Posts

7 days in healthcare (July 3rd-9th, 2023)

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Summary

From the point of view of Biomedicine, the contribution of Artificial Intelligence to medical diagnosis is reviewed by JAMA magazine. It seems clear that AI is not going to replace the so-called Narrative Medicine, that ability of the doctor to communicate and to listen and interpret the history of the patients. Interesting advances in the field of  a simple way to diagnose pre-eclampsia and Parkinson’s.

With regard to Global Health, more and more importance is given to loneliness and its consequences on health, according to an editorial in The Lancet. Hunger and famine as a product of human activity, especially armed conflicts, is treated by Nature. Concern regarding the AIDS situation in sub-Saharan Africa, where anti-retroviral therapy has barely reached.

Regarding International Health Policy, in the United States, the FDA approves the first drug to slow down the progression of Alzheimer’s. In the UK, three health think tanks (King’s Fund, Nuffield Trust and The Health Foundation) are addressing both the government and the opposition calling for solutions to the critical situation of the NHS. They denounce a decade of underfunding, which has led the UK to have far fewer human and material resources than most European countries. An interesting subscription model for antibiotics is being considered in the United Kingdom. Pharmaceutical companies will receive 20 million pounds per antibiotic put on the market, regardless of the prescription. In France, the Cour des comptes publishes documents to promote home palliative care and the development of advanced practice nursing. An interesting WHO-Europe document on hospitals and their challenges is published.

If we talk about National Health Policy (Spain), the beginning of the general elections on July 23, has made the different parties have made their programs public, including the health ones. The PP dedicates 24 measures to health. The strong points are: the Primary Care Shock Plan (although the title on emergencies is debatable); the State Public Health Agency; the Agency for Innovation and Quality (similar to NICE); digitization; palliative care; and, the mental health strategy. A new General Health Law is announced. Although the current law has many obsolete points, the legal technique of addressing a new law (instead of partial reforms in relation to different issues) is debatable. There is a risk of opening a very large melon, of generating long delays and of putting health into the same dynamic as education (a law for each new government). Conspicuous absences: nothing about financing, no mention of waiting lists (one of the most serious problems in the system), dental care (an area in which we are very far from Europe) and nothing about public/private collaboration. The PSOE program continues to identify public service with public management, thus distancing itself from any form of public/private collaboration. Many measures are contemplated, seeming more like a government plan than an electoral program, so the priorities are difficult to identify. The star measure seems to be announcing a law on waiting lists. Laws on waiting lists have never been effective in any autonomous community. The solution to the waiting lists does not go through a time guarantee law but rather resources and productivity of the public system and an updated and agile system of collaboration with the private sector. SUMAR incorporates the Podemos program: creation of a public pharmaceutical company; end of the MUFACE model; deprivatization plan, including cleaning, catering and laundry; progressive elimination of the pharmaceutical co-payment; they also announce a law on waiting lists. The Vox program represents an amendment to the whole: recentralization of health, recovering powers in health matters; approach waiting lists; repeal of the euthanasia and abortion law; strong criticism of the WHO, which they accuse of dependence on China. At the national level, the other great news is the alarm given by the insurers involved in the MUFACE model (Adeslas, Asisa and DKV) regarding the fact that its financing is generating large losses, unaffordable in the long term.

In the field of Companies, internationally, large pharmaceutical companies (Merck, BMS) are suing the American government for what they consider lowering prices, as a consequence of the anti-inflation law. In Spain, Ribera continues to bet on public/private collaboration, but this time in Portugal.

Biomedicine

Global Health

  • Editorial of The Lancet: Loneliness as a health problem. In the UK and Japan there are loneliness ministers. The health damages are clear: cardiovascular disease, hypertension, diabetes, infectious diseases, depression and anxiety. Loneliness is not the same as being alone and can affect all ages (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01411-3/fulltext)
  • Hunger and famines are not accidents, but facts created by human action. Around 200 million people experience acute food insecurity. Especially Afghanistan, Burkina Faso, Ethiopia, Mali, Sudan and Syria. Hunger and conflict are connected (https://www.nature.com/articles/d41586-023-02207-2)
  • HIV in Africa. Antiretroviral therapy has transformed AIDS into a chronic disease. But in sub-Saharan Africa, where 70% of AIDS patients live, few have access to this therapy, which greatly decreases life expectancy in the area (https://www.nejm.org/doi/full/10.1056/NEJMp2304600)

