Posts

7 days in healthcare (March 14-20, 2022)

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SUMMARY

From the point of view of biomedicine, to highlight the new treatment for malaria in children; the new variant “Delatacron”, similar to the “ómicron”; and, the possibilities of artificial intelligence to accelerate the appearance of new medicines. We would like to underline the studies promoted by Valentín Fuster on ultrasound of the neck and groin arteries and their possibilities of detecting the risk of myocardial infarction and stroke to be promising, although it is a topic that has been talked about for a long time without much results.

Regarding Global Health, an interesting editorial in the British Medical Journal, entitled climate change, pandemic and war: an uncontrolled multi-crisis, since it seems that in this decade of the 21st century all the problems have accumulated; the verification that the low level of vaccinations in Africa is not so much due to the low level of vaccines, but rather due to the difficulties of reaching the population; interesting report on Nigeria and the problems of its health system.

In terms of international health policy, the problems of Asia’s “covid zero” strategy are noteworthy, which gave so much political return to the Chinese regime, presenting its low mortality successes and comparing them with the high mortality rates of other countries in the world ( United States, Brazil, United Kingdom, India, etc.). It seems that the “ómicron” variant, due to its contagiousness, is not easily approachable with the “covid zero” strategy, since that would lead to massive confinements in China. Resurgence of covid cases in Europe and Asia, which coincides with a relaxation of control measures.

If we talk about national health policy (Spain), it should be noted that the incidence of covid is growing, while the measures are relaxed, although there is concern in the Ministry of Health about a possible new wave of covid at the gates of Easter. Very important COFARES report on the pharmacy sector, proposing many innovative measures, which contrasts with the usual narcissism and laudatory speeches about the “Mediterranean model of pharmacy”, so liked by some professional representatives. Primary Care is trying to get back to normal, although with a thousand fewer doctors than before the pandemic. The birth rate in Spain is at historic lows, which is a serious problem. The Council of Dentists, in reporting that 34 million Spaniards have cavities, presents us with the reality of poor dental care in our country. A revolution in the use of biosimilars is coming, given the large number of biological medicines that will lose their patent in the coming years.

In the field of companies, it should be noted that Pfizer and BioNTech have requested authorization in the United States for a second “booster” for older Americans. Grifols bets on a vaccine against Alzheimer’s. HIPRA, the veterinary pharmacy company until now, hopes to start marketing its vaccine against covid in June.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

  • COVID

o The “ómicron” variant is changing China’s “zero covid” strategy, at the moment more than 40 million Chinese are suffering some type of confinement, which is tolerated by the remaining 1.4 billion who lead normal lives. The legitimacy of the party is given by the low mortality. We’ll see if that can be sustained with the “omicron” (https://www.economist.com/china/2022/03/19/omicron-is-changing-chinas-covid-strategy)

o China reports the first deaths from covid in more than a year (https://www.nytimes.com/live/2022/03/18/world/covid-19-mandates-cases-vaccine)

o Shanghai, possible confinement, after the discovery of 150 new cases of covid (https://www.ft.com/content/659a5337-681b-4ef2-a9ac-db9aaaa78cef)

o Concern that new lockdowns in China may disrupt supply chains (https://www.economist.com/finance-and-economics/will-chinas-covid-lockdowns-add-to-strains-on-supply- chains/21808193)

o Resurgence of covid cases in Europe and Asia, infections have risen 8% worldwide, but they are skyrocketing in Vietnam and Germany (https://www.larazon.es/sociedad/20220317/z4bkdrxn2vddtcbvhi5equn45e.html)

  • Other issues

o According to an American study (Health Affairs), hospitals differ in their services depending on whether they are for-profit, non-profit or government-owned, with the former tending to offer more profitable services and discontinue the others (https://www.healthaffairs. org/doi/epdf/10.1377/hlthaff.2021.01115)

