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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)

7 days in healthcare (13-19 December, 2021)

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Summary

From an international point of view, perhaps the most striking thing is the great growth worldwide of the “omicron” variant, already present in 89 countries. Although it is clear that it is much more transmissible than the Delta variant, it is not clear that the disease is milder. Some countries in Europe decree confinements. The effectiveness of COVID passports is demonstrated, in terms of increased vaccinations. Figures for healthcare spending in the United States are released in 2020, spending increased significantly, especially federal spending, related to COVID. It reaches 19.7% of GDP (which is said soon). It is also striking that for the first time in the history of the United States, public health spending exceeds private spending.

Regarding national news, great concern about the rapid expansion of the pandemic, which forces the President of the government to convene a Conference of Presidents, for two days before Christmas Eve, which prevents measures from being adopted for Christmas. The plenary session of the Interterritorial Council approves the “Primary and Community Care Plan 2022-2023”, a set of good intentions and the announcement of measures that, where appropriate, would have to be implemented by the autonomous communities. Once again you see how difficult “co-governance” without good governance.

In relation to the activity of companies and other agents in the sector, the activity of vaccine manufacturing companies continues. Two things are difficult to understand: the letter from the President of the Madrid Medical Association to the President of ASISA and the launch by DKV-Yoigo of a medical insurance for 20 euros. We believed, on the one hand, that health insurance companies were free to hire their medical staff; and, on the other hand, that it was difficult to continue lowering the price of health insurance in our country. It is true that in the United States and other countries online insurance, Oscar type, is emerging with cheaper policies than conventional insurance. But in Spain the policies are already very cheap and I do not think that it is about making policies for young and healthy people, who hardly consume health care.

International

  • The “omicron” variant advances at an incredible speed (The Economist, 18 Dec 21)
  • The ECDC warns that vaccination alone is not enough and calls for drastic measures (La Razón, Dec 15 21)
  • The “omicron” variant grows 70 times faster than the Delta in bronchial tissue (The Guardian, Dec 15 21)
  • The “omicron” variant is already present in 89 countries and is growing rapidly, according to the WHO (The Guardian, 18 Dec 21)
  • There is no evidence that the “omicron” variant is more benign than the delta (FT, Dec 17 21)
  • Seven people die in the United Kingdom from the “omicron” variant (El Independiente, 18 Dec 21)
  • The Netherlands decrees a new strict confinement until January 14 (El Periódico de España, Dec 18 21)
  • COVID passports have a positive effect on the number of vaccinated, according to an international study carried out in six countries (Denmark, Israel, Italy, France, Germany and Switzerland), (The Lancet, Dec 13 21)
  • The United States exceeds 800,000 deaths from COVID, the country with the highest mortality (The Guardian, Dec 15 21)
  • The scientific advances of 2021, according to the journal Science (the ease of identifying the structure of proteins, the most significant advance. In relation to medicine, several advances: treatments for COVID-19; psychedelic drugs versus some psychiatric disorders; artificial antibodies to infectious diseases; CRISP tools to modify genes within the body; Alzheimer’s medication, despite doubts about its efficacy) (Science, Dec 17, 219
  • The figures for healthcare spending in the USA in 2020 are published. The growth was 9.7% over the previous year, which had grown by 4.3%. The acceleration is due to the increase in federal spending, which grew 36%, especially in relation to COVID. The percentage of GDP dedicated to health reached 19.7%. The number of uninsured decreased. For the first time in US history, public health spending surpasses private spending (51% vs 49%) (Health Affairs, January, 22)
  • The repetition of epidemics due to different types of coronavirus (SARS, 2002 and 2003; MERS, since 2012 and COVID-19, since 2019) leads some to demand a kind of universal vaccine against coronaviruses. The article is signed, among others, by Fauci (New England Journal of Medicine, Dec 15, 2021)
  • Medicare Advantage for All, a potential pathway to universal coverage in the USA. Against Medicare for All, it would keep private insurers (JAMA, Dec 16 21)

