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7 days in healthcare (May 13th-19th, 2024)

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Summary

Biomedicine

  • Other uses of weight loss drugs: Weight loss drugs can reduce heart attacks by 20%, in what could be the biggest advance in this disease since statins.
  • Possible cheaper MRI equipment: A cheaper MRI machine can democratize access. MRIs have meant a spectacular advance in medicine by allowing images of soft tissues. But they are expensive and complex machines. The new devices allow us to spend a fraction of the energy and produce almost no noise. The development is by a team from the University of Hong Kong.
  • A revolutionary vaccine to combat HIV: This disease until now was refractory to the development of a vaccine for it. However, four publications in Science lay the foundations for developing formulas that allow obtaining antibodies against the virus.

Global Health

  • New covid variants: New covid variants (FLIRT) activate fear of an increase in cases in summer. The new variants of covid are spreading throughout the world. KP2, one of the variants, already represents 28.2% of cases in the USA. The WHO has said that FLIRT variants have already been found in 14 European countries, as well as Israel.
  • New version of the Global Burden of Disease (GBD): The publication in The Lancet of the GBD 2021 Causes of Death Collaborators analyzes the global burden of the disease and life expectancy. 288 causes of death and life expectancy in 204 countries are studied and territories for the period 1990-2021. Globally, life expectancy increased between 1990 and 2019, which has been interrupted by the pandemic.
  • New effort in vaccine research: Given the proliferation of vaccines against different diseases, the idea is to move from monopathogenic formulations, difficult to administer by any health system, to combinations against different diseases. A research effort is proposed in this field.

International health policy

  • Fall in overdose deaths in the USA: Overdose deaths fell in the USA in 2023 for the first time in the last 5 years, which is basically attributed to the decrease in deaths from synthetic opioids, mainly fentanyl, although deaths by stimulants, such as cocaine and methamphetamine, increased.
  • The Nuffield Trust (a major British health think tank) analyzes the changes in the NHS as a result of the increase in private activity: How private healthcare has changed British healthcare. In real terms, trusts (hospitals) spent £1.6bn in 2019/20; but this has risen to 3.12 billion in 2022/2023. Since Covid there has been a substantial increase in spending on the NHS purchasing private care.
  • Important hospital reform in Germany: Bankrupt hospitals in Germany approve a broad reform, which consists of the closure of part of the 1,700 hospitals, the most important reform in the last 20 years. Social Democratic German Health Minister Karl Lauterbach said there were too many hospitals and that Germany has neither the financial means nor the medical or nursing staff for that number. Its application will take about ten years and a transformation fund of 50,000 million euros has been allocated to implement it, half of which is borne by the federated states and the other half by the federal government.
  • Problems of private health insurers in Latin America: Both the ISAPRES in Chile (Boric government) and the EPS in Colombia (Petro government) are suffering very serious problems, which threaten their continuity.

National Health Policy (Spain)

  • The government proposes changes in private healthcare and its collaboration with the public system: The Ministry of Health puts out the draft Law on Public Management and Integrity of the SNS for public consultation. According to the text made public and the minister’s statements, the law proposes, among other things, to repeal Law 15/1997 (which established the framework for the participation of different forms of public and private management in the provision of public service and which was approved by broad consensus), as well as establish discrimination between private companies with business benefit and charitable companies. It is more than doubtful that this law will be approved, given the situation of the legislature, and, even in the highly unlikely event that it were approved, that it will have a significant impact, since the management of health services is transferred. However, it seems that modifying the MUFACE model is not on the government’s agenda.
  • In Madrid, the white tides return: This Sunday the white tides returned to Madrid, this time with the presence of the Minister of Health, in what seems a gesture difficult to understand from an institutional point of view, given that the demonstration was clearly directed against the Community of Madrid, in which there are many healthcare problems but which, however, has one of the lowest waiting lists in the country.

Companies

  • International
    • Takeda and the Alzheimer’s vaccine: Takeda reaches a $2 billion agreement to develop a vaccine against Alzheimer’s, by the Swiss start-up AC Inmune.
    • The WHO supports Takeda’s dengue vaccine: It does so at a time when several Latin American countries are suffering the worst dengue epidemic in their history. The vaccine is aimed at minors between 6 and 16 years old.
  • National
    • Vithas reaches one million digital patients: They access their private health area through the app or the website.
    • Esteve grows: Esteve grows by double digits in 2023, up to 710 million euros.
    • Sanofi announces layoffs in Barcelona: The pharmaceutical company Sanofi announces a collective layoff of 89 people, the majority from its Barcelona center.

Biomedicine

Global Health

International health policy

  • Germany
    • Bankrupt hospitals in Germany approve a broad reform, which consists of the closure of part of the 1,700 hospitals, the most important reform in the last 20 years. Social Democratic German Health Minister Karl Lauterbach said there were too many hospitals and that Germany has neither the financial means nor the medical or nursing staff for that number. Its application will take about ten years and to carry it out a transformation fund of 50,000 million euros has been allocated, half of which will be borne by the federated states and the other half by the federal government (https://elpais.com/society/2024-05-16/hospitals-in-bankruptcy-germany-approves-a-broad-reform-to-fight-against-its-precarious-situation.html)

National health policy

Companies

 

 

7 days in healthcare (September 4th-10th, 2023)

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Summary

From the point of view of Biomedicine, in an editorial article, the Financial Times comments on the promise of anti-obesity drugs. Despite the clear benefits of the new drugs, there are unresolved issues: first, the limited knowledge of long-term effects; second, the drug is initially expensive. Private patients in the UK are expected to pay £300 a month; and, third, medications should be a complement rather than a substitute for general lifestyle measures. The first human organ created in an animal opens the door to manufacturing spare parts for people.

With regard to Global Health, the new director of Africa CDC publishes in Nature magazine the new policy guidelines of this body, aimed at addressing public health problems in Africa.

Regarding International Health Policy, it is confirmed that the latest versions of the vaccines are prepared for the new variants. Profound administrative reform of healthcare in Portugal, driven by the socialist government and, specifically, by the SNS administrator appointed about a year ago, Fernando Araujo. 31 management units (ULS, local health units) are created, which will be public business entities, with a board of directors, and a financing model in which money follows the patient. All hospitals will be assigned to one of these units. Strong criticism for the government’s secrecy in this reform, which has been carried out without prior consultation. The doctors’ order says that the reform will be a “complete disaster.” Despite what has been said, the reform has nothing to do with an implementation of the Spanish Alzira model in Portugal, but it is a public reform. Although some of the measures (business configuration of the management units, board of directors, new financing model in which money follows the patient) “sound good”, the truth is that a reform of this caliber carried out no longer without consensus political but without even public debate it is more than doubtful that it can be successful. He also questions the government’s idea of “getting out of the way” of healthcare by delegating changes to an “administrator.”

If we talk about National Health Policy (Spain), commitment of the Ministry of Health with the measures agreed with the pharmaceutical industry, with the participation even of President Sánchez, to ensure the investment of 8 billion euros. It seems that the conditions are to improve access to medicines; enhance R&D; increase industrial capacities and create supply chains for resilient drugs. Although it is logical and desirable for the government to be “business friendly” with companies in general and with pharmaceutical companies in particular, it is doubtful that such an explicit agreement is the best path for both parties. On the other hand, it must not be forgotten, in view of the government’s commitments, that we are in full discussion of European pharmaceutical policy. Certain relevant changes in the Community of Madrid: possibility of requesting any test from Primary Care and facility for non-EU doctors to work in Madrid. The Royal Decree approving the specialty of emergencies comes out in public hearing, something long awaited and promised, but no less controversial and debatable. The general director of Pharmacy, César Hernández, says that “we do not have a general problem of access to medicines”, which can also be controversial in certain environments.

In the field of Companies, at the international level, Novonordisk becomes the most valuable company in Europe according to market capitalization. Lilly tries to get ahead of Novordisk in the obesity market. Regarding national news, HM Hospitales expands its offer in Madrid with a new polyclinic in an area of intense growth such as Vadebebas.

Biomedicine

Global Health

  • New public health model in Africa. Article in Nature by Jean Kaseya, the new director of Africa CDC. 6 proposals: local manufacture of vaccines; improved tracking system; integrated health systems; laboratory network; emergency response design; robust national institutes of public health (https://www.nature.com/articles/d41586-023-02749-5)
  • Cancers in young people (under 50) have risen by 80% in the last three decades, including breast, lung, stomach and colorectal cancers. (https://www.ft.com/content/b3140954-3cd0-4a3e-b554-92efa7ed7538). Original article in the BMJ: https://bmjoncology.bmj.com/content/2/1/e000049#

International Health Policy

  • Portugal
    • Deep administrative reform of healthcare, promoted by the socialist government. 31 management units (ULS, local health units) are created, which will be public business entities, with a board of directors, and a financing model in which money follows the patient. All hospitals will be assigned to one of these units. Strong criticism for the government’s secrecy in this reform, which has been carried out without prior consultation. The doctors’ order says that the reform will be a “complete disaster.” The reform is attributed to Fernando Araujo, the SNS administrator appointed by the government last year (https://www.portugal.gov.pt/pt/gc23/comunicacao/noticia?i=nova-organizacao-dos-cuidados-de-saude-conheca-a-grande-reforma-do-sns-para-2024)

National health policy

Companies