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o Latest report: the incidence of covid rise and 287 deaths, in Friday’s report (since Tuesday) (https://www.consalud.es/pacientes/especial-coronavirus/covid-19-espana-registra-64597 -cases-287-deaths-ia-upload-44580-points_111800_102.html)

o The new plan against covid will put an end to the isolation of positives (https://www.lavanguardia.com/vida/20220319/8136758/nuevo-plan-covid-pondra-aislamientos-positivos.html)

o The Ministry of Health fears the arrival of a new wave of covid at the gates of Holy Week (https://www.elespanol.com/espana/20220314/sanidad-llegada-septima-covid-puertas-semana-santa/656934435_0 .html)

o Paxlovid, the anticovid treatment promised by Sánchez, has not yet reached patients (https://www.elmundo.es/ciencia-y-salud/salud/2022/03/17/623244e021efa054348b458d.html)

  • Other themes

o Spain was left out of the top 10 in public health spending in 2020, according to a report made public by Eurostat and spent an average of 600 euros less per inhabitant than the EU average (https://www.consalud.es/politica/espana- top-10-ue-public-expenditure-health-2020_111467_102.html). To access the Eurostat report: https://ec.europa.eu/eurostat/databrowser/view/GOV_10A_EXP__custom_2243551/bookmark/table?lang=en&bookmarkId=8df11907-86e8-4f5b-a62e-a7d09828e303)

o Important COFARES report: pharmacist skills in the 21st century, proposing digitization, home delivery, legal changes and the sustainability of the pharmacy model (https://www.consalud.es/profesionales/profesionales-analizan- evolution-pharmacy-role-pharmacist_111660_102.html)

o The Ministry of Health and the regions coordinate health care for refugees from Ukraine (https://www.diariofarma.com/2022/03/18/sanidad-y-las-cc-aa-garantizan-la-atencion- health-for-refugees-from-ukraine)

o The Ministry of Health puts the average time to approve a drug at “9 months” (https://www.consalud.es/politica/ministerio-sanidad/sanidad-asegura-la-media-espana-aprobar-medicamento-9- months_111648_102.html)

o The flu enters Spain with force (https://www.lavanguardia.com/vida/20220317/8130742/gripe-fuerza-espana.html)

o Primary Care is trying to get back to normal, with a thousand fewer doctors than before the pandemic (https://elpais.com/sociedad/2022-03-20/la-atencion-primaria-intenta-volver-a-la- normality-with-a-thousand-less-doctors-than-before-the-pandemic.html)

o The birth rate in Spain, at lows not known in several centuries, according to a study by the San Pablo CEU University (https://www.eldebate.com/sociedad/20220315/pandemia-apenas-pasa-factura-natalidad-espana. html)

o A total of 34 million people in Spain have cavities, according to the General Council of Dentists (https://www.actasanitaria.com/politica-y-sociedad/total-34-millones-personas-en-espana-tienen- caries_2001822_102.html)

o The Ombudsman receives 2,300 health complaints in 2021, according to the report presented (https://www.defensordelpueblo.es/informe-anual/informe-anual-2021/)

o La Paz, on October 12 and Gregorio Marañón among the 100 best hospitals in the world, according to the classification prepared by Newsweek magazine (https://www.elmundo.es/madrid/2022/03/14/622e4da7e4d4d894118b45c8.html )

o Incorporating 6,000 doctors in primary care would cost 358 million euros, according to the Collegiate Medical Organization (https://www.elmundo.es/ciencia-y-salud/salud/2022/03/14/622df5e7fc6c83c80d8b4583.html)

o Mariano Esteban’s covid vaccine will not continue the clinical phase in Spain (https://www.diariomedico.com/medicina/enfermedades-infecciosas/empresas/la-vacuna-de-la-covid-de-mariano-esteban -csic-will-not-continue-the-clinical-phase-in-spain.html)

o Spain needs a plan for the second revolution in biosimilars, since one hundred biological drug patents expire between 2024 and 2029 (https://cincodias.elpais.com/cincodias/2022/03/16/companias/1647452966_841014.html)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

  • International News

o Moderna supplies 70 million additional doses of its vaccine to Japan (https://www.plantadoce.com/empresa/moderna-suministra-70-millones-de-dosis-addicionales-de-su-vacuna-anti-covid- 19-a-japan.html)

o Pfizer and BioNTech request authorization for a second “booster” for older Americans (https://www.nytimes.com/2022/03/15/us/politics/pfizer-second-booster-shot-older-americans.html )

o AstraZeneca, prepared not to continue with the efforts to obtain authorization in the USA for the covid vaccine (https://www.ft.com/content/e1edb2b2-0e12-4c83-9257-eeeb2ba29267)

