Posts

7 days in healthcare (September 5th-11th, 2022)

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Summary

From the point of view of Biomedicine, to highlight the work that shows an association between artificial sweeteners and increased cardiovascular risk. Also that air pollution causes lung cancer.

As far as Global Health is concerned, apart from the serious humanitarian crises in Pakistan and Somalia, the most promising is the new malaria vaccine, which could be operational as early as 2023.

Regarding international health policy, assisted suicide and euthanasia are news in Canada (where the rate of euthanasia is very high and there is concern) and in France (which is considering passing a law). Macron has launched a major national debate on this issue, following a report to appear next week from the Ethics Committee. This great debate on such a delicate subject was missed in Spain. Certain issues should not be subject only to conjunctural parliamentary majorities, but should be preceded by a great national debate. It is also worth mentioning that Chile rejected the draft Constitution in a referendum. According to an article published in El País, doubts about the possibility of choosing the health system (the continuity of the ISAPRES, as health insurers are called in Chile), is one of the causes of this rejection.

If we talk about national health policy (Spain), it should be noted that Aragón proposes a great debate on the efficiency of the National Health System, a brave and valuable initiative. It will first analyze the Aragonese health system, and then share that analysis with the rest of the autonomies. Also that the Ministry of Health promises to change the law to favor the local manufacture of medicines. It is also worth underlining the pronouncement of the Catalan Evaluation Agency, on the need for a state policy for the digital transformation of the health system and the promotion of telemedicine.

In the field of companies, from the international point of view, to mention the purchase of Signify a home care group by CVS (an American pharmaceutical chain), in a process in which Amazon also showed interest. In terms of news at the national level, to highlight the great investment of Novartis in our country.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (June 13th-20th, 2022)

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Summary

From the point of view of biomedicine, to highlight the new therapy against a disease as terrible as ALS tested in Canada. Unfortunately there are doubts as to its effectiveness.

As far as Global Health is concerned, it is verified that it is the vaccine nationalism of the States that has led to the failure of COVAX, which failed to extend covid vaccination to poor countries in significant percentages.

Regarding international health policy, the approval in the United States of the covid vaccination for children under five years of age should be highlighted. Also the agreement of the World Trade Organization regarding the temporary suspension of patents on covid vaccines, something he was discussing for two years. We will see if this agreement translates into relevant measures. For now, the IFPMA (World Association of Pharmaceutical Manufacturers) has already spoken out against it. Hospitalizations for covid increase in Europe, specifically in France, Germany and the United Kingdom.

If we talk about national health policy (Spain), we must mention the controversial announcement by the Minister of Health of the fourth dose of covid for the entire population, something partially rectified by the Ministry itself and which has been rejected by many experts. Also the approval by the Government of the preliminary draft of the Equity Law. Great controversy with the private sector, since it tries to minimize and declare exceptional the collaboration of the private sector in the public service of the National Health System. But by declaring “direct management” as preferable in the SNS, it also positions itself against the more entrepreneurial development of public management, despite the fact that the benefits of legal personality and the labor regime are known in terms of greater efficiency than direct management. On the other hand, the draft may undermine the powers of the autonomous communities, since health management (and therefore the way of carrying it out) is a transferred matter. It is not surprising that very important Catalan institutions (such as UCH, CSC, ACES and Círculo de Sanidad) have taken a position against it. Important demonstration by nurses in the center of Madrid, highlighting the importance of the abandoned professional policy in the National System of Health.

In the field of companies, it is worth noting the birth of the largest pediatric oncology center in Spain and one of the largest in Europe: the one located in the Sant Joan de Deu Hospital in Barcelona. Expansión highlights that the remarkable growth of health insurance is compatible with a loss of its operating profitability.

Biomedicine

Global health

International health policy

National health policy

• Monkeypox

• COVID

• Regulatory announcements

• Other themes

Companies

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

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SUMMARY

In biomedicine, we have to highlight the studies that are confirming a modest association between an increased incidence of mental illness after COVID.

As far as Global Health is concerned, mention should be made of the book by Ed Miliband, a British parliamentarian, former leader of the Labor Party and minister with Gordon Brown, which amounts to a manifesto on public health in the wider sense, which, at the moment, is already beginning to be a literary genre, among which the books by Gordon Brown, Minouche Shafik, Fareed Zakaria and, soon, Bill Gates stand out.

