Posts

7 days in healthcare (April 24th-30th, 2023)

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Summary

From the point of view of Biomedicine, to mark the 70 years since the discovery of the structure of the DNA molecule, which was to revolutionize the field of biology and medicine, allowing in 2003 the development of the human genome and in 2023 the approval of the first drug based on gene therapy. Nature warns that the gene therapy revolution may be threatened if cost is not discussed, proposing regulatory changes and new intellectual property laws.

With regard to Global Health, a Fund was created (similar to that for HIV, tuberculosis or malaria) to fight against hepatitis, that great plague that worldwide causes more than a million deaths a year. Great repercussion of the conflict in Sudan on the health situation in that unfortunate country.

As for International Health Policy, any other international news pales in comparison to the importance of the new proposals from the European Commission regarding the new pharmaceutical regulation. They propose changes to fundamental rules that had worked without modification for more than twenty years. It is difficult to pronounce, given the great weight of the interests at stake: those of patients, those of pharmaceutical research in Europe, those of the pharmaceutical industry, those of the Member States that want to see their pharmaceutical bills reduced. The texts of the new Directive and new Regulation are still proposals, but they will give people talk.

If we talk about National Health Policy (Spain), the new Minister of Health pronounces himself saying that the waiting lists “are not the responsibility of the Government”, a statement that could be considered unacceptable, since someone might think that the Ministry has more responsibilities apart those of compiling and disseminating the lists. The IDIS Foundation publishes its annual report, now in its 13th edition, on “Private healthcare: providing value”, which has become essential in the sector, due to the transparency it gives to the situation of the private sector. The data from the WAIT report are not favorable for Spain, in terms of the average time elapsed since the approval of medicines by the European Agency and their availability in Spain. Our country is among those that accumulate the most delays in this process.

In the field of Companies, at the international level, spectacular news is the purchase by Kaiser Permanente (a giant on the American West Coast) of Geisinger (a smaller operator on the East Coast) to found a customer service system. non-profit community health. In Spain it seems that the INCOSOL model wants to be replicated outside of Spain.

Biomedicine

Global Health

International Health Policy

National health policy

  • Pharmaceutical policy
    • The WAIT 2022 report, which has just appeared, establishes the delays in different European countries, including Spain, for the incorporation of medicines. Spaniards have to wait an average of 629 days from the approval by the European Agency until they are available in Spain. Spain in the range of countries with the longest wait. The least expected countries are Germany and Denmark (https://www.abpi.org.uk/media/news/2023/april/efpia-wait-indicator-survey-2022-launches/)

Companies

7 days in healthcare (March 7th-12th, 2023)

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Summary

From the point of view of Biomedicine, the geneticist Francisco J Ayala, one of the great Spaniards of science, with important contributions in the field of the human genome and other diseases, dies. Some obscure episodes, not fully clarified, pointed to him as a target of the “me too” initiatives. It is increasingly clear that gene therapies will soon explode and will be useful in multiple hematological, cardiac, ocular, muscular and even neurodegenerative processes. An ethical reflection is essential, which ensures, on the one hand, that these treatments are accessible, and, on the other, the limits of these treatments. It seems that we are closer to having specific treatments against fatty liver, a serious disease responsible for tens of thousands of deaths.

As regards Global Health, young people, including adolescents, with gender dysphoria are growing all over the world. There is no accepted professional consensus on how to approach these situations. It seems increasingly clear that inequality in the face of covid vaccines responsible for thousands of deaths from this disease. Although there is no absolute consensus, it seems increasingly clear that smartphones and social networks are responsible for serious mental health problems among young people. 24/7 access to these technologies minimizes face-to-face contact between young people.

Regarding International Health Policy, the WHO maintains the covid as a “health emergency of international concern”. In the United States, the budget presented by Biden – which will not be approved – proposes a significant increase in funds for Medicare. Problems continue for the Walgreens pharmacy chain for not selling abortion pills in 21 states. The USA plans to eliminate hepatitis C, almost a decade after highly effective therapies for this disease appeared. Concern in the United Kingdom about the interruption of the improvement in life expectancy for a decade, before the covid, contrary to what is happening in France or Denmark, for example. Australia is preparing to tackle a health reform, after the preparation of an independent report, a model that could well be inspiring for Spain. Newsweek magazine publishes its well-known ranking of the best hospitals in the world. The Mayo Clinic, in Rochester, and the Cleveland Clinic, in Cleveland, considered the best hospitals in the world. Among the first hundred there are 6 Spaniards, all of them public, except one private: the Clínica Universidad de Navarra (CUN).