  • National News

o Grifols bets on the Alzheimer’s vaccine and ends phase II of clinical trials (https://www.plantadoce.com/empresa/grifols-apuesta-por-la-vacuna-contra-el-alzheimer-finaliza-la- phase-ii-trials-of-abvac40.html)

o The Danish A.P. Moller Holding completes the purchase of Unilabs (https://www.plantadoce.com/empresa/la-danesa-ap-moller-holding-completa-la-compra-de-unilabs.html)

o The founders of Rovi sell 5% after the success of the Moderna vaccine (https://www.europapress.es/economia/noticia-fundadores-laboratorios-rovi-venden-capital-empresa-1808-millones-20220315082314.html )

o Hipra hopes to market its covid vaccine in June (https://www.businessinsider.es/vacuna-hipra-covid-comercializar-junio-primera-espanola-1029741)

 

 

7 days in healthcare (January 31-February 6, 2022)

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SUMMARY

As far as biomedicine is concerned, the report on the value of death by The Lancet stands out; also the development of the nasal vaccine against COVID; the new horizon of transplants, derived from the possibilities of genetic editing of animal organs; and, the revolution that the new cancer vaccines based on mRNA technology may entail.

In terms of global health, the AstraZeneca vaccine is the most widely used worldwide, due to its contribution to COVAX. More than 2,500 million doses have been placed globally.

In international health policy, the most striking is the study by Johns Hopkins University, which minimizes the effectiveness of confinement, which contrasts with previous studies; the 900,000 deaths from COVID in the United States and the 500,000 in India; the WTO continues to request the release of vaccine patents. In Europe, it is worth highlighting the new clinical trial system approved by the European Union and its new approach to cancer.

National health policy continues to be dominated by COVID. The numbers of cases are decreasing, which speaks of the decline of the “sixth wave”. However, deaths are still very high. The announcement that oncological biomarkers will be included in the portfolio of the National Health System is very important. Cancer mapping in Spain presents very striking results, with a high concentration of cancer incidence in certain geographical areas. Subject to study and act.

In company news, the leading role of venture capital companies is notable, with the large operations underway by Sandoz (a generic and biosimilar branch of Novartis) and IVI (a Spanish fertility company). The interest of private equity companies is concentrated around these companies. Also the acquisition of MIR Asturias by CVC and the Alfonso X University. The attempt by Correos to enter pharmaceutical distribution will bring a tail.

BIOMEDICINE

  • Report on the value of death: while in developed countries there is hypertreatment around death, in most countries death occurs without access to basic pain treatment (The Lancet, January 31, 22)
  • The nasal vaccine may be better for successive doses. There are a dozen such vaccines in development in phase 3 trials (NYT, February 2, 22)
  • The “stealth” variant (stealth) does not generate alarm, but it can slow down the decline in the number of cases (NYT, January 31, 22)
  • The sub-variant “ómicron” BA.2, more contagious than the original (FT, 31 January 22)
  • The new variant BA.2, already present in 57 countries, according to the WHO (FT, February 3, 22)
  • New variant of the HIV virus, discovered in the Netherlands (FT, February 3, 22)
  • Genetic editing of pig hearts: a new horizon for transplants (FT, February 2, 22)
  • Cancer vaccines: the new mRNA revolution (El País, Vozpópuli, February 4, 22)
  • Amidst the wide debate on abortion, a simple pill seems the most viable option (The Economist, 5 February 22)

GLOBAL HEALTH

  • AstraZeneca, the most distributed vaccine through COVAX, has already given 2,500 million doses worldwide (ConSalud, January 31, 22)
  • Humanitarian groups denounce that sanctions against Mali may have very adverse health consequences (The Lancet, February 5, 22)

