Posts

7 days in healthcare (August 21st-27th, 2023)

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Summary

From the point of view of Biomedicine, to highlight the results of the devices that read the brain and allow certain people to speak using their thoughts. In September the Human Brain Project will be presented, the most ambitious research project financed by the European Union. The British NICE recommends stool tests to be carried out at home for colorectal cancer screening.

As regards Global Health, the journal Science analyzes how climate change can amplify epidemics and give rise to new pandemics.

Regarding International Health Policy, important developments in the USA: the CDC establishes new standards for the approach to sepsis in hospitals; large increase in sex change surgeries in recent years; AstraZeneca is suing the American government for its plans to negotiate the price of medicines, which reflects the great tension between the pharmaceutical industry and the American government, which next week will reveal the 10 medicines on which the price is going to be negotiated; and, a large increase in mental health spending after the pandemic, something that is not expected to change. The British Nuffield Trust analyze the income of English doctors in the various categories. The WHO launches an interesting digital health initiative.

If we talk about National Health Policy (Spain), the Ministry of Public Health publish in the BOE the call for specialized health training with places for doctors, pharmacists, nurses, psychologists, chemists, biologists and physicists. The Ministry also publishes a very complete analysis on the relevance of lung cancer screening. Although it has been said that the Ministry refuses to implement this screening, the truth is that it has limited itself to publishing the report, which will be analyzed by the Interterritorial Council. In Europe there is no public system that has programs of this type in place. The positions of the Scientific Societies must be heard, but they are not the only ones to consider, taking into account that these Societies usually support everything that favors the activity of the respective specialty. But in these types of decisions, many circumstances must be weighed, including cost/effectiveness. Important confrontation between doctors and health insurers in Seville, which will take place throughout September. Some complaints from physicians have been made public in relation to the SELENE computer program, which is widely implemented in the hospital public sector. A subject on which it is difficult to pronounce, but clearly to follow, due to its importance. Having a user-friendly, fast computer application with innovative features is essential for medical practice.

In the field of Companies, internationally, it seems that Roche and MSD will lead the billing of pharmaceutical companies in the next five years. As far as national news is concerned, Europe is not opposed for competition reasons to the agreement between Esteve and Lubea.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (June 26th-July 2nd, 2023)

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Summary

From the point of view of Biomedicine, clinical trials in humans begin with drugs developed by artificial intelligence, such as one for idiopathic pulmonary fibrosis. Álvaro Pascual-Leone, a prestigious Spanish neuroscientist based in the United States, announces that in about ten years the brain will be able to be manipulated . Surely at that time the manipulation of the brain will be something as normal as today the replacement of the crystalline lens for the cataract. A new world is coming.

In Global Health, two charities (the Gates Foundation and the Wellcome Foundation) set to fund a TB vaccine, which could save 8.5 million lives over the next quarter century. Gavi, the organization that provides vaccines to developing countries, approves a vaccine that protects against polio and five other diseases.

Regarding International Health Policy, the editor of the American Journal Medicine publishes in the last issue an article with the five great challenges of the American health system in the 21st century. However, from a reporting point of view, the most interesting news comes from the UK. The King’s Fund, a major British health think tank, publishes a comparative analysis of that country’s health system, which it analyzes together with 19 health systems, including the Spanish one. The analysis is very interesting, and the conclusion is that the NHS is efficient, but with big problems, not only with waiting lists, but also with results. It seems to imply a chronic underfunding of the NHS, when compared to systems in other countries. For its part, the NHS publishes for the first time a long-term plan on personnel. It basically deals with three things: training, retention and reform. The Guardian hails the report but says it is years overdue. For their part, both The Lancet and the British Medical Journal publish editorials on the 75th anniversary of the NHS, which coincides with its deep crisis. In both positions, political consensus is claimed as a key piece to fix the serious problems of the NHS. The WHO-Europe publishes a document with architectural recommendations on the hospitals of the future.

If we talk about National Health Policy (Spain), there are several news of interest: the Audit Office of Catalonia publishes an interesting report on waiting lists. It seems that 9% of the cases on the waiting list in Catalonia were not counted on the Department of Health website, which leads some to use the word makeup. With regard to private healthcare, the IDIS is starting a very interesting project to share the patient’s clinical history among various provider and insurer entities, only an initial but very important step in what is to come. In the course of the pre-election debate, the President of the Popular Party announces a new General Health Law and a State Pact on Health if it reaches La Moncloa. Interesting announcements since, as The Lancet says for the NHS, only a certain political consensus and a new partnership, will be able to solve the problems of the health system in our country.

At the Corporate level, internationally, GSK completes the acquisition of Bellus Health. As far as national news is concerned, we must highlight Roche’s investment in Sant Cugat.

