Posts

7 days in healthcare (April 22nd-28th, 2024)

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Summary

From the point of view of Biomedicine, AI makes it possible to detect the origin of metastatic cancer. An algorithm examines images of metastatic cells to identify the primary location of the tumor. Currently the origin of up to 5% of all tumors cannot be identified. If this is confirmed, the concept of “metastasis of unknown origin” will disappear. Many mental illnesses have body triggers. Evidence is accumulating that a host of infections can activate conditions such as obsessive-compulsive syndrome, anxiety, depression and even psychosis. This finding can improve many psychiatric treatments. The EU approves a new antibiotic to track the growth of resistant bacteria. It will be used in pneumonia and urinary tract infections, representing an advance in the treatment of these bacteria. Health politicians are trying to introduce incentives for the development of these antibiotics linked to bacterial resistance.

Regarding Global Health, new publication of the European Observatory on Health Systems and Policies: health in all policies. The philosophy is to move from health in all policies to health through all policies. Smoking bans are coming. Countries are moving forward to ban tobacco use and vaping, which can save thousands of lives and billions of dollars. The WHO estimates that tobacco use costs the world $1.4 trillion each year in health spending and reduced productivity. The British initiative to ban tobacco consumption for those born after 2004 is very ambitious and would mean creating a smoke-free generation by 2040. Vaping is already more common in 2023 than smoking among young people, and its damage goes beyond lung and brain damage, according to a report from the University of Glascow, commissioned by WHO-Europe. Nicotine can have long-lasting effects on the adolescent brain. The upcoming ban on disposable vapes, for example in the United Kingdom, Belgium, France or Spain may not be enough. The WHO is concerned about the alarming consumption of alcohol and electronic cigarettes among adolescents, between 11 and 15 years old.

Regarding International Health Policy, National plan on waiting lists in Sweden. Waiting times have always been a problem in that country, with great disparities between regions and between different parts of healthcare. The plan seeks to identify areas with excess capacity in the country, allowing faster access to those waiting. The EU presents the Critical Medicines Alliance as a response to shortages. It is a consultative body to identify priorities for action and propose solutions. The Alliance will last for five years. On the part of Spain, among other entities, there will be the General Council of Pharmaceutical Colleges, Farmaindustria and the Spanish Society of Hospital Pharmacy. The European Parliament approves the European Health Data Space (EEDS), which will allow the primary (for care) and secondary (for research) use of health information. Secondary use for commercial purposes will not be permitted. Among companies, there is great concern, since they are above all concerned about, for example, “the voluntary acceptance of users.”

If we talk about National Health Policy (Spain), the competition for doctors to be permanent threatens the large hospitals in Madrid (and, without a doubt, in other communities). In the Community of Madrid there are more than 6,000 specialists who are involved in these stabilization processes. Logically, the problem is not stabilization, but two circumstances: that the solution is to transform the interim workers into statutory ones (wouldn’t it have been possible to favor an indefinite employment contract?) and, above all, that the selection is made without the intervention or of the hospital managements, nor of the services, nor of the professionals. A telematic system will be used, in which vacancies will appear to choose from. That method is incredible in the 21st century. Health outbreak against the norm that would allow a Basque MIR, by the highest representation of doctors and nursing. What is considered an unprecedented attack on the fairness of the SNS. The homogeneity in obtaining degrees and the mobility of professionals between the National Health System seemed to be one of the attributes of our health system. The Valencian Community will replace 1,800 professionals in Manises (who will be treated as statutory) and will create 400 new positions. It is difficult to understand that the statutory regime is the solution and that 400 more professionals are needed to do the same. The IDIS publishes its annual report, which is now called “Private Health Sector Observatory 2024”, maintaining the subtitle of “adding value”. This report is a very relevant contribution to the knowledge of a part of the health sector, such as the private part. Some criticize IDIS by saying that they are judge and party for the publication of this report. But it is true that the private health sector before the appearance of these IDIS reports was the great unknown and, furthermore, no one takes away from other institutions (call it the Ministry of Health, the Association of Health Economics, the Spanish Society of Public Health, etc.) to analyze and publish analysis on the private sector. This work of IDIS has come to fill a void. Farmaindustria denounces the Andalusian Health Service and the Andalusian Colleges of Pharmacists for favoring generics. The agreement between these entities involves the promotion of the dispensing of generics in pharmacies when they are prescribed by active ingredient. Farmaindustria rejects this agreement, considering it discriminatory towards the brand. They argue that branded medicines are in Spain at the same price as generic ones. The latter is true, but it is no less true that this constitutes an exception in Europe, which is more concerned with the promotion of generics and the promotion of companies related to their manufacturing and launch.

