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

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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 12th-18th, 2022)

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Summary

From the point of view of biomedicine, immunotherapy (in colon cancer) and CAR-T therapies (in lupus) continue to expand their therapeutic possibilities. Advances against infections for resistant bacteria. Will there ever come a time when cancer can be diagnosed by a simple blood test? This possibility does not seem very remote, according to papers presented at the meeting of the European Society of Medical Oncology.

Regarding Global Health, an important work directed by Jeffrey Sachs and published by The Lancet on the delays and errors of both governments and the WHO in dealing with the covid pandemic, which could have produced 17.7 million of  deaths, many of them preventable.

Regarding international health policy, the WHO says that the end of the covid pandemic may be in sight, although at the same time a new variant (BJ.1) of covid is evident in Europe. Important debate in Europe (Scotland and France) on euthanasia and assisted death. The French Ethics Committee opens the door to this possibility. The financing of the American FDA was questioned, due to its great economic dependence on the pharmaceutical industry. Biden launches a speech commemorating Kennedy’s in 1962 when he decided to go to the Moon, but this time oriented towards the fight against cancer.

If we talk about national health policy (Spain), the PDeCAT presents an amendment to the entire equity law, which it accuses of interfering in regional powers and of confusing agreement with privatization. Surprising statements from the Ministry of Health in a parliamentary response, saying that its functions in relation to the waiting lists are only to inform and monitor, as if it did not have the possibility of signing agreements with the communities to address this problem or of launching other actions. Concern, there are even demonstrations in the street, of the relatives of the elderly admitted to residences. The Community of Madrid announces that it will reduce the waiting lists by half. Although we would like it not to be the case this time, this announcement is preceded by other similar ones from different governments, which always came to nothing in terms of effectiveness. The search for solutions by the Ministry of Finance to the MUFACE model, highly impacted by inflation, seems to recognize its underfinancing.

In the field of companies, from the international point of view, important success for Sanofi, with its new vaccine against bronchiolitis. In Spain, important corporate movements in Korian, HM Hospitales, Miranza and Ribera.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

Korian: a leading multinational for a sector such as nursing homes and mental health care that in our country requires innovation and business muscle

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On May 22, 2022, a breakfast was held at the headquarters of Roland Berger in which Mr. Jaume Raventós, CEO of Korian Spain, acted as a guest. What follows is a summary of his intervention.

The presentation used by Mr. Raventós can be seen below:

Presentacion-Korian-Spain-RB-v3

The Korian group

A large international presence

  • An international group that in 2021 had a turnover of 3.9 billion euros, of which 68% came from residential care; 20% health care; and 12% community care
  • Listed group, operating on the Paris Stock Exchange
  • In residential care it has 721 residences
  • In healthcare 170 facilities
  • In community care, a network of home care, with 194 centers
  • It is a leader in residential care in France, Germany, Belgium and Italy

Main lever of growth

  • The main lever for growth is to offer a continuum of care for an aging and fragile population

Heavy weight on quality control

  • More than 200 people dedicated to quality control
  • Growing weight in its establishments of external accreditations

Type of Korian services

  • Long-term care (nursing homes)
  • Health services
    • Primary Care
    • Specialties and post-acute
  • Community care
    • Home care
    • Residential solutions

Korian has the ambition to create a great mental health group

  • It is already the third group in Spain, with ITA, after the Institut Pere Mata and Domus
  • It is already the third group in France, with the acquisition in 2020 of INCEA
  • The revenue target for 2022 is 250 million euros

Korian is considered a player well positioned for growth

  • Increased demand, with the growth of people over 80 years of age
  • Increased dependency on Europe
  • Very fragmented market
  • Leadership position, with high entry barriers and few actors with scale

Korian values

  • As a service provider for frail people, having strong values ​​is essential
  • Korian’s vision is to provide innovative solutions for a more inclusive society
  • Some recent incidents of other actors in the sector demonstrate the importance of this commitment to values

Korian in Spain

Two great lines of activity

In Spain, Korian has two main lines of activity: nursing homes and mental health services.

Care for the elderly: residences, Seniors

  • 18 accredited residential centers
  • The expected turnover in 2022 is 46 million euros
  • It has more than 2,116 beds and is present in Andalusia, Mallorca, Valencia and Castilla-La Mancha.
  • Has specialized units
    • Behavior Disorder Unit
    • Rehabilitation Unit
    • Alzheimer and Dementia Unit
    • Neurorehabilitation Unit
    • Day Center Unit

Mental Health: ITA

  • Since its foundation in 2016, ITA has been growing rapidly, both organically and inorganically
  • It is organized by specialties
    • Eating disorders, 33% of activity
    • Behavior disorders, 27% of activity
    • Personality disorders, 9% activity
    • General psychiatry, 20% activity
    • Neurodevelopment and rehabilitation: 11% activity
  • It is the largest mental health group in Spain, with more than 5,000 patients a year; more than 38 specialized centers and more than 1,000 professionals
  • Growth is constant, even during the pandemic, with an expected turnover of 58.8 million euros in 2022
  • Incorporates great digital innovation, both in terms of satisfaction surveys, such as patient management and agendas, and in digital therapies
  • ITA has a network of healthcare partners (Quirón, DKV, Vithas, Keralty, etc.) and academic partners (several Universities)

A great growth potential for Korian Spain

  • Without prejudice to the great possibilities for growth in the areas in which Korian is already in Spain (nursing homes and mental health), in relation to Korian’s care offer at a global level, Korian Spain is neither in primary care nor in home care, looming there a great potential for growth

The challenges of the future of care services for vulnerable people

Both the residential and mental care sectors have significant challenges:

General challenges of the sector of vulnerable people

1. Sector concentration vs. fragmentation. Entry of large international groups. Overcoming small-scale farming and professionalization and renewal of the sector.

Senior sector

2. Residential sector, change of model, from large residences of around 200 beds to smaller and more specialized units.

Mental health

3. Financing mental health benefits

    • In the public sector: insufficient means and financing
    • or private sector:
      • Role of health insurers. Insufficient and unspecific coverage (in general, only 20 visits and 30 days of hospitalization). Covering mental health care well is a major challenge for health insurers.
      • School insurance. INSS (1.2 euros/family/year)
      • Possibilities of public/private collaboration. The insufficient means in the public sector and the growing needs offer great possibilities for public collaboration.

 

4. Prevention of mental health problems. Involve the educational system and families

5. Very complicated future due to the lack of professionals. New professional roles. It seems evident that only the development of new professional roles and the promotion of digital therapies will make it possible to advance in this field, where the lack of professionals is frightening and difficult to solve in the short and medium term.

6. Post-COVID stage, until when?

7. The role of digital technology and new surgical and pharmacological therapies