Summary

From the point of view of Biomedicine, the first effective medication against endometriosis, the growth of the mucosa that internally lines the uterus in other parts of the body, which produces serious disorders, is on the horizon. The Lancet insists that population screening, including genomic screening, requires robust evidence. Population screenings generate considerable expenses, in some cases they are not risk-free and can generate false expectations, so only the most proven ones should be launched. Obesity drugs show other superpowers. They seem to have the ability to control inflammation, including brain inflammation. In this way, it is thought that they may be useful in certain neurological diseases, such as Parkinson’s or Alzheimer’s.

As far as Global Health is concerned, malaria vaccines, currently in use in Africa, are one of the great current tests of Global Health. An article in The Lancet criticizes the WHO’s desire to assimilate policies on tobacco products with those on e-cigarettes. For the author this is a retrograde position, since they are not comparable products in terms of the damage they cause. It is said that the focus should remain on what is the main public health problem: the harmful effects of tobacco consumption. Some directors of scientific advisory committees on covid sign an article in The Lancet, with general recommendations for these committees. Among the signatories is Fernando Simón, whose role in Spain was highly questioned and criticized.

Regarding International Health Policy, British experts from the Academy of Medical Sciences warn of the decline in the level of health of children in the United Kingdom. Due to its importance in the Spanish debate, we simply have to mention that the French Social Security agreed to raise the price of consultations for liberal practice general practitioners to 30 euros per consultation.

If we talk about National Health Policy (Spain), after the monographic meeting of the Interterritorial Council of the SNS on Primary Care, it was agreed, among other things, that the government, after checking the teaching capacity by the autonomous communities, will increase the number of places in training for primary care, although it is simultaneously reported that up to 90% of those who do this specialty leave it for various reasons, to move to the emergency room, to do another specialty or to go abroad. Publication of the Health Observatory (Ministry of Health-CIS) corresponding to 2023. The time to be seen in primary care is very striking, since 70% of patients wait nine days to be seen. The Department of Health of Catalonia addresses the places that are difficult to fill in Primary Care, after identifying 73 primary care teams with these characteristics. Design an incentive program. Among the economic ones are 3,500 gross euros per year for doctors, which may seem little since it represents just over 200 euros net per month, although the Metges union considers it a big step. ASPE publishes, in collaboration with a team from the Complutense University of Madrid, a study on MUFACE, joined by the IDIS Foundation, which calls for a PP-PSOE political agreement and a review of the governance of the model. It is also made public that the insurers that are in MUFACE (Adeslas, Asisa and DKV) already assume losses of 200 million with the current agreement. This is difficult to maintain since private companies in public/private collaboration can be asked to innovate, offer high quality, invest or even, with a long-term perspective, take short-term losses, but not that they lose money continuously and indefinitely, since the possibility of that collaboration is put at risk. Osasunbidea (the Navarrese Health Service) opens, through the intervention of the LAB union, a file on several doctors for making public and private practice compatible, without giving up a supplement. It seems like a debate from another era. Furthermore, there are great differences in the application of this regulation in the national territory. Therefore, a strict approach to incompatibility is only being followed in Navarra and Asturias. A group of Catalan health workers asks to expel another group of Spanish speakers, a notable example of intransigence, regardless of the dubious legality. Another of the conclusions of the Ministry’s Health Observatory is the great growth of private insurance, which went from 6.5% of the population in 1995 to 30.9% in 2023. The great leap occurred in the last decade.

As for Companies, at the international level, Big Pharma still needs successes in clinical trials to compensate for the loss of patents. At the national level, Magnum Partners is preparing to launch a premium aesthetic medicine group. The giant DomusVi offers the largest portfolio of nursing homes in Spain for sale.

Biomedicine

• First endometriosis drug in four decades on the horizon. Endometriosis is the growth of the mucosa that internally lines the uterus outside of it. According to the WHO, one in ten women suffers from this disease at some point in her life, which produces multiple disorders. Until now there was no treatment. Things are starting to change, a trial in Scotland and a French pharmaceutical firm (Ziwig) claim to have reached an effective treatment for this disease (https://www.economist.com/science-and-technology/2024/02/07/the-first-endometriosis-drug-in-four-decades-is-on-the-horizon#)
• Population screening requires robust evidence, genomic screenings are no exception (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02295-X/fulltext)
• Another superpower of obesity medications. Its ability to control inflammation has been seen in the liver, kidneys and heart. And also in the brain, which suggests that they could be effective against diseases such as Parkinson’s and Alzheimer’s (https://www.nature.com/articles/d41586-024-00118-4)
• A new age of precision gene therapy. The Lancet presents a review of the current situation and promising prospects for gene therapy (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01952-9/fulltext)

Global Health

• Scientific advisory committees on covid. The Lancet publishes an article with recommendations from scientific advisory committees on covid on the composition and functioning of these committees. Among the signatories, Fernando Simón, from Spain (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01846-9/fulltext)
• Malaria vaccines: a test for global health. Target 3.3 of the United Nations Sustainable Development Goals aims for a reduction in malaria incidence and mortality by 2030 and elimination of malaria in at least 35 endemic countries. The use of the two vaccines with which we are operating is the most important Public Health challenge of the current moment (https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(24)00235-6.pdf)
• Controlling tobacco reduction policies. An article published in The Lancet criticizes the WHO policies that equate tobacco products with e-cigarettes, which contain nicotine, which is considered a retrograde position, since they are not comparable products in terms of harm. that cause. It is said that the focus should remain on what is the main public health problem: the harmful effects of tobacco consumption (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00140-5/fulltext)
• Tabernero, former president of European oncologists: almost half of cancers are preventable (https://www.elespanol.com/ciencia/salud/20240204/tabernero-expresidente-oncologos-europeos-mitad-canceres-evitables/829667220_0.html)
• Brazil has a dengue emergency, heralding a possible health crisis in the Americas (https://www.nytimes.com/2024/02/10/health/dengue-brazil-americas.html)

International health policy

• USA
  • More and more teenage boys have eating disorders (https://www.nytimes.com/2024/02/08/health/adolescents-boys-eating-disorders.html)
  • Many transgender Americans face stigma and financial problems (https://www.nytimes.com/2024/02/07/health/trangender-survey-harassment-poverty.html#:~:text=The%20survey%20of%20more%20than,with%20their%20decision%20to%20transition.&text=Transgender%20and%20nonbinary%20Americans%20experience,their%20life%20experiences%2)

• United Kingdom and the National Health Service
  • Privatization through the main door. What the new public/private Primary Care model means in the United Kingdom, according to the Nuffield Trust. The acceptance of private patients (who pay for the consultation) in Primary Care practices in Northern Ireland is discussed (https://www.nuffieldtrust.org.uk/news-item/privatisation-by-the-front-door-what-does-a-new-public-private-gp-model-mean)
  • New rise in the incidence of measles (https://www.bmj.com/content/384/bmj.q259)
  • Experts warn of the intense decline in the level of health of children in the United Kingdom, according to a report by the Academy of Medical Sciences, which places the United Kingdom in position 30 out of 49 OECD countries in infant mortality. Children are considered collateral victims of wars and rising costs of living (https://www.bmj.com/content/384/bmj.q313#:~:text=The%20Academy%20of%20Medical%20Sciences,tooth%20decay%20in%20recent%20years.)
  • Mental emergencies in children increase by 53% (https://www.theguardian.com/society/2024/feb/07/childrens-emergency-mental-health-referrals-in-england-soar-by-53)

• France
  • The consultation of liberal generalist doctors in France is revalued up to 30 euros (https://www.lemonde.fr/societe/article/2024/02/08/revalorisation-des-medecins-liberaux-la-consultation-a-30-euros-chez-le-generaliste_6215514_3224.html#:~:text=L%27Assurance%2Dmaladie%20a%20enfin,le%201er%20novembre%202023.)
  • Sharp rise in suicidal thoughts and attempts among young adults in France (https://www.lemonde.fr/societe/article/2024/02/05/forte-hausse-des-pensees-et-tentatives-de- suicide-des-jeunes-adultes-francais-selon-une-etude_6214813_3224.html#:~:text=Santé%20mentale-,Forte%20hausse%20des%20pensées%20et%20des%20tentatives%20de%20suicid)

• Brazil
  • A year of Lula, the impact on health analyzed by The Lancet (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00234-4/fulltext)

• Netherlands
  • Health insurance reform in the Netherlands in maternal health (https://eurohealthobservatory.who.int/monitors/health-systems-monitor/updates/hspm/netherlands-2016/changes-in-health-insurance-in-the-netherlands-in-2024)
  • Attempt to include dental care in public coverage, failed, although it is expected to be approved once the new government is formed (https://eurohealthobservatory.who.int/monitors/health-systems-monitor/updates/hspm/netherlands-2016/attempts-to-include-dental-care-in-the-basic-benefits-package-are-unsuccessful-yet-again-in-the-netherlands)

• Canada
  • Review of the right to die. Although the right to die with dignity is well established in Canada, an attempt to extend this right to the mentally ill has failed (https://www.lemonde.fr/international/article/2024/02/07/au-canada- le-droit-a-mourir-dans-la-dignite-est-entre-dans-les-m-urs_6215161_3210.html#:~:text=Canada-,Au%20Canada%2C%20le%20droit%20à%20mourir% 20dans%20la%20dignité%20est,dans%20le%20pays%20en%20202)

National health policy

• Repercussions Monographic Interterritorial Council on Primary Care
  • The Ministry of Health, willing to create more family medicine training places, after pressure from PP councilors. Three things have been agreed: 1. That the communities review the teaching accreditation agreements, since the Ministry cannot increase the number of positions offered if the training positions are not accredited; 2. That the communities fill out the registry of professionals to know where they are; and 3. That communities improve the working conditions of Primary Care doctors and their daily lives (https://www.elmundo.es/ciencia-y-salud/salud/2024/02/10/65c6733ae4d4d8b95a8b4592.html)
  • Up to 90% of family MIRs leave the specialty upon completing their training. Way to do it: going to the emergency room; doing a new specialty or emigrating abroad (https://elpais.com/sociedad/2024-02-09/hasta-el-90-de-los-mir-de-medicina-de-familia-abandona-la-especialidad-at-the-end-of-the-training.html#)

• Publication of the Health Observatory (Ministry of Health, CIS)
  • Original documents. Graphic summary (https://www.sanidad.gob.es/estadEstudios/estadisticas/BarometroSanitario/Barom_Sanit_2023/Barom_Sanit_2023_totales/Resumen_grafico_BS2023.pdf), Executive summary (https://www.sanidad.gob.es/estadEstudios/estadisticas/BarometroSanitario/Barom_Sanit_2023/Barom_Sanit_2023_totales/Resumen_ejecutivo_BS2023.pdf)
  • Waiting time in Primary Care increases by 57.2% in five years (https://www.vozpopuli.com/espana/sanidad-tiempo-atencion-primaria-2.html)
  • Almost 70% of patients wait nine days to be treated in Primary Care (https://www.epe.es/es/sanidad/20240207/pacientes-espera-9-dias-atencion-primaria-97870040)

• The Department of Health of Catalonia addresses the places that are difficult to cover in Primary Care
  • Press release from the Department. Incentives to ensure the presence of primary doctors in rural areas. 73 primary care teams that are difficult to cover are identified, one in five. Financial incentives (3,500 euros/year for doctors; 2,000 euros/year, for the rest of the professionals), professional and personal (https://govern.cat/salapremsa/notes-premsa/578824/salut-desplegara-un-pla-amb-incentius-per-atraure-professionals-pels-equips-d-atencio-primary-de-dificil-cobertura-de-l-ambit-rural)

