Posts

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

 

 

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 (June, 19th-25th, 2023)

 

Summary

From the point of view of Biomedicine, ethical problems continue to be discussed as a consequence of the creation of embryos without eggs or sperm. Until now, an embryo required an egg and a sperm, but this new approach would allow, in hypothesis, to solve problems of infertility or pregnancy loss, but it is a matter to regulate very carefully. Two studies in Nature seem to show that the Y chromosome makes men more vulnerable to tumors.

With regard to Global Health, The Lancet focuses on the great threat of diabetes, since it is estimated that in 2050 there will be 1.3 billion diabetics, a disease related to obesity, diet, tobacco, alcohol and sedentary lifestyle. Inequalities in access to morphine are denounced, with the United States and Europe almost completely monopolizing its use. An important issue, since this drug has a relevant role in the treatment of pain and in palliative care.

Regarding International Health Policy, according to the weekly WHO report, covid is declining in both the number of cases and deaths in all WHO regions of the world. Only in the African region is there a slight increase in the number of deaths, with a decrease in the number of new cases. In the United States, the commercialization of meat grown in the laboratory is approved. One of the authorized establishments belongs to the Spanish philanthropist José Andrés. Also in the United States, not minor problems continue as a result of the annulment of the Roe v Wade ruling that transfers the authorization of abortion to the states. In the United Kingdom, the problems with the emergency services continue and a strike of resident doctors is called. New health insurance law in South Africa, which appears to represent progress towards universal coverage in that country.

If we talk about National Health Policy (Spain), according to the WHO weekly bulletin, Spain is the country in Europe with the highest mortality from covid. The government and the communities agree to abolish the mandatory nature of masks in health centers and pharmacies. Ayuso, proclaimed President of the Community of Madrid, after the last elections. Absence of great news in the announcements of health measures for this legislature. As was already known, Spain is consolidating itself as a world power in clinical trials, an achievement no less.

In the field of Companies, internationally, Walmart (the largest supermarket chain in the USA) enters the primary care business, with 32 centers in 5 states. Walmart was already in healthcare, but it was with small clinics for minor care. Significant company purchases by Merck MSD and Lilly, which seems to confirm that M&A activity in pharmaceutical companies is reviving. In the Spanish national arena, ASEBIO announces an increase in investment in R&D by biotech companies in 2022.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (April 10th-16th, 2023)

 

Summary

From the point of view of Biomedicine, this week marked the 20th anniversary of the completion (later it turned out not completely) of the Human Genome Project, whose results were presented on April 14, 2003. A project that revolutionized biology and Medicine. Many of the treatments that are now in sight, such as gene editing, or the screening of certain diseases come from the progress of that project.

As far as Global Health is concerned, the criminalization of suicide (considering suicide attempts as a crime subject to fines or imprisonment) is still in force in more than 20 countries. Not so many years ago suicide attempts were decriminalized in advanced societies, as recently as 1966 in England or 1993 in Ireland. Clearly, what these suicidal individuals need is care and treatment.

As for International Health Policy, the United States continues to have problems with the Supreme Court’s decision to annul the FDA’s authorization of an abortion pill, a measure that was later put on hold. The crisis in the British NHS continues, with two important strikes called: nurses and junior doctors.

If we talk about National Health Policy (Spain), the incidence of covid has grown slightly in the last week. Medical and health conflicts continue in various autonomous communities: the Valencian Community, Galicia, the Canary Islands, Madrid and Andalusia. Great news, if confirmed, the arrival of the first publicly funded biomarkers on the SNS. It will start with those related to oncology. A breakthrough in precision medicine. Initiative from Aragon for a debate on health that is intended to be held at the Conference of Presidents. Although everything that represents a debate on health in the highest instances is positive, the lack of ambition of the document proposed from Aragon is truly surprising, where neither the care model nor the management model nor the personnel policy (except in what refers to the planning of professionals), nor many other very relevant things. A real disappointment the document of the Aragonese initiative. The central government supports the Spanish covid vaccine, buying 3.2 million vaccines. FENIN makes some interesting proposals, closely linked to healthcare technology, before the new legislature that is looming.