Nationals

  • Spain is at a very high risk of contagion, after exceeding an incidence of 500 per 100,000 in the last fourteen days (El País, 17 Dec 21)
  • Sánchez calls the conference of presidents for next week, given the worsening of the pandemic (El País, 18 Dec 21)
  • Announcement on TV on Sunday, December 19, by Sánchez of the presidents’ conference for Wednesday, December 22, without advancing any measures. Logically, due to the date, there is no possibility of organizing measures for Christmas (El Mundo, 19 Dec 21)
  • Navarra and the Basque Country among the five regions with the most COVID in Europe (El Español, Dec 16 21)
  • Third dose for people over 40 and vaccinated with AstraZeneca (El Confidencial, Dec 16 21)
  • Spain is at the forefront of Europe in excess of mortality, according to the EuroMoMo (The Objective, 19 Dec 21)
  • On December 15, the plenary session of the Interterritorial Council approved the “Plan for Primary and Community Care 2022-2023”, continuation of the “Strategic Framework for Primary and Community Care”, approved in 2019 and never implemented. The plan is a set of promises, which to a large extent have to be implemented by the autonomous communities (such as the finalist budget, telemedicine and others). The plan is strongly criticized by SEMERGEN (Spanish Society of Primary Care Physicians and by FADSP (Federation of Associations for the Defense of Public Health) (Infolibre, Dec 16 21)
  • Antigen test: pharmacies appear to be short of supplies (El País, 19 Dec 21)
  • The Government (Ministry of Social Affairs and Agenda 2030) proposes to limit the residences for the elderly to a maximum of 50 places, as well as some ratios of staff per resident. The text must be consensual, which seems difficult (Infolibre, Dec 17 21)

Companies, employers and other agents in the sector

 

  • María Vila, elected President of FENIN (El Español, Dec 14 21)
  • Ana Polanco, reelected President of ASEBIO (Planta Doce, 16 Dec 21)
  • Letter from the President of the College of Physicians of Madrid to ASISA, reproaching him for the dismissal of doctors for the MUFACE system (Sanifax, Dec 15 21)
  • Spain has already manufactured 380 million vaccines for COVID (CincoDías, Dec 17, 21)
  • Catalonia creates a venture capital fund to promote scientific entrepreneurship (PlantaDoce, Dec 16 21)
  • The European Medicines Agency approves Pfizer’s anti-COVID pill (El Debate, 16 Dec 21)
  • Pfizer’s (Paxlovid) anti-COVID pill works well against the “omicron” variant, the company confirms (NYT, Dec 14 21)
  • The WHO and the EMA could approve the American vaccine NOVAVAX next week (FT, Dec 16 21)
  • Oracle, about to buy CERNER for US $ 30,000 million (FT, Dec 17 21)
  • The CDC discourages the use of the J&J vaccine, due to some clot problems (NYT, Dec 16 21)
  • Sanofi intends to request approval of its vaccine again (FT, Dec 15 21)
  • The IMED healthcare group invoices 12% more and its profit almost doubles, reaching 6 million (Valencia Plaza, Dec 15, 21)
  • The CEU and ASISA sign an agreement for the training of students at the HLA Moncloa hospital (El Debate, 18 Dec 21)
  • Venture capital is pushing for the formation of MIRs. The CVC fund studies buying MIR Asturias (El Periódico de España, 19 Dec 21)
  • Vivanta requests a ransom of 40 million euros from SEPI (PlantaDoce, Dec 16 21)
  • Quirón proton therapy successfully treats its first 100 children (ConSalud, Dec 14 21)
  • Philips expands its portfolio with the purchase of Vesper Medical (PlantaDoce, Dec 15 21)
  • Modern: agreement to bring a mRNA vaccine factory to Australia (PlantaDoce, Dec 14 21)
  • Company health insurance will become more expensive by 7.2% in 2022 (PlantaDoce, Dec 14 21)
  • Grifols sells VCN Biosciences for 66 million euros (PlantaDoce, Dec 15 21)
  • CSL acquires Vitor Pharma for 11.7 billion dollars (PlantaDoce, Dec 16 21)
  • Asistensi and Clínica de Navarra, agreement to export health insurance to immigrants (PlantaDoce, Dec 16 21)
  • Ysios enters the Dutch Northsea leading a round of 77 million euros (El Economista, Dec 17 21)
  • Biontech investors are studying buying Sandoz (El Economista, Dec 14 21)
  • Atrys Health acquires Simm molecular (Expansión, Dec 17 21)
  • DKV and the telephone company Yoigo launch a family health insurance for less than twenty euros (El Economista, 9 Dec 21)
  • The Savana company, founded in 2014, with an ecosystem of 160 hospitals in Europe and America, intends to lead the “healthcare data lake” (El Economista, 18 Dec 21)
  • Rovi receives the European recommendation for its own research antipsychotic (CincoDías, 17 Dec 21)
  • Almirall wins the rights to a drug against autoimmune diseases (CincoDías, Dec 14 21)

