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7 days in healthcare (January 8th-14th, 2024)

 

Summary

From the point of view of Biomedicine, it is worth highlighting the first results of the genomic studies of tumors carried out by the British public company, created in Cameron’s time, Genomics England, which will allow new therapeutic orientations in tumors. Certain hopes for patients with schizophrenia, a disease with a limited therapeutic arsenal. A Phase III trial gives promising results. It is expected that the drug can be approved in 2024 by the FDA. The WHO organizes a World Forum on Clinical Trials, establishing the four pillars for their development, which is of special interest to Spain, which is a power in clinical trials, a leader in Europe and only surpassed globally by the United States, China, India and Iran.

As far as Global Health is concerned, the WHO warns that a new pandemic will arrive and it will be more deadly.

In terms of International Health Policy, the growth of total health expenditures in the USA returns to pre-pandemic levels. They rose 4.1% in 2022, while in 2020 they had risen 10.6%. The New England Journal of Medicine publishes an interesting article on the “financialization” (non-financing) of health in the United States, distinguishing this from “corporatization” (the role of large corporations) or “privatization” (greater role of the private sector). “Financialization” refers to the greater role of financial or private equity companies in the healthcare world, in many cases as direct owners of healthcare companies, especially pharmaceutical and insurance companies. The effects of this phenomenon are not yet well analyzed. The FDA approves 55 drugs in 2023, up 48% from the previous year. Of those 55, 28 were intended for rare diseases. The Economist analyzes in an article that the British health system is acquiring a shape similar to that of the 1930s, with a large role of private companies and charities, when Aneurin Bevan created the NHS. It should be noted that the so-called generation Z (between 18 and 24 years old) are the largest users of private healthcare. The EU, through HERA, the body created as a result of Covid, will launch a vaccine development center.

If we talk about National Health Policy (Spain), the Ministry of Health agreed, in the face of the growth of the tripledemic, two measures: the first, the so-called “auto-sick leaves” (sick leaves of up to three days without prior medical report, by the exclusive decision of the worker); and, the second, the mandatory nature of masks in health centers. Both very controversial measures. The first was due to disagreements with the unions, employers and within the government itself, which speaks of improvisation on a very sensitive issue and which forced it to be postponed indefinitely. The second, with opposition from several communities and legal problems in its design. Measures continue to be taken to address problems such as pandemics without the expert advice of an organization such as the Public Health Agency, which has not yet been created, which could possibly have avoided or mitigated some of the problems that the Ministry has encountered. The Catalan government, faced with a growth in pharmaceutical spending, intends to control it with several measures. One of the requests is the transfer of the powers of the Interministerial Price Commission, in order to be able to negotiate the price of medicines with the laboratories at the community level. An issue that could threaten the necessary cohesion of the National Health System. Budgeted public health spending amounts to 89 billion in 2023, 29% more than in 2019, before the pandemic. The unions propose to the Ministry changes in the human resources policy and in the Framework Statute. Given the well-known aversion of unions to differentiation and individual and collective recognition, basic needs of the system, surely the approaches will not be very innovative.

In the field of Companies, on an international level, Goldman Sachs is making its debut in health, with a fund of 650 million dollars, in a line that seems to reinforce the idea of the “financialization” of health, discussed in the article this week from the New England Journal of Medicine. When it comes to national news, the highlight is the upheaval at Grifols, which has lost 3.2 billion euros in five days. After the Gotham Research City report, the company has not been able to convince shareholders of its reliability.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

7 days in healthcare (October 30th-November 5th, 2023)

 

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 (May 29th-June 4th, 2023)

 

Summary

From the point of view of Biomedicine, it is worth noting the death of the virologist Harald sur Hausen, whose name will not mean anything to many, but who 50 years ago discovered the relationship between papillomavirus and cervical cancer, initiating studies of the relationship between viruses and cancer. Reading the DNA of a large and highly varied number of primates allows us to better understand what a human person is and the origin of some diseases. An international consortium discovers that the nucleus of cells is metabolically active.

As regards Global Health, The Economist focuses on the decline in global fertility, due to a decrease in births, not an increase in deaths, a fact with great consequences in our societies. The WHO puts a target by means of cheap vaccines to the global vaccination against cervical cancer, which still produces a large number of deaths. The UN warns about the great sources of hunger in the world: Haiti, Mali, Burkina Faso and Sudan.

Regarding International Health Policy, Canada is preparing a regulation that will make it mandatory to carry warnings of negative health effects on each cigarette. The EU finalizes a regulation to remunerate plasma donations. The WHO celebrates the 76th World Assembly in Switzerland, in which several topics were discussed, among others, the next UN High-Level meeting on universal health coverage, to be held on September 23.

If we talk about National Health Policy (Spain), the call for early elections for July 23 paralyzes the processing of more than 60 laws in relation to health, including some as important as the Equity Law, the Framework Statute, the Law of the National Agency of Public Health or the Law of Guarantees and Rational Use of Medicines. In the Valencian Community, Mazón (the winning candidate of the PP in that Community and foreseeable new president) announces the freezing of the reversal process of the concessions of Manises, Denia and Elche, which had already started or were planned by the Ximo Puig government. He also doesn’t rule out launching new concessions. The Princess of Asturias Award for International Cooperation, awarded to the non-profit initiative Medicines for Neglected Diseases, which focuses not on rare diseases, but on highly prevalent diseases, especially in underdeveloped countries, such as Chagas disease, dengue fever, kala-azar or river blindness and which are considered to affect around 1,000-1,500 million people in those countries, without any research, industry or commercial effort commensurate with their importance.

In the field of Companies, internationally, China breaks the veto on Western vaccines and will allow Moderna to settle in that country. For its part, AstraZeneca defies geopolitical challenges and intends to grow in China. At the national level, Zurich joins forces with Google and DKV to launch digital health insurance. Quirónsalud intends to grow in telemedicine and closes a contract to serve university students.

Biomedicine

Global Health

International Health Policy

  • France
    • Tobacco use is stable in France, one in four adults smokes daily (https://www.lemonde.fr/sante/article/2023/05/31/avec-un-adulte-sur-quatre-qui-smoke-quotidiennement-le-tabagisme-reste-stable-en-france_6175491_1651302.html#:~:text=Tabac-,Tabac%20%3A%20avec%20un%20adulte%20sur%20quatre%20qui%20fume%20quotidiennement%2C% twenty)
  • Canada
    • Canada is going to require that a warning about the danger be printed on each cigarette, since it has been seen that young people start smoking when they receive the offer not of a pack, but of a cigarette (https://www.lemonde. fr/international/article/2023/05/31/le-canada-va-demiger-qu-un-avertissement-soit-imprime-sur-chaque-cigarette_6175630_3210.html)

National health policy

Companies

 

 

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

 

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 (1-7 november, 2021)

 

 

ABSTRACT

From an international point of view, to highlight something we knew: that WHO, in its current configuration, is not prepared for global health challenges. However, this finding is important in the article in the British Medical Journal by Anthony Costello. Europe, once again in the center of expansion of the pandemic. The decision of the North American Democrats to reduce the price of medicines, via the negotiation in Medicare, is very far-reaching. This decision, if applied, will have major consequences for the entire pharmaceutical industry globally.

At the national level, to highlight the article in The Lancet, which says that Spain could have achieved group immunity. For the rest, the incidence of COVID continues to grow in our country, although it does not reach, by far, those of other European countries. Waiting lists are a big concern throughout Spain. Controversy over the new Equity, Universalization and Cohesion Law. Podemos wants to take advantage of it to repeal Law 15/1997, which allows the outsourcing of health services.

As a business activity, to highlight the two new antivirals against covid-19, one from Merck and the other from Pfizer. Merck has released the patent so that it can be used widely in developing countries. Novartis dissociates itself from Roche, selling it its 33% stake in the latter company.

INTERNATIONAL

  • The WHO, in its current configuration, is not ready for its purpose, but is limited by lack of funds and political interference, and this has been demonstrated in this pandemic that has produced more than 18 million deaths, writes the economist Anthony Costello in the British Medical Journal (BMJ, 3 Nov 21)
  • Europe once again at the center of the covid pandemic, says WHO, (The Guardian, 4 Nov 21)
  • The WHO warns of the increase in deaths from covid in 56 countries, and insists that vaccine manufacturers have not done their job well (ConSalud, 5 Nov 21)
  • Democrats in the United States reach an agreement to reduce the price of drugs, allowing the government to negotiate the price of Medicare drugs. The United States pays three times more for many drugs than Europe, according to a study by the Brookings Institution. Initially, the measure will be launched with the 12 most expensive drugs (FT, 2 Nov 21)
  • The fourth wave continues to beat the record of infections in Greece, with almost 7,000 daily (El Confidencial, 6 Nov 21)
  • Excess mortality grows in Russia, since the beginning of the pandemic (FT, 2 Nov 21)
  • The management of the pandemic leaves a trail of investigated political leaders: Brazil, France, Italy, Austria, India, … (El Debate, 2 Nov 21)
  • India’s successes against covid are analyzed: more than half of Indians have received at least one dose of the vaccine. 6 million are vaccinated every day (The Economist, 29 Oct 21)

NATIONAL

 

  • The Lancet suggests that Spain could have achieved group immunity. They are based on the high infections and the high percentage of vaccination (La Razón, 3 Nov 21)
  • The incidence of covid rises more than two points, to 53.7 cases per 100,000 inhabitants (El País, 5 Nov 21)
  • Madrid for the first time exceeds half a million patients to see the specialist. Experts warn that the pandemic has generated in Spain a dammed demand that will emerge in the coming semesters (El País, 5 Nov 21)
  • Spain, one of the five countries in which Covid-19 caused the greatest loss in life expectancy, according to a study published by the British Medical Journal (ABC, 3 Nov 21)
  • The Health Ministry sells a million vaccines to Australia, New Zealand and Paraguay, before they expire (El Español, 2 Nov 21)
  • The WHO requests to increase oral public coverage in Spain (Health Act. The proposal receives the support of the General Council of Dentists (Health Act, 5 Nov 21)
  • Podemos will not support the Darias Equity Law. The Ministry wants to promote a Law of Equity, Universality and Cohesion and Podemos does not support it by not repealing Law 15/1997, which allows the outsourcing of health services (ConSalud, 5 Nov 21)
  • The Health Ministry seeks location for its strategic reserve of covid material (El Periódico de España, 5 Nov 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

 

  • Merck drug effective to treat covid-19. The drug is an oral antiviral, called molnupiravir, and has already been approved by the British Agency. It has been launched by Merck and Ridbback Biotherapeutics, a Florida-based biotech. The drug is indicated for the unvaccinated and for those vaccinated who develop the disease. The treatment will be worth US $ 700 in developed countries. Merck will allow the development of generics in 105 countries (The Economist, 4 Nov 21)
  • Alphabet, Google’s parent company, launches an AI company, Isomorphic Labs, for the discovery of new drugs. It will work together with DeepMinds, Google’s AI company (FT, 4 Nov 21)
  • Pfizer increases the sales forecast of its covid vaccine in 2021 to 36,000 million US $ (FT, 2 Nov 21)
  • Biogroup, a bioanalysis group piloted by Stéphane Eimer and with a presence in Belgium, Luxembourg and the United Kingdom, enters the Iberian Peninsula with the purchase of Cerba Internacional and Analiza (both owned by Marcelo Weisz). ASISA will retain its 50% stake in Analiza (Les Echos, 4 Nov 21)
  • Novavax, a protein-based American covid-19 vaccine, receives its first approval in Indonesia. May promote immunization in developing countries. An application for authorization has also been sent to Canada, the United Kingdom and the European Union (FT, 1 Nov 21)
  • Pfizer announces an antiviral pill (Paxlovid) that prevents 89% of hospitalizations and deaths from covid (El País, 5 Nov 21)
  • The Valencian government will propose to the Data Protection Agency a sanction to Ribera for withholding data from the Torrevieja hospital (eldiario.es, Nov 4 21)
  • Centene closes the year of the coronavirus with losses in its health adventure in Spain (Nov 6, 21)
  • “Son Espases”: the macro-investigation on the concession to OHL of this hospital in the Balearic Islands, which links the Balearic Islands with the illegal financing of the PP (eldiario.es, Nov 5, 21)
  • Novartis sells its 33% stake to Roche for more than US $ 20 billion. A relationship of more than twenty years between the two companies is ended (PlantaDoce, Nov 4, 21)
  • MD Anderson launches a clinical trials unit (PlantaDoce, 3 Nov 21)
  • Eugin expands through Canada and acquires the fertility centers of Trio Fertility (PlantaDoce, 2 Nov 21)
  • Affidea, a European provider of diagnostic imaging, outpatient services and cancer care, expands in Spain and Northern Ireland with two new acquisitions (PlantaDoce, Nov 3, 21)
  • The biotechnology company of Spanish origin Aura Biosciences, jumps to the Nasdaq (PlantaDoce, 3 Nov 21)
  • Rovi doubles its profit in the first nine months of 2021, to 99 million (PlantaDoce, 3 Nov 21)