In the field of Companies, at the international level, KKR promotes the merger of IVI and General Life, to give rise to an infertility giant. At the national level, the creditors of Dentix, a former network of dental clinics, now defunct, accuse KKR of the bankruptcy of this company.

Biomedicine

Global Health

International Health Policy

National health policy

  • FENIN petitions
    • FENIN prepares some requests with 10 points for the new legislature, among them a stable regulatory environment, digital transformation of the SNS, public purchase based on value and the renewal of the health technology park (https://www.fenin.es/resources/press-notes/1011)

Companies

7 days in healthcare (February 6th-12th, 2023)

 

Summary

From the point of view of Biomedicine, vaccines against cancer; precision surgery in lung cancer; the use of bacteriophage viruses against antibiotic resistant bacteria; stem cells for a wide variety of diseases; and micromotor robots, great promise in the development of new advances in medicine.

With regard to Global Health, it should be noted that 839 million people around the world cannot eat with dignity, for various reasons; the magazine Nature calls for a treaty against new pandemics, since it estimates that the covid represented “a catastrophic failure of the international community in achieving solidarity and equity”. The malaria pandemic is still active in more than 30 countries .

Regarding International Health Policy, in the United States the practices of certain pharmaceutical companies to prevent the entry of generics and biosimilars are denounced. International effort in the search for antibiotics to combat bacterial resistance.

If we talk about National Health Policy (Spain), the incidence of the covid has a small rebound, hopefully in a context of falling incidence, although high mortality persists. The Spanish Public Health Agency, whose bill has just been approved, possibly the most important consequence of the covid crisis. The conflict of public health continues, focused on Primary Care. The Constitutional Court recognizes the constitutionality of the abortion law of deadlines. AESEG and BIOSIM request modification of the reference prices and urgent measures along these lines, since many medicines are at the limit of economic viability.

In the field of Companies, at the international level, it should be noted that Sanofi and Merck MSD significantly increase their profits in 2022. At the national level, Quirónsalud announces the start-up of a new hospital in Valencia. For its part, Consentino, a company that had plans to go public, may see its intentions cut short for health reasons, given the high incidence of silicosis among its workforce.

Biomedicine

Global Health

International Health Policy

  • USA

National Health Policy

Companies

7 days in healthcare (January 9th-15th, 2023)

 

Summary

From the point of view of Biomedicine, everything seems to indicate that important advances in the diagnosis and treatment of certain diseases are coming in the not too distant future, with cancer vaccines, the new FLASH radiotherapy, the diagnostic revolution of virtual biopsies and the incorporation of certain devices (such as smart watches) in the prevention and monitoring of certain pathologies.

With regard to Global Health, it should be noted that climate change seriously threatens our health, according to The Lancet. Another important article in this magazine refers to the fact that the covid has revealed the inequalities between social groups and countries in dealing with the pandemic, as well as the absence of a global health architecture.

As for International Health Policy, with regard to covid, an editorial in The Lancet says that far from being overcome, 2023 brings new concerns, such as the impact of the situation in China or the new form XBB.1.5 in the United States. In China, the post-covid zero situation continues, officially acknowledging almost 60,000 deaths in the last month, despite the fact that the WHO insists on the request for more transparency in that country. In the United States, the abortion pill, according to the FDA, can already be purchased in pharmacies and by mail order, even in states where abortion is totally prohibited, which indicates the difficulty of shortcuts and of wanting to close doors to the field. In the United Kingdom the serious crisis of the NHS continues. The health minister of the shadow Labor cabinet publishes in the Financial Times an article with a long-term approach to reforms, something that, regardless of its content, we miss in Spain by all parties. An important editorial in The Economist where it says that part of the solution to the NHS’s problems involves solving the problems of Primary Care, proposing several changes, but without losing perspective that a large part of the problems are in hospitals, with the situation of waiting lists and emergencies. He also opposes the Labor Party’s proposal, made last week, to end the independent mini-company character of Primary Care in the UK, in order to make primary care physicians salaried. The Economist carries out a study that says that in the United Kingdom there are 260 deaths a week (more than 12,000 a year) as a result of delays in the emergency room. The British are turning more and more to private healthcare, as increase problems in the public sector. The EU devises plans to avoid medicine shortages and dependence on China.

