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

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Summary

Biomedicine

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

Global Health

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

International health policy

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

National Health Policy (Spain)

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

Companies

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

Biomedicine

Global Health

International health policy

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

National health policy

Companies

 

 

7 days in healthcare (15th-21st, 2024)

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Summary

From the point of view of Biomedicine, after an extensive study it is detected that in approximately 1 in 10 cases of multiple sclerosis, antibodies are detected in the blood years before the disease develops. It may be too early to draw conclusions about the repercussions of this finding.

As far as Global Health is concerned, plans to expand vaccine production to Africa are facing serious problems. This follows Moderna’s halt to the construction of a €500 million plant in Kenya, although other schemes continue, such as plans including facilities in Rwanda, Senegal and South Africa, carried out by BioNTech. Producing more vaccines in Africa is a moral imperative, says Martin Friede, head of vaccine research at the WHO. Article in Lancet Americas: Corruption, the greatest threat to healthcare. The cases in Peru as a result of the covid-19 pandemic and in Brazil (Rio de Janeiro) are discussed. It seems to be demonstrated, analyzing the experience of the few countries in which cannabis consumption has been legalized for a few years, that its legalization produces an increase in consumption in adults.

In terms of International Health Policy, initiatives in the USA against Chinese biotech companies will harm American patients. The Biosecure Act, which gained bipartisan support in Congress, proposes ending government contracts with biotechnology firms that have agreements with Chinese companies as clients or suppliers. This can greatly harm Americans, since, for example, BGI (Beijing Genomics Institute) is the largest human DNA sequencer in the world and operates in 100 countries. Facilitates the manufacture of prenatal tests and other diagnostic tests. In the United Kingdom, Brexit has exacerbated drug shortages in pharmacies. This is deduced from the study by the Nuffield Trust, a prestigious British health think tank, which released a report analyzing the impact of Brexit on the health system. Also in the United Kingdom there is a report published by Reform, a British think tank committed to public services and the effectiveness of the State, proposing a major organizational change in the health system in England, trying to decentralize and abolishing NHS England, since it is considered that such a centralized system is preventing the transition towards a more preventive model, guided by local needs. The role of NHS England would be assumed by the Department of Health, although with a much more strategic vision. England (with around 57 million people) is considered to be the most centralized healthcare system in Europe, despite devolution processes in Scotland (5.4 million), Wales (3.1 million) and Northern Ireland (1.9 million). This same idea of the problems of large centralization of the NHS is held by Nigel Edwards, former chief executive of the Nuffield Trust and now senior associate. The House of Commons votes in favor of the ban on smoking for those born after 2009, despite the Prime Minister being met with the vote against more than 50 Conservative MPs. A controversial measure whose only precedent is New Zealand and was recently repealed by the new government. In Germany, a commission recommends that abortions be legalized in the first 12 weeks. Although abortions in Germany are regulated by a 153-year-old law and are illegal, in practice they are performed in an accessible way. It is assumed that the current law does not meet current international standards.

