Posts

7 days in healthcare (April 22nd-28th, 2024)

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Summary

From the point of view of Biomedicine, AI makes it possible to detect the origin of metastatic cancer. An algorithm examines images of metastatic cells to identify the primary location of the tumor. Currently the origin of up to 5% of all tumors cannot be identified. If this is confirmed, the concept of “metastasis of unknown origin” will disappear. Many mental illnesses have body triggers. Evidence is accumulating that a host of infections can activate conditions such as obsessive-compulsive syndrome, anxiety, depression and even psychosis. This finding can improve many psychiatric treatments. The EU approves a new antibiotic to track the growth of resistant bacteria. It will be used in pneumonia and urinary tract infections, representing an advance in the treatment of these bacteria. Health politicians are trying to introduce incentives for the development of these antibiotics linked to bacterial resistance.

Regarding Global Health, new publication of the European Observatory on Health Systems and Policies: health in all policies. The philosophy is to move from health in all policies to health through all policies. Smoking bans are coming. Countries are moving forward to ban tobacco use and vaping, which can save thousands of lives and billions of dollars. The WHO estimates that tobacco use costs the world $1.4 trillion each year in health spending and reduced productivity. The British initiative to ban tobacco consumption for those born after 2004 is very ambitious and would mean creating a smoke-free generation by 2040. Vaping is already more common in 2023 than smoking among young people, and its damage goes beyond lung and brain damage, according to a report from the University of Glascow, commissioned by WHO-Europe. Nicotine can have long-lasting effects on the adolescent brain. The upcoming ban on disposable vapes, for example in the United Kingdom, Belgium, France or Spain may not be enough. The WHO is concerned about the alarming consumption of alcohol and electronic cigarettes among adolescents, between 11 and 15 years old.

Regarding International Health Policy, National plan on waiting lists in Sweden. Waiting times have always been a problem in that country, with great disparities between regions and between different parts of healthcare. The plan seeks to identify areas with excess capacity in the country, allowing faster access to those waiting. The EU presents the Critical Medicines Alliance as a response to shortages. It is a consultative body to identify priorities for action and propose solutions. The Alliance will last for five years. On the part of Spain, among other entities, there will be the General Council of Pharmaceutical Colleges, Farmaindustria and the Spanish Society of Hospital Pharmacy. The European Parliament approves the European Health Data Space (EEDS), which will allow the primary (for care) and secondary (for research) use of health information. Secondary use for commercial purposes will not be permitted. Among companies, there is great concern, since they are above all concerned about, for example, “the voluntary acceptance of users.”

If we talk about National Health Policy (Spain), the competition for doctors to be permanent threatens the large hospitals in Madrid (and, without a doubt, in other communities). In the Community of Madrid there are more than 6,000 specialists who are involved in these stabilization processes. Logically, the problem is not stabilization, but two circumstances: that the solution is to transform the interim workers into statutory ones (wouldn’t it have been possible to favor an indefinite employment contract?) and, above all, that the selection is made without the intervention or of the hospital managements, nor of the services, nor of the professionals. A telematic system will be used, in which vacancies will appear to choose from. That method is incredible in the 21st century. Health outbreak against the norm that would allow a Basque MIR, by the highest representation of doctors and nursing. What is considered an unprecedented attack on the fairness of the SNS. The homogeneity in obtaining degrees and the mobility of professionals between the National Health System seemed to be one of the attributes of our health system. The Valencian Community will replace 1,800 professionals in Manises (who will be treated as statutory) and will create 400 new positions. It is difficult to understand that the statutory regime is the solution and that 400 more professionals are needed to do the same. The IDIS publishes its annual report, which is now called “Private Health Sector Observatory 2024”, maintaining the subtitle of “adding value”. This report is a very relevant contribution to the knowledge of a part of the health sector, such as the private part. Some criticize IDIS by saying that they are judge and party for the publication of this report. But it is true that the private health sector before the appearance of these IDIS reports was the great unknown and, furthermore, no one takes away from other institutions (call it the Ministry of Health, the Association of Health Economics, the Spanish Society of Public Health, etc.) to analyze and publish analysis on the private sector. This work of IDIS has come to fill a void. Farmaindustria denounces the Andalusian Health Service and the Andalusian Colleges of Pharmacists for favoring generics. The agreement between these entities involves the promotion of the dispensing of generics in pharmacies when they are prescribed by active ingredient. Farmaindustria rejects this agreement, considering it discriminatory towards the brand. They argue that branded medicines are in Spain at the same price as generic ones. The latter is true, but it is no less true that this constitutes an exception in Europe, which is more concerned with the promotion of generics and the promotion of companies related to their manufacturing and launch.

As for Companies, at the international level, an important article in the New England Journal of Medicine considers the existence of the free market in the pharmaceutical world a myth. Europe is falling below the USA and China in pharmaceutical innovation, warns the CEO of AstraZeneca. Clinical trials on obesity are growing by 68% and laboratories are preparing 124 drugs. Regarding national information, Domus Vi is considering divesting itself of the Mentalia division for more than 100 million euros. The anti-smoking plan threatens an investment by Philip Morris in Spain of up to 1.2 billion, based on the government plan to equate the taxation of new devices to traditional cigarettes. Caser boosts its dental clinic business with more capital, expanding by 4.25 million euros. This will undertake the opening and purchase of eight new dental clinics.

Biomedicine

Global Health

International health policy

National health policy

Companies

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

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Summary

From the point of view of Biomedicine, Nature magazine analyzes the clinical trials that will shape medicine in 2024, including genetic editing for hypercholesterolemia; AI for early diagnosis of lung cancer; HIV vaccines; stem cells for Parkinson’s; the use of machine learning for patient triage; conjugated antibodies for brain metastases; and, computed tomography for lung cancer screening. The New England Journal of Medicine analyzes whether clinical trials with xenotransplants should be “liberalized” in the absence of human donors, especially in the United States.