INTERNATIONAL HEALTH POLICY

  • COVID

o A study by Johns Hopkins University (Applied Economics Studies magazine) questions the effectiveness of confinement in reducing mortality, which contrasts with the analysis published in Nature in June 2020, which estimates that three million deaths have been prevented in Europe by confinement, 450,000 in Spain (El Independiente, February 3, 22)

o The UK approves the Novavax vaccine (FT, 3 February 22)

o The American army begins to fire its members who refuse the vaccine (The Guardian, February 2, 22)

o The New Zealand border will be reopened in phases from the end of February, the Prime Minister announces (The Guardian, 2 February 22)

o The United States reaches 900,000 deaths from COVID (The Guardian, February 4, 22)

o India exceeds 500,000 deaths from COVID (The Guardian, February 4, 22)

o Europe facing a “long period of tranquility” in the pandemic, says the WHO, due to the lesser severity of the “ómicron” variant, the high percentages of immunization and the good weather (The Guardian, February 3, 22)

o The WTO (World Trade Organization) wants an agreement to release vaccine patents this month (El Español, February 1, 22)

o The German Vaccine Commission recommends the fourth dose for vulnerable and health groups (El País, February 3, 22)

o Beijing seals off several communities for two cases of COVID (The Guardian, January 31, 22)

o The COVID vaccine is already mandatory in Austria, with a great social fracture (Expansión, February 5, 22)

  • Other issues

o New clinical trial system in Europe, which Farmaindustria sees as an opportunity (diariofarma, February 1, 22)

o The EU will act against inequalities against cancer (ConSalud, February 3, 22)

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o The sixth wave is being left behind, the cases and hospitalizations are slowing down, although not the deaths that already exceed 6,000 since November (El País, February 5, 22)

o The mask outdoors will no longer be mandatory from next Thursday (El País, February 4, 22)

o Health has not yet closed the purchase of 344,000 doses of Paxlovid (El Español, February 3, 22)

o The AEM authorizes the HIPRA vaccine to go to phase 3 of clinical trials (The Objective, February 1, 22)

  • Political ads

o The new public health center, affected by the decentralization of public offices (diariofarma, February 1, 22)

o The approval of oncological biomarkers, announced as a pending objective of the expansion of the NHS portfolio (diariofarma, February 1, 22)

o The Minister of Health says that the Anti-Tobacco Law needs to be updated (ConSalud, February 4, 22)

  • Other issues

o 27% of pharmaceutical innovations approved in 2021, subject to special financing conditions (diariofarma, February 1, 22)

o Access to new cancer drugs takes more than 19 months in Spain, while in Germany it takes two months, according to doctors and patients (La Vanguardia, February 2, 22)

o Health plan to make rural pharmacies more viable (ConSalud, January 28, 2022)

o The private e-prescription is consolidated (diariofarma, February 2, 22)

o The cartography of cancer in Spain has been published, with very striking results, according to the “Atlas of Cancer Mortality in Portugal and Spain” (El Periódico de España, February 5, 22)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

  • American pharmaceutical companies (J&J and three of the largest drug distributors in the United States) agree to pay 590 million dollars to Native Americans for the opioid crisis (El País, February 1, 22)
  • Pharmaceutical cold distribution, new Correos service (Redacción Médica, February 2, 22)
  • Pfizer-Biontech requests authorization from the FDA for the approval of the vaccine for children under 5 years of age (El País, February 1, 22)
  • Private equity companies consider offers of more than 25,000 million dollars for the generics unit of Novartis, Sandoz, Blackstone, Carlyle and EQT, among the most interested (FT, February 1, 22)
  • KKR, CVC, Permira, Bain, Carlyle and PAI outline their bids to take over the fertility company of Valencian origin IVI, the bids range from 1,500 million euros (CincoDías, January 31, 22)
  • Atrys enters the continuous market, as of February 7 (PlantaDoce, February 3, 22)
  • Sanitas gains ground and plans to open 7 rehabilitation centers in 2022 (PlantaDoce, February 1, 22)
  • Adeslas and Caixabank extend their agreement in the Bankia network for 650 million euros (CincoDías, January 27, 22)
  • MIR Asturias acquired by CVC and Alfonso X University (La Nueva España, February 3, 22)
  • Quirón acquires Clínicas Vida and strengthens its care network in Tenerife (PlantaDoce, January 28, 22)
  • Vitaldent expands throughout Andalusia and opens a new clinic in Benalmádena (PlantaDoce, February 3, 22)
  • Group 5 opens a residence for serious mental disorders in Madrid (PlantaDoce, February 3, 22)
  • Prim is reinforced with the purchase of Herbitas laboratories (Expansión, February 4, 22)
  • Pharmamar leads a consortium of companies for the development of advanced therapies (El Economista, February 3, 22)