Regarding international health policy, verifying that the calculation of excess mortality is the best way to assess mortality from COVID. The problem is that this may be valid for Europe and the Americas, but not for Asia and Africa, where the low mortality figures are hardly credible. Gordon Brown, former British Prime Minister, asks the G20 for a global financial solution to tackle the pandemic, similar to what was done in the 1960s with smallpox. The Economist highlights Africa’s low capacity for vaccine production, in contrast to its large population.

Regarding the national health policy, the first thing to mention is the drop in the incidence of COVID, which last Friday reached 919 per 100,000 inhabitants, which is compatible with the fact that mortality skyrockets in the sixth wave and there is a delay in receiving the new antivirals. The government approves the Science Law project, with controversial elements among researchers. The massive retirement of professionals (including doctors) is probably the most far-reaching problem of the SNS. The SEOM (Spanish Society of Medical Oncology) denounces the lack of equity in access to drugs and markers.

In business news, we must mention the FENIN declaration in favor of the manufacture of medical technology in Spain, to avoid dependency in the event of pandemics; also that the fifth vaccine approved in Europe (NOVAVAX) receives authorization to be manufactured in Galicia (Porriño); Rovi extends its alliance with Moderna for the manufacture of vaccines for ten years.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o The incidence of COVID drops to 919 cases per 100,000 inhabitants, with 7.8% occupancy of hospital beds due to COVID and 13.7% of ICU beds (https://www.consalud.es/pacientes/especial -coronavirus/covid-19-spain-records-30615-cases-288-deaths-ia-baja-919_110353_102.html)

o Deaths from covid skyrocket in the sixth wave (https://www.elindependiente.com/vida-sana/salud/2022/02/19/las-muertes-por-covid-se-disparan-en-febrero-con-4-365-fallecidos-y-elevan-a-11-081-las-de-la-sexta-ola/)

o Waiting for the antivirals that Sánchez promised in January (https://www.elespanol.com/ciencia/salud/20220214/omicron-mata-espera-antivirales-sanchez-prometio-enero/650185438_0.html)

o Public health detects an explosion of scabies cases related to the pandemic (https://elpais.com/sociedad/2022-02-19/la-sanidad-publica-detecta-una-explosion-de-casos-de- scabies-related-to-the-pandemic.html)

o Sports events capacity returns to 100% on March 4 (https://www.consalud.es/politica/consejo-interterritorial-decide-recuperar-aforos-deportivos-100-4-marzo_110196_102.html)

  • Political announcements

o The Government approves the Science Law project that the sector sees with room for improvement (https://www.diariomedico.com/investigacion/el-gobierno-aproba-una-ley-de-ciencia-que-los-investigadores-ven-muy -improveable.html?check_logged_in=1)

o Changes in the portfolio of services: more oral health and screening (https://www.redaccionmedica.com/secciones/ministerio-sanidad/la-nueva-cartera-comun-del-sns-contempla-mas-salud-bucodental- y-screened-6455)

o Spain adheres to the International Vaccine Institute (https://www.consalud.es/politica/gobierno-aprob-adhesion-espana-instituto-internacional-vacunas_110110_102.html)

  • Other issues

o Health approves the new vaccination schedule for 2022 (https://www.larazon.es/sociedad/20220217/as5pmub735hwpmxosjjwlzapty.html)

o Strong mobilizations in the Andalusian health sector (https://www.elconfidencial.com/espana/andalucia/2022-02-19/sanidad-andalucia-manifestaciones-sindicatos-partidas_3378408/)

o Mass retirement of health workers: a drag on the SNS (https://www.consalud.es/profesionales/jubilacion-masiva-sanitarios-quebradero-cabeza-sistema-nacional-salud_110332_102.html)

o Private healthcare demands a clear legal framework in the National Security Law (https://www.redaccionmedica.com/secciones/privada/la-privada-reclama-un-marco-juridico-claro-en-la-nueva- security-law-8788)

o Lack of equity in access to drugs and markers (https://cincodias.elpais.com/cincodias/2022/02/16/companias/1645013239_112550.html)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

7 days in healthcare (January 24-30, 2022)

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Summary

From the point of view of biomedicine, the concern regarding resistance to antibiotics continues, after the extensive report published by The Lancet. This pandemic produces more deaths than AIDS and malaria. New variant of “ómicron” appeared in Denmark.