Regarding Global Health, at COP28, 124 countries, including Spain, sign a Declaration on Climate and Health. It remains surprising, however, that the president of the COP28 meeting, held in Dubai, is the president of that country’s state oil company, which did not stop expressing its skepticism regarding decarbonization actions. On the other hand, populist leaders around the world (Wilders, Milei, Bolsonaro, Trump) have made climate change denial an electoral platform. Decline of AIDS worldwide, particularly in sub-Saharan Africa.

In terms of International Health Policy, the White House creates an Office for the Prevention of Firearm Violence. Large drop in state health insurance policyholders in China, the largest health insurance organization in the world. In the United Kingdom, the Tony Blair Institute for Global Change analyzes the high and increasing cost of being overweight. Many Britons, despite their adoration of the NHS, choose to pay for certain interventions and procedures, in order to avoid the waiting list. In that country, this form of payment for certain actions is more common than insurance, which is expensive in Britain. Germany announces a plan to strengthen the pharmaceutical industry. It seems that the promotion of research and production in the country will be the main axes. The European Union definitively approves the AI law, the first law in the world on this subject. Without a doubt, it will have a great impact on health.

If we talk about National Health Policy (Spain), after the constitution of the writing team appointed by the Ministry of Health in October 2021, 2023 is about to end without the official report on the management of the pandemic having been made public, which which puts us behind many countries that have already published analyzes and reports. On the other hand, it does not seem that, contrary to what was done in other countries, such as the United Kingdom, where even Boris Johnson had to appear, the Spanish commission has sought the opinion of many actors. Surely the delay in publication could come from the problems of managing the pandemic in our country: two confinements declared unconstitutional by the Constitutional Court, delay in decision-making, high mortality figures at the beginning, high mortality among professionals, serious problems in purchasing supplies, etc. The Minister of Health takes her first steps, having to face in the coming weeks the problem of the lack of doctors in Primary Care. In Asturias, the autonomous community will dedicate 57 million extra hours for professionals to address the problem of waiting lists. A measure that seems reasonable and that overcomes the criticism of the so-called “peonadas”, as if activity in the public sector could not be controlled.

In the field of Companies, on an international level, Roche is jumping on the obesity bandwagon, following moves in this direction by NovoNordisk, Lilly and AstraZeneca. In our country, Ribera is finalizing the purchase of IMSKEN, an important trauma hospital in Valencia. The bankruptcy administrator and creditors are demanding the seizure of KKR, which they accuse of the bankruptcy of Dentix.

Biomedicine

Global Health

International health policy

  • China
    • The Chinese state health insurance, the largest in the world with 1.3 billion insured, loses tens of millions of members. In 2022, 19 million people were no longer covered, an unprecedented drop. It is blamed on the rise in premiums and co-payment increases and the decline in household income, https://www.ft.com/content/0ef68e30-bbe7-4b6e-8d17-479a552be994

National health policy

  • Lack of professionals in Primary Care

Companies

7 days in healthcare (June 5th-11th, 2023)

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Summary

From the point of view of Biomedicine, to point out a new drug that gives hope to patients with certain brain tumors (low-grade gliomas). The amino acid taurine, related to the delay of aging. Biological drugs enter the treatment of COPD (chronic obstructive pulmonary disease).

As regards Global Health, the journal Nature publishes a set of articles on the effects of tobacco on health. Although the percentage of smokers has gone down from 1990 to 2019 (not the total number of smokers which has gone up, due to population growth), the battle against tobacco is not won. 14% of deaths globally in 2019 were due to tobacco. Whether nicotine is harmful to health is still being investigated. What is clear is that it is addictive, that is why it is said that you smoke because of the nicotine, but you die because of the tar. Difficult regulations against tobacco in Africa, due to the pressures of the industry and the lack of means. In Malaysia, suicide is going to be decriminalized, which is considered a good strategy for its prevention.

Regarding International Health Policy, regarding the covid, the weekly WHO report published on June 8 speaks of a decrease in new cases and mortality globally in the last 28 days, compared to the 28 days previous. The Lancet warns that this is not the time for complacency about the covid in Europe, since mortality continues to be unacceptably high. Interesting article from the New England Journal of Medicine on the origins of the covid, and the reasons that make it convenient to clarify that origin. In the United States, the debate on the negotiation of the price of medicines by Medicare continues, surely the most important health measure taken in the United States in recent years and which will have an impact not only in that country, but also in the pharmaceutical market, globally. Shortage of many medicines, some oncological in the USA. In the UK the difficult work continues for the report on the management of covid. The EU is discussing legislation to protect the health of sex workers.

If we talk about National Health Policy (Spain), the Ministry of Health submits the emergency MIR to public consultation, a long-standing promise, which surprisingly is launched almost during the electoral period. Psychiatrists denounce the need for these professionals, as Spain is one of the countries in Europe with fewer psychiatrists per 100,000 inhabitants, which contrasts with the increase in demand for mental health. Dentists, on the other hand, denounce from their Professional College, the growth in the number of dentists (26% growth in the last 10 years), having a high number of graduates, due to the proliferation of Dentistry Schools. In this case, on the other hand, it coincides with low dental care activity in Spain, in relative terms with other countries. Oncologists warn of an explosion of cancer cases by 2040, both globally and in Spain.

In the field of Companies, at the international level, Pfizer proposes a change in the payment model for antibiotics, proposing a kind of “subscription payment”, separating the volume from the value. Regarding the national situation, CASER announces growth in dental clinics and Hospitén a considerable investment in the Dominican Republic, where this company of Canary origin is very active.

Biomedicine

Global Health

International Health Policy

National health policy

Companies