If we talk about National Health Policy (Spain), the drop in the incidence of covid continues, despite the situation in China and the American variant called Kraken. The Primary Care strike in the Community of Madrid is reactivated and a strike is on the brink in 8 autonomous communities, while the emergencies are collapsed. Despite the plans, recent studies show that almost half of public health workers are temporary. In relation to the Strategic Plan of the pharmaceutical industry, both BIOSIM and AESEG, as well as the representatives of orphan drugs, position themselves with requests, in a clear attempt not to leave this plan only in the hands of large innovative companies, as suggested by the photo of La Moncloa, with Sánchez meeting with the main leaders of pharmaceutical multinationals.

In the field of Companies, internationally, relevant news for Pfizer, BioNTech and AstraZeneca. In our country, it is worth noting the steps taken by Viamed (new hospital in Tarragona), Ribera (great growth in turnover in 2022), Miranza (which continues its growth), Korian (which is preparing to integrate Group 5) and the CUN (which has just renovated part of its hospitalization area). For its part, KKR has completed the acquisition of IVI, an important in vitro fertilization company of Spanish origin.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

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

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

 

7 days in healthcare (April 18-24, 2022)

Summary

From the point of view of biomedicine, to highlight the new devices that read the brain (brain-reading-devices) and allow movement, touch and speech to be recovered. Also the great future of liquid biopsy in the early diagnosis of cancer.

As far as Global Health is concerned, there is no choice but to quote Bill Gates’ new TED video discussing how to avoid a new pandemic, which follows his previously celebrated video from 2015, five years before COVID-19. . Also the devastating effects of covid on the evolution of tuberculosis. It is highly worrying that in Africa there is a large backlog of vaccines, after multiple donations, which speaks of serious logistical problems. More than 100 confirmed cases in a dozen countries of the new acute childhood hepatitis of unknown origin.

Regarding international health policy, it should be noted that, according to the WHO, the incidence and mortality of COVID is falling globally. The United States will host the second global conference on COVID on May 12, 2022. Serious problems continue to arise in China, particularly in Shanghai, where respect for the most minimal freedoms collides with certain public health measures that are intended to be imposed. The new outbreak of covid in Beijing highlights the difficulty of following the “zero-covid” policy without many deaths, due to the low percentage of vaccination among the elderly in China and the less efficacy of the Chinese Sinovac vaccine, compared to that of Pfizer-Biontech.

If we talk about national health policy (Spain), although the incidence of COVID continues to grow, the mandatory use of the mask indoors has been abolished, which for some is premature. From the regulatory point of view, the Health Advertising Law and the Pharmacy Law of the Community of Madrid are announced, both with controversial components. The CNI warns of the large number of cyberattacks in health so far in 2022. The “Vanguard Health” Alliance is created to coordinate the health PERTE. Great media impact of the publication “Private healthcare, adding value” by the IDIS Foundation.

In the field of companies, from the international point of view, it is worth noting the movements of KKR to buy the largest hospital company in Australia (Ramsay). In our country, the position of the AESEG on the need to establish differential prices between generics and brands is important. Also the five-year agreement between the Junta de Andalucía and the Pascual Hospital Group.

