Posts

7 days in healthcare (November 6th-12th, 2023)

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Summary

From the point of view of Biomedicine, Victor R. Fuchs, a pioneer of health economics and possibly the most recognized and prestigious health economist in the world, dies. He always defended universal health coverage for the United States, although he was very aware of the difficulties of its implementation, due, among other circumstances that he explained, to the heterogeneity of American society. And it must be said that he was not wrong in that. The FDA has just approved an oral drug based on the intestinal microbiome, a new horizon in medicine.

As far as Global Health is concerned, although tuberculosis is preventable and treatable, it continues to be the infectious disease with the most mortality globally, after a short period of time in which it was covid. But 40% of the world’s population with tuberculosis is not treated.

In terms of International Health Policy, it seems that the covid pandemic did not damage developed economies as much as initially thought. This seems to be deduced from studies of initials from the United Kingdom and Italy. The EFPIA, the pharmaceutical industry’s association, continues to complain that the new European legislation could end incentives for innovation and put Europe in an even worse relative position than the one it already has with respect to the USA and China. The OECD has just published “Health at a Glance 2023”, a must-read.

If we talk about National Health Policy (Spain), the agreements of the PSOE and Junts (and also those signed with the PNV for the Basque Country and with the BNG for Galicia) contemplate the transfer of powers over the MIR (and in the case of the Basque Country also of the issuance of titles). Some say that constitutional values and democratic principles have been subordinated in the investiture agreements. Obviously, this does not happen with the MIR, but an important value is put at risk: the cohesion of the National Health System, based, among other issues, on the uniformity of the training system and recognition of titles and specialties, being , on the other hand, a highly recognized system. 11 public hospitals appear to be starting a lung cancer screening program. Since this procedure is not recognized in the SNS service portfolio, the innocent question is: who pays for this? Or is it simply a pilot program with special funding? The Community of Madrid proposes a modification of the current Law of Good Government, which required the appointment of managers of health centers by competition and which at the time was approved by broad consensus, to another system that allows the direct appointment of these positions by part of the SERMAS Board of Directors.

In relation to Companies, at the international level, the battle between pharmaceutical companies in relation to obesity continues (the main players are NovoNordisk, Lilly and AstraZeneca). Amazon is relaunching in health, providing health services through One Medical to its premium customers. At the national level, great growth in the 22nd year of dental, ophthalmological and aesthetic clinics. The purchase of the Eugin assisted reproduction clinics from Fresenius by KKR and GED is completed. The latter retains the business in Spain, while KKR will integrate the international business into IVI RMA.

Biomedicine

Global Health

International health policy

  • United Kingdom and the National Health Service
  • OECD
    • The OECD publishes “Health at a glance 2023”. Main conclusions: healthcare systems are under severe financial pressure; there has been no complete recovery after covid; unhealthy lifestyles cause millions of deaths; Access barriers persist, despite universal coverage in most OECD countries; the quality of care is improving; digital health has immense potential (https://www.oecd.org/health/health-at-a-glance/)

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 (September 4th-10th, 2023)

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Summary

From the point of view of Biomedicine, in an editorial article, the Financial Times comments on the promise of anti-obesity drugs. Despite the clear benefits of the new drugs, there are unresolved issues: first, the limited knowledge of long-term effects; second, the drug is initially expensive. Private patients in the UK are expected to pay £300 a month; and, third, medications should be a complement rather than a substitute for general lifestyle measures. The first human organ created in an animal opens the door to manufacturing spare parts for people.

With regard to Global Health, the new director of Africa CDC publishes in Nature magazine the new policy guidelines of this body, aimed at addressing public health problems in Africa.

Regarding International Health Policy, it is confirmed that the latest versions of the vaccines are prepared for the new variants. Profound administrative reform of healthcare in Portugal, driven by the socialist government and, specifically, by the SNS administrator appointed about a year ago, Fernando Araujo. 31 management units (ULS, local health units) are created, which will be public business entities, with a board of directors, and a financing model in which money follows the patient. All hospitals will be assigned to one of these units. Strong criticism for the government’s secrecy in this reform, which has been carried out without prior consultation. The doctors’ order says that the reform will be a “complete disaster.” Despite what has been said, the reform has nothing to do with an implementation of the Spanish Alzira model in Portugal, but it is a public reform. Although some of the measures (business configuration of the management units, board of directors, new financing model in which money follows the patient) “sound good”, the truth is that a reform of this caliber carried out no longer without consensus political but without even public debate it is more than doubtful that it can be successful. He also questions the government’s idea of “getting out of the way” of healthcare by delegating changes to an “administrator.”

If we talk about National Health Policy (Spain), commitment of the Ministry of Health with the measures agreed with the pharmaceutical industry, with the participation even of President Sánchez, to ensure the investment of 8 billion euros. It seems that the conditions are to improve access to medicines; enhance R&D; increase industrial capacities and create supply chains for resilient drugs. Although it is logical and desirable for the government to be “business friendly” with companies in general and with pharmaceutical companies in particular, it is doubtful that such an explicit agreement is the best path for both parties. On the other hand, it must not be forgotten, in view of the government’s commitments, that we are in full discussion of European pharmaceutical policy. Certain relevant changes in the Community of Madrid: possibility of requesting any test from Primary Care and facility for non-EU doctors to work in Madrid. The Royal Decree approving the specialty of emergencies comes out in public hearing, something long awaited and promised, but no less controversial and debatable. The general director of Pharmacy, César Hernández, says that “we do not have a general problem of access to medicines”, which can also be controversial in certain environments.

In the field of Companies, at the international level, Novonordisk becomes the most valuable company in Europe according to market capitalization. Lilly tries to get ahead of Novordisk in the obesity market. Regarding national news, HM Hospitales expands its offer in Madrid with a new polyclinic in an area of intense growth such as Vadebebas.

Biomedicine

Global Health

  • New public health model in Africa. Article in Nature by Jean Kaseya, the new director of Africa CDC. 6 proposals: local manufacture of vaccines; improved tracking system; integrated health systems; laboratory network; emergency response design; robust national institutes of public health (https://www.nature.com/articles/d41586-023-02749-5)
  • Cancers in young people (under 50) have risen by 80% in the last three decades, including breast, lung, stomach and colorectal cancers. (https://www.ft.com/content/b3140954-3cd0-4a3e-b554-92efa7ed7538). Original article in the BMJ: https://bmjoncology.bmj.com/content/2/1/e000049#

International Health Policy

  • Portugal
    • Deep administrative reform of healthcare, promoted by the socialist government. 31 management units (ULS, local health units) are created, which will be public business entities, with a board of directors, and a financing model in which money follows the patient. All hospitals will be assigned to one of these units. Strong criticism for the government’s secrecy in this reform, which has been carried out without prior consultation. The doctors’ order says that the reform will be a “complete disaster.” The reform is attributed to Fernando Araujo, the SNS administrator appointed by the government last year (https://www.portugal.gov.pt/pt/gc23/comunicacao/noticia?i=nova-organizacao-dos-cuidados-de-saude-conheca-a-grande-reforma-do-sns-para-2024)

National health policy

Companies

 

 

 

7 days in healthcare (July 3rd-9th, 2023)

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Summary

From the point of view of Biomedicine, the contribution of Artificial Intelligence to medical diagnosis is reviewed by JAMA magazine. It seems clear that AI is not going to replace the so-called Narrative Medicine, that ability of the doctor to communicate and to listen and interpret the history of the patients. Interesting advances in the field of  a simple way to diagnose pre-eclampsia and Parkinson’s.

With regard to Global Health, more and more importance is given to loneliness and its consequences on health, according to an editorial in The Lancet. Hunger and famine as a product of human activity, especially armed conflicts, is treated by Nature. Concern regarding the AIDS situation in sub-Saharan Africa, where anti-retroviral therapy has barely reached.

Regarding International Health Policy, in the United States, the FDA approves the first drug to slow down the progression of Alzheimer’s. In the UK, three health think tanks (King’s Fund, Nuffield Trust and The Health Foundation) are addressing both the government and the opposition calling for solutions to the critical situation of the NHS. They denounce a decade of underfunding, which has led the UK to have far fewer human and material resources than most European countries. An interesting subscription model for antibiotics is being considered in the United Kingdom. Pharmaceutical companies will receive 20 million pounds per antibiotic put on the market, regardless of the prescription. In France, the Cour des comptes publishes documents to promote home palliative care and the development of advanced practice nursing. An interesting WHO-Europe document on hospitals and their challenges is published.

If we talk about National Health Policy (Spain), the beginning of the general elections on July 23, has made the different parties have made their programs public, including the health ones. The PP dedicates 24 measures to health. The strong points are: the Primary Care Shock Plan (although the title on emergencies is debatable); the State Public Health Agency; the Agency for Innovation and Quality (similar to NICE); digitization; palliative care; and, the mental health strategy. A new General Health Law is announced. Although the current law has many obsolete points, the legal technique of addressing a new law (instead of partial reforms in relation to different issues) is debatable. There is a risk of opening a very large melon, of generating long delays and of putting health into the same dynamic as education (a law for each new government). Conspicuous absences: nothing about financing, no mention of waiting lists (one of the most serious problems in the system), dental care (an area in which we are very far from Europe) and nothing about public/private collaboration. The PSOE program continues to identify public service with public management, thus distancing itself from any form of public/private collaboration. Many measures are contemplated, seeming more like a government plan than an electoral program, so the priorities are difficult to identify. The star measure seems to be announcing a law on waiting lists. Laws on waiting lists have never been effective in any autonomous community. The solution to the waiting lists does not go through a time guarantee law but rather resources and productivity of the public system and an updated and agile system of collaboration with the private sector. SUMAR incorporates the Podemos program: creation of a public pharmaceutical company; end of the MUFACE model; deprivatization plan, including cleaning, catering and laundry; progressive elimination of the pharmaceutical co-payment; they also announce a law on waiting lists. The Vox program represents an amendment to the whole: recentralization of health, recovering powers in health matters; approach waiting lists; repeal of the euthanasia and abortion law; strong criticism of the WHO, which they accuse of dependence on China. At the national level, the other great news is the alarm given by the insurers involved in the MUFACE model (Adeslas, Asisa and DKV) regarding the fact that its financing is generating large losses, unaffordable in the long term.

In the field of Companies, internationally, large pharmaceutical companies (Merck, BMS) are suing the American government for what they consider lowering prices, as a consequence of the anti-inflation law. In Spain, Ribera continues to bet on public/private collaboration, but this time in Portugal.

Biomedicine

Global Health

  • Editorial of The Lancet: Loneliness as a health problem. In the UK and Japan there are loneliness ministers. The health damages are clear: cardiovascular disease, hypertension, diabetes, infectious diseases, depression and anxiety. Loneliness is not the same as being alone and can affect all ages (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01411-3/fulltext)
  • Hunger and famines are not accidents, but facts created by human action. Around 200 million people experience acute food insecurity. Especially Afghanistan, Burkina Faso, Ethiopia, Mali, Sudan and Syria. Hunger and conflict are connected (https://www.nature.com/articles/d41586-023-02207-2)
  • HIV in Africa. Antiretroviral therapy has transformed AIDS into a chronic disease. But in sub-Saharan Africa, where 70% of AIDS patients live, few have access to this therapy, which greatly decreases life expectancy in the area (https://www.nejm.org/doi/full/10.1056/NEJMp2304600)

International Health Policy

  • COVID19
    • Weekly covid report published by the WHO, July 6, 2023. The African region has shown a slight increase in deaths with a decrease in cases. The remaining five WHO regions show a decrease in both the number of cases and deaths (https://apps.who.int/iris/handle/10665/370545)
  • United Kingdom and National Health Service
    • Three health think tanks (King’s Fund, Nuffield Trust and The Health Foundation) address government and opposition on NHS issues. They are betting that the next election will end short-term politics in the NHS. The recovery of NHS services and waiting lists must be a priority. They denounce a decade of underfunding. They welcome the long-term plan on personnel, published last week. They point out that life expectancy is the second worst (before only the USA) of the 19 health systems analyzed in the King’s Fund report (https://www.health.org.uk/news-and-comment/news/joint-letter-to-political-leaders-in-england-on-future-of-nhs)
    • The NHS intends to roll out the subscription model for antibiotics. Under the new proposal pharmaceutical companies would receive £20m for their new antibiotics, regardless of how many may be prescribed (https://www.ft.com/content/a0b5a2ad-06a4-499d-8195-b4d6a3f65f7a)

National health policy

  • 23 J elections: the health program of the PP
    • The PP dedicates 24 measures to health. The strong points are: the Primary Care Shock Plan (although the title urgent and emergencies is debatable); the State Public Health Agency; the Agency for Innovation and Quality (similar to NICE); digitization; palliative care; and, the mental health strategy. A new General Health Law is announced. Although the current law has many obsolete points, the legal technique of addressing a new law (instead of partial reforms in relation to different issues) is debatable. There is a risk of opening a very large melon, of generating long delays and of putting health into the same dynamic as education (a law for each new government). Conspicuous absences: nothing about funding, no mention of waiting lists (one of the most serious problems in the system), dental care (an area in which we are very far from Europe) and nothing about public/private collaboration (https://www.pp.es/sites/default/files/documentos/programa_electoral_pp_23j_feijoo_2023.pdf)
  • 23 J elections: the health program of the PSOE
    • The PSOE program continues to identify public service with public management, thus distancing itself from any form of public/private collaboration. Many measures are contemplated, seeming more like a government plan than an electoral program, so the priorities do not look good. The star measure seems to be announcing a law on waiting lists. Laws on waiting lists have never been effective in any autonomous community. The solution to waiting lists does not go through a time guarantee law but resources and productivity of the public system and an updated and agile system of collaboration with the private sector (https://www.psoe.es/media-content/2023/07/PROGRAMA_ELECTORAL-GENERALES-2023.pdf)
  • 23 J Elections: SUMAR’s health program

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

7 days in healthcare (January 9th-15th, 2023)

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Summary

From the point of view of Biomedicine, everything seems to indicate that important advances in the diagnosis and treatment of certain diseases are coming in the not too distant future, with cancer vaccines, the new FLASH radiotherapy, the diagnostic revolution of virtual biopsies and the incorporation of certain devices (such as smart watches) in the prevention and monitoring of certain pathologies.

With regard to Global Health, it should be noted that climate change seriously threatens our health, according to The Lancet. Another important article in this magazine refers to the fact that the covid has revealed the inequalities between social groups and countries in dealing with the pandemic, as well as the absence of a global health architecture.

As for International Health Policy, with regard to covid, an editorial in The Lancet says that far from being overcome, 2023 brings new concerns, such as the impact of the situation in China or the new form XBB.1.5 in the United States. In China, the post-covid zero situation continues, officially acknowledging almost 60,000 deaths in the last month, despite the fact that the WHO insists on the request for more transparency in that country. In the United States, the abortion pill, according to the FDA, can already be purchased in pharmacies and by mail order, even in states where abortion is totally prohibited, which indicates the difficulty of shortcuts and of wanting to close doors to the field. In the United Kingdom the serious crisis of the NHS continues. The health minister of the shadow Labor cabinet publishes in the Financial Times an article with a long-term approach to reforms, something that, regardless of its content, we miss in Spain by all parties. An important editorial in The Economist where it says that part of the solution to the NHS’s problems involves solving the problems of Primary Care, proposing several changes, but without losing perspective that a large part of the problems are in hospitals, with the situation of waiting lists and emergencies. He also opposes the Labor Party’s proposal, made last week, to end the independent mini-company character of Primary Care in the UK, in order to make primary care physicians salaried. The Economist carries out a study that says that in the United Kingdom there are 260 deaths a week (more than 12,000 a year) as a result of delays in the emergency room. The British are turning more and more to private healthcare, as increase problems in the public sector. The EU devises plans to avoid medicine shortages and dependence on China.

If we talk about National Health Policy (Spain), the drop in the incidence of covid continues, despite the situation in China and the American variant called Kraken. The Primary Care strike in the Community of Madrid is reactivated and a strike is on the brink in 8 autonomous communities, while the emergencies are collapsed. Despite the plans, recent studies show that almost half of public health workers are temporary. In relation to the Strategic Plan of the pharmaceutical industry, both BIOSIM and AESEG, as well as the representatives of orphan drugs, position themselves with requests, in a clear attempt not to leave this plan only in the hands of large innovative companies, as suggested by the photo of La Moncloa, with Sánchez meeting with the main leaders of pharmaceutical multinationals.

In the field of Companies, internationally, relevant news for Pfizer, BioNTech and AstraZeneca. In our country, it is worth noting the steps taken by Viamed (new hospital in Tarragona), Ribera (great growth in turnover in 2022), Miranza (which continues its growth), Korian (which is preparing to integrate Group 5) and the CUN (which has just renovated part of its hospitalization area). For its part, KKR has completed the acquisition of IVI, an important in vitro fertilization company of Spanish origin.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (December 26th, 2022-January 1st, 2023)

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Summary

From the point of view of Biomedicine, it is worth noting the ambitious project of the United Kingdom “Our Future Health”, which aims to place this country at the forefront of genomic research, and which seeks to carry out genetic analyzes of 5 million adult British volunteers, then looking at the correlation with lifestyles and medical records. Undoubtedly, this project will allow us to advance a lot in the knowledge of a wide variety of diseases.

With regard to Global Health, great concern in the world, since the large number of cases in China increase the probability that new variants will appear. There is no doubt that the covid – which had appeared, artificially or naturally, in China – has entered a new phase in which the epicenter is once again China.

Regarding International Health Policy, countries are preparing to put control measures at airports and borders against travelers from China, although the ECDC sees this type of control as unfounded and the EU has not adopted a common policy. Joschka Fischer (former – German Foreign Minister) publishes an in-depth article, whose conclusion is that, in contrast to what had previously been said that authoritarian regimes that do not depend on public opinion can impose drastic and effective measures in crisis situations such as covid, experience has shown that liberal democracies are more effective than autocracies in dealing with these situations. Great controversy in the European Union over the claim of the pharmaceutical industry to agree to produce new antibiotics, under the condition of increasing the patent term of certain drugs.

If we talk about National Health Policy (Spain), Spain has approved airport control measures to control travelers from China, which will be in force between December 31, 2022 and February 15, 2023. Primary Care doctors have opposed the hiring of doctors without MIR training, since this seems more like an opportunistic measure than addressing the underlying problems of Primary Care. The central government, so little fond of publishing and preparing expert analyzes on the covid management, instead presents a self-assessment on its management. According to this report “Cumpliendo” (“Fulfilling”) 64% of the health promises have already been fulfilled and 35% are in process. Bearing in mind that none of the structural healthcare problems have been addressed (personnel regime, management model, governance, accessibility and waiting lists, etc.) this self-assessment seems to us grated on complacency and even propaganda. Unless the promises -which are said to have been fulfilled- have nothing to do with the real problems of the sector. An interesting initiative from the private sector through the IDIS Foundation, which announces the start-up of a pilot on interoperability, should be highlighted. The fact that companies that compete with each other -both from the insurance and provisioning fields- agree on the interoperability of medical records is something that deserves to be highlighted.

In the field of Companies, the American Congress has taken an unusual decision: criticize the FDA for its inadequate collaboration with Biogen for the approval of the drug against Alzheimer’s. At the national level, Atrys continues its growth, both in Spain and abroad (United Kingdom, Middle East and Latin America).

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (September 19th-25th, 2022)

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Summary

From the point of view of biomedicine, to review the articles in The Economist on advances in knowledge of the brain, which will have a great impact on the appearance of new drugs and pain therapy.

With regard to Global Health, the WHO report of September 21, which places cancers, cardiovascular conditions and diabetes as responsible for three quarters of global mortality.

In terms of international health policy, an important initiative in France to offer three preventive consultations free of charge by the public system: at 25, 45 and 65 years of age. The EU launches a plan for the elimination of tuberculosis in Europe.

If we talk about national health policy (Spain), great debate around the Equity Law. What should have been just a law to correct the access deficiencies of the Montón Law, is being flamboyantly called “Equity” (as if accessibility guaranteed equity, not having a single provision to improve equity), and It is used to introduce the aspirations of Unidas Podemos to annul Law 15/97, approved almost unanimously at the time. The IDIS Foundation has warned of the damage to assistance and, specifically, the waiting lists, if some precepts of the Law are approved. It seems that the Catalan consortiums are going to respect each other, which is important, but it is also important to preserve and reinforce public/private concerts throughout the national territory.

