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7 days in healthcare (November 20th-26th, 2023)

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Summary

From the point of view of Biomedicine, in the United Kingdom an initiative aims to be able to produce medicines for individual patients in less than a year. According to the National Bureau for Economic Research (NBER) of the United States, artificial intelligence, even with use cases already developed, will produce savings in healthcare expenses between 5-10%. This will offset the rise in other expenses in the sector, such as new medicines and medical technologies.

As far as Global Health is concerned, there is a relationship between the pattern of economic income and obesity, which occurs more in low-income workers, in relation to those with higher incomes. The fight against climate change has already produced some results. The COP28 conference, which will take place starting next week in Dubai, is expected to produce a declaration on climate and health. Polio is about to be eradicated in a few months, but the great challenge is that it does not return, since eradication is not the same as extinction.

Regarding International Health Policy, in its latest issue The Economist dedicates a supplement to forecasts for 2024. Among the 10 general forecasts, there is one that says that in an older world, health expenditures will grow to reach one tenth of global GDP. Among the specific health forecasts, it is noted that the pandemic has led to a growth in public spending on health (up to 80%, starting from 75%). Growth in private activity and an increase in the global pharmaceutical market is expected, with research efforts concentrating on medications against obesity and mRNA patents. In the United States, there is evidence of the inadequacy of private health insurance to provide financial security to the elderly for long-term care. Important agreement in the United Kingdom between the NHS and pharmaceutical companies, with which an annual growth in spending on medicines of 4% is agreed until 2027. Surely, an example for many countries, including Spain. Also in the United Kingdom, an agreement between the NHS and community pharmacies for the provision of a series of services, which will mean a large reduction in consultations in Primary Care. The health insurance boom in the United Kingdom, due to the problems of the NHS, is revealing certain limitations of private health insurance to meet demand. Something similar to what happens in Spain. Important document from the WHO (European region) and the Observatory on health systems, in which several governments participate, including the Spanish one, talking about the convenience of the participation of the private sector in the public health service, establishing the requirements for this to be successful. European countries warn of the health problems of climate change, since Europe is the continent in which temperatures have risen the most.

If we talk about National Health Policy (Spain), new change in the Ministry of Health. Going to minister for a year or less does not seem like the best formula to address the long-term challenges of healthcare, without prejudice to the qualities of the new minister, which will have to be observed. Record in the waiting list, after the publication of the lists as of June 30 by the Ministry of Health. Important study on obesity in Spain published by the Carlos III Health Institute and AESAN, which demonstrates the relationship between the level of obesity and the postal district. A study by the Institute of Fiscal Studies shows that between the beginning of 2020 and the end of 2022, the number of doctors in the SNS has decreased by 17,000, despite the fact that the number of staff has increased globally. The Valencian Community launches a specific competition for positions that are difficult to fill. Aside from the approach of the tender, it is good that the specificities of this type of places are taken into account. There is no doubt that the standardizing approach to personnel policy does not allow us to solve certain problems, such as what are now called difficult-to-fill positions. Farmaindustria carries out, in collaboration with scientific societies, a study on clinical research in Primary Care. We are a powerhouse in clinical research in hospitals and there is no doubt that the bases of this success must be extended to other environments.

In the field of Companies, on an international level, problems in Bayer with a sharp drop in the stock, which the CEO of this company attributes to a limited pipeline, a consequence of a lack of effort in investment. At the national level, Vithas confirms its new hospital project in Valencia. For its part, Sanitas announces an investment to grow in nursing homes.

Biomedicine

Global Health

International health policy

  • European Union
    • European countries warn of the health problem of climate change. It is estimated that last summer there were 62,000 deaths in Europe due to heat, since this is the continent with the highest temperature rises. 18 member states ask the European Commission and ECDC for action (https://www.ft.com/content/52e71922-d9fc-49b6-98b5-3a4d37c21dbc)

National health policy

Companies

 

7 days in healthcare (October 30th-November 5th, 2023)

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Summary

From the point of view of Biomedicine, the FDA opens the door to the first treatment with CRIPSR gene editing, applied in this case to sickle cell anemia. The “liquid biopsy” seems to be able to detect cancer recurrence before any radiological signs. A change is proposed in the regulation of embryo research. The laws and conventions in force do not allow embryos to be investigated in the laboratory beyond day 14. There is a gap until day 28, when embryos from abortions can already be investigated. This seems to prevent us from knowing many elements of organ development and that is what we are trying to modify. Although it is often assumed that dementia is increasing as the population ages, there appears to already be some evidence that the incidence of dementia is decreasing quite significantly.