Biomedicine

Global health

News international health policy

  • COVID-19

o According to the WHO, both the number of cases and mortality fell in the last week, following a decline from the end of March (https://www.theguardian.com/world/2022/apr/21/new-covid- cases-globally-down-by-nearly-a-quarter-last-week)

o The United States will host the second global summit on COVID. It will be online on May 12, 2022 (https://www.consalud.es/politica/eeuu-cumbre-mundial-pandemia-covid-19_113280_102.html)

o Shanghai wants to open factories with employees living in them (https://www.lavanguardia.com/internacional/20220418/8203602/shanghai-covid-china-pandemia-empresas-impacto.html)

o New COVID outbreak in Beijing. The Chinese authorities do not want the situation in Shanghai to be reproduced (https://elpais.com/sociedad/2022-04-24/pekin-toma-medidas-de-contencion-tras-detectar-un-subito-aumento-de -cases-of-covid.html)

  • Other themes

o The questioning of the authorization of abortion in the USA (Roe v Wade ruling), can cause serious health problems. It can increase the mortality of women in relation to pregnancy by 21% and 33% in black women (https://www.bmj.com/content/377/bmj.o1019). Many media worldwide denounce the toxicity of these restrictive laws (https://www.ft.com/content/a2b0d282-9baa-40ed-9a2c-64bbeaa5e375)

o New incentives are needed to fight antibiotic resistance, a pioneering subscription system in the UK can help improve the situation (https://www.ft.com/content/954d5e13-884e-4090-afca- 378993510558)

o Europe will not approve Biogen’s aducanumab for Alzheimer’s for now, approved in the USA by the FDA, amid great controversy (https://www.diariomedico.com/farmacia/industria/empresas/europa-no-aprobara-por-ahora- aducanumab-for-alzheimer.html)

News national health policy (Spain)

  • COVID

o The incidence of COVID continues to rise: 555.47 cases on Friday, April 22, in people over 60 years of age per 100,000 in the last 14 days, compared to 505.86 on Tuesday, April 19 (https://www.elconfidencial .com/espana/2022-04-22/espana-suma-49-143-cases-and-187-deaths-and-the-incidence-in-over-60s-up-50-points_3412937/)

o After 700 days, the Council of Ministers approves the no obligation to wear a mask indoors, with some exceptions (https://www.elmundo.es/ciencia-y-salud/salud/2022/04/19/625e955c21efa04b4d8b45d0.html)

o The majority of Spaniards believe that it is soon to remove the mask indoors (https://elpais.com/sociedad/2022-04-20/la-mayoria-de-los-espanoles-cree-que-es-pronto -to-remove-the-masks-indoors-and-continue-wearing-it.html)

o The XE variant of covid is already beginning to circulate in Spain (https://www.abc.es/sociedad/abci-variante-coronavirus-empuerta-circular-espana-202204202033_noticia.html)

o Great controversy over the distribution of antivirals (https://www.larazon.es/sociedad/20220421/yda2ugjo3rcszl56bzcp75rvvm.html)

  • Regulatory announcements

o The health advertising law, presented by the PP, to be examined in Congress. It is promoted by the Council of Dentists and also by the OMC (Doctors Order) (https://www.consalud.es/politica/parlamentos/ley-publicidad-sanitaria-pp-examen-congreso-semana_113468_102.html)

o Madrid approves the Pharmacy Law, among the novelties, it develops home distribution (closing the door to the delivery of medicines from entities outside pharmacies) and makes schedules more flexible (https://www.diariomedico.com/farmacia/politica/ madrid-approves-the-new-pharmacy-law-in-its-government-council.html). The Spanish Society of Hospital Pharmacy opposes this bill, for not contemplating hospital pharmacy in the regulations (https://www.diariofarma.com/2022/04/22/la-sefh-rechaza-la-loaf- Madrid)

  • Other themes

o Public healthcare spending skyrockets in 2020 due to the pandemic (https://www.plantadoce.com/entorno/el-sns-pisa-el-acelerador-tras-la-pandemia-y-dispara-el-gasto-sanitario -up-to-83811-million-euros.html)

o CNI alert: large number of cyberattacks in healthcare in 2022 (https://www.elespanol.com/invertia/observatorios/sanidad/20220422/alerta-cni-sanidad-publica-espanola-ciberataques-peligrosidad/666683412_0.html)

o The Fundación Instituto Roche addresses the involvement of the microbiome in maintaining health (https://www.actasanitaria.com/tecnologia/fundacion-instituto-roche-aborda-implicacion-microbioma_2002274_102.html). To access the full document: https://www.institutoroche.es/recursos/publicaciones/202/Hablando_sobre_microbioma