With regard to global health, the tenth anniversary of the declaration on “Neglected tropical diseases” should be highlighted, which provides an opportunity to reflect on a change in which progress has been made, but much remains to be done. COVAX does not have the capacity to receive more donations in the absence of basic financing for the purchase of syringes and other materials, essential to administer the vaccine.

As for international news, the WHO will publish a plan for the transition of the pandemic to the “control phase” in February. IHI initiative, of the European Union, to create a public/private platform for drug research.

In national news from Spain, the sixth wave seems to be starting to subside in terms of new cases, but still with high mortality. Interesting report promoted by Vitaldent on the public financing of dental care. Biosim highlights the savings potential of biosimilars in 2022. The issue of professional recertification advances, with a leading role for FACME.

In company news, the approval by the EMA of Paxlovid, Pfizer’s antiviral pill against COVID, is important. Also the large expected growth in turnover by COVID vaccine manufacturers in 2022 (29%, compared to 2021). Boom of online psychology platforms

Biomedicine

  • It is time to confront the pandemic of antibiotic resistance, since this resistance causes more deaths than AIDS and malaria. AMR Action Fund, a public/private initiative to develop new antibiotics, is underway (FT, January 28, 22)
  • The new BA.2 omicron, which appeared in Denmark, the stealthy variant of the “‘omicron”, warns the WHO that it may not be detectable with PCR (La Razón, January 25, 22)
  • New research identifies the 4 factors that can favor prolonged covid (NYT, January 25, 22)

Global health

  • 10th anniversary of the London declaration on “Neglected tropical diseases”, much progress has been made. Trachoma, schistosomiasis and visceral leishmaniasis are the most frequent of this type of disease (The Lancet, January 29, 22)
  • Developed countries throw away 61.5 million vaccines for having expired in 2021 (El Español, January 28, 22)
  • World Day against Leprosy, the covid pandemic has silenced it, a disease almost eradicated in Europe but still present in the world (ConSalud, January 30, 22)
  • Lack of funding to buy syringes and other accessories means COVAX cannot accept new doses of vaccines (FT, 25 Jan 22)
  • The United States donated 400 million doses of covid vaccine to 112 countries, according to the White House (The Guardian, January 26, 22)
  • Project Syndicate magazine publishes an analysis (How Much Has the Pandemic Cost?) of the economic impact of the pandemic, based on years of life lost and the value of life in different countries. If the official figure of 5.6 million dead at the end of 2021 is taken, this means 38 trillion (American) dollars or 40% of global GDP; If the estimate of deaths from The Economist (17 million) is taken, we would reach 114 trillion or 120% of global GDP (Project Syndicate, January 27, 22)

International News

  • The WHO will publish in February a plan for the transition of the pandemic to the “control phase” (La Razón, January 24, 22)
  • Notable increase in telemedicine in Medicare (USA) during the pandemic (JAMA, January 25, 22)
  • The British Medical Association recommends the use of FPP3 mask to health professionals who have to deal with patients with viral respiratory disease (BMJ, 21 January 22)
  • The new normal in New Zealand goes from covid 0 to covid acceptance (The Guardian, 26 January 22)
  • An Israeli panel recommends the fourth dose to all adults (FT 25 Jan 22)
  • In Canada, demonstrations against compulsory vaccination (The Guardian, January 30, 22)
  • The European Union launches IHI, a public/private initiative for drug research, as a continuation of the Innovative Medicines Initiative, which was launched in 2008 (Acta Sanitaria, January 26, 22)

National News

  • COVID

o The epidemic curve in Spain consolidates its decline, but experts call for caution (El País, January 29, 22)

o The sixth wave already registers 5,674 deaths from covid and could exceed the sixth before February (El Español, January 27, 22)

o Health and the communities extend the limited capacity at sporting events (El País, January 26, 22)

o The anti-vaccines are responsible for increasing deaths by 32% in the sixth wave, according to Fedea (El Español, January 24, 22)

o Those vaccinated have a hundred times less chance of dying if they become infected (El Mundo, January 28, 22)

o Catalonia abolishes the covid passport (La Razón, January 26, 22)