As far as Global Health is concerned, the director general of the WHO is alarmed by the indescribable situation in Gaza. Nigeria is preparing to vaccinate 8 million girls with the papillomatosis vaccine, related to cervical cancer.

Regarding International Health Policy, in the United States, despite the prohibition of abortion in some states as a consequence of the Dobbs ruling of the Supreme Court, the abortion rate has not decreased a year after this ruling. The Economist considers how it is possible that doctors in the United States earn so much ($350,000/year on average), coming to the conclusion that it is due to an artificial shortage of doctors, due to the few places in Medical Schools, despite that there is no shortage of candidates. In the United Kingdom, the investigation into covid seems to show the disaster in management during the Boris Johnson period. Bad business, although the case of Spain is worse, where, despite promises, no report on the management of the pandemic has been made public. Health changes are on the horizon in Poland, following the arrival of the new government. Kenya, with 53 million inhabitants, joins the movement of so many other countries to move towards universal health coverage.

If we talk about National Health Policy (Spain), the XENOMA project in Galicia is very important, which aims to analyze the DNA of 400,000 Galicians. One of the precedents is the project to analyze the genome of 100,000 Britons, promoted during the David Cameron period and managed by Genomics England. Surely a project of this style should have been promoted at the national level, but it is good that, in the absence of the above, it should be promoted by an autonomous community. Doubts among experts about one of the measures of the PSOE-Sumar agreement on a law to end waiting lists. Without funding, better accounting and prioritization, organizational measures, new incentives and public/private collaboration, no law is capable of solving this problem. After all, a Royal Decree that establishes maximum times for certain procedures has already been in force since 2011, but it is not being complied with. Virtually all autonomous communities are approving increased health budgets for 2024, rising especially in Primary Care. Just because the budgets grow compared to the previous year does not mean that they are higher than the real spending in 2023, which is happening in Madrid, for example. The PSOE-ERC agreement contemplates the transfer of at least 150 million euros/year to Catalonia, for scientific and technical research.

In the field of Companies, on an international level, Google intends to grow in healthcare, based above all on artificial intelligence tools. Regarding the covid vaccine, GSK raises profit forecasts, while Moderna and Pfizer contemplate setbacks. At the national level, Fresenius sells its Quirón business in Peru. The Sant Joan de Deu Hospital in Barcelona creates an artificial intelligence laboratory with Microsoft.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

 

7 days in healthcare (January 16th-22nd, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting, as the Science article does, the celebration of a decade of CRISPR gene editing technology, whose impact on medicine is only just beginning. Janssen withdraws from the HIV vaccine, a new failure in the attempt to discover a vaccine against this disease. Moderna, on the other hand, presents positive results with a vaccine against bronchiolitis. A new report points to wastewater analysis as fundamental to monitoring threats from a wide variety of diseases, not just covid.

As regards Global Health, The Lancet in an editorial underlines the importance of the One Health concept, this idea of the interdependence between human, animal and ecosystem health. The Economist publishes an editorial and an article on the problems of health systems that are in crisis everywhere in the post-covid era (even in Switzerland!), which is making mortality in Europe have been in the last year 10% higher than in a normal year.

Regarding International Health Policy, in the USA the opponents of abortion are manifested. Problems continue in the NHS, with Sajid Javid, former health secretary, proposing something as unusual in the UK as a co-pay in Primary Care and Emergency. He says an overly religious view of the NHS prevents reforms. Important debate and tensions about the price of medicines in the European continent (UK and EU) in relation to prices in the USA. Pharmaceutical companies, very reluctant to price controls, when they are also in the USA with the application of the Inflation Act, which gradually imposes a negotiation of the price of medicines between the Medicare Administration and pharmaceutical companies.

If we talk about National Health Policy (Spain), the incidence of covid continues to drop. Medical conflicts extend to various autonomous communities (Madrid, Catalonia, Navarra, etc.). The agreement in Aragon should be highlighted, which indicates that it is possible to reach agreements, possibly when they are well negotiated. The Ministry, completely absent from this problem. As for the public system, the statements by Lasquetty, Madrid’s Treasury Councilor, who points to “my own place” as one of the great rigidities of the public system, are very interesting. Conflict also in private health between doctors and insurers, raised in Seville. Abortion enters the national debate, following the picturesque proposals of Vox in Castilla y León, never applied. The Constitutional Court opens its new session with the debate on the recourse to the Law of deadlines presented in its day by the PP. The CIS survey presents health as the second problem that worries the Spanish.