o The Ministry of Health reports eight cases of severe childhood hepatitis of unknown origin (https://www.eldiario.es/sociedad/sanidad-notifica-ocho-casos-hepatitis-aguda-infantil-origen-desconocido_1_8935838.html)

o The investigations for the purchase of masks already exceed ten (https://www.elperiodico.com/es/politica/20220423/investigaciones-contratos-mascarillas-covid-superan-decena-13553701)

o The “Salud de Vanguardia” Alliance is born to coordinate the health PERTE (https://www.diariofarma.com/2022/04/20/nace-la-alianza-salud-de-vanguardia-para-coordinar-el-perte -sanitary)

o Great impact of the document “Private healthcare, adding value” from the IDIS Foundation: https://www.fundacionidis.com/uploads/informes/informe_sanidad_privada_aportando_valor_2022.pdf.

Companies

  • International News

o The private equity firm KKR launches an offer for the largest Australian private hospital group, Ramsay (https://www.ft.com/content/ee5553e3-5d5c-4fbb-af4b-72dd9be0ef0a)

o GBL (Group Bruxelles Lambert) acquires the diagnostic imaging company Affidea, which at the time had acquired some assets in Spain (Q Diagnóstica) (https://www.plantadoce.com/empresa/gbl-adquiere-la-compania -of-medical-diagnostic-services-affidea.html)

o GSK, Sanofi and J&J accelerate spin offs in the pharmaceutical business (https://www.expansion.com/empresas/2022/04/19/625de599e5fdea36148b4677.html)

  • National News

o Generics: AESEG rejects the current plan for generics and biosimilars (made public, but not yet implemented due to the pandemic) if there is no price differential with brands (https://www.redaccionmedica.com/secciones/industria/el -generic-reformulates-the-national-plan-with-the-price-difference-as-axis-1032)

o The Junta de Andalucía signs a five-year agreement with the Pascual hospitals for an amount of 771 million euros (https://sevilla.abc.es/andalucia/sevi-junta-andalucia-firma-contrato-clinicas-pascual-cinco -hospitals-until-2027-771-millions-202203291523_noticia.html)

o DKV skyrockets its profits, largely due to the extraordinary results of the sale of its stake in the Denia hospital, acquired by Ribera (https://cincodias.elpais.com/cincodias/2022/04/20/companias/1650456633_959356 .html)

o Sacyr will build a pediatric center in Canada for more than 60 million euros (https://www.plantadoce.com/empresa/sacyr-construira-un-centro-pediatrico-en-canada-por-mas-de-60- million-euros.html)

o Atrys Health sprints on the Stock Market and targets revenues of 200 million in 2022 (https://www.plantadoce.com/empresa/atrys-health-sprints-on-the-continuo-y-apunta-a-incomes- of-220-million-euros-in-2022.html)

 

 

7 days in healthcare (March 28-April 3, 2022)

 

SUMMARY

From the point of view of biomedicine, the publication in Science that completes the analysis of the human genome should be highlighted, which seems to open the door to the therapy of various diseases.

As far as Global Health is concerned, polio reappearance in Malawi is of concern.

As for international health policy, problems with the covid-zero policy in China continue, which has led to the confinement of millions of people in Shanghai. As it happens, many older Chinese are unvaccinated, apparently out of fear. The satisfaction of the British public with the NHS falls to the lowest levels in history. At this rate, the UK is going to lose faith in what is said to be their last remaining religion.

If we talk about national health policy (Spain), we are witnessing a new phase of the pandemic, with cases on the rise and hospitalizations on the decline. The Lancet shows that the consumption of opioid analgesics is higher in Spain than in the United States.