International Health Policy

  • COVID19
    • Weekly covid report published by the WHO, July 6, 2023. The African region has shown a slight increase in deaths with a decrease in cases. The remaining five WHO regions show a decrease in both the number of cases and deaths (https://apps.who.int/iris/handle/10665/370545)
  • United Kingdom and National Health Service
    • Three health think tanks (King’s Fund, Nuffield Trust and The Health Foundation) address government and opposition on NHS issues. They are betting that the next election will end short-term politics in the NHS. The recovery of NHS services and waiting lists must be a priority. They denounce a decade of underfunding. They welcome the long-term plan on personnel, published last week. They point out that life expectancy is the second worst (before only the USA) of the 19 health systems analyzed in the King’s Fund report (https://www.health.org.uk/news-and-comment/news/joint-letter-to-political-leaders-in-england-on-future-of-nhs)
    • The NHS intends to roll out the subscription model for antibiotics. Under the new proposal pharmaceutical companies would receive £20m for their new antibiotics, regardless of how many may be prescribed (https://www.ft.com/content/a0b5a2ad-06a4-499d-8195-b4d6a3f65f7a)

National health policy

  • 23 J elections: the health program of the PP
    • The PP dedicates 24 measures to health. The strong points are: the Primary Care Shock Plan (although the title urgent and emergencies is debatable); the State Public Health Agency; the Agency for Innovation and Quality (similar to NICE); digitization; palliative care; and, the mental health strategy. A new General Health Law is announced. Although the current law has many obsolete points, the legal technique of addressing a new law (instead of partial reforms in relation to different issues) is debatable. There is a risk of opening a very large melon, of generating long delays and of putting health into the same dynamic as education (a law for each new government). Conspicuous absences: nothing about funding, no mention of waiting lists (one of the most serious problems in the system), dental care (an area in which we are very far from Europe) and nothing about public/private collaboration (https://www.pp.es/sites/default/files/documentos/programa_electoral_pp_23j_feijoo_2023.pdf)
  • 23 J elections: the health program of the PSOE
    • The PSOE program continues to identify public service with public management, thus distancing itself from any form of public/private collaboration. Many measures are contemplated, seeming more like a government plan than an electoral program, so the priorities do not look good. The star measure seems to be announcing a law on waiting lists. Laws on waiting lists have never been effective in any autonomous community. The solution to waiting lists does not go through a time guarantee law but resources and productivity of the public system and an updated and agile system of collaboration with the private sector (https://www.psoe.es/media-content/2023/07/PROGRAMA_ELECTORAL-GENERALES-2023.pdf)
  • 23 J Elections: SUMAR’s health program

Companies

 

7 days in healthcare (May 29th-June 4th, 2023)

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Summary

From the point of view of Biomedicine, it is worth noting the death of the virologist Harald sur Hausen, whose name will not mean anything to many, but who 50 years ago discovered the relationship between papillomavirus and cervical cancer, initiating studies of the relationship between viruses and cancer. Reading the DNA of a large and highly varied number of primates allows us to better understand what a human person is and the origin of some diseases. An international consortium discovers that the nucleus of cells is metabolically active.

As regards Global Health, The Economist focuses on the decline in global fertility, due to a decrease in births, not an increase in deaths, a fact with great consequences in our societies. The WHO puts a target by means of cheap vaccines to the global vaccination against cervical cancer, which still produces a large number of deaths. The UN warns about the great sources of hunger in the world: Haiti, Mali, Burkina Faso and Sudan.

Regarding International Health Policy, Canada is preparing a regulation that will make it mandatory to carry warnings of negative health effects on each cigarette. The EU finalizes a regulation to remunerate plasma donations. The WHO celebrates the 76th World Assembly in Switzerland, in which several topics were discussed, among others, the next UN High-Level meeting on universal health coverage, to be held on September 23.

If we talk about National Health Policy (Spain), the call for early elections for July 23 paralyzes the processing of more than 60 laws in relation to health, including some as important as the Equity Law, the Framework Statute, the Law of the National Agency of Public Health or the Law of Guarantees and Rational Use of Medicines. In the Valencian Community, Mazón (the winning candidate of the PP in that Community and foreseeable new president) announces the freezing of the reversal process of the concessions of Manises, Denia and Elche, which had already started or were planned by the Ximo Puig government. He also doesn’t rule out launching new concessions. The Princess of Asturias Award for International Cooperation, awarded to the non-profit initiative Medicines for Neglected Diseases, which focuses not on rare diseases, but on highly prevalent diseases, especially in underdeveloped countries, such as Chagas disease, dengue fever, kala-azar or river blindness and which are considered to affect around 1,000-1,500 million people in those countries, without any research, industry or commercial effort commensurate with their importance.

In the field of Companies, internationally, China breaks the veto on Western vaccines and will allow Moderna to settle in that country. For its part, AstraZeneca defies geopolitical challenges and intends to grow in China. At the national level, Zurich joins forces with Google and DKV to launch digital health insurance. Quirónsalud intends to grow in telemedicine and closes a contract to serve university students.

Biomedicine

Global Health

International Health Policy

  • France
    • Tobacco use is stable in France, one in four adults smokes daily (https://www.lemonde.fr/sante/article/2023/05/31/avec-un-adulte-sur-quatre-qui-smoke-quotidiennement-le-tabagisme-reste-stable-en-france_6175491_1651302.html#:~:text=Tabac-,Tabac%20%3A%20avec%20un%20adulte%20sur%20quatre%20qui%20fume%20quotidiennement%2C% twenty)
  • Canada
    • Canada is going to require that a warning about the danger be printed on each cigarette, since it has been seen that young people start smoking when they receive the offer not of a pack, but of a cigarette (https://www.lemonde. fr/international/article/2023/05/31/le-canada-va-demiger-qu-un-avertissement-soit-imprime-sur-chaque-cigarette_6175630_3210.html)

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 (March 7th-12th, 2023)

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Summary

From the point of view of Biomedicine, the geneticist Francisco J Ayala, one of the great Spaniards of science, with important contributions in the field of the human genome and other diseases, dies. Some obscure episodes, not fully clarified, pointed to him as a target of the “me too” initiatives. It is increasingly clear that gene therapies will soon explode and will be useful in multiple hematological, cardiac, ocular, muscular and even neurodegenerative processes. An ethical reflection is essential, which ensures, on the one hand, that these treatments are accessible, and, on the other, the limits of these treatments. It seems that we are closer to having specific treatments against fatty liver, a serious disease responsible for tens of thousands of deaths.

As regards Global Health, young people, including adolescents, with gender dysphoria are growing all over the world. There is no accepted professional consensus on how to approach these situations. It seems increasingly clear that inequality in the face of covid vaccines responsible for thousands of deaths from this disease. Although there is no absolute consensus, it seems increasingly clear that smartphones and social networks are responsible for serious mental health problems among young people. 24/7 access to these technologies minimizes face-to-face contact between young people.

Regarding International Health Policy, the WHO maintains the covid as a “health emergency of international concern”. In the United States, the budget presented by Biden – which will not be approved – proposes a significant increase in funds for Medicare. Problems continue for the Walgreens pharmacy chain for not selling abortion pills in 21 states. The USA plans to eliminate hepatitis C, almost a decade after highly effective therapies for this disease appeared. Concern in the United Kingdom about the interruption of the improvement in life expectancy for a decade, before the covid, contrary to what is happening in France or Denmark, for example. Australia is preparing to tackle a health reform, after the preparation of an independent report, a model that could well be inspiring for Spain. Newsweek magazine publishes its well-known ranking of the best hospitals in the world. The Mayo Clinic, in Rochester, and the Cleveland Clinic, in Cleveland, considered the best hospitals in the world. Among the first hundred there are 6 Spaniards, all of them public, except one private: the Clínica Universidad de Navarra (CUN).

If we talk about National Health Policy (Spain), in terms of covid, the accumulated incidence continues to rise slightly, with a fairly high mortality (139 patients in one week). In Castilla y León, the health areas will have access to a team on rare diseases. Serious concerns among psychiatrists about the large increase in cases of gender dysphoria. The actors in the cyber attack on the Hospital Clínic de Barcelona request a ransom of 4.5 million dollars, which the Administration refuses to deliver. Some Catalan doctors are organized to attend only in Catalan, something against repeated court rulings and the Generalitat’s own protocols.

At the Corporate level, at the international level, investors are rubbing their hands at the prospects of big business in anti-obesity drugs. Morgan Stanley has quantified what this can mean in billions of dollars worldwide. Pfizer places its vaccine against covid as the drug with the highest income in the world. At the national level, Quirón reaches an agreement with the City Council for the construction of its hospital in Gijón and Hospitén announces the construction of a new hospital in Madrid with a large investment of 160 million euros. Thus, the boom in new private hospitals continues, for which there is a real race in which several actors participate (Quirón, Viamed, Vithas, Hospitén, Imed, and others). Hipra will return aid to the covid vaccine in ten years.

Biomedicine

Global Health

International Health Policy

  • Best hospitals in the world
    • Newsweek magazine publishes its traditional ranking of the best hospitals in the world. The first three are: the Mayo Clinic in Rochester, the Cleveland Clinic in Cleveland, and the Massachusetts General Hospital in Boston. Among the first 100 are 6 Spanish hospitals: La Paz, (53); Barcelona Clinic (62); October 12 (72); Vall d’Hebrón (83), Gregorio Marañón (90) and the CUN (97) (https://www.newsweek.com/rankings/worlds-best-hospitals-2023)

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 (October 17th-23rd, 2022)

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Summary

From the point of view of biomedicine, the announced “vaccine against cancer” should be highlighted, which could be prepared before 2030. Although not strictly a vaccine, it represents a promising treatment against this disease based on mRNA technology, the same used for covid vaccine.

Regarding Global Health, an important announcement by the WHO about the dangers of a sedentary lifestyle, which could produce 500 million chronic patients in 2030. The WHO dedicates 2,600 million in its next strategy 2022-2026 for the eradication of polio .

Regarding international health policy, an important debate introduced by The Economist on the massive use of antidepressants, when only in 15% of cases do they have an effect other than placebo. Opioids in the United States and antidepressants worldwide are examples of the misuse of medications, which can lead to, and in many cases lead to, health problems. The post-pandemic horizon has generalized a hybrid work model (face-to-face and online) for office professionals.

If we talk about national health policy (Spain), the pressure on hospitals due to covid remains low, despite a slight rise in this disease. Intense debate on the flight of Spanish doctors to other countries, attracted by better salary and professional conditions. No matter how much the number of MIR vacancies and Faculties of Medicine increases, the problem will not be solved if working conditions are not acted upon. Teleconsultations seem to consolidate in Primary Care, already being more than 50% of the visits. The Trans law is the subject of great controversy. Most psychiatrists and psychologists, against. Obviously, we are in favor of the position of the WHO by removing from the list of diseases already in 2018 these cases of having a gender identity other than biological sex and wanting to change the morphology of their body. We welcome that there is a law on the subject as in most Western civilized countries. But one thing is that and another that 14-year-olds can choose sex without a psychological evaluation carried out by experts, who can rule out cases. Irreversible problems may occur. There is a certain consensus that the current wording of the law does not sufficiently protect minors.

In the field of companies, at the international level, we must welcome the first agreement with a pharmaceutical company (Novartis) to produce an anticancer drug as a generic that is still protected by patent, for its production in developing countries. As far as Spain is concerned, the continuous growth of health insurance should be highlighted, which in 2022 until September grows considerably more than the insurance as a whole.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (1st-7th August 2022)

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Summary

From the point of view of biomedicine, to highlight the use of monoclonal antibodies to combat malaria; also the return to life of cells and tissues in dead pigs, which may be important in transplants; and, the fact that the genomic map of chronic lymphatic leukemia has been completed, which, sooner or later, will have consequences in the treatment of this disease.

As far as Global Health is concerned, the poor preparation of most countries in the face of the increasingly frequent heat waves is confirmed, according to The Lancet.

As for international health policy, the United States declares monkeypox a public health emergency, the Administration covering itself up against certain accusations of slowness in dealing with this problem; global decline in the number of covid cases, particularly in Europe. Problems continue in the United States due to restrictions on abortion. Three news to highlight in the United States: the number of uninsured reaches the record low figure of 8%; the American Democrats have a majority in Congress within reach to approve the law that tries to reduce the price of medicines, by way of allowing Medicare to negotiate prices; and, finally, for the first time in decades, health spending in the United States fell in the first quarter of 2022, although it is doubtful that this will continue.

If we talk about national health policy (Spain), monkeypox continues with a very high number of infected people and a shortage of vaccines; large drop in the incidence of covid. Great and difficult to justify delay in the report commissioned by the Ministry of Health from experts on the management of the covid pandemic. Surely there will be more than technical analysis problems in the cause of this delay. The doctors of the private health, threaten with the copayment, before what they consider low rates of the insurers.

In the field of companies, Pfizer continues with its aggressive policy of buying companies, while the growth of Quirónsalud, which already exceeds 2 billion euros in turnover, should be highlighted.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

7 days in healthcare (April 25-May 1, 2022)

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Summary

From the point of view of biomedicine, to highlight the evolution of acute hepatitis in children; Lilly’s announcement of a drug to tackle obesity that could compete with bariatric surgery; and the analysis of the New England Journal of Medicine on the “boosters” for covid.

As far as Global Health is concerned, we again quote Bill Gates, who is publishing a new book on pandemic prevention. Great concern about the resurgence of measles, yellow fever and polio in Africa, due to the low levels of vaccination against these diseases, given that resources have been largely diverted to covid.

As for international health policy, the problems of the “zero-covid” policy in China continue, which threatens the global economy, due to the closure of the largest port in the world: Shanghai. It seems increasingly clear that for political reasons this “zero-covid” approach will not change until the approval of a third term for its leader Xi. Also noteworthy is the very serious discrediting of the National Health Service in the United Kingdom, which until now had been the object of almost religious veneration.

If we talk about national health policy (Spain), the incidence of covid continues to increase, particularly in some regions (Galicia, Navarra, Asturias and Castilla y León). The Health Advertising Law was not approved by Parliament, which is not necessarily bad news, since it was largely part of the confrontation between the College of Dentists and the dental care networks. The announced strike of doctors in Madrid, regardless of its results, has its origin in a very serious problem: the very high rate of temporary employment (more than 50% of doctors in the public system in Madrid). Very interesting statements by José Ramón Repullo, proposing national accreditation and hiring at the local level.

In the field of companies, from the international point of view, certain possible disruptive changes for the pharmaceutical industry should be highlighted: 3D printing, which would allow the “manufacturing” of medicines in a clinical environment; and the movements of Amazon for the sale of prescription drugs.

Biomedicine

Global Health

International health policy

  • COVID-19

o Serious problems continue in China with the “zero-covid” policy. The general impression is that the rhetoric of war does not help to defeat covid (https://www.economist.com/leaders/2022/04/30/chinas-martial-rhetoric-will-not-help-it-defeat- covid), while the global economic implications of the closure of Shanghai persist, the largest port in the world (https://www.epe.es/es/internacional/20220429/estrategia-covid-cero-china-dessolucion-inflacion-13586353)

o The “zero-covid” policy in China, a great personal bet of the leader Xi and difficult to be modified before his re-election for a third term (https://www.ft.com/content/33b7fcb2-bc88- 4a76-9b81-d561deaabc5c)

o Covid cases on the rise in virtually all of the United States (https://www.nytimes.com/2022/04/29/world/coronavirus-cases-us.html)

  • Other issues

o The FDA, about to ban menthol cigarettes. They are the most used among the black population (https://www.nytimes.com/2022/04/28/health/menthol-ban-fda.html)

o Very serious loss of prestige of the National Health Service, which is ending an almost religious adoration of this body in the United Kingdom. A survey says that global satisfaction dropped to 36%, something never known. Poor staff planning among major problems (https://www.economist.com/britain/2022/04/28/the-nhs-is-in-seriously-poor-shape)

National health policy (Spain)

  • COVID

o The cumulative incidence among people over 60 years of age continues to rise, reaching (April 29) 676.43 cases per 100,000 inhabitants in the last 14 days, an increase of almost 70 points compared to the previous measurement. Occupation rate due to covid: 5.12% in the ward and 3.66% in the ICU (https://www.consalud.es/pacientes/especial-coronavirus/covid-19-espana-notifica-62695-casos-229- deceased-ia-exceeds-676-points_113987_102.html)

o The Ministry of Health reports almost 2,000 deaths in April, the first full month of “flu” from covid (https://www.elespanol.com/ciencia/salud/20220430/sanidad-notifica-muertes-primer-completo- flu-covid/668683313_0.html)

o Increase in the incidence of covid grows by 35% after Easter and there are already four regions with the unbridled incidence (Galicia, Navarra, Asturias and Castilla y León) (https://www.elespanol.com/ciencia/salud/20220428 /revenues-covid-semana-santa-ccaa-incident-runaway/668183406_0.html)

o The Ministry of Health will authorize the fourth dose for those over 80 years of age and those who live in residences, a total of about 3 million people (https://www.lavanguardia.com/vida/20220425/8219507/sanidad-autorizara- fourth-dose-vaccine-covid-older-80.html)

  • Regulatory announcements

o The Health Advertising Law presented by the PP fails, which is regretted by the professional associations, in particular that of dentists. Apparently, the Government is preparing a Royal Decree on the subject (https://www.diariofarma.com/2022/04/28/el-congreso-desestima-la-ley-de-publicidad-sanitaria-del-pp)

  • Other issues

o Madrid hospital doctors go on strike over temporary contracts (https://www.epe.es/es/sanidad/20220429/medicos-hospitales-madrid-huelga-contratos-temporales-13587639)

o Interesting statements by José Ramón Repullo regarding the temporality of doctors and health professionals and their non-solution through the OPEs. He proposes national accreditation and contracting by centers, as exists in other countries (https://elpais.com/espana/madrid/2022-04-30/la-temporalidad-de-los-medicos-es-el-resultado -of-a-bad-system-worse-governed.html)

o Cases of severe hepatitis in children in Spain rise to 22 (https://www.lavanguardia.com/vida/20220429/8233030/hepatitis-aguda-ascienden-22-casos-espana.html)

o 700,000 Spaniards on the surgical waiting list, the worst figure in the history of public healthcare (https://www.elespanol.com/espana/20220501/espanoles-lista-espera-quirurgica-historia-sanidad-publica/668683270_0. html)

o Núñez Feijóo calls for the creation of the emergency specialty, with the argument of preventing primary care professionals from leaving (https://www.consalud.es/autonomias/galicia/feijoo-pide-creacion-urgencias_113617_102.html)

o Facme presents the Spanish recertification model (https://www.diariofarma.com/2022/04/22/facme-presenta-el-programa-espanol-de-recertificacion)

o Five communities (Extremadura, Aragón, Baleares, Comunidad Valenciana and Navarra) ask AIReF to evaluate their healthcare and pharmaceutical spending (https://www.diariofarma.com/2022/04/26/cinco-ccaa-piden-a- the-airef-assess-your-health-care-and-pharmaceutical-expenditure)

o Very interesting article by José Luis Puerta: “Data saves lives”, on the need to overcome the situation in which the custodians of the data are not capable of exploiting them, nor do they allow third parties to do so (https://www.diariomedico .com/opinion/data-saves-lives.html)

Companies

  • International News

o Possible disruptive changes for the pharmaceutical industry (http://gestionclinicavarela.blogspot.com/2022/04/aires-de-disrupcion-en-la-industria.html?utm_source=feedburner&utm_medium=email): volumetric 3D printing that would allow drugs to be “manufactured” in a clinical setting (https://www.sciencedirect.com/science/article/abs/pii/S2214860422000781) and Amazon Prime’s offer to facilitate basic drugs for $1 a month (https://www.reuters.com/business/healthcare-pharmaceuticals/amazon-pharmacy-offers-half-yearly-prescriptions-starting-6-2021-06-08/)

o Roche sales soar in the United States due to the demand for covid tests (https://www.ft.com/content/ed5f4f64-4fa6-4663-bc75-8860bb1ad997)

o Investors pressure Nestlé and Kraft Heinz to target health (https://www.ft.com/content/545651c2-c408-4cad-b724-698ed896ee89)

o Philips records losses of 151 million euros in the first quarter of 2022 (https://www.plantadoce.com/empresa/philips-registra-unas-perdidas-de-151-millones-de-euros-en-el -first-quarter-of-2022.html)

o Abbie strengthens its neurosciences portfolio and acquires Syndesis Therapeutics (https://www.plantadoce.com/empresa/abbvie-strengthens-its-neurosciences-portfolio-and-acquires-syndesi-therapeutics.html)

  • National News

o Lácer attracts the interest of venture capital funds (https://www.expansion.com/empresas/distribucion/2022/04/29/626afa0de5fdeaa9578b45a2.html)

o Grifols closes the purchase operation of its German rival Biotest (https://cincodias.elpais.com/cincodias/2022/04/25/companias/1650876940_315447.html)

o Faes Farma profit grows 24% thanks to licenses and the Latin American market (https://www.eleconomista.es/pais_vasco/noticias/11743403/04/22/El-beneficio-de-Faes-Farma-crece -a-24-thanks-to-the-licenses-and-the-latin-american-market.html)

o Senniors disembark in Abu Dhabi with the support of the country’s sovereign wealth fund (https://www.plantadoce.com/empresa/senniors-desembarca-en-abu-dabi-con-el-apoyo-del-fondo-soberano-del -country.html)