In the field of Companies, internationally, Pfizer’s initiative to sell medicines at cost prices in 45 poor countries must be highlighted. At the national level, the launch by DKV of an insurance product that allows choosing a family doctor is notable. In a context in which insurers actually forget about Primary Care, this is something that deserves to be highlighted.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies

7 days in healthcare (November 7th-13th, 2022)

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Summary

From the point of view of biomedicine, to highlight the blood transfusion with cells generated in the laboratory from donor stem cells, carried out in the United Kingdom, which opens up possibilities for what has been pursued for years: the so-called “artificial blood”. Likewise, two advances that originate in Spain: the discovery of a genetic variant that favors thinness (CNIO) and the fact that malignant cells break off from cancer and cause deaths by metastasis (Institute of Medical Research of Barcelona).

As regards Global Health, Nature insists in an editorial, following the COP27 meeting, that rich countries must advance compensation for polluting. Important challenges for the new Brazilian President in health matters, particularly in primary care.

Regarding International Health Policy, debate on the covid-zero policy in China, on the one hand, there seem to be signs that China is easing quarantines, on the other hand, according to José Luis Puerta in an article, this policy is a death trap , since its abandonment may mean assuming a high number of deaths, given the low percentage of vaccination in China. In the United Kingdom (NHS) a nurses’ strike for salary demands is raised for the first time, which. according to the Government, they are unaffordable.

If we talk about National Health Policy (Spain), it seems that the crisis of Primary Care, long incubated, has exploded. Although the problems of low wages, poor working conditions for doctors and flight or refusal to go to Primary Care is a national problem, the crisis has broken out above all, although not only, in Madrid, which has some peculiarities that aggravate the situation: 1. the closure of out-of-hospital emergencies for two years; 2. the low funding of the health system in Madrid and of Primary Care; and, 3. some confrontation practice. The truth is that the “white tide” has been activated, with a large demonstration in defense of public healthcare in the center of Madrid, which was a great success for the organizers. As always in these cases, the defense of public healthcare is mixed with the rejection of any form of public/private collaboration. Tensions in primary care also in the rest of Spain. Highly recommendable is the video on YouTube entitled “Doctors are lacking in Spain”?

In the field of companies, at the international level Bavarian Nordic increases its growth due to the monkeypox vaccine, while BioNTech’s revenues fall, due to the drop in sales of the covid vaccine. In Spain, changes in the CEO of Quirón, to whom Víctor Madera, the company’s founder, returns to executive positions. Success for Ribera, which is awarded an important contract for a hospital concession in Cascais (Portugal). New delays in the approval by the EMA of the HIPRA vaccine.

Biomedicine

Global Health

International health policy

  • COVID-19
    • China eases quarantine rules, with Guangzhou close to lockdown. There is speculation that Beijing is considering a relaxation of the covid-zero policy (https://www.ft.com/content/709e95e6-cc63-4fe0-9c4a-5683c87f7e7b)
    • Interesting article by José Luis Puerta: “China: the deadly trap of the covid-zero policy”. If the government lifts the restrictions, which are sinking the economy, the country risks suffering a tsunami of infections, due to the low level of vaccination. It is estimated that this could cause 1.6 million deaths and a demand for intensive care that exceeds its current capacity by 15.6 times (https://theobjective.com/internacional/2022-11-12/china-covid-zero/ )

National health policy

Companies

 

7 days in healthcare (August 15-21, 2022)

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Summary

From the point of view of biomedicine, the first drug is prepared using CRISPR (gene editing) technology. Important publication from The Lancet in the largest effort yet to identify risk factors in relation to cancer. Not surprisingly, however, tobacco and alcohol are the biggest risk factors, particularly tobacco.

As far as Global Health is concerned, polio is back and the UK is now offering vaccinations to children in London between the ages of 1 and 9.