7 days in healthcare (January 17-23, 2022)

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SUMMARY

From an international point of view, the article published in The Lancet should be highlighted, in which mortality due to antimicrobial resistance, one of the most important causes of death in the world, is analyzed at a global level. Also the demand of the British Medical Journal that the scientific community have access to all the original data on the clinical trials of vaccines, since at this time these data are only accessible to employees of pharmaceutical companies. The Economist analyzes if the mandatory nature of the vaccine works, concluding that it does. It looks like all the COVID restrictions in England are going to end soon. The European Union gives more powers to the EMA, in case of having to manage future health crises.

As for the national news, the pandemic is still unchecked, in very high numbers and with high mortality; the debate on treating the covid as influenza continues, with opposing positions, those who are against it and those who defend it; the Ministry of Health wants to advance in the recertification, in dialogue with the FACME and the Organization of Medical Orders; The situation of health insurance in 2021 is presented, which did not stop growing, until the sector as a whole reached a turnover of close to 10,000 million euros; the Madrid College of Physicians signs a controversial agreement with UNIPROMEL, in theory to “defend doctors in free practice”, but, more possibly, with the intention of reinforcing the current weakened board of directors.

As far as companies are concerned, perhaps the most outstanding news is the sale by IBM of Watson Health, the artificial intelligence solution, designed to solve diagnostic and therapeutic problems, which had had so many problems in some centers such as MD Anderson from Houston. Although it was a good and ambitious idea, it was possibly ruined by short-termism, hyperselling and not taking enough into account the complexities of medicine and medical practice.

INTERNATIONAL NEWS

  • The Lancet publishes an article on the mortality of antimicrobial resistance. 204 countries and territories are analyzed in 2019. 4.95 million deaths from antimicrobial resistance were found in 2019. Antimicrobial resistance is one of the most important causes of death in the world (The Lancet, 20 January 22)
  • The British Medical Journal, after the Tamiflu experience, asks that the original data (raw data) from the clinical trials of vaccines be accessible to all researchers, not just those from the pharmaceutical industry, as is the case now (BMJ, January 19, 22)
  • The WHO gives the green light to the wider use of the third dose against COVID (FT, January 21, 22)
  • The fourth dose of the vaccine, infective in the extension of the “ómicron” variant, according to an Israeli study (FT, January 18, 22)
  • The Economist analyzes if the compulsory nature of the vaccine works. After analyzing the cases of Canada, France, Italy and Germany, he concludes that it works (The Economist, January 22, 22)
  • The covid passport strengthens the economy and vaccination (FT, January 18, 22)
  • Bill Gates warns against a pandemic potentially worse than COVID and calls on governments to spend billions of dollars to prevent it. He also says that this effort can contribute to improving the prevention and treatment of current extended diseases: HIV, tuberculosis, malaria (FT, January 19, 22)
  • All restrictions in England may end in March, according to the British Prime Minister’s plans (The Guardian, 17 January 22)
  • The EU approves the reform that gives more powers to the EMA in the management of future health crises (The Objective, 20 January 22)
  • Italy registers an increase in vaccination, after making it mandatory for those over 50 years of age (El País, January 17, 22)

NATIONAL NEWS

  • Situation of the pandemic

o COVID, still unchecked, breaks a new record of 3,418 cases per 100,000 inhabitants (El País, January 21, 22)

o The ICUs are at the limit of their structural capacity but far from the worst moments (El País, January 17, 22)

  • Debate about dealing with the covid as if were “flu”

o Two opposing positions:

 “Gripalizing the covid or how to believe we are winners”, article by Santiago Cervera, January 15, 22)

 Antonio Zapatero is committed to self-care and not to restrictions (El Español, January 17, 22)

  • Sick leave

o Processed 21,000 sick leaves and registrations in Madrid in the first days of the new system (El País, January 20, 22)

o The doctors accuse Escrivá of violating the law with the casualties, by giving in the same act for 7 days (La Razón, January 17, 22)

  • Recertification

o The Ministry of Health commits with FACME and the WTO to promote professional recertification (Acta Sanitaria, January 21, 22)

  • Situation schools

o The avalanche of school confinements puts families on the ropes (El País, January 21, 22)

  • Health insurance

o Health insurance grows by 4.93% in 2021 and totals 9,849 million euros (Acta Sanitaria, January 18, 22)

o According to forecasts by Javier Murillo, health insurance will grow in 2022 by around 5.5-6% (presentation at ICEA)

o MJ Montero (Finance Minister): great support for the MUFACE system (MUFACE Magazine, nº 252, winter 2021)

  • Other issues

o Organ transplants overcome the slump of 2020 and grow 8% in 2021 (El País, January 21, 22)

o Argimón presents the 2021-2025 health plan (Consalud, January 20, 22)

o Health, forced by Transparency to deliver to Farmaindustria the minutes of the Pharmacy Commission of the Interterritorial Council (diariofarma, January 16, 22)

o The MIR exam will bring together candidates from 4 continents and 88 countries (redacción Médica, January 20, 22)

o The Madrid College of Physicians signs an agreement with UNIPROMEL, “to defend free practice physicians” (Official Note ICOMEM, January 21, 22)

o Health awards 81 linear accelerators, in compliance with the INVEAT plan, three lots: Ab Salud, Varian and Elekta (ConSalud, January 18, 22)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

  • IBM sells Watson Health to an investment firm. The sale was preceded by resounding failures of this artificial intelligence tool for medical diagnosis and treatment (WSJ, January 21, 22)
  • Moderna intends to launch a joint COVID-flu vaccine in two years (The Guardian, January 17, 22)
  • Djokovic has 80% of the shares in a Danish biotech firm (QuantBioRes) that intends to release a vaccine against COVID (The Guardian, January 19, 22)
  • Pfizer becomes the largest provider of the pandemic and it is estimated that it will double its income (eldiario.es, January 17, 22)
  • Pfizer, AstraZeneca and the Chinese Sinopharm and Sinovac will manufacture 70% of the COVID vaccines (CincoDías, January 20, 22)
  • Merck entrusts the manufacture of its pill against COVID to 27 manufacturers (PlantaDoce, January 20, 22)
  • More than 100 laboratories in Asia and Africa could manufacture vaccines for Pfizer and Moderna (El Independiente, January 19, 22)
  • The “telecos” take advantage of the pandemic to add clients in telemedicine (El Independiente, January 19, 22)
  • AstraZeneca, the most widely used COVID vaccine in the world that is no longer administered in Spain (El Español, January 21, 22)
  • St John of God (important hospital network in Spain, until now divided into three “provinces”) consolidates its management structure at the national level (Acta Sanitaria, January 20, 22)
  • Acciona, Sacyr and OHLA bid for a new hospital in Chile for 265 million euros (PlantaDoce, January 16, 22)
  • Dental Residency, objective by 2022 to double billing and provide coverage to 250,000 residents (PlantaDoce, January 20, 22)
  • The EMA asks HIPRA to show greater efficiency than Pfizer, if it wants to be part of the European Union’s portfolio (El Economista, January 18, 22)
  • HIPRA will carry out the last clinical trial of its vaccine at HM Hospitals (El Economista, January 17, 22).
  • Viamed is preparing an offer for one of the “Catholic” hospitals in Madrid: San Francisco and Beata María Ana (Sanifax, January 21, 22)
  • ASISA renews its Board of Directors with three members, one internal and two independent directors (Europa Press, January 20, 22)
  • Mercadona offered the Government to sell tests in its establishments at 2.90 euros. The Government preferred to keep pharmacies as the only test point of sale (Sanifax, January 20, 22)
  • Lilly publishes an overview of start ups in health in Spain (Lilly, January 22)