As for Companies, at the international level, an important article in the New England Journal of Medicine considers the existence of the free market in the pharmaceutical world a myth. Europe is falling below the USA and China in pharmaceutical innovation, warns the CEO of AstraZeneca. Clinical trials on obesity are growing by 68% and laboratories are preparing 124 drugs. Regarding national information, Domus Vi is considering divesting itself of the Mentalia division for more than 100 million euros. The anti-smoking plan threatens an investment by Philip Morris in Spain of up to 1.2 billion, based on the government plan to equate the taxation of new devices to traditional cigarettes. Caser boosts its dental clinic business with more capital, expanding by 4.25 million euros. This will undertake the opening and purchase of eight new dental clinics.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (January 1st-7th, 2024)

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Summary

From the point of view of Biomedicine, scientists celebrate a new antibiotic, currently undergoing Phase 1 clinical trials, that can kill resistant bacteria. The magazine Nature publishes precisely an editorial in relation to the need to encourage the appearance of new antibiotics against resistant bacteria. The problem is that the current business model in the pharmaceutical industry does not introduce incentives to companies for investments in this field. This is why it proposes “push” solutions (strategies to reduce the cost that may include government aid for the initial stages of research) and “pull” (compensating companies that develop successful antibiotics).

As far as Global Health is concerned, we should mention an interesting article in The New York Times about the need to set up a kind of global immune system against multiple health threats. It would consist of a system of detection and immediate action. Great progress towards the objectives in relation to HIV, almost reaching the aspiration of achieving 95-95-95 (95% of patients with HIV, diagnosed; 95% with antiretroviral treatment; and, 95% with viral suppression).

In terms of International Health Policy, Case and Deaton’s theory in the United States of deaths due to despair (alcohol, drugs and suicide) seems to be dismantled, which would affect mainly white American men without university studies and who had reached relate even to Trump’s victory. Recent studies show that these deaths are not limited to this population, but affect all social classes. Also in the United States, the authorization by the FDA of the importation of medicines from Canada by the State of Florida is of great significance. The price is substantially cheaper for these medications than the one currently in force in the USA. Pharmaceutical companies have cried foul, since this is the first time this has happened in the USA. Litigation is more than assured. The tripledemic (respiratory infections of influenza A, covid and RSV in children) is spreading throughout Europe, with Spain and Italy being precisely the most affected countries.

If we talk about National Health Policy (Spain), the Interterritorial Council of the SNS will address next Monday (January 8) the measures against the tripledemic, in particular the possible mandatory nature of masks in health centers, something already imposed by some communities . The overcrowding in hospital emergencies highlights the absence of demand management: more role for Primary Care; less face-to-face activity  and online attention; and more paper for nursing. The El Español Health Observatory makes public a document of proposals for the health system, the result of the symposium held between October 2-5, 2023, with the participation of more than 150 speakers. The common genetics portfolio of the SNS will be presented on January 23, in what appears to be a great advance for the system. The Ministry of Health of Andalusia announces measures against waiting lists, based on what they call “restructuring the bases of activity.” Without a specific budget, trying to act on productivity without adequate management tools and avoiding agreements with the private sector, we dare say that the measures are doomed to failure.