o Quirónsalud launches a new rehabilitation center in Ronda de Triana (https://www.plantadoce.com/empresa/quironsalud-pone-en-marcha-un-nuevo-centro-de-rehabilitacion-en-ronda-de -triana.html)

o Hospitales Parque (CASER) accelerates in 2021 and raises its income by 46%, up to 58 million euros (https://www.plantadoce.com/empresa/hospitales-parque-acelera-en-2021-y-eleva-un -46-your-income-up-to-58-million-euros.html)

o Asisa strengthens Otoaudio and opens its first center in Seville (https://www.plantadoce.com/empresa/asisa-refuerza-otoaudio-y-abre-su-primer-centro-en-sevilla.html)

o Asisa Dental opens its first own clinic in the Canary Islands in Las Palmas (https://www.consalud.es/ecsalud/nacional/asisa-dental-abre-palmas-clinica-canarias_113952_102.html)

 

 

 

 

 

 

7 days in healthcare (January 17-23, 2022)

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SUMMARY

From an international point of view, the article published in The Lancet should be highlighted, in which mortality due to antimicrobial resistance, one of the most important causes of death in the world, is analyzed at a global level. Also the demand of the British Medical Journal that the scientific community have access to all the original data on the clinical trials of vaccines, since at this time these data are only accessible to employees of pharmaceutical companies. The Economist analyzes if the mandatory nature of the vaccine works, concluding that it does. It looks like all the COVID restrictions in England are going to end soon. The European Union gives more powers to the EMA, in case of having to manage future health crises.

As for the national news, the pandemic is still unchecked, in very high numbers and with high mortality; the debate on treating the covid as influenza continues, with opposing positions, those who are against it and those who defend it; the Ministry of Health wants to advance in the recertification, in dialogue with the FACME and the Organization of Medical Orders; The situation of health insurance in 2021 is presented, which did not stop growing, until the sector as a whole reached a turnover of close to 10,000 million euros; the Madrid College of Physicians signs a controversial agreement with UNIPROMEL, in theory to “defend doctors in free practice”, but, more possibly, with the intention of reinforcing the current weakened board of directors.

As far as companies are concerned, perhaps the most outstanding news is the sale by IBM of Watson Health, the artificial intelligence solution, designed to solve diagnostic and therapeutic problems, which had had so many problems in some centers such as MD Anderson from Houston. Although it was a good and ambitious idea, it was possibly ruined by short-termism, hyperselling and not taking enough into account the complexities of medicine and medical practice.

INTERNATIONAL NEWS

  • The Lancet publishes an article on the mortality of antimicrobial resistance. 204 countries and territories are analyzed in 2019. 4.95 million deaths from antimicrobial resistance were found in 2019. Antimicrobial resistance is one of the most important causes of death in the world (The Lancet, 20 January 22)
  • The British Medical Journal, after the Tamiflu experience, asks that the original data (raw data) from the clinical trials of vaccines be accessible to all researchers, not just those from the pharmaceutical industry, as is the case now (BMJ, January 19, 22)
  • The WHO gives the green light to the wider use of the third dose against COVID (FT, January 21, 22)
  • The fourth dose of the vaccine, infective in the extension of the “ómicron” variant, according to an Israeli study (FT, January 18, 22)
  • The Economist analyzes if the compulsory nature of the vaccine works. After analyzing the cases of Canada, France, Italy and Germany, he concludes that it works (The Economist, January 22, 22)
  • The covid passport strengthens the economy and vaccination (FT, January 18, 22)
  • Bill Gates warns against a pandemic potentially worse than COVID and calls on governments to spend billions of dollars to prevent it. He also says that this effort can contribute to improving the prevention and treatment of current extended diseases: HIV, tuberculosis, malaria (FT, January 19, 22)
  • All restrictions in England may end in March, according to the British Prime Minister’s plans (The Guardian, 17 January 22)
  • The EU approves the reform that gives more powers to the EMA in the management of future health crises (The Objective, 20 January 22)
  • Italy registers an increase in vaccination, after making it mandatory for those over 50 years of age (El País, January 17, 22)

NATIONAL NEWS

  • Situation of the pandemic

o COVID, still unchecked, breaks a new record of 3,418 cases per 100,000 inhabitants (El País, January 21, 22)

o The ICUs are at the limit of their structural capacity but far from the worst moments (El País, January 17, 22)