If we talk about National Health Policy (Spain), in terms of covid, the accumulated incidence continues to rise slightly, with a fairly high mortality (139 patients in one week). In Castilla y León, the health areas will have access to a team on rare diseases. Serious concerns among psychiatrists about the large increase in cases of gender dysphoria. The actors in the cyber attack on the Hospital Clínic de Barcelona request a ransom of 4.5 million dollars, which the Administration refuses to deliver. Some Catalan doctors are organized to attend only in Catalan, something against repeated court rulings and the Generalitat’s own protocols.

At the Corporate level, at the international level, investors are rubbing their hands at the prospects of big business in anti-obesity drugs. Morgan Stanley has quantified what this can mean in billions of dollars worldwide. Pfizer places its vaccine against covid as the drug with the highest income in the world. At the national level, Quirón reaches an agreement with the City Council for the construction of its hospital in Gijón and Hospitén announces the construction of a new hospital in Madrid with a large investment of 160 million euros. Thus, the boom in new private hospitals continues, for which there is a real race in which several actors participate (Quirón, Viamed, Vithas, Hospitén, Imed, and others). Hipra will return aid to the covid vaccine in ten years.

Biomedicine

Global Health

International Health Policy

  • Best hospitals in the world
    • Newsweek magazine publishes its traditional ranking of the best hospitals in the world. The first three are: the Mayo Clinic in Rochester, the Cleveland Clinic in Cleveland, and the Massachusetts General Hospital in Boston. Among the first 100 are 6 Spanish hospitals: La Paz, (53); Barcelona Clinic (62); October 12 (72); Vall d’Hebrón (83), Gregorio Marañón (90) and the CUN (97) (https://www.newsweek.com/rankings/worlds-best-hospitals-2023)

National health policy

Companies

7 days in healthcare (January 30th- February 5th, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting the review by The Lancet on lung cancer screening, which shows that the low-dose Scanner is effective in reducing mortality, although there are aspects of cost-effectiveness that they remain as a problem; neural implants in rats open the prospect of brain transplants; the gene therapy revolution, previously abandoned for safety reasons, is now in full swing; and mRNA vaccines, which may be useful for cancer, with fewer side effects than conventional chemotherapy. The debate on check-ups is current, proving, once again, that annual check-ups do not reduce mortality, and despite everything, they are increasingly in demand.

As regards Global Health, The Lancet publishes an editorial in which it tries to change the narrative of little hope until now on cancer, due to the great disparities between countries in this fight.

Regarding International Health Policy, the New England Journal Medicine magazine publishes an article that affects the approach to the new reality of the covid, despite the new perception as a minor nuisance, it continues to represent between 300 and 500 deaths a day in USES. According to The Economist, we will most likely never know the number of deaths from covid in China, since the official mortality figures are not credible. The crisis in the British NHS continues, which seems to have been exacerbated by Brexit. Prime Minister Sunak’s proposals are for more ambulances, more hospital beds and home care. El Mercurio, the leading newspaper in Chile, editorializes on the critical situation of the ISAPRES (health insurers) in that country, which could fall into insolvency, which occurs due to the government’s indifference to this situation.

If we talk about National Health Policy (Spain), the incidence of covid continues to drop, although mortality remains high. World Cancer Day (February 4) coincides with the appearance of interesting publications on the cancer situation in our country, both by SEOM and the OECD. This latest report warns Spain about accessibility problems. The implementation of cancer screening has been uneven, which leads to inequities between autonomous communities. Cancer already represents 10% of public health spending. The celebration of Cancer Day also coincides with two new inaugurations of centers dedicated to this disease: the Cancer Center of the Clínica Universidad de Navarra and the experimental oncology center of the Hospital 12 de Octubre in Madrid. The Ministry of Health of the Valencian Community announces the non-extension of the Denia concession contract. The Government publishes the Regulatory Plan for 2023, the law of the National Public Health Agency among the three health laws planned for 2023.

In the field of Companies, internationally, it should be noted that Pfizer is the first pharmaceutical company to reach revenues of more than $100,000 a year, thanks largely to the boost of the covid vaccine. As far as Spain is concerned, both Vitaldent and IMED are launching new centers. It seems that we are witnessing a fever of new private hospitals (Vithas in Barcelona; Sanitas in Madrid; Viamed in Tarragona; IMED in Alicante; Quirón in Asturias; and a long etcetera).

Biomedicine

Global Health

International Health Policy

  • COVID
    • Addressing the new reality of covid. The covid passed, in the popular perception from a terrible threat to a minor inconvenience with a few days of symptoms. The reality, however, is not that and the covid still means between 300 and 500 deaths a day in the USA, equivalent to a mortality higher than that of a serious flu epidemic. To this must be added the effects of persistent covid (https://www.nejm.org/doi/full/10.1056/NEJMp2213920)
  • Changes in the United States
    • The implications of the results of the US elections in 2022 in health. Results of a survey conducted by Robert Blendon. It is striking that despite the fact that the United States is the country that spends the most on healthcare, the majority of the population thinks that little is spent. This opinion is very predominant among Democrats, but also in the majority among Republicans (https://www.nejm.org/doi/full/10.1056/NEJMsr2214949)
    • The response of the National Health Institutes (NHI) to covid (https://www.science.org/doi/10.1126/science.adf5167)

National health policy

Companies

7 days in healthcare (December 12th-18th, 2023)

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Summary

From the point of view of Biomedicine, The Lancet commemorates the 200th anniversary of the birth of Pasteur, the creator of the germ theory. Even today a high percentage of deaths are from infections. Promising results of an mRNA vaccine against melanoma, presented by Moderna and Merck.

As far as Global Health is concerned, it is worth highlighting the article published in Nature that says that without a strategy and global financing of vaccines, the world will be unable to successfully face new epidemics.

As for international health policy, the discouraging news of China’s abandonment of the covid-zero policy continues, when the country is not prepared and is most likely to suffer high mortality. The CDC quantifies the deaths from persistent covid in the USA. The conflict of nurses in the NHS continues, which coincides with the appearance of a report from the Institute for Fiscal Studies in the United Kingdom that attributes the problems of the NHS to underfunding of the system. New Zealand, the second country in the world to announce a ban on tobacco sales.

If we talk about national health policy (Spain), in terms of covid, the incidence continues to decrease, what has not completely decreased, or has decreased very slowly, is mortality (236 deaths in the last week). After confinement in a unit of the Regional Ministry of Health, the strike committee of primary care doctors in Madrid decided to continue the strike, extending the conflict to a demonstration, along the lines of the “white tides”.

In the field of companies, internationally, it seems that Jeff Bezos and Bill Gates are making an important bet in the field of neurotechnology with the company Synchron. As far as national news is concerned, perhaps highlighting that it seems that the hopes placed on the Spanish HIPRA vaccine are fading.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (August 21st-28th, 2022)

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Summary

From the point of view of biomedicine, the very encouraging results of the polypill published by a Spanish group led by Valentin Fuster should be highlighted. The Economist underlines the great future of gene therapies in medicine, with a list of diseases for which there is a therapy or is in advanced study.

Regarding Global Health, The Lancet publishes a report with some conclusions and lessons regarding future pandemics.

As for International Health Policy, both monkeypox and covid are plummeting in Europe. The controversial annulment of the Roe v Wade ruling in the United States, which leaves the right to abortion to the criteria and regulation of the states, continues to be talked about. American companies, including Walmart, the largest American employer, introduce this benefit for women, regardless of the state where they work.

If we talk about National Health Policy (Spain), covid continues to drop and especially the number of cases in the ICU. The Government approves the bill that creates the Public Health Agency, probably the largest, if not the only, far-reaching measure after the pandemic. The text of the law is not yet public, and therefore important aspects such as governance and functions are not known. The location is not known either, although the Government has advanced that it would not be in Madrid, which is not without controversy either. Next week the government will approve the abortion law, according to a text promoted by Podemos.