In the field of Companies, on an international level, what stands out as a novelty is that Lilly is entering B2C, launching in the United States a website for direct sales of medicines to the public and even with a direct home delivery service. A very innovative experience, of which we will have to see the results. As far as Spain is concerned, Domus Vi sells five residences.

Biomedicine

Global Health

International health policy

  • USA
    • The theory of “deaths of despair” (Case and Deaton) no longer holds. This theory, which caused a lot of impact, said that in the USA deaths due to despair (alcohol, drugs and suicide) mainly affected whites without university education. This has changed and today it is known that they affect practically all social classes, without special predominance of the groups indicated by Case and Deaton (https://www.economist.com/united-states/2023/12/23/the-deaths-of-despair-narrative-is-out-of-date)
    • The FDA approves the first mass importation of medicines from Canada to Florida. The price is much lower than that of medicines in the USA, pharmaceutical companies are opposed and it is believed that the PhRMA (representative of American pharmaceutical companies) will file an appeal. Florida says it will save $150 million with the program in the first year alone. It is the first time that something like this has happened in the USA (https://www.nytimes.com/2024/01/05/health/drug-imports-canada-florida.html)
    • The rise in rates and costs drives the bankruptcy of healthcare companies. 18 healthcare companies went bankrupt in the last year. (https://www.ft.com/content/65dfbc81-2641-48fa-a40a-647076943194)
  • Europe
    • Europe fights against the tripledemic of respiratory infections. Tripledemic is the coexistence of covid, influenza A and RSV in children. Spain and Italy, the most affected countries. Also Germany and France. The term means that all three infections coexist, not that individuals have more than one disease. In fact, there are few cases of co-infection (https://www.ft.com/content/449c4748-ef63-4f0a-b26e-4e528889fac4)

National health policy

  • Recruitment of doctors in the Basque Country
    • After requiring Basque from doctors, it is now proposed to hire foreigners without requiring it (https://www.eldebate.com/sociedad/20240105/pais-vasco-queda-medicos-imponerles-euskera-ahora-contratara-extranjeros-exigirselo_164608. html – :~:text=The Government of the Basque Country, first time to non-EU personnel.)

Companies

 

 

7 days in healthcare (March 13th-19th, 2023)

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Summary

From the point of view of Biomedicine, the debate on the governance, supervision and ethical limits of human genome editing is increasingly present, precisely when it seems that many medicines based on this technique are in advanced development, to treat many sicknesses. Nature publishes a novel approach to disseminate Magnetic Resonance, which fifty years after its birth is still a very expensive technique and not accessible to many countries. The mapping of the brain of a larva, after decades of research, heralds advances in the knowledge of more complex brains.

As regards Global Health, the WHO has drawn up the first draft of a treaty on pandemics, precisely to avoid what happened during the covid, the great differences in mortality, morbidity and access to treatment between the different countries.

Regarding International Health Policy, in the United States, the New York Times denounces that aggressive medical behavior continues to be common at the end of life. This same newspaper echoes in its editorial section the serious crisis of the British National Health Service, where several strikes are coexisting at this moment: nurses, consultants, junior doctors and ambulance drivers. The prestige of the NHS among the population plummets. Le Monde publishes in France a report on the change of pharmacies: from drug stores to health “hubs”. BCG releases a report on the scope and benefits of the metaverse in health.

If we talk about National Health Policy (Spain), the incidence of covid continues to increase. It is estimated that 1 million people in Spain may have persistent covid. The conflict between the Primary Care doctors in Madrid ends (it was about time). The SNS will address the problem of the carbon footprint of hospitals. The low remuneration of consultations by healthcare insurance companies is denounced, it is urgent in this sector to move from a model of payment by activity to another of payment by value.

At the Corporate level, internationally, Pfizer is addressing the purchase of Seagen, a biotech-oriented biotech company. As far as national news is concerned, it should be noted that HM Hospitales opens (in Rivas) its eighth hospital in Madrid.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies