Posts

7 days in healthcare (July 1st-7th, 2024)

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Summary

Biomedicine

  • Anniversary of IVF. The first in vitro baby turns forty years old, with the technique becoming the new normal. After 40 years of development and 12 million children born thanks to it, the technique has reached maturity, with less invasive techniques, more effective procedures and a change in the patient profile.
  • “Common Sense Oncology”. This association wants to provoke a public debate about a worrying trend in oncology. Although many cancer treatments have saved the lives of many patients or have prolonged their lives with well-being, there are more and more that offer small benefits for a very high price, a lot of toxicity and keeping patients in the hospital for a long time. time at the end of life.
  • Not everything is good at Ozempic. Harvard researchers link it to an increased risk of blindness.

Global Health

  • Political courage needed to prevent the next pandemic. In May 2021, the Independent Panel for Pandemic Preparedness and Response recommended a set of actions to make Covid-19 the latest pandemic with similar devastation. Three years later, progress is very limited, even though the threats are there.
  • 50% of the population will have myopia in 2050. Experts say that the abuse of screens and little outdoor activity favor this pathology.
  • The approval of a vaccine does not necessarily mean its dissemination. Although the malaria vaccine was approved in 2015, it was not included in vaccination programs in Africa until 2024.

International health policy

  • Biden calls on NovoNordisk and Lilly to lower the price of their slimming products. Both the President and Senator Bernie Sanders ask these companies to lower the price in a joint article published in USA Today, since they estimate that the cost is $1,100 per month.
  • Labour considers strengthening Whitehall (government) control over the NHS. It seems that Alan Milburn, former Minister of Health (1999-2003) under Tony Blair, who defends a greater role for the private sector, is playing an active role in the NHS plans. We will have to be very attentive from Spain to the movements in the NHS.
  • Australia against recreational vaping. In this pioneering country in the fight against smoking, vapes can only be purchased in pharmacies.
  • Thailand: the successes of universal coverage in a developing country. Life expectancy is 80 years (which must be compared with 73 in South East Asia). Last year 99.5% of the population of 72 million people was covered by health insurance. The GDP per capita is 11 times less than that of the USA.

National Health Policy (Spain)

  • The government approves the specialty of Urgencies and Emergencies. This ends an unprecedented situation in Europe. Currently, most of these professionals came from Primary Care, aggravating the crisis that this specialty is experiencing. The training of the new four-year specialty will be done in accredited teaching units. Infectious and Genetics are now the specialties awaiting recognition.
  • A Pact for Health is in sight in Balares and the Basque Country. In the absence of progress on a national plan, these regional pacts are welcome.
  • Health barometer (April-May 2024). Citizens’ assessment of public health has improved in the last year, although it is still below what it was before the pandemic. The grade for primary care is 6.29, compared to 6.19 a year ago, while hospitals and the care received in them continue to be the most valued by citizens: 7.51 points for emergencies and 7 .14 ​​points for “hospital care”. Regarding waiting lists, the percentage of citizens who consider that they have worsened is reduced by more than four points, from 39.2% to 34.6%.

Companies

  • International
    • Aging is the new horizon for investors. In 2050, 16% of the population will be over 65 years old, up from 9% today. In the United States and Europe this figure will be 27%. Healthcare is an obvious beneficiary. The universe reaches to pharma, implants and devices and services related to dental and eye care. Aside from treatments, financial services and hospital providers will play a greater role.
    • The FDA approves Lilly’s new drug (Kinsula, scientifically donanemab) against early Alzheimer’s. Lilly enters that market after Biogen and Eisai. The drug slows the development of Alzheimer’s, which causes memory loss, dementia and other cognitive impairments. The price will be $32,000 per year of treatment, 20% more than its rival Leqembi. Both treatments act on amyloid plaque in the brain.
  • National
    • Two new biopharmaceutical companies will operate in España. These are the American Dr. Ferrer and the German Bionorica.
    • HM hospitals increase their billing significantly. HM hospitals grow by 50% in billing in 2023 and exceed 650 million.

Biomedicine

Global Health

International health policy

  • Brazil
    • New abortion law in Brazil. Thousands of protesters have protested against what they consider an attack on women’s rights. The new law makes abortion after 22 weeks equivalent to homicide. In Brazil there are three situations in which abortion is permitted by law: fetal anencephaly, life-threatening pregnancy for the mother, and pregnancy resulting from rape (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01392-8/abstract)
  • Thailand

National health policy

Companies

7 days in healthcare (October 2nd-8th, 2023)

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Summary

From the point of view of Biomedicine, Katalin Karikó and Andrew Weissman, awarded the Nobel Prize in Medicine, for their discoveries that allowed the implementation of the mRNA vaccine against covid. When Watson and Crick discovered the structure of DNA in 1953, RNA was not known, not discovered until 1961. DNA is the matrix for RNA and this is the matrix for proteins to be produced in ribosomes. mRNA was later discovered. Dr. Karikó immigrated to the United States from her native Hungary in 1968 to find a therapeutic role for messenger RNA. For 20 years she worked unsuccessfully in that attempt. At the University of Pennsylvania, where she worked, she met Dr. Drew Weissman. They had made RNA, injected it into mice but they got sick and died. After some chemical changes in the RNA they avoided rejection. They believed they were on the path to discovering a new way of making vaccines. They tried to publish it in “Nature”, but the prestigious magazine rejected the work. They published it in 2005 in the minor journal “Immunology”. Two biotechnology companies saw the therapeutic potential of RNA: Moderna, in the United States, and BioNTech, in Germany. In 2013 Katalin Karikó became vice president of BioNTech, there she developed the vaccine against covid that has saved so many lives. In 2022 she left BioNTech to devote more time to research. She has returned to Hungary as a professor at the University of Szeged. Andrew Weissman’s life is less eventful, he is a professor of medicine at the University of Pennsylvania and had worked with Anthony Fauci, the doctor who led American efforts against covid-19. In another vein, The Lancet magazine publishes an experimental work in which a blood test detects tumors in asymptomatic people. It is only a first step, but the day does not seem far away when we can diagnose the existence of a tumor through a blood test.

Regarding Global Health, the WHO approves the long-awaited second vaccine against malaria. It should be noted that the number of cholera cases has doubled between 2021 and 2022, according to the WHO.

Regarding International Health Policy, in the United States, a strike at the important integrated insurer Kaiser Permanente ended without an agreement. The FDA launches a program to accelerate the emergence of therapies against rare diseases. Let’s not forget that most rare diseases have no treatment by 2023. Prime Minister Sunak of the United Kingdom seems determined to set limits on the age at which people start smoking. The EFPIA (European medicines association) appeals in writing to the European Parliament to amend the European pharmaceutical reform, which is underway.

If we talk about National Health Policy (Spain), as is known, the Government has authorized the increase in the number of places in Medical Schools. This initiative has been made against the opinion of the doctors and the Association of Medical Students. Obviously, the issue of health professionals requires planning, precisely what there has not been. Planning cannot be replaced with any measure if it is not well thought out and matured among the various agents of the health system. Andalusia takes a step to promote public/private collaboration, by approving 734 million euros to refer patients to private clinics. As for the Zendal Hospital, it seems that it the purpose of that hospital is already defined. After an investment of 50 million: the Zendal hospital will be a neurorehabilitation hospital. At one point it had been designed as a Covid hospital, something only seen in China and some other low-developed countries, not Europe. There was no functional plan for said hospital. We now do not know which studies have recommended its transformation into a neurorehabilitation hospital and whether the different agents (hospitals, scientific societies, expert groups, etc.) have been consulted.

In the field of Companies, on an international level, KKR finalizes the purchase of Eugin, to create a giant in assisted reproduction. At the national level, HM Hospitals announces the opening of its 9th hospital in Madrid. A story of undoubted success, based on a family initiative.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

7 days in healthcare (April 17th-23rd, 2023)

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Summary

From the point of view of Biomedicine, this week, exceptionally, two important advances in Spain are mentioned. On the one hand, the important investigations of the team led by Dr. Obeso, at HM Hospitales, on how to “open” the blood-brain barrier, that barrier that, among other things, prevented the arrival of drugs to the brain. It seems that in this way possibilities could be opened for the treatment of Parkinson’s. On the other hand, at the Vall d’Hebrón Hospital in Barcelona, the first robotic lung transplant was approached through a small incision.

As far as Global Health is concerned, there is a great alarm, highlighted by UNICEF and The Lancet magazine, about the drop in immunizations in children after the covid. Although the covid highlighted the efficacy of the vaccines, it brought the side effect of this drop in immunizations globally. In Uganda, the new anti-homosexuality law takes repression against this sexual option to an extreme, endangering anti-HIV campaigns in that country. The G7, to be held in Japan in May, emphasizes various health issues, including the importance of universal health coverage and the need for resilient health systems.

Regarding International Health Policy, the WHO warns of the non-solution of the covid problem, since in the last 28 days there were 23,000 deaths and 3 million new cases globally, even with reduced test figures. High mortality in the USA, with around 245 deaths per day. In the United States, the government is preparing to finalize the guidelines for negotiating the price of drugs in Medicare in July, something totally new in that country and that is shocking the pharmaceutical industry. The American Supreme Court rectifies its previous decisions and allows the abortion pill mifepristone to continue to be used, amid abundant criticism of the Court, for having questioned something that the FDA had already authorized more than 20 years ago. According to The Economist, the annulment of the Roe v Wade ruling caused the number of abortions in the USA to drop by 6%. In the United Kingdom, the consequences in the NHS of the multiple and continuous strikes and conflicts of health personnel continue. The German government is clashing with other European governments in its efforts to reduce the timeframe for generics to appear, calling into question the pharmaceutical investment model, according to some.

If we talk about National Health Policy (Spain), the incidence of covid continues to rise, amid controversies about the advisability or not of suppressing masks where they are still mandatory (health centers, social health centers and pharmacies). Conflicts with health personnel continue in several autonomous communities. In public healthcare, quite important allocation of resources by the Ministry to primary care and mental health. In private health, in the first quarter of the year there was a growth of 7.5% in the policies of private health insurers. “Voting with your feet” is called that figure. The IDIS Foundation focuses, through an interesting publication, on an important problem: the mental health situation in our country. Since we have few problems, Catalonia insists on an artificial conflict: the use of Catalan in the healthcare system in that autonomous community. Both in Aragon and in Castilla-La Mancha, two initiatives of dubious utility and even suspected of electoralism are launched. In Aragon, a national debate on health is proposed through a very typical document of those that come out in the autonomous communities that could be summarized as “More money for health without reforms.” As for Castilla-La Mancha, a law on waiting lists is promoted, when the terminal state of the legislature suggests that it will not be approved.

In the field of Companies, internationally, Nestlé is accused of manufacturing unhealthy products, due to their high load of fat, sugar and salt. Merck makes a major investment buying Prometheus Biosciences for $11 billion. At the national level, Moderna opens a laboratory in Madrid.

Biomedicine

Global Health

International Health Policy

National health policy

Companies