In the field of companies, Moderna’s lawsuit against Pfizer and BioNTech has been shocked, which it accuses of plagiarism of its mRNA technology in the covid vaccine. Amazon closes its telecare service, which once again demonstrates the difficulties of the large technology platforms in finding an adequate strategy for health, a sector in which they want to be above all else. In Spain, the export of drugs manufactured in Spain grows by 60% in one year.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

 

7 days in healthcare (May 2nd-8th, 2022)

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Summary

From the point of view of biomedicine, two important editorials in The Economist should be highlighted on wearables (devices to wear, mainly smart watches) and medicalized apps, which could represent a new form of relationship between citizens and the health system and greater involvement of the population in maintaining their own health.

As far as Global Health is concerned, two books stand out, the one by Bill Gates on the pandemic, in which he says, in short, that outbreaks are not avoidable, but pandemics are, and the one by Devi Sridhar on the pandemic in general, commented by The Lancet.

As for international health policy, much of the debate in the international press is centered around the controversy over abortion in the United States, which is dividing American society. Much of the international media speaks out against the reversal of the Roe v Wade ruling, which established abortion as a constitutionally based right in the United States (The Economist, New York Times, Financial Times, Le Monde), although some they do it for (Wall Street Journal). Especially harsh is the article in the New England Journal Medicine, which says that the reversal of this sentence would mean a return to 1973, where women with resources could access an abortion by changing state or country, while the poor had to assume a pregnancy not desired or undergo interventions without guarantee, with high mortality and complications.

If we talk about national health policy (Spain), we must highlight the important editorial in El País on cancer drugs, which try to be introduced despite their high price and poor results in terms of survival. It is also necessary to highlight the “Update of the Stability Program 2022-2025“, where the government puts black on white that it will not fulfill its programmatic promise of reaching 7% of GDP in health in 2023.

In the field of companies, from the international point of view, it is worth noting the dismissal of the head of Biogen, after the controversial introduction of a drug against Alzheimer’s, whose approval by the FDA had already produced a cataclysm in this organism, with deep internal divisions. In the national environment, the important Pfizer document on gene therapies should be highlighted, as well as Quirónsalud’s proposal for a new hospital in Gijón, which could renew the private hospital scene in that region.

Biomedicine

Global health

International health policy

  • COVID-19

o In China, the covid-zero policy accentuates the slowdown in the economy (https://www.lemonde.fr/economie/article/2022/05/06/en-chine-la-politique-zero-covid-accentue -le-slow-down-de-l-economie_6125001_3234.html)

o Deaths from covid worldwide are at their lowest since the start of the pandemic (https://www.elespanol.com/ciencia/salud/20220507/muertes-covid-mundo-situan-minimos-inicio-pandemia/ 670433394_0.html)

  • The great debate on abortion in the United States

o The leak of an exploratory vote in the United States Supreme Court on the abolition of the Roe v Wade judgment (which declared abortion legal throughout the United States), unleashed a great controversy. If Roe v Wade is amended, abortion rights would become an issue for the states, not for the United States as a whole. There would be states in which abortion would be legal, while others would not (https://www.nytimes.com/article/abortion-laws-us.html)

o The most important international media editorialize and publish articles on the subject, such as The Economist (https://www.economist.com/united-states/how-the-end-of-roe-v-wade-will- affect-american-politics/21809130), The New York Times (https://www.nytimes.com/2022/05/06/opinion/roe-v-wade-constitution.html), Financial Times (https:// www.ft.com/content/92042f8d-7954-4ffa-a0f5-b0fae12f7da3), Le Monde (https://www.lemonde.fr/international/article/2022/05/07/avortement-aux-etats-unis- un-retour-en-arriere-de-la-cour-supreme-serait-l-aboutissement-de-cinquante-ans-de-combat-de-la-droite-religieuse-contre-l-ivg_6125107_3210.html) and The Wall Street Journal (https://www.wsj.com/articles/the-end-of-roe-will-be-good-for-america-supreme-court-draft-leak-decision-abortion-pro-life-choice-justices-alito-11651787057), by cite just a few

o The medical press also speaks out: important article in the New England Journal Medicine, totally against the possible annulment of Roe v Wade (https://www.nejm.org/doi/full/10.1056/NEJMp2119364)

o The position on abortion in the United States: religion, not gender, is the greatest predictor of position (https://www.economist.com/graphic-detail/2022/05/07/religion-not-gender -is-the-best-predictor-of-views-on-abortion)

o The debate on abortion in the United States is unsettling in Canada (https://www.lemonde.fr/international/article/2022/05/05/le-retour-du-debat-sur-l-avortement-aux-etats -unis-restless-le-canada_6124913_3210.html)

o The American corporate world (Corporate America) is silent on the subject (https://www.ft.com/content/b1f32dd2-e01b-4b7f-880d-946d8b0db1ca)