7 days in healthcare (November 29-December 5, 2021)

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SUMMARY

From the international point of view, it is worth highlighting the beginning of the work of the WHO for the approval of a Treaty on pandemics. It seems that the alarm about the new “‘ ómicron “variant is lowered, after the WHO announcement that there had been no case of death. We must be attentive to the program of the new German coalition government, and its impact on the health system. It seems that its actions are concentrated in the pharmaceutical sector. The failure, for various reasons, of the COVAX platform for immunization of low- and middle-income countries is confirmed.

At the national level, the growth of COVID continues to figures that are already beginning to be worrying, despite the advantage over other European countries. The council of ministers approves the Mental Health Strategy, a plan that, unlike the one approved a few years ago on Primary Care, does have funding, despite having aroused reservations among experts. The council of ministers also approves the PERTE for health. As of December 13, the vaccines for children will be available.

Regarding companies, it should be noted that both Pfizer and Moderna are preparing to adapt their vaccines to the new COVID variant.

 

INTERNATIONAL

 

  • The WHO agrees on December 1, 2021 to begin negotiating an international agreement on how countries should prevent, prepare for and react to pandemics. The agreement is to hold a meeting before March 1, 2022 and discuss a draft before August 1, 2022 (British Medical Journal, Dec 2, 21)
  • A law to introduce dental care in Medicare is discussed in the American Congress (NEJM, 2 Dec 21)
  • An article is published that compares the evolution and behavior in 24 months of a large number of people from the Veterans Administration vaccinated with Moderna and Pfizer-BioNTech (NEJM, Dec 1 21)
  • The need for the health sector to contribute to decarbonization continues to be present (NEJM, Dec 2 21)
  • The WHO warns of a high risk due to the new “omicron” variant (FT Nov 29, 21)
  • WHO says there have been no deaths from the new “omicron” variant, despite its expansion (The Guardian, 4 Dec 21)
  • The “ómicron” variant, with a wide worldwide diffusion: apart from its origin in South Africa, and the expansion to 11 European countries, also present in Canada, Brazil, Australia and Saudi Arabia, among others (CNN Español, Dec 1 21)
  • Van der Leyden calls to discuss the mandatory nature of the vaccine (FT, Dec 1 21)
  • Analysts say that the economic impact of the “omicron” variant will not be important (FT, Nov 29, 21)
  • The program of the new German coalition government has an impact on the healthcare and pharmaceutical sector. Most important measures: price containment in medicines, push for healthcare digitization and use of medical data for research (Covington, Nov 29 21)
  • Biden rules out a new lockdown to tackle the new “omicron” variant (FT, Nov 29, 21)
  • The United Kingdom urgently calls a meeting of the G7 to discuss the problem of the new variant (La Razón, 28 Nov 21)
  • The new variant presents more than 50 mutations over the original from Wuhan (La Razón, Nov 29, 21)
  • COVAX has only distributed 26% of the promised covid vaccines for 2021. The most unanimous explanation is that rich countries have monopolized the market (El Español, Dec 4, 21)
  • The EMA would need three to four months to approve vaccines if they have to be modified by “omicron” (El Confidencial, Nov 30, 21)
  • Europe steps on the accelerator with the third doses in full uncertainty for the new variant (eldiario.es, Nov 29, 21)
  • The lack of vaccines, logistical limitations and the rejection of part of the population hinder immunization in Africa (El País, 28 Nov 21)
  • Germany imposes a de facto confinement to the unvaccinated: leisure and commerce will be banned (El País, 2 Dec 21)
  • Agreement between the Council and the European Parliament to strengthen the role of the ECDC (El Global, 30 Nov 21)