If we talk about National Health Policy (Spain), the Ministry of Health seems to focus on issues such as the promise to the white tides of the imminent hearing of the Public Management Law; while the Commissioner of Mental Health prepares a guide to reduce psychotropic drugs, as well as launching more than debatable messages such as that “long-term drug treatments kill. These people live 20 years less”, which generated a negative response from Dr. Celso Arango, from the Gregorio Marañón Hospital; or he tries to change the 24-hour guard system, without really knowing how; “green” anesthesia; announcements that possibly, as intended in the United Kingdom, smoking will be banned for those born after 2009; etc. It does not seem that a very varied set of measures on often non-central issues constitute a strategy of anything. While serious underlying problems remain or worsen, such as waiting lists, which in the Ministry’s last publication reached a record of more than 850,000 people waiting. The Zendal Hospital, of the Community of Madrid, admitted one patient a day in 2023. It is increasingly clear that this hospital, launched without a minimum professional planning project, is a clear example of bad governance. The WHO threatens to break its agreement with the Andalusian School of Public Health, if it is diluted in the new Health Institute. The entity warns that the bilateral agreement signed in 1989 is not “transferable” and that, unless it is negotiated again, the collaboration as an associated center “automatically comes to an end.” The plans of the Andalusian Government in relation to the prestigious Andalusian School of Public Health are difficult to understand. Possibly the most regrettable operation underway in public health in Spain at the moment are the famous OPEs. The temporality wants to be resolved with a system of coverage of places with regional calls, not participating in the selection of the professionals nor the hospitals nor, much less, the services involved. There is a risk of destroying the unit and the configuration of services, which in many cases took years to implement. A real shame, much to the taste of the more traditional administration and the unions. In this sense, the 76 service heads of the 12 de Octubre hospital, in Madrid, have sent a letter to the counselor, warning of the problem of disintegration of services as a consequence of the ongoing OPE. We must see, in this sense, the recommendations of the Commission for Social and Economic Reconstruction, in whose opinion approved in Congress, it is committed to a national qualification for medical specialists and local hiring. In the MIR call, the worst figure is for Family Medicine, with 459 free places in the first round, double that in 2023. Making family medicine attractive – salary-wise and professionally – is indeed an emergency to be addressed and a problem important. The newspaper El Mundo reports on the cheapest health insurance. From ASISA (25.99 euros/month) to Sanitas (51.68). In all of them, hospitalization is included, with some form of co-payment. If this isn’t a price war, it certainly looks a lot like one. It is not surprising then that there are problems with rates for hospitals and professionals.

As for Companies, internationally, funds are moving on the board of Novavax, after the failures in the covid vaccine. In terms of national information, AI will revolutionize mental health, generating 2.5 billion euros in Spain. The largest seller of flu vaccines in Spain entrusts its production to Rovi.

Biomedicine

Global Health

International health policy

  • USA
    • Philip Morris funds smoking cessation plans. Medscape, a leading health information company in the USA, is accused of having accepted courses financed by this company. The criticism is based on the tobacco industry’s history of ignoring scientific teachings about the dangers of tobacco (https://www.bmj.com/content/385/bmj.q830)
    • American movements against Chinese biotech companies will harm American patients. The Biosecure Act, which gained bipartisan support in Congress, proposes ending government contracts with biotechnology firms that have agreements with Chinese companies as clients or suppliers. This can greatly harm Americans, since, for example, BGI (Beijing Genomics Institute) is the largest human DNA sequencer in the world and operates in 100 countries. Facilitates the manufacture of prenatal tests and other diagnostic tests (https://www.economist.com/leaders/2024/04/18/americas-moves-against-chinese-biotech-will-hurt-patients-at-home)
    • Scientists miss action against bird flu outbreaks on American farms (https://www.nytimes.com/2024/04/19/health/bird-flu-usda-cattle.html)

National health policy

  • Central government initiatives
    • Sánchez announces the expansion of the basic screening portfolio from 7 to 11 detectable diseases (https://www.diariomedico.com/medicina/politica/sanchez-anuncia-ampliacion-cartera-basica-cribado-neonatal-7-11- detectable-diseases.html)
    • García announces to the white tides the imminent hearing of the Public Management Law (https://diariofarma.com/2024/04/11/garcia-anuncia-a-las-mareas-blancas-la-inminente-audiencia- of-the-public-management-law-of-the-sns)
    • The Commissioner of Mental Health prepares a guide to reduce psychotropic drugs, as well as launches more than debatable messages such as that “long-term pharmacological treatments kill. These people live 20 years less”, which generated a negative response from Celso Arango , from the Gregorio Marañón Hospital (https://www.diariomedico.com/medicina/politica/comisionado-salud-mental-prepara-guia-prescripcion-psicofarmacos-reducer-consumo.html)

Companies