Biomedicine

Global Health

International Health Policy

  • USA
    • The challenges of the American healthcare system in the 21st century, according to the editor of the American Journal Medicine. Five big challenges: 1. Insufficient insurance coverage; 2. Low health education among the population; 3. Prevention and management of chronic diseases; 4. Great disparities in quality and results; and. 5. Trust in doctors? (https://www.amjmed.com/article/S0002-9343(23)00035-9/fulltext)

National Health Policy

Companies

 

 

 

 

 

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

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Summary

From the point of view of Biomedicine, to point out that human embryos have been produced without eggs or sperm, using stem cells, which raises far-reaching ethical questions. Joseph Alpert, editor of the American Journal of Medicine, recounts the 10 advances in clinical medicine he has seen since he was an intern in 1969-70. A whole different world, from the mortality of myocardial infarction, the evolution of HIV, the approach to leukemia, the possibilities offered by ICUs, the treatment of tuberculosis, etc. From that point of view, there is no doubt that the world is better than fifty years ago.

As regards Global Health, an unexplained increase in the incidence of cancer has been detected in people under 50 years of age, with this trend particularly affecting the population between 25-29 years of age. The Lancet denounces what it considers pressure from the pharmaceutical industry in the pandemic treaty, currently under discussion at the initiative of the WHO, according to a draft that was leaked on May 22 and published. It would be good if this treaty corrected the major failures that occurred during the covid pandemic in access to vaccines in developing countries, particularly in Africa.

Regarding International Health Policy, according to the weekly WHO report, covid is declining in both the number of cases and deaths in all regions of the world. Forecasts of health spending in the USA are published. Although growth will be moderate in the coming years, it will reach 20% of GDP in 2023, more than any country in the world. The National Oncology Plan in Italy is published. The European Monitoring Center for Drugs publishes its report for 2023. Cannabis, followed by cocaine, are the most widely used illegal drugs in Europe.

If we talk about National Health Policy (Spain), the incidence of covid is decreasing, which makes the government consider removing the mandatory use of masks in pharmacies and health centers. Madrid, the autonomous community with the shortest waiting list for non-urgent surgery. Although our country has a low birth rate, the use of in vitro fertilization is skyrocketing.

At the Business level, internationally, Philips has serious problems with faulty respirators. A collective accuses this company of involuntary manslaughter. The 10 largest pharmaceutical companies have more than 110,000 million dollars available for operations to purchase other companies, a move that is undoubtedly spurred on by the loss of patents in many of them. Lobbyists linked to tobacco companies are accused of advertising vaping online, against the recommendations of the WHO, with many reservations about this practice, considering it harmful to health. On a national level, Quirón presents its new hospital project in Badalona. Grifols will refinance its debt after divesting from its business in China. Asterion, the largest Spanish fund, breaks into health, by buying a health transport company.

Biomedicine

Global Health

International Health Policy

  • Europe
    • The European Monitoring Center for Drugs publishes the report on Drugs 2023: Trends and development. Cannabis (marijuana or hashish) is the most widely used illicit drug in Europe, followed by cocaine. Heroin is the most widely used opioid and the one that causes the most health problems (https://www.emcdda.europa.eu/publications/european-drug-report/2023_en)

National Health Policy

Companies

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 (April 3rd-9th, 2023)

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Summary

From the point of view of Biomedicine, vaccines against cancer and heart disease, based on mRNA technology, which are looming on the horizon 2030, seem to be the next great advance in medicine, potentially saving millions of lives. The Economist dedicates an article and an editorial to demonstrate the weak evidence for the therapy of gender transitions in adolescents, especially when they include pharmacological or surgical medication. Contrary to what had been a very popular assumption, moderate alcohol consumption does not produce health benefits, according to a study of more than 40 years published by the JAMA Network Open. Rather the opposite is true.

As regards Global Health, the WHO, born after the Second World War, is celebrating its 75th anniversary. He has emerged from the pandemic with injuries and issues, but acutely aware of his mission, purpose, and need for change. One of the problems it encounters is the discrepancies between countries in the discussion of a treaty on pandemics, which it intends to be approved in 2024. The Lancet publishes several articles on the commercial determinants of health, a subject of great interest. interest. Four industries – tobacco, unhealthy eating, oil and fossil fuels, and alcohol – are responsible for a third of deaths each year globally.

As for International Health Policy, in the United States, a federal judge in Texas has just banned the use of an abortion drug, which had been approved by the FDA more than 20 years ago. In France, the citizens’ convention, made up of 184 citizens chosen by lot, has just ruled in favor of euthanasia and assisted suicide, although with certain “red lines”. Macron wants to discuss the bill before the summer.

If we talk about National Health Policy (Spain), surgical waiting lists set a new record, according to the report made public by the Ministry of Health, with data as of December 31, 2022. Almost 900,000 people waiting for a surgical intervention. An absolutely delegitimizing element of the system. As is well known, the Ministry only makes public the waiting lists for surgical intervention or specialist consultations, but not for special tests (radiology, radiotherapy, ultrasound, etc.), on which there are no national data, although there are some autonomous communities. Interesting article published in Gaceta Sanitaria on the economic impact of including dental care in public coverage. This is an issue that the majority political parties have been pronouncing in favor of for several years, but nothing has been done on it. Spain is possibly the European country with the least percentage of its health spending devoted to dental care. The declarations of the Minister of Health of Catalonia are surprising, justifying the dismissal of the nurses who criticized the Catalan C1. Since this type of statement about specific dismissals is not common among regional ministers, it is to be assumed that there is an important political background. The decision of Navarra and Asturias to launch public companies, one for medical transport and another for a hospital laundry, is also surprising. Wouldn’t there have been the possibility of resorting to private initiative to solve these needs, perhaps more efficiently than through a public company?

