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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