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7 days in healthcare (August 28th-September 3rd, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting how therapy with psychedelics is opening up among mental health professionals, especially for cases of depression, anxiety, post-traumatic stress, eating disorders and addictions.

As far as Global Health is concerned, a study of 18 clinical trials shows that screening for early detection of cancer does not make this population live longer than those who do not undergo this type of testing. WHO concern about blindness and vision disorders. More than 2.2 billion people globally have vision disorders, generally attributable to refractory disorders and cataracts.

In terms of International Health Policy, the expected bomb exploded from the application of the “Inflation Reduction Law”, approved in the USA in August 2022, which included something prohibited until now: price negotiation between pharmaceutical companies and Medicare. . The American government made public the 10 drugs that will be negotiated in 2023 and affects the main companies: Pfizer, Lilly, Novartis, AstraZeneca, J&J, etc. Although the established system is very gradual, since 10 drugs will be negotiated each year for the next four, the truth is that this breaks the status quo of the pharmaceutical industry not only in the USA (the largest drug market) but in the world. It is difficult to counter Biden’s argument, which he plans to use in the 2024 campaign, that Americans do not have to pay two to three times more for medicines than the rest of the developed countries, such as in Europe. However, The Economist, which recognizes the need for this price negotiation, nevertheless sees problems in its application due to the appeals filed by large pharmaceutical companies and the risk that these companies will distance themselves from the necessary medicines and concentrate on others unrelated to price control. He also says that if R&D expenses are taken into account, the profitability of pharmaceutical companies is not extraordinary, when compared to the companies in the S&P 500.

If we talk about National Health Policy (Spain), the incidence of covid shoots up by 70% in just one week. The Ministry of Health recommends the fifth dose to selected groups: over 60 years of age, health personnel and the vulnerable. The Supreme Court faces a complex issue: the ruling on thousands of compensation payments to businessmen due to the pandemic. These are property claims to the State due to Covid-19 from businessmen and self-employed workers, who are awaiting compensation for the damage caused by the restrictions during the states of alarm that were later cancelled.

In the field of Companies, on an international level, the most notable is the abandonment of CENTENE from the United Kingdom, where it had a chain of primary care centers and the CIRCLE hospital network. The movement follows his departure from Spain with the sale of Ribera. A concentration in the American market, difficulties with the anti-privatisation movements of healthcare in Europe and problems with hospital integration may be at the origin of the problems, to which perhaps we should also add an underdeveloped growth strategy for this American company in Europe. In any case, a shame, since CENTENE is a great American insurance company, with a lot to teach in the European world. As far as national news is concerned, Spain is the only country that has purchased (31 million euros) several million vaccines from HIPRA, which is not updated for the new strains. Big problem for the Ministry if it decides to use it.

Biomedicine

Global Health

International health policy

  • USA
    • The American government reveals the 10 drugs on which price negotiations will take place with Medicare. Under the proposed reform the minimum price decrease will be 25%. According to the Congressional Budget Office, the savings to the public coffers will be $100 billion over a decade. The affected companies are BMS, Pfizer, Boeheringer, Lilly, J&J, Merck, AstraZeneca, Novartis, Amgen, AbbVie, Novonordisk (https://www.ft.com/content/fa9b0422-6f93-4703-9358-6396660f63b6)
    • The Economist, critical of the American government’s measure, although it recognizes that price negotiation was obligatory. He says that the prohibition on negotiation was nonsense, but the proposed negotiation system could have perverse effects. If R&D expenses are taken into account, pharmaceutical companies do not have extraordinary profits, compared to those of the S&P 500 (https://www.ecocom/leaders/2023/08/30/americas-new-drug-pricing-rules-have-perverse-consequences)
    • Biden makes the negotiation of drug prices one of the central axes of his campaign for 2024, despite the fact that the price reduction will not begin until 2026 and that is if the law resists all judicial attacks (https://www.nytimes.com/2023/08/30/us/politics/biden-medicare-drug-prices-2024-campaign.html)
    • Opinion article in FT: “The world needs to stop depending on the American pharmaceutical industry.” Americans pay up to three times more than other developed countries for medications. The American market is the main market for pharmaceutical companies. This policy is popular among Americans, but it may affect drug R&D globally. Pharmaceutical companies can orient themselves from the most needed medicines to those that escape price control (https://www.ft.com/content/0c20c518-60a8-4dd0-87be-f03adc8ec0e1)

National health policy

  • Judicial consequences of the pandemic
    • The Supreme Court faces the sentencing of thousands of compensations to businessmen due to the pandemic. These are property claims to the State due to Covid-19 from businessmen and self-employed workers, who are awaiting compensation for the damage caused by the restrictions during the states of alarm that were later cancelled. About 9,000 resources are expected. The sentence is very complex, due, among other things, to the high economic amount that it could represent (https://www.expansion.com/juridico/sentencias/2023/09/01/64f1cc47e5fdea09658b45ba.html)

Companies

 

 

 

7 days in healthcare (March 27th-April 2nd, 2023)

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Summary

From the point of view of Biomedicine, the latest issue of The Lancet dedicates a special article and an editorial to chronic pain, which affects millions of people daily; For its part, the New England Journal of Medicine publishes a review and an editorial on Artificial Intelligence in medicine. It seems that humanity will soon break historical records in terms of longevity. It is also worth highlighting the advances that are being announced in regenerative medicine (xenotransplant, 3D organ printing and stem cells).

With regard to Global Health, the most important thing is the WHO’s warning to governments in dedicating efforts to health professionals, since many of them are close to retirement and the needs are increasing for many reasons.

Regarding International Health Policy, in the United States, the FDA authorizes the free sale of Narcan, a nasal spray against opioid overdose, which represents life or death for many people. In the United Kingdom, the popularity of the NHS is the lowest it has been for 40 years, when this type of study began.

If we talk about National Health Policy (Spain), a new replacement in the Ministry of Health. Some consider that this Ministry has become the electoral launching pad for its incumbents (Illa, for Catalonia; Darias, for Las Palmas, and, apparently, Miñones, for Galicia). This approach, together with the short duration of the ministers, is one of the causes that contribute to the loss of prestige, leadership and role of the Ministry of Health, which has a policy of contingency management, but without a true project of transformation of the system, to propose to the different agents. The Minister of Health of Catalonia seems to have a plan to reinforce and retain professionals, something very necessary. I hope this plan works. The EMA has given the green light to the Spanish vaccine against the HIPRA covid, although only as a booster dose to the mRNA vaccines. Important social debate around surrogacy, as a result of the use of this procedure by a “celebrity”. Very different positions on the subject. Perhaps the most correct approach, as a quoted writer does, is to see who this procedure harms, if the parents, the unborn child, or the woman who lends her uterus. If the conclusion is that no one has been harmed, the most reasonable thing to do would be to approve this practice in our country, as it is in so many others.

In the field of Companies, internationally, BioNTech’s sales forecasts plummet, as a result of the lower demand for covid vaccines. At the national level, perhaps the most far-reaching news is the purchase by Viamed (Macquarie) of the Fátima hospital in Seville, after stiff competition with many other interested parties, including Vithas and Sanitas. Hospitales Parque (CASER) is set to grow at the rate of one hospital per year in the next three years.

Biomedicine

Global Health

International Health Policy

  • COVID
    • Data from Gisaid, the global repository of covid genomic data, increases the chances of discovering the origin of covid. Three years into the pandemic, it is still not certain whether the virus arose accidentally from a laboratory or was transmitted through an animal host (https://www.ft.com/content/f0733683-cb6d-4578-915a-aa60d7ba4c1d)

National Health Policy

Companies