Regarding international health policy, the famous North American Inflation Reduction Act has been signed by President Biden. Despite its name, the law has more to do with climate change and health, especially drug prices. No large growth in monkeypox is predicted, based on modeling carried out by The Economist. Deaths from covid remain high (15,000 a week globally) warns the Director General of the WHO. The Director of the American CDC denounces serious failures in the management of covid and announces substantial changes in the functioning of this body. A clear contrast to what is happening in Spain, where no conclusions seem to be drawn from the management of covid, despite being one of the most affected countries in terms of the number of cases and mortality in relation to the population.

If we talk about national health policy (Spain), the good news are that covid continues to decline, although there are still 62 deaths per day. The approval of the State Center for Public Health, scheduled for next week, is possibly the biggest consequence of covid. The birth rate in Spain falls to historical lows.

In the field of companies, drug prices break historical records in the USA. In Spain, HIPRA is preparing to manufacture 250 million doses of covid vaccines, pending approval by the EMA.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (December 27, 2021-January 2, 2022)

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SUMMARY

 

From an international point of view, to highlight the 50th anniversary of “Médecins sans Frontières”; also the impressive success of vaccines that saved hundreds of thousands of lives globally; the great expansion of COVID by the “omicron” variant, which is leading to the record of infections in many countries; as well as the strengthening of three important institutions linked to health in the European Union: the ECDC, the EMA and the HERA. To verify that COVID produced more deaths globally in 2021 than in 2020.

With regard to national news, it should be noted that Spain leads the number of infections in Europe, in the midst of a collapse of Primary Care and pressure on hospital emergencies and, little by little, also on hospitalization areas and ICUs. Antigen tests are scarce and, in addition, they are very expensive. The government submits the MUFACE model to AIReF’s evaluation, which is good news, if that evaluation is done rigorously. The Community of Madrid is tackling a very difficult project: the creation of a health purchasing center. Once again, it is necessary to do it very well, obtain the synergies of the large public buyer, without altering the autonomy of the centers and without evaluating exclusively the price of the items, but other elements (quality, safety for the patient, technical service, etc.)

In relation to companies, it should be noted that this year we will probably see the first Spanish vaccine (HIPRA) in operation, also that El Corte Inglés, Carrefour and Alcampo offer to sell COVID tests in their establishments, something until now reserved for pharmacies.

INTERNATIONAL NEWS

 

  • Eight medical advances (not related to COVID) in 2021: 1. The structure of proteins, within reach of an algorithm; 2. Live CRISPR; 3. Closer to the chimera (monkey-human chimeras); 4. New and controversial drug against Alzheimer’s: 5. Neuroprosthesis to communicate; 6. Avoid relapses into depression; 7. Impact of salt on strokes; and 8. Triple “jump” in child transplantation (Diario Médico, Dec 31 21)
  • 50 years after the creation of “Médecins sans Frontières” (Doctors without Borders), founded in 1971, as an independent non-governmental association, currently formed by 25 national or regional associations, which works in more than 70 countries and employs in around 45,000 people (The Lancet, 1 Jan 22)
  • One year of COVID vaccines. In the USA alone there are more than 200 million vaccinated, and the vaccine has prevented millions of COVID-19 cases, thousands of hospitalizations and saved hundreds of thousands of lives. An unprecedented success. Experience indicates that vaccines alone do not save lives, it is the vaccination process that saves them (including manufacturing, distribution and administration), which requires robust organizations (JAMA, Dec 21, 21)
  • The Wellcome’s Global Monitor 2020, which assesses trust in science and scientists, is released. The survey covers 113 countries. Although with large regional differences, it is detected that confidence in science grew during the pandemic (The Lancet, 1 Jan 22)
  • COVID leaves more deaths in the world in 2021 than in the year of its outbreak (El Confidencial, 1 Jan 22)
  • The “omicron” variant produces records of infections in 20 countries, among which are Australia, Canada, Denmark, Ireland, Italy, Spain, Switzerland, the United Kingdom and the United States (FT, Dec 31 21)
  • The United States reduces the period of isolation due to COVID to 5 days (FT, Dec 28 21)
  • The WHO warns of a “tsunami of cases” due to the “omicron” and Delta variants (FT, Dec 29 21)
  • WHO says the pandemic may overwhelm health systems, as cases reach records in Europe (FT, The Guardian, Dec 29 21)
  • Shortage of COVID tests in the UK, as cases rise (FT, Dec 29 21)
  • Europe: promoting the “European Health Union”, reinforcing the ECDC (European Center for Disease Prevention and Control) and the EMA (European Medicines Agency) and activating the creation of the HERA (European Preparedness and Response to Health Emergencies Agency), which is expected to start operating in early 2022, with an initial budget of 6,000 million euros, although it is expected to reach 30,000 million, with contributions from the States and the private sector (ConSalud, 30 Dec 21)
  • Persistent COVID and its more than 200 sequels already have an official definition (El País, Dec 28 21)
  • According to a survey, one in four Britons do not believe that the NHS can serve them well, which is surprising given the extraordinary prestige of the NHS so far in the UK (The Guardian, 26 Dec 21)