  • Other themes

o The WHO warns that covid has accelerated the obesity pandemic. Proposes taxes on less healthy food and subsidizing fruits and vegetables (https://elpais.com/sociedad/2022-05-03/la-oms-alerta-de-que-el-impacto-del-coronavirus-ha-acelerado -another-epidemic-of-obesity.html)

National health policy

  • COVID

o Contagios in the elderly continue to rise and the deaths are about 70 a day (https://www.lavanguardia.com/vida/20220507/8249221/contagios-mayores-siguen-alza-muertes-continuan-70-diarias.html )

o Seventh wave or new phase of the pandemic? (https://www.epe.es/es/sanidad/20220506/septima-ola-covid-13618507)

  • Regulatory announcements

o List of essential drugs imminently (https://www.redaccionmedica.com/secciones/industria/la-inminente-lista-de-farmacos-de-sanidad-abre-una-nueva-via-de-rebaja-2143 )

o A reform of the Framework Statute is controversially proposed (https://www.redaccionmedica.com/bisturi/union-y-rebelion-sindical-ante-la-reforma-del-estatuto-marco-9760)

  • Other themes

o Important editorial in El País on cancer drugs, their high price and their sometimes minor effects on survival (https://elpais.com/opinion/2022-05-07/el-precio-de-la-salud. html)

o The “Update of the Stability Program 2022-2025“, presented by the Government to Brussels, does not foresee that the government’s promise to reach 7% of GDP in 2023 in public health spending will be fulfilled (https://www. hacienda.gob.es/CDI/Programas%20de%20Estabilidad/Programa-de-Estabilidad-2022-2025.pdf)

o The doctors maintain the strike for May 10, rejecting the Community of Madrid-ICOMEM agreement (https://elpais.com/espana/madrid/2022-05-07/la-encrucijada-final-de-los-medicos -de-madrid.html)

o Order of the Government of Catalonia on unit prices for compensation for hospital and specialized care (https://www.iberley.es/legislacion/orden-slt-88-2022-22-abril-determinan-ano-2022 -unit-prices-consideration-specialized-hospital-care-27084794)

Companies, employers and other agents of the sector

  • International News

o The head of Biogen dismissed due to the failure of the new drug against Alzheimer’s, after detecting that it has unproven benefits and serious health risks (https://www.nytimes.com/2022/05/03/business/biogen- aduhelm-michel-vounatsos.html)

  • National News

o Pfizer presents in Congress a Decalogue to promote gene therapy (https://www.pfizer.es/sites/default/files/2022-04/TERAPIA%20GENICA%20SNS%20interact%20v1.pdf)

o Quirón intends to build a new hospital in Gijón, with an investment of 40 million and 300 jobs (https://www.plantadoce.com/empresa/quironsalud-inviertera-40-millones-de-euros-en-nuevo-hospital -en-gijon.html)

o Teladoc Health is reinforced in Barcelona and will open a new digital hub in the city (https://www.plantadoce.com/empresa/teladoc-health-se-refuerza-en-barcelona-y-abrira-un-hub-digital -in-the-city.html)

o Vitaldent continues to grow and opens clinics in Pola de Siero, Lugo and Getafe (https://www.eleconomista.es/salud/noticias/11748887/05/22/Vitaldent-abre-tres-nuevas-clinicas-en-Espana. html)

o Besins Healthcare, a company based in Mónica and specialized in novel therapies in gynecology, fertility and endocrinology, lands in Spain and invests 25 million in a plant in Muel (Zaragoza) (https://www.plantadoce.com/empresa/besins -healthcare-lands-in-spain-and-invests-25-million-in-a-plant-in-muel.html)