  • Other issues

o Financing dental health (one of the promises of the PSOE-Unidos Podemos government program) will cost the State 5,423 million euros, according to a study promoted by Vitaldent and presented to the Ministry of Health (El Economista, January 25, 22)

o A third of doctors will retire in the next five years (The Objective, January 28, 22)

o Telemedicine is good for reducing CO2 into the atmosphere, it would reduce 277,120 tons of CO2 in Spain in Primary Care alone, according to the report prepared by “GEN Europe Energy Solutions” (ConSalud, January 28, 22)

o More than 13,000 applicants opt for the 8,200 MIR places in the exam on January 29 (Acta Sanitaria, January 28, 22)

o Biosim puts the savings on biosimilars at 1,048 million euros in 2022 (diariofarma, January 26, 22)

o FACME claims its role in the recertification and creates a specific council, chaired by Cecilio Santander (Diario Médico, January 28, 22)

o ISFAS statement on difficulties in negotiating insurance companies-hospital groups for the coverage of this group (Sanifax, January 24, 22)

Companies, employers and other agents of the sector

  • The EMA approves Paxlovid, Pfizer’s antiviral pill against covid (El Economista, January 27, 22)
  • The large vaccine manufacturers will invoice 75,000 million euros for the covid vaccine this year 2022, this is a 29% jump over the estimate for 2021, according to the consulting firm Airfinity (CincoDías, January 25, 22)
  • Pfizer will produce 120 million doses of its drug against covid in Europe (El Español, January 29, 22)
  • Cinfa leads the market in pharmacies and Novartis in hospitals (CincoDías, January 24, 22)
  • The French group Orpea with problems in its listing due to accusations of mistreatment (FT, January 27, 22)
  • BioNTech begins clinical trial for “ómicron” vaccine (FT, January 25, 22)
  • The business of mental health: boom in online psychology platforms (El Periódico de España, 30 January 22)
  • Mifarma (the leading company in Europe for the online sale of pharmacy and parapharmacy products) reinforces its position in Spain with a new image and online platform (La Razón, January 25, 22)
  • United Imaging Healthcare lands in Spain hand in hand with APR Salud (PlantaDoce, January 25, 22)
  • Sanitas is interested in the purchase of the IMQ (Redacción Médica, January 26, 22)
  • Healthcare Activos continues its expansion and will buy a residence in Ferrol (PlantaDoce, January 21, 22)
  • Corachán becomes stronger in Barcelona with a new center in Sarriá (PlantaDoce, 27 January 22)

Which Country Has The World’s Best Health Care?

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The famous physician, health economist and bioethicist, Ezekiel J. Emanuel, has recently published a book (Public Affairs, New York, 2020) that tries to answer the famous question of what is the best healthcare system in the world. Obviously, after a long exploration, the answer is that there is no system that can be classified as the best in the world, but rather that they all have their strengths and weaknesses.

But the exploration is not without interest, since he analyzes with some detail, the systems of 11 countries: the United States, Canada, the United Kingdom, Norway, France, Germany, the Netherlands, Switzerland, Australia, Taiwan and China. Very much in the Anglo-Saxon tradition, Spain does not exist and, what is even more surprising, none of the Latin American and Caribbean countries.

The book analyzes the 7 challenges that healthcare systems usually face:

  1. Cost pressure
  2. The price of medicines
  3. Inefficiency in the provision of services
  4. Coordination of patients with chronic diseases
  5. Mismatch between the organization of provision services and the needs of chronic patients
  6. Provision of mental care
  7. Long-term care

The book has very interesting graphs that analyze: a) the different types of coverage in each country; b) financing and origin of funds; c) the system of payment to hospitals and doctors; d) organization of provision (including hospital care, outpatient care, mental care, long-term care and prevention); e) pharmaceutical coverage and price control; and, finally, f) human resources.

The challenges of each country are analyzed objectively.