NATIONAL NEWS

  • “Redacción Médica” analyzes the 10 highlights of 2021: 1. COVID has not abandoned us; 2. Filomena tests the capacity for healing; 3. Relief in the Ministry of Health: Darias instead of Illa; 4. Euthanasia, regulated by Law; 5. Spanish stamp for the first public CART therapy in Europe; 6. Controversial choice of MIR places; 7. Industry is ahead of the virus, with an arsenal of vaccines and treatments; 8. Muface “illuminates” the future of health mutualism; 9. Several strategies in Spanish health: Cancer, Mental Health and Primary Care; and, 10. Various variants of COVID (Redacción Médica, Dec 31 21)
  • Elements that are considered essential for 2022: COVID, Primary Care and Mental Health. The Center for Public Health and improvements for professionals is also expected (ConSalud, 1 Jan 22)
  • Spain closes 2021 at the head of infections in Europe (Diario Médico, Dec 31 21)
  • On December 30, 21, the COVID rate reached 1,775 cases per 100,000 inhabitants. Despite everything, no new official information on the number of cases will be published until January 3 (El Español, Dec 31 21)
  • The collapse in primary care due to COVID leads to hospital emergencies (eldiario.es, Dec 26 21)
  • Health and communities agree to reduce the COVID quarantine period to 7 days (La Razón, Dec 29, 21)
  • Antigen tests in Spain: scarcity and high prices, while in other countries (France and the United Kingdom) they are free (El Debate, 1 Jan 22)
  • The Spanish Medicines Agency advises not to buy antigen tests online (El Debate, Dec 28 21)
  • The Council of Ministers endorses the Plan to improve Primary Care (Health Act, Dec 28 21)
  • Numerous unions and scientific societies (especially those linked to Primary Care) demonstrate against the approved Plan (Consalud, Dec 31 21)
  • The MUFACE model will be subject to review, the government instructs AIReF to evaluate it (El Español, Dec 28 21)
  • Very important draft bill of the Community of Madrid: “Draft Bill of urgent measures to promote economic activity and modernization of the Administration of the Community of Madrid”. Article 44 of the preliminary draft develops the Sanitary Contracting Agency of the Community of Madrid, which becomes a health purchasing center for Madrid. It is more than foreseeable that this is a controversial law with suppliers. (Draft project disseminated by the Community of Madrid: https://www.comunidad.madrid/transparencia/sites/default/files/2._anteproyecto_ley_omnibus_texto_completo_21-12-2021_0.pdf)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

 

  • 2022: the year in which the first Spanish vaccine will reach patients (El Español, Dec 30 21)
  • Private healthcare, years ahead of the SNS in telemedicine (Redacción Médica, Dec 29 21)
  • J&J (Janssen) Vaccine Protects Against Severe “Omicron”, Study Says (NYT, Dec 30, 21)
  • Teva found liable in the US opioid trial (NYT, Dec 30 21)
  • HM acquires a plot of land in Tres Cantos, for the construction of a university hospital (Acta Sanitaria, 23 Dec 21)
  • HM buys the Dr. Gálvez clinic in Malaga, the fourth clinic that the HM group buys in the region (Málagahoy, Dec 31 21)
  • Atrys has 100 million to buy health companies (El Economista, Dec 29 21)
  • Antigen test manufacturers (such as Abbott, Siemens Healthineers and Roche groups) end the year skyrocketing on the stock market (CincoDías, Dec 28, 21)
  • El Corte Inglés, Carrefour or Alcampo offer to sell antigen tests at their centers, according to their employer Anged (CincoDías, Dec 30 21)
  • Magnum Capital starts the international leap of its Miranza ophthalmology clinics: Portugal and Andorra (CincoDías, Dec 27 21)
  • The Jiménez Díaz Foundation leads for the sixth consecutive year the Hospital Excellence Index of the Coordinates Institute (ABC, Dec 27 21)