beverages, including Coca-Cola. The WHO statement is not without controversy.

If we talk about National Health Policy (Spain), to highlight the private health agreement in Madrid, with a rise of 15% in four years. The private provision employers address a decalogue of petitions to the new government. One of them is not addressed so much to the government as to health insurers, by requesting that relations between insurers and health centers be regulated in writing. The Coordinates Institute reveals the very different development of the right of choice in health in the national territory. On the other hand, the Minister of Health presents the new citizen folder. According to him “with one click you can access the medical history”. This of presenting a project of this magnitude a week before the elections cannot be taken very seriously.

In the field of Companies, internationally, Moderna has established itself in China. As for national news, Quirón announces a new hospital in Badajoz and Viamed the expansion of its hospital in Zaragoza. The funds, interested in radiodiagnostic companies, a sector so far very fragmented. ALSA, the bus company of Asturian origin, together with the Asturian health transport company Trasinsa, agree to launch a new health transport operator: SANIR.

Biomedicine

Global Health

International Health Policy

  • USA
    • The American regulator (FDA) approves the first contraceptive pill for sale without a prescription. It is called Opill and it will be available in pharmacies, supermarkets and online from 2024. The manufacturer is Perrigo, an American-Irish consortium. This pill can be used with a prescription for 50 years. The change is that, from now on, it is freely dispensed (https://www.nytimes.com/2023/07/13/health/otc-birth-control-pill.html)

National health policy

Companies

 

7 days in healthcare (May 15th-21st, 2023)

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Summary

From the point of view of Biomedicine, to point out certain warnings about the use of blood tests for the detection of cancer, an area with great growth, since in some cases there may be errors in diagnosis, over diagnosis and over treatment . Researchers are trying to improve Nuclear Resonance imaging, through fMRI, which will be able to detect brain activity on the millisecond scale. The WHO warns about the use of sweeteners for weight control and ChatGPT in health, without careful prior examination.

With regard to Global Health, The Lancet denounces in an editorial the continuation of the practice of the death penalty in some countries, but most fundamentally in China. The International Treaty on Pandemics, which may be one of the positive consequences of the covid, seems to be ready in May 2024.

Regarding International Health Policy, very interesting statements by the Director General of the WHO to The Economist magazine, following the lifting of the global alarm due to the covid. Trying to explain why the covid affected developed countries (such as the USA) in many cases more than developing countries, he comments that possibly a certain self sufficiency about the strength of their health systems and a concentration towards investments in specialized hospitals and high technology, in instead of public health, is at the origin of this situation. The crisis in the NHS continues, Starmer (Labor Party leader) says the system cannot be fixed without fixing the “fundamentals”. He seems to understand by “fundamentals” the need for reforms and not just more funding. EMA 2022 annual report, which greets that year as very positive due to the rapid development of new vaccines and new drugs.

If we talk about National Health Policy (Spain), apart from the rise in the incidence of covid, possibly the most far-reaching news is the shortage of certain medicines in pharmacies. It seems that the causes can be multiple, but basically three: the dependence on certain raw materials that are manufactured in India and China; parallel exports due to the lower price of medicines in Spain compared to other European countries; and the very low price of some drugs that discourages their production. In Primary Care, the real problems far exceed the weekend promises to give more money, apparently already committed. In-depth reforms and increased funding is what Primary Care needs, after a deep negotiation and consensus. The PP of Asturias promises to end, if it wins, with the exclusivity of doctors in that region, apparently already the only one in Spain that rigorously applies this regulation. The project of the new Hospital Clinic (Barcelona) of more than 1,500 million surprises by its grandeur. It is to be assumed that such a large investment is fully justified and explained very well to the population.

In the field of Companies, at the international level, a large fine was imposed on the pharmaceutical chain Walgreens in San Francisco for promoting the use of opiates. In Spain, the construction of a new hospital in Alicante by IMED stands out (is there a real boom in new private hospitals?); the sale to a German fund of 26% of ESTEVE; and, as unusual, the denunciation by the hospital employer ASPE of the agreement between Sanitas and Generali. It seems that the discrepancy is that Sanitas extends the advantageous rates that it had negotiated with suppliers, which are more favorable than those of Generali, to Generali customers in this way.

Biomedicine

Global Health

International Health Policy

  • China
    • What happened in China after the abandonment of the covid zero policy and the massive infection of omicron? The official figures for deaths are 87,475 between February 24 and March 16, 2023. Other estimates speak of between 1-1.5 million deaths. Surely the reality is somewhere in between (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2804631)

National health policy

Companies

 

 

7 days in healthcare (October 31st-November 6th, 2022)

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Summary

From the point of view of Biomedicine, the start of human trials of drugs discovered by Artificial Intelligence should be highlighted, something that is attracting the attention of all Big Pharma companies.

With regard to Global Health, it should be noted that COP27, the major international conference on climate change, will be held in Cairo on November 7 and 8. His opening coincides with the editorial in The Economist in which he says that the goal of keeping the temperature from rising 1.5º is totally unrealistic, proposing various alternatives. Ukraine’s health system prepares for nuclear disaster. Cholera outbreaks in various parts of the world.

Regarding International Health Policy, the WHO publishes a document on the development of telemedicine in Europe, identifying the problems of the user, technology and infrastructure as the main obstacles to its development. Problems in the British and French health systems.

If we talk about National Health Policy (Spain), the CESM denounces the proliferation of contracts for doctors without a MIR system. Surprisingly, there is no exact figure for how many doctors practice in Spain without MIR. Serious tensions in the Madrid healthcare system, mainly in out-of-hospital emergencies, although not only. It seems that the politics of confrontation prevails, which is neither positive nor desirable. There are no good memories of the famous “white tides” in Madrid, which should not be reactivated. The debate on the delay in access to medicines continues. The Ministry of Health affirms that part of this delay is due to pharmaceutical companies, which prioritize some countries over others in their marketing requests. At the national level, mention must be made of the death of Dr. Fernando Alonso-Lej, the great introducer of the MIR system in Spain and, therefore, deserving of maximum recognition.

In the Corporate arena, internationally J&J acquires a cardiac device company. In our country, it should be noted that the private sector builds more than 80% of nursing homes.

Biomedicine

Global Health

International health policy

National health policy

Companies

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 (March 21-27, 2022)

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SUMMARY

From the point of view of biomedicine, the progress in the treatment of breast cancer should be highlighted, according to the article published by the NEJM, with a brake of around 80% of this advanced cancer and makes it disappear in 16%. .

As far as Global Health is concerned, there are undiagnosed cases of tuberculosis (the missing tuberculosis), a disease that continues to have 10 million new cases a year and causes 1.5 million deaths. The Lancet report on what needs to be done to meet target 3.4 of (on non-communicable diseases) of the Sustainable Development Goals. Inequality in covid vaccination and its possible ways to solve it are the subject of an analysis by the NEJM. Concern for the health of the 3.5 million refugees from Ukraine. The low mortality of covid in Africa, a continent that was thought could be devastated by this disease, remains a mystery.

As for international health policy, the debate continues on the covid-zero policy in China, which has achieved great results so far (both in terms of mortality and economics), but it is not known if it will be able to continue with the variant “omicron”. The WHO judges the lifting of COVID measures in Europe too premature, considering that cases are growing, among other countries, in the United Kingdom, Ireland, Greece, France, Italy and Germany.

If we talk about national health policy (Spain), we are witnessing a relaxation of the measures against covid, despite its upward trend in recent days. Arrival of Paxlovid, Pfizer’s treatment for severe cases of covid. The important report published by the Catalan Society of Health Management, with an exceptional team led by Jordi Varela, on the forms of contracting health services from the point of view of value, is very noteworthy. The deans of Medicine react to the Ministry’s announcement of the increase in the “numerus clausus” in medicine by 10%.

In the field of companies, it is worth highlighting the evolution of the purchase of the fertility company IVI, the largest operation carried out by private equity companies in healthcare in Spain and with a company valuation of around 2,500 million euros.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

NATIONAL HEALTH POLICY (SPAIN)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

 

 

7 days in healthcare (February 28-Mars 6, 2022)

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SUMMARY

From the point of view of biomedicine, the approach (apparently possible) of obtaining a vaccine for the next pandemic in 100 days stands out, compared to 10 years of previous situations and the year of COVID 19. Concern, according to an editorial in The Lancet, for depression, which is estimated to affect one billion people in the world. The WHO warns about the high figures of obesity: 650 million adults, 340 million adolescents and 39 million children. Great hopes in the combination of gene therapy and xenotransplantation, with great impact on the future of transplants.

Regarding global health, the great concern is the health consequences of the war in Ukraine and the WHO calls for the creation of a safe corridor to carry medical supplies. Pharmaceutical companies plan to manufacture 2.9 billion COVID vaccines in Africa.

Regarding international health policy, it should be noted that, according to experts, billions of dollars are needed to prevent the next pandemic.

As far as national health policy is concerned, it should be noted that the incidence of COVID is falling, although more slowly than a few weeks ago, and the mortality rate remains high (more than 150 deaths per day). The (official) deaths from COVID already exceed 100,000 in Spain. The Ministry plans to give the COVID data twice a week, instead of the current daily frequency (except weekends). Great collaboration in medical supplies and supply of beds by Spain in the face of the tragedy in Ukraine.

If we talk about companies, we would highlight the information from FENIN that Catalonia manufactures more than 35% of the health technology produced in Spain. Also the important investment in Barcelona by Novartis in an antibiotic center.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o The incidence of COVID drops to 463 per 100,000 inhabitants, but the decreases are smaller than in previous weeks and the figure of more than 150 deaths per day continues (https://www.consalud.es/pacientes/especial-coronavirus/covid-19-espana-registra-22400-casos-174-muertes-ia-desciende-463-puntos_111057_102.html)

o 100,000 (official) deaths from COVID in Spain (https://www.redaccionmedica.com/secciones/sanidad-hoy/espana-supera-los-100-000-muertos-por-covid-desde-el-inicio-de-la-pandemia-7926)

o The Ministry of Health will give COVID data twice a week instead of daily (https://www.elconfidencial.com/espana/2022-03-02/sanidad-pasara-dar-datos-covid-dos-veces-por-semana-en-lugar-de-a-diario_3384902/)

  • Political announcements

o The bill project amending the National Security Law is published (https://www.congreso.es/public_oficiales/L14/CONG/BOCG/A/BOCG-14-A-91-1.PDF)

o The bill project amending the Law on Science, Technology and Innovation is published (https://www.congreso.es/public_oficiales/L14/CONG/BOCG/A/BOCG-14-A-92-1.PDF)

  • Other issues

o Catalonia wants to extend pharmacological abortion up to 14 weeks (https://elpais.com/espana/catalunya/2022-03-02/cataluna-quiere-ampliar-el-aborto-farmacologico-hasta-las-14-semanas.html)

o Spain will send more than 20 tons of medicines and medical supplies to Ukraine (https://www.elindependiente.com/espana/2022/02/26/espana-enviara-20-tonadas-de-medicinas-y-material-sanitario -to-ukraine/)

o The autonomous communities offer 3,000 beds to care for the victims of Ukraine (https://www.elespanol.com/espana/politica/20220227/ccaa-ofrecen-hospitalarias-acoger-victimas-invasion-ukrania/653434701_0.html)

o Spain joins the health PERTE at European level (https://www.lamoncloa.gob.es/serviciosdeprensa/notasprensa/industria/Paginas/2022/030322-ipceisalud.aspx)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

 

 

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)