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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 (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

 

 

 

 

7 days in healthcare (August 14th-20th, 2023)

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Summary

From the point of view of Biomedicine, surely the most far-reaching news is the success obtained with a transplant to a brain-dead human of a genetically modified pig kidney, which worked perfectly, both from the point of view of renal function and of non-rejection. This represents great hope for transplants, especially in the United States where transplant waiting lists are very long. It is estimated that some 5,000 people in the USA die each year waiting for a kidney transplant. The idea is to request authorization from the FDA to carry out a clinical trial.

As far as Global Health is concerned, an interesting WHO summit in India on traditional medicine (which includes treatments as varied as Ayurveda, yoga, homeopathy and complementary therapies), although we don’t have to expect much from the results. The truth is that traditional medicine is followed by billions of people and the WHO wants to see how it integrates with conventional medicine. The Lancet comments that malnutrition is the greatest risk for tuberculosis. In fact between 1900 and 1940 the incidence of tuberculosis plummeted, in the absence of any effective treatment or vaccines, simply because of improved socioeconomic conditions.

As for International Health Policy, two Chinese manufacturers are making “copycats” of weight-loss drugs, threatening Western companies in their development in this huge obesity market. An international study (United States, Germany and Switzerland) warns of the “cancer premium” in the price of medicines, which reaches up to three times that of medicines for other diseases, this price not being justified either by the manufacturing process or by because of the research, but, fundamentally, because of the extreme concern and anguish in the face of this disease. Although the study refers to those countries, this phenomenon occurs in all nations, including Spain.

If we talk about National Health Policy (Spain), denounce the low rates of insurers with doctors. Although the matter will surely have many nuances, the truth is that the low rate of insurers (20 euros on average for a first consultation and 10 for a subsequent one) make this model of care provision very unstable. La Rioja proposes with the new government of the PP to have a Faculty of Medicine. The map of the Faculties of Medicine in Spain has been highly denounced both by the Association of Medical Students and by the Medical Deans’ Conference. We have a ratio of medical schools per population that is second only to South Korea, of course much higher than that of France, the United Kingdom and Germany, which should be our benchmarks. The peculiar distribution of powers between the State, the communities and the Universities has led to this certainly anomalous situation. The pharmaceutical industry has become the leading export sector in Spain, ahead of the automobile industry, which traditionally led the ranking. A complete success for this industry, of which there are 173 production plants, most of them in Catalonia, followed by Madrid.

In the field of Companies, at the international level, Novartis plans to separate from Sandoz (its division for generics and biosimilars), following the same path as Pfizer with its Upjohn generic business, which it merged with Mylan to form Viatris. Various private equity firms interested in the operation. At the national level, it is worth highlighting the large increase in Ferrer’s profit.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

7 days in healthcare (July 31st-August 6th, 2023)

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Summary

From the point of view of Biomedicine, it seems that for the first time, apart from the complicated bariatric surgery, medicine will have a treatment for obesity, this disease that affects more than 1 billion people worldwide. With GLP-1 it seems that we are entering the phase of effective drugs against obesity. Generative AI, which is capable of generating new algorithms, based on the patterns and structure of the data, is called to play an important role in health care. It seems that cancer is growing at younger ages. The WHO declares the polypill, developed by the CNIC and Ferrer, as an “essential medicine”.

With regard to Global Health, a call by the editors of the most important scientific journals in the world, through a common article, for health professionals to get involved in the fight against the risk of nuclear war, since it seems that we are in a situation of risk not seen since the Cold War. The WHO detects progress in tobacco control in many countries, through the WHO Framework Agreement for Tobacco Control, signed 20 years ago.

Regarding International Health Policy, in the United States a cyberattack forces the paralyzation of the activity of several hospitals. In the United Kingdom, new diagnostic centers are being created to increase the capacity to carry out tests and reduce the waiting list. Of the 13 centers announced, 8 will be privately financed and managed. The waiting list is a political priority for Prime Minister Sunak.

If we talk about National Health Policy (Spain), the incidence of covid has risen since July. It is extremely striking that a new registry multiplies by four the official number of maternal mortality in Spain. Maternal mortality is precisely one of the indicators most taken into account when establishing the health of a country. The Health Accounts System document has been published, which updates the data with those of 2021. Between 2017 and 2021 there has been a 25% increase in health spending, including public and private. The MUFACE system is doubly threatened, firstly because of its high losses and, secondly, because the SUMAR program, Sánchez’s possible partner in a new government, is sponsoring its disappearance. The agreement signed in Aragon for the constitution of the new PP-Vox government contemplates resorting to public/private collaboration to address the waiting list. It should be noted that the integration of the workforce of the former Health Agencies of Andalusia has been completed, which affects 3,500 workers, who may be integrated as permanent statutory employees. An important regression, which reinforces the most rigid aspects of the public health system, precisely what the public hospitals with the configuration of public companies, unfairly called by the PP in Andalusia as “chiringuitos”, had tried to overcome with remarkable success. A blunder, not to use euphemisms, both from the Andalusian government and from the party that supports it. Information from the old management teams ensures that the deterioration is already taking place. If, rightly, an audit is required to see the results of the reversals of the concessions in the Valencian Community, something similar will have to be done in due course with these Andalusian hospitals.

In the field of Companies, internationally, Amazon launches a new documentation service based on generative AI. The pharmaceutical companies that had made cash with the covid vaccine are deflating, something that was already discounted by the market. At the national level, a new incursion of Magnum Partners into health, by buying the nutraceutical company Martínez Nieto. Apax acquires 50% of Palex, a company that had become a target for many funds, and which will surely herald a consolidation of the medical technology distribution sector.

Biomedicine

Global Health

International Health Policy

National health policy

Companies