Posts

7 days in healthcare (March 25th-31st, 2024)

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Summary

From the point of view of Biomedicine, it should be noted that possibly the next “boom” will be everything related to anti-aging therapies, an aspect to which the Financial Times dedicates an article, following the appearance of three books on the subject. . The Economist dedicates a lot of space in its latest issue to the issue of AI in healthcare, no less than an editorial and four articles. The conclusion is that AI will have a great impact on healthcare. However, as Eric Topol, the well-known cardiologist and health publicist, comments in another article in the Financial Times, “AI is very transformational, but these things always take longer than you initially think.” Nature magazine analyzes the reasons for optimism about cancer vaccines. Vaccines to treat, not to prevent.

Regarding Global Health, the WHO focuses on the millions of undiagnosed cases of tuberculosis, which compromise efforts to combat this disease. The WHO estimates that in 2023 there will be three million new cases not known to health services. Problems continue between developed and developing countries, which do not agree on the Treaty on the prevention of pandemics, proposed by the WHO as a goal for 2024.

In terms of International Health Policy, the King’s Fund and the Nuffield Trust, two prestigious British think tanks on health, analyze satisfaction with the NHS, which is the lowest in the entire history of this institution. Only 24% of citizens in England, Scotland and Wales are happy with the service, with waiting lists being the most common complaint. In France, the Sorbonne Faculty of Medicine and a former health minister propose “strong measures” to, they say, prevent the degradation of the health system in France. Of the three measures they propose, one of them has to do with the preservation of “medical time” (through non-medical assistants in consultation); and the other with the promotion of advanced practice nursing.

If we talk about National Health Policy (Spain), based on Primary Care analysis that is on the Ministry’s website, it is observed that people treated in primary health centers who earn less than 18,000 euros per year are medicalized more frequently, have prescribed more chronic drugs and consume more pills for pain, anxiety or depression. The Ministry of Health is studying allowing price competition between medicines so that generics can gain market share. This would affect generics and biosimilars, which would be cheaper than brand-name ones and it would be the patient who, if they wanted, would assume the difference. The situation in Spain of the same price for generics as for branded ones is unique in Europe. The objective is to stimulate the development of the generic and biosimilar industry and, ultimately, reduce the pharmaceutical bill for these medicines, in order to allow the incorporation of innovations. If it is carried out, it will be great news. Of note is the agreement signed between the Colleges of Pharmacists of the Basque Country and the Department of Health of that community, with the idea of facilitating the integration of community pharmacies as health agents in the health system. More than interesting is the article published in Human Resources for Health, and whose first signatory is Sara Calderón-Larrañaga, and which analyzes the reasons why primary doctors leave Spain. The work consisted of a survey, focus groups and interviews with 158 primary doctors who had left Spain. The causes of their departure were, in order of importance: insufficient salary, temporary employment, excessive workload, poor governance of primary care, lack of flexibility in the workplace and personal circumstances. There are the keys to a reform of Primary Care.

As for Companies, internationally, a cancer drug (Keytruda, from Merck-MSD), the best-selling drug in the world. In Spain, the historic achievements of Rovi, with a business approach that goes beyond covid. We must also highlight Vithas’ hospital commitment in Barcelona, where construction is underway.

Biomedicine

Global Health

International health policy

National health policy

Companies

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

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Summary

From the point of view of Biomedicine, highlight the article by Dr. Topol, famous American cardiologist and doctor, who says how generative AI can contribute to significantly reducing medical errors, which cause hundreds of thousands of deaths a year in the United States and around the world. An initial cancer screening seems to be making its way through a simple blood test, taking advantage of the sharing of certain molecular characteristics in all cancers. The University of Gothenburg in Sweden is developing a blood test for the early diagnosis of Alzheimer’s disease.

With regard to Global Health, an editorial in The Lancet refers to the economic problems in low- and middle-income countries in addressing health expenditures, given the great weight of debt interest, which is why it proposes as a solution its condonation. The first mass malaria vaccination begins in Africa. Universal healthcare in Tanzania. Universal coverage, long exclusive to Europe and high-income countries (with the exception of the United States), is now spreading to developing countries as well.

In terms of International Health Policy, the next American elections in 2024 already show what could be the priority issues during the campaign for Democrats and Republicans. For the former, reducing the high price of prescription drugs and women’s health (with pro-choice options); for Republicans, overcoming covid-19 and drug overdose. It does not seem that the repeal of Obamacare, which has reached a record of 21 million affiliates, is going to be a priority in the Republican campaign.