NATIONALS

 

  • COVID cases continue to rise, reaching an AI (cases per 100,000 in the last 14 days) of almost 250 (El Confidencial, Dec 3, 21)
  • Health advises limiting participants in social events during Christmas after the advance of COVID (La Razón 1 Dec 21)
  • The government does not have a “legal plan B” before the “omicron”, it trusts everything to vaccination and rejects restrictions that could affect the economy (La Razón, Dec 1 21)
  • The Government defends the need for an International Treaty on Pandemics, as stated by Minister Darias during the Extraordinary Assembly of the WHO in Geneva (ConSalud, 29 Nov 21)
  • The Council of Ministers approves the Mental Health Strategy 2022-2026, the last was of 2009. It is criticized by experts (Spanish Society of Psychiatry, Spanish Society of Dual Pathology) for its lack of ambition, although the effort of consensus. Among the criticisms is the lack of standards such as professional ratios, number of beds in children’s and adolescent hospitals, waiting lists, etc. It has financing of 100 million euros for the next three years, 30 million for 2022. Intervention in the workplace, the approach to suicide and the gender perspective, among the novelties of this Strategy (El Mundo, Dec 4, 21)
  • The council of ministers officially approves the PERTE for health. Investment of more than 1,400 million euros, between 2021 and 2023. These investment agendas are articulated through tenders, the creation of an investment, development and innovation (R + D + i) structure for advanced online therapies, launch of a public-private investment vehicle in advanced therapies (public-private commercial company) with the participation of companies with production capacity in Spain, elements of early coordination and identification of capacities and needs of the National Health System, public procurement innovative and pre-commercial, agreements with communities, private initiatives and co-programmed projects and public tenders (PlantaDoce, Nov 30 21)
  • The Interterritorial Council of December 2 addresses the Royal Decree of Specialties, so that it is approved before the end of 2021. It contemplates approving new specialties and reviewing access to specific training areas (ConSalud, Nov 30, 21)
  • Pfizer vaccines for children, available from December 13 (ConSalud, Dec 1 21)
  • AESEG presents a report “The sector of generic drugs in the economic and social reconstruction of Spain”, in which it advocates a differential price of generics in relation to brands (AESEG, Dec 1 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

 

  • Continuity of care, interoperability, innovation and the promotion of the SDGs (Sustainable Development Goals), among the objectives of the IDIS Foundation for 2022 (ConSalud, 2 Dec 21)
  • Teladoc Health grows 81% in the third quarter (PlantaDoce, Dec 1 21)
  • Pfizer and Moderna are preparing to adapt their vaccines to the new “omicron” variant (El Global, Nov 29, 29)
  • Merck’s COVID Treatment (Molnupiravir), Endorsed by FDA (NYT, Nov 30 21)
  • HM Hospitales will have a new space of 1,000 square meters in Valdedebas (PlantaDoce, Nov 30, 21)
  • HIPRA relies on its covid vaccine to grow 13% in 2021 (PlantaDoce, Dec 1 21)
  • The major private equity companies (CVC, Advent, Cinven, PAI, KKR,…) prepare offers for around 1,500 million for IVI (CincoDías, Nov 30, 21)