  • Debate about dealing with the covid as if were “flu”

o Two opposing positions:

 “Gripalizing the covid or how to believe we are winners”, article by Santiago Cervera, January 15, 22)

 Antonio Zapatero is committed to self-care and not to restrictions (El Español, January 17, 22)

  • Sick leave

o Processed 21,000 sick leaves and registrations in Madrid in the first days of the new system (El País, January 20, 22)

o The doctors accuse Escrivá of violating the law with the casualties, by giving in the same act for 7 days (La Razón, January 17, 22)

  • Recertification

o The Ministry of Health commits with FACME and the WTO to promote professional recertification (Acta Sanitaria, January 21, 22)

  • Situation schools

o The avalanche of school confinements puts families on the ropes (El País, January 21, 22)

  • Health insurance

o Health insurance grows by 4.93% in 2021 and totals 9,849 million euros (Acta Sanitaria, January 18, 22)

o According to forecasts by Javier Murillo, health insurance will grow in 2022 by around 5.5-6% (presentation at ICEA)

o MJ Montero (Finance Minister): great support for the MUFACE system (MUFACE Magazine, nº 252, winter 2021)

  • Other issues

o Organ transplants overcome the slump of 2020 and grow 8% in 2021 (El País, January 21, 22)

o Argimón presents the 2021-2025 health plan (Consalud, January 20, 22)

o Health, forced by Transparency to deliver to Farmaindustria the minutes of the Pharmacy Commission of the Interterritorial Council (diariofarma, January 16, 22)

o The MIR exam will bring together candidates from 4 continents and 88 countries (redacción Médica, January 20, 22)

o The Madrid College of Physicians signs an agreement with UNIPROMEL, “to defend free practice physicians” (Official Note ICOMEM, January 21, 22)

o Health awards 81 linear accelerators, in compliance with the INVEAT plan, three lots: Ab Salud, Varian and Elekta (ConSalud, January 18, 22)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

  • IBM sells Watson Health to an investment firm. The sale was preceded by resounding failures of this artificial intelligence tool for medical diagnosis and treatment (WSJ, January 21, 22)
  • Moderna intends to launch a joint COVID-flu vaccine in two years (The Guardian, January 17, 22)
  • Djokovic has 80% of the shares in a Danish biotech firm (QuantBioRes) that intends to release a vaccine against COVID (The Guardian, January 19, 22)
  • Pfizer becomes the largest provider of the pandemic and it is estimated that it will double its income (eldiario.es, January 17, 22)
  • Pfizer, AstraZeneca and the Chinese Sinopharm and Sinovac will manufacture 70% of the COVID vaccines (CincoDías, January 20, 22)
  • Merck entrusts the manufacture of its pill against COVID to 27 manufacturers (PlantaDoce, January 20, 22)
  • More than 100 laboratories in Asia and Africa could manufacture vaccines for Pfizer and Moderna (El Independiente, January 19, 22)
  • The “telecos” take advantage of the pandemic to add clients in telemedicine (El Independiente, January 19, 22)
  • AstraZeneca, the most widely used COVID vaccine in the world that is no longer administered in Spain (El Español, January 21, 22)
  • St John of God (important hospital network in Spain, until now divided into three “provinces”) consolidates its management structure at the national level (Acta Sanitaria, January 20, 22)
  • Acciona, Sacyr and OHLA bid for a new hospital in Chile for 265 million euros (PlantaDoce, January 16, 22)
  • Dental Residency, objective by 2022 to double billing and provide coverage to 250,000 residents (PlantaDoce, January 20, 22)
  • The EMA asks HIPRA to show greater efficiency than Pfizer, if it wants to be part of the European Union’s portfolio (El Economista, January 18, 22)
  • HIPRA will carry out the last clinical trial of its vaccine at HM Hospitals (El Economista, January 17, 22).
  • Viamed is preparing an offer for one of the “Catholic” hospitals in Madrid: San Francisco and Beata María Ana (Sanifax, January 21, 22)
  • ASISA renews its Board of Directors with three members, one internal and two independent directors (Europa Press, January 20, 22)
  • Mercadona offered the Government to sell tests in its establishments at 2.90 euros. The Government preferred to keep pharmacies as the only test point of sale (Sanifax, January 20, 22)
  • Lilly publishes an overview of start ups in health in Spain (Lilly, January 22)