If we talk about National Health Policy (Spain), presentation by Minister Mónica García of her priorities in the Congressional health commission. Laws against alcohol consumption in young people and to protect direct public management in public healthcare. Announcement of the legalization of cannabis and increase in the portfolio of services in “dental” and “visual health”. The imminent approval of the Public Health Agency and the reform of the Framework Statute in 2024 are announced. In relation to this last point, it was announced that negotiations are being carried out with the unions and the communities. And what about the professionals? Don’t they have anything to say on this topic? Important announcement by the Ministry of the genetic portfolio of the National Health System, to be launched gradually throughout 2024. Health maps are being reformed and simplified in several communities: Aragón, Cantabria, Valencian Community and Asturias . It is striking that the reforms are promoted by PP governments in the first three communities, while the reform in Asturias, sponsored by a PSOE government, is opposed by the PP. Catalonia promotes the discussion of a National Health Pact. Among other issues, the elimination of the statutory personnel regime is proposed. Possibly this change cannot be made legally from an autonomous community, but the much-needed idea and the opening of the discussion are welcome.

As for Companies, at the international level, Novo Nordisk and Lilly find themselves with a new player in their battle regarding obesity: the Danish biotech company Zeland Pharma. When it comes to national news, the problems with Grifols continue. Interesting article in Expansión on professionalization and corporate governance in family businesses.

Biomedicine

Global Health

International health policy

  • USA
    • Article in JAMA: Focus on health problems in the 2024 American elections. It seems that health care is going to be very present in the American elections. Democrats’ issues are lowering prescription drug prices and women’s health (with pro-choice options); while the Republican issues are overcoming covid-19 and drug overdoses and border control policies in this regard. Despite Trump’s criticism of the Obamacare law, repealing the law is unlikely to be made a campaign priority (https://jamanetwork.com/journals/jama/fullarticle/2814471)
    • Obamacare enrollment boom, reaching 21 million in 2024 (https://www.nytimes.com/2024/01/25/us/politics/obamacare-open-enrollment.html)

National health policy

Companies

 

 

7 days in healthcare (September 11th-17th, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting that the famous doctor and communicator Eric Topol publishes an article in the magazine Science about the multiplication of medical applications of artificial intelligence. The number of variables of each individual person (anatomical, genomic, metabolomics, epigenomics, etc.) can only be captured and used in diagnosis and treatment through the use of artificial intelligence. Clinicians must become familiar with these new tools and possibilities.

Regarding Global Health, The Lancet comments on what happened with the mpox pandemic (previously called monkeypox), which triggered a global alarm from the WHO and which today has decreased significantly. UN high-level meeting on tuberculosis, whose mortality has increased recently, after years of decline. The Gates Foundation proposes simple and cheap measures to improve the health of women who give birth, since 800 women globally die in childbirth every day.

In terms of International Health Policy, there is an emphasis on measures not learned during Covid, as global politicians seem to move away from fundamental concerns such as equitable access to vaccines and greater transparency. Alcoholism is a serious and very common disease in the USA, causing around 140,000 alcohol-related deaths each year in that country. It seems that the new medications (Ozempic, Wegovby) now used for obesity may also be useful in alcoholism, by curbing consumption. In the NHS the waiting list continues to grow, reaching historic record levels, which contrasts with Prime Minister Sunak’s promises. Serious problem for the Nigerian government to retain its doctors, since six out of ten intend to emigrate in search of better opportunities. Eurostat publishes the most frequent surgical interventions in Europe. Caesarean sections and cataracts, the most frequent interventions.

If we talk about National Health Policy (Spain), covid infections skyrocket due to the drop in immunity. Spain has 100 million vaccines not adapted to the new strains. However, the public health commission recommends the use of adapted vaccines. Problem for Spain, since these vaccines not prepared for the new strains cannot be sold or donated. Spain takes 780 days to supply the new medications. Apart from the 629 days recognized in the WAIT report, from the time the drug is approved by the EMA until the price and public financing are approved in Spain, another five months must be added for approval by the autonomous communities and it would even be necessary to add delays due to approval by hospital commissions. Cosmetic surgery operations have increased rapidly in Spain in recent years.

In the field of Companies, at the international level, the Strasbourg plenary session supports the plasma law that favors Grifols. At the national level, private hospitals (ASPE) take the Sanitas and Generali alliance to court. Ferrer and Almirall, with very good prospects.

Biomedicine

Global Health

International health policy

  • Mexico
    • Abortion, not criminalized in Mexico. The decision of the Supreme Court to reject the law that criminalized abortion opens the door to its legalization, increasing the liberalization of abortion in Latin America (https://www.bmj.com/content/382/bmj.p2060)

National health policy

Companies