At the corporate level, from an international point of view, the shares of the large vaccine manufacturers (especially Moderna, BioNTech and Novavax) plummeted, as a result of President Biden’s announcement that “the pandemic has been feared”. In Spain, it should be noted that Moderna will install its first quality laboratory outside the United States in Madrid.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

7 days in healthcare (September 12th-18th, 2022)

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Summary

From the point of view of biomedicine, immunotherapy (in colon cancer) and CAR-T therapies (in lupus) continue to expand their therapeutic possibilities. Advances against infections for resistant bacteria. Will there ever come a time when cancer can be diagnosed by a simple blood test? This possibility does not seem very remote, according to papers presented at the meeting of the European Society of Medical Oncology.

Regarding Global Health, an important work directed by Jeffrey Sachs and published by The Lancet on the delays and errors of both governments and the WHO in dealing with the covid pandemic, which could have produced 17.7 million of  deaths, many of them preventable.

Regarding international health policy, the WHO says that the end of the covid pandemic may be in sight, although at the same time a new variant (BJ.1) of covid is evident in Europe. Important debate in Europe (Scotland and France) on euthanasia and assisted death. The French Ethics Committee opens the door to this possibility. The financing of the American FDA was questioned, due to its great economic dependence on the pharmaceutical industry. Biden launches a speech commemorating Kennedy’s in 1962 when he decided to go to the Moon, but this time oriented towards the fight against cancer.

If we talk about national health policy (Spain), the PDeCAT presents an amendment to the entire equity law, which it accuses of interfering in regional powers and of confusing agreement with privatization. Surprising statements from the Ministry of Health in a parliamentary response, saying that its functions in relation to the waiting lists are only to inform and monitor, as if it did not have the possibility of signing agreements with the communities to address this problem or of launching other actions. Concern, there are even demonstrations in the street, of the relatives of the elderly admitted to residences. The Community of Madrid announces that it will reduce the waiting lists by half. Although we would like it not to be the case this time, this announcement is preceded by other similar ones from different governments, which always came to nothing in terms of effectiveness. The search for solutions by the Ministry of Finance to the MUFACE model, highly impacted by inflation, seems to recognize its underfinancing.

In the field of companies, from the international point of view, important success for Sanofi, with its new vaccine against bronchiolitis. In Spain, important corporate movements in Korian, HM Hospitales, Miranza and Ribera.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (September 5th-11th, 2022)

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Summary

From the point of view of Biomedicine, to highlight the work that shows an association between artificial sweeteners and increased cardiovascular risk. Also that air pollution causes lung cancer.

As far as Global Health is concerned, apart from the serious humanitarian crises in Pakistan and Somalia, the most promising is the new malaria vaccine, which could be operational as early as 2023.

Regarding international health policy, assisted suicide and euthanasia are news in Canada (where the rate of euthanasia is very high and there is concern) and in France (which is considering passing a law). Macron has launched a major national debate on this issue, following a report to appear next week from the Ethics Committee. This great debate on such a delicate subject was missed in Spain. Certain issues should not be subject only to conjunctural parliamentary majorities, but should be preceded by a great national debate. It is also worth mentioning that Chile rejected the draft Constitution in a referendum. According to an article published in El País, doubts about the possibility of choosing the health system (the continuity of the ISAPRES, as health insurers are called in Chile), is one of the causes of this rejection.

If we talk about national health policy (Spain), it should be noted that Aragón proposes a great debate on the efficiency of the National Health System, a brave and valuable initiative. It will first analyze the Aragonese health system, and then share that analysis with the rest of the autonomies. Also that the Ministry of Health promises to change the law to favor the local manufacture of medicines. It is also worth underlining the pronouncement of the Catalan Evaluation Agency, on the need for a state policy for the digital transformation of the health system and the promotion of telemedicine.

In the field of companies, from the international point of view, to mention the purchase of Signify a home care group by CVS (an American pharmaceutical chain), in a process in which Amazon also showed interest. In terms of news at the national level, to highlight the great investment of Novartis in our country.

Biomedicine

Global Health

International health policy

National health policy

Companies