In the field of Companies, internationally, agreement between Medtronic and Davita to launch Mozarc. At the national level, it is worth noting the start of work on the Viamed hospital in Tarragona, and the separation of the “pharmacy” and “chemistry” areas of the company Esteve.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies

 

 

7 days in healthcare (December 26th, 2022-January 1st, 2023)

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Summary

From the point of view of Biomedicine, it is worth noting the ambitious project of the United Kingdom “Our Future Health”, which aims to place this country at the forefront of genomic research, and which seeks to carry out genetic analyzes of 5 million adult British volunteers, then looking at the correlation with lifestyles and medical records. Undoubtedly, this project will allow us to advance a lot in the knowledge of a wide variety of diseases.

With regard to Global Health, great concern in the world, since the large number of cases in China increase the probability that new variants will appear. There is no doubt that the covid – which had appeared, artificially or naturally, in China – has entered a new phase in which the epicenter is once again China.

Regarding International Health Policy, countries are preparing to put control measures at airports and borders against travelers from China, although the ECDC sees this type of control as unfounded and the EU has not adopted a common policy. Joschka Fischer (former – German Foreign Minister) publishes an in-depth article, whose conclusion is that, in contrast to what had previously been said that authoritarian regimes that do not depend on public opinion can impose drastic and effective measures in crisis situations such as covid, experience has shown that liberal democracies are more effective than autocracies in dealing with these situations. Great controversy in the European Union over the claim of the pharmaceutical industry to agree to produce new antibiotics, under the condition of increasing the patent term of certain drugs.

If we talk about National Health Policy (Spain), Spain has approved airport control measures to control travelers from China, which will be in force between December 31, 2022 and February 15, 2023. Primary Care doctors have opposed the hiring of doctors without MIR training, since this seems more like an opportunistic measure than addressing the underlying problems of Primary Care. The central government, so little fond of publishing and preparing expert analyzes on the covid management, instead presents a self-assessment on its management. According to this report “Cumpliendo” (“Fulfilling”) 64% of the health promises have already been fulfilled and 35% are in process. Bearing in mind that none of the structural healthcare problems have been addressed (personnel regime, management model, governance, accessibility and waiting lists, etc.) this self-assessment seems to us grated on complacency and even propaganda. Unless the promises -which are said to have been fulfilled- have nothing to do with the real problems of the sector. An interesting initiative from the private sector through the IDIS Foundation, which announces the start-up of a pilot on interoperability, should be highlighted. The fact that companies that compete with each other -both from the insurance and provisioning fields- agree on the interoperability of medical records is something that deserves to be highlighted.

In the field of Companies, the American Congress has taken an unusual decision: criticize the FDA for its inadequate collaboration with Biogen for the approval of the drug against Alzheimer’s. At the national level, Atrys continues its growth, both in Spain and abroad (United Kingdom, Middle East and Latin America).

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (September 26th-October 2nd, 2022)

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Summary

From the point of view of Biomedicine, to review the advances, still to be confirmed, in the treatment of two terrible diseases: ALS and Alzheimer’s.

Regarding Global Health, concerns continue about the evolution of polio, whose eradication was announced in 2019, but which is reappearing in several countries.

Regarding International health policy, it is worth noting the similarities between the covid-zero policy in China and the era of prohibition in the United States, something pointed out by The Economist. Very worrying is the “burnout” of doctors, a phenomenon highlighted by the New York Times in the United States, but which seems to be universal.

If we talk about National health policy (Spain), the debates on the Equity Law continue. The update of the RD on the minimum data set of the SNS leaves out the private sector, despite the opposition of the POP, IMAS Foundation, IDIS Foundation and ASPE. It is a modification of a 2010 RD, but in twelve years the private sector has developed a lot and it is no longer so easy to leave it out in certain decisions. The Senate rejects the PP’s motion to facilitate access to medicines and reduce the time it takes to join the SNS. Surely the motion of the PP was too vague and, at this point, it is necessary to explain very well the “what” and the “how” of any proposal.

At the corporate level, at the international level, big rise in Biogen shares, spurred by what appear to be hopeful results from its Alzheimer’s drug. At the national level, there are rumors that KKR and CVC could be trying to buy Quirónsalud, currently in the hands of the German group Fresenius, which has recently changed its CEO. The Murcian company Vócali develops the Inbox Medical software for transcription of medical reports.

Biomedicine

Global Health

International health policy

National health policy

Companies