In the field of companies, from the international point of view, the plan of the Cleveland Clinic to build a hospital in the center of London, with a large investment of 1 Billion pounds, should be highlighted, which could herald the landing of hospitals Americans in Europe. In our country, the private equity company KKR will pay almost 3 Billion euros for IVI, the largest fertility company in the world, in what is one of the largest operations of its kind in Spain. IMQ approves the sale of shares (50% of the insurer) to SegurCaixa Adeslas, which was already a minority shareholder in the company. Important announcement by Sanitas to launch its fifth hospital in Spain. It will be in Valdebebas, it will come into operation in 2025 and will have 100 beds, 23 of which are for mental health, which is a very innovative element in the Spanish hospital landscape.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

  • COVID

o Many older Chinese remain unvaccinated, many out of fear (https://www.economist.com/china/2022/04/02/why-so-many-elderly-chinese-are-unvaccinated)

o Lockdown in Shanghai, while covid cases rise throughout China (https://www.theguardian.com/world/2022/mar/28/shanghai-to-lock-down-millions-for-mass-testing-as -chinas-covid-cases-surge)

o The FDA allows a second “booster” for those over 50 (https://www.nytimes.com/2022/03/29/us/politics/second-coronavirus-booster-shot.html)

o The CDC lifts the order that prevented immigration during the pandemic (https://www.nytimes.com/2022/03/30/us/politics/immigration-cdc-biden.html)

  • Other themes

o British public satisfaction with the NHS drops to lowest levels since 1997 (https://www.theguardian.com/society/2022/mar/30/public-satisfaction-with-nhs-sinks-to-lowest- level-since-1997)

o The growth of health spending in the USA was reduced, after the pandemic. In 2021 it rose 4.2%, while in 2020 it had risen 9.7% (https://www.wsj.com/articles/us-healthcare-spending-slowed-in-2021-after-covid-19- surge-11648497601)

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o New phase of the pandemic: cases on the rise and hospitalizations on the decline (https://elpais.com/sociedad/2022-03-29/espana-entra-en-la-nueva-fase-de-control-de- the-pandemic-with-cases-on-the-rise-and-hospitalizations-on-the-low.html)

  • Other themes

o The flu gets out of control in Spring, it already supposes more hospitalizations than covid in several autonomous communities (https://www.elespanol.com/espana/20220331/descontrola-primavera-supone-ingresos-hospitalarios-covid-ccaa/660934368_0. html)

o The health plan against tobacco will raise its price and will prohibit smoking in cars and terraces, seeking a 25% drop in smoking (https://theobjective.com/sociedad/2022-03-30/sanidad-tabaco-precio- taxes/)

o Spain exceeds the United States in the consumption of opioid analgesics, according to The Lancet (https://www.elindependiente.com/vida-sana/salud/2022/03/31/espana-supera-a-eeuu-en-el -consumption-of-opioid-analgesics-according-to-the-lancet/)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

  • International News

o United Health buys home care firm LHC for $5.4 billion (https://www.wsj.com/articles/unitedhealth-to-buy-home-health-firm-lhc-group-for-5-4- billion-11648550701)

o Great bet by the Cleveland Clinic, to build a hospital in central London for 1 Billion pounds (https://www.ft.com/content/c42bc01c-346c-4ae7-a931-4bbf0605e3ec)

o BioNTech returns almost 2 Billion euros to shareholders after the success of the vaccine (https://www.ft.com/content/db1c6786-6707-4d22-bf43-9c7686cbe97b)

o Fresenius acquires mABxscience and Ivenix to accelerate “biopharma” and “medtech” (https://www.plantadoce.com/empresa/fresenius-acquires-mabcience-and-ivenix-to-accelerate-in-biopharma-and-medtech .html)

  • National News

o The EMA begins the evaluation of HIPRA, the Spanish vaccine against covid (https://www.eldiario.es/sociedad/ema-comienza-evaluacion-hipra-vacuna-espanola-covid-19_1_8871634.html)

o The private equity company KKR will pay almost 3 Billion euros for IVI, the Spanish company that is the largest fertility company in the world (https://www.elconfidencial.com/empresas/2022-03-28/kkr-ivi -rma-transition-fertility_3399221/)

o IMQ approves the sale of shares to SegurCaixa Adeslas (https://www.redaccionmedica.com/secciones/privada/los-medicos-de-imq-aproven-la-venta-del-grupo-a-segurcaixa-adeslas-1096 )

o IMED hospitals opens a new polyclinic in Alcoy (https://www.plantadoce.com/empresa/imed-hospitales-abre-una-nueva-policlinica-en-alcoy.html)

o Sanitas will open a new hospital in Madrid, in the Valdebebas neighbourhood, it will be its fifth hospital in Spain and it is expected to open in 2025. It will have 100 individual rooms, 22 dedicated to mental health. Sanitas will be the tenant, the property will be owned by Pryconsa (https://cincodias.elpais.com/cincodias/2022/04/01/companias/1648816602_273605.html)

o LetsGetChecked acquires the Spanish biotechnology company Veritas (https://www.europapress.es/corporate-y-ma/noticia-letsgetchecked-adquiere-100-biotecnologica-espanola-veritas-20220329123245.html)

 

7 days in healthcare (8-14 November, 2021)

 

ABSTRACT

 

From an international point of view, the appearance of two new drugs for COVID (Merck and Pfizer) is considered a milestone in the evolution of the pandemic. Both drugs are small molecule, easy to produce, and for oral use. The other great milestone of the pandemic was, at the time, the appearance of vaccines. Especially worrying are the high numbers of COVID in Europe, especially in the United Kingdom, Ireland, but also Germany and the Netherlands, without forgetting the special situation due to its seriousness in Romania and Bulgaria.

From the national point of view, the announced draft bill on Equity, Universality and Cohesion of the SNS is of great interest. Although the text of the preliminary draft is not known at the time of writing this note, from what was announced it could be said that the positive aspect is universality (provided that universality is not identified with equity) and the negative are the possible repeal of Law 15 / 97, on enabling new forms of management in the National Health System, the imposition of direct management compared to other more flexible forms of management and bad messages regarding co-payments. It seems that he wants to transfer the idea that “privatization” and “copayments” are the problems of the sector, which is absurd.

Regarding companies, the disappearance of large industrial business conglomerates, such as J&J and GE, is striking. It should be noted that in both operations one of the bets is health. This contrasts, instead, with the creation of tech giants (Google, Amazon, Apple, etc.).

 

INTERNATIONAL

 

  • The Economist forecast: COVID will most likely disappear by 2022. Success: vaccines and new drugs. Failure: immunity at terrible cost, 16.5 million deaths worldwide (The Economist, 8 Nov 21)
  • The Economist welcomes the extension of “assisted death” as a new and important right, started in 1995 in Australia and already legal in a dozen countries, most recently Portugal. It is not yet legal in the UK, but Parliament is discussing a law on the subject. In the Netherlands, 4% of deaths are assisted (The Economist, 13 Nov 21)
  • The new anti-COVID drugs represent a significant change in the pandemic (the first notable change was that of vaccines). The new drugs are malnupiravir (Merck) and paxlovid (Pfizer). Both are “small molecule” drugs, easy to produce and for oral use (The Economist, 12 Nov 21)
  • 100 Years of Insulin (Toronto, 1922), a therapeutic success, but a failure in its worldwide spread. The producing companies are Novo Nordisk, Eli Lilly and Sanofi. Now there is biosimilar (The Lancet, Nov 13, 21)
  • The 100,000 genomes project in the United Kingdom (Genomics England) has made it possible to catalog, and in some cases treat, many rare diseases (New England Journal of Medicine, 11 Nov 21)
  • The rise of the COVID epidemic in Germany (almost 500 cases in the last 14 days per 100,000 inhabitants), at the peak and rising, is considered an pandemic of the unvaccinated. Among the factors, the interim Merkel government is valued (NYT, 11 Nov 21). Merkel will meet with the “Länder” next week to take measures against the growth of the covid (El Mundo, 11 Nov 21)
  • The Netherlands imposes new restrictions, as COVID cases are very high (The Guardian, 12 Nov 21)
  • The governments of 42 countries (including the United States, the United Kingdom and Germany) ask to cut emissions from the healthcare sector. The sector’s emissions represent 5% of the total. If it were considered a country, the health sector would be the 5th emitter of CO2 pollution (NYT, 8 Nov 21)
  • The Economist analyzes the non-zero cost of China’s zero-COVID policy (The Economist, 13 Nov 21)
  • COVID vaccination will be mandatory for NHS staff starting next spring (FT, 9 Nov 21)
  • Waiting lists on the NHS soared. They grow by 100,000 people in a month. More than 5.8 million were waiting in September, with 12,500 awaiting treatment for more than two years (FT, Nov 11 21)

NATIONAL

 

  • The government approves the “preliminary draft of the Law by which various norms are modified to consolidate the equity, universality and cohesion of the National Health System” (reference of the Council of Ministers 8 Nov 21)
  • The Secretary of State for Health publishes a prior consultation on the draft bill of measures for equity, universality and cohesion of the National Health System, establishing the November 19 deadline for submitting opinions.
  • The Minister of Health, in public statements, mentions the laws that are going to be repealed or modified. Among those that will be repealed, “explicitly and expressly”, she mentions Law 15/97, on enabling new forms of management in the National Health System (El Periódico de España, 8 Nov 21)
  • The BOE publishes the agreement between the Government, certain autonomous communities and the Amando Ortega Foundation, for the implementation of 10 proton therapy equipment in the public system. A monitoring commission is created on the subject (BOE, no. 267, 8 Nov 21)
  • The health PERTE is presented on November 15. It is integrated into the five PERTES that the government has devised: cutting-edge healthcare, electric vehicle, new language economy, aerospace and smart and sustainable food chain. It appears that the health PERTE will have three components: 1. Innovative techniques and technologies for the diagnosis and prevention of diseases; 2. Development of advanced therapies; and, 3. Platform for the design and industrial production of medicines and vaccines (ConSalud, 11 Nov 21)
  • The autonomies claim to maintain the covid funds for 2022 (El País, 9 Nov 21)
  • The University of Washington predicts a sixth wave of covid in Spain (Vozpópuli, 8 Nov 21)
  • The cumulative incidence of covid grows in Spain to 71.5 cases per 100,000 inhabitants in the last 14 days. It is not comparable to the figures of other European countries, but it continues to rise slowly (ConSalud, 12 Nov 21)
  • The waiting list grows. The latest data published is from December 31, 2020 and the waiting time had passed, in relation to the previous record, from 121 to 148 days for interventions. Pending publication of the data corresponding to June 2021 (ConSalud, 8 Nov 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

 

  • J&J (Johnson & Johnson) will be divided into two companies: one dedicated to consumer products and the other to drugs and medical devices (NYT, 12 Nov 21)
  • GE (General Electric) will be divided into three companies: health, energy and aviation (FT, 9 Nov 21)
  • The Spanish pharmaceutical industry proposes a plan of 1.7 billion to produce essential drugs (CincoDías, 10 Nov 21)
  • Moderna rejects the claims of the American government to appear as a co-inventor of vaccine technology (FT, 11 Nov 21)
  • BioNTech shoots its profit up to 7,126 million euros in the first nine months of the year. (Floor Twelve, Nov 9, 21)
  • The Zendal hospital in the post-pandemic: 400 personnel for 38 patients (Diario.es, Nov 7 21)
  • Fresenius is interested, along with other investors, in InsudPharma, specialized in biosimilars and valued at 1,000 million euros (El Periódico de España, Nov 9, 21)
  • Advent gives gas to Vitaldent, with the purchase of Smysecret (dental aesthetic treatments) (PlantaDoce, 12 Nov 21)
  • Acciona will build a hospital in Chile (PlantaDoce, 11 Nov 21)
  • KKR enters fertility with the purchase of GeneraLife from Invesindustrial (Expansión, 10 Nov 21)
  • HIPRA will imminently begin the new phase of clinical trials for its vaccine (El Economista, Nov 8, 21)
  • Grifols liquidates the blood bag business and closes production in Brazil and Murcia (Cinco Días, Nov 12, 21)