• Controversy over MUFACE
  • Publication of a document by ASPE and a team from the Complutense University (https://tribuna.ucm.es/news/la-catedra-extraordinaria-de-salud-sostenible-y-responsable-presenta-su-informe-about-health-mutualism)
  • The IDIS Foundation requests a PP-PSOE agreement for the continuity of MUFACE and to review the governance of the model (https://www.diariomedico.com/medicina/politica/fundacion-idis-pide-atrabajo-pp-psoe-continuidad-muface-review-governance-model.html)
  • MUFACE insurers already assume losses of 200 million with the current concert (https://www.elespanol.com/invertia/observatorios/sanidad/20240208/aseguradoras-muface-asumen-perdidas-millones-actual-convertir/830917166_0.html#:~:text=The%20insurers%20signers%20(SegurCaixa%20Adeslas,the%20accounts%20correspondents%20to%202023.)
  • The end of the MUFACE model would mean a 266% increase in the waiting list for external consultations in public health (https://www.epe.es/es/sanidad/20240207/muface-modelo-dispararia-listas-espera-public-health-97825566)
  • AIREF calls Adeslas, Asisa and DKV to evaluate MUFACE (https://www.expansion.com/empresas/seguros/2024/02/09/65c5176d468aeb30028b4582.html)

• Actions by Osasunbidea against doctors who make their public and private practices compatible
  • Complaints from the LAB union activate the action of the Navarrese government (https://elpais.com/sociedad/2024-02-08/el-gobierno-navarro-confirma-que-siete-medicos-cobraron-la-exclustividad-pese-to-work-at-the-private-at-the-time.html)

• Tensions over the mandatory use of Catalan in healthcare in Catalonia
  • A group of Catalan health workers asks to expel another group of Spanish speakers (https://theobjective.com/sanidad/2024-02-07/sanitarios-catalanes-expulsar-castellano/)

• Melilla
  • The PP requests the transfer of healthcare to Melilla (https://www.redaccionmedica.com/secciones/parlamentarios/dos-mociones-del-pp-instan-al-gobierno-al-traspaso-de-la-sanidad-a-melilla-1433)

• Pharmacists
  • Pharmacists demand more role in healthcare (https://www.larazon.es/salud/farmaceuticos-reclaman-mas-papel-atencion-sanitaria_2024021065c6cb16344c980001b68488.html)

• Supply of medicines
  • The problems with the supply of medicines triple in just two years (https://elpais.com/sociedad/2024-02-09/los-problemas-de-suministro-de-medicamentos-en-las-farmacias-se-triple-in-just-two-years.html)

• Private health insurance
  • How the contracting of private health insurance has evolved in Spain. According to data from the Health Observatory, the contracting of private health insurance went from 6.5% of the population in 1995 to 30.9% in 2023. The great leap occurred in the last decade (https://www.consalud.es/patiientes/clase-media-alta-con-estudios-superiores-quien-contrata-seguros-sanitarios-privados-en-espana_140040_102.html)

• Lawsuits against vaccines
  • The National Court admits the first lawsuit for the side effects of the AstraZeneca vaccine (https://theobjective.com/economia/2024-02-09/audiencia-admite-primera-demanda-efectos-secundarios-vacuna-astrazeneca/#:~:text=The%20Liberal%20%2D%20Economy-,The%20Audience%20admits%20the%20first%20demand%20for,secondary%20of%20the%20vaccine%20AstraZenec)

• Boom in Health Sciences Faculties
  • Carlos III University will have a Faculty of Health Sciences (https://www.comunidad.madrid/noticias/2024/02/05/comunidad-madrid-da-luz-verde-nueva-facultad-ciencias-salud-universidad-publica-carlos-iii)

Companies

• International News
  • The most important digital and AI companies in health in 2024. The Medical Futurist publishes, like every year, the 100 most outstanding companies in this field. It is a publication without sponsorship. The four values considered are: innovation orientation; disruptive technology; viable business model; and, clear dedication to digital health technology (https://ramaonhealthcare.com/5-insights-of-the-medical-futurists-100-digital-health-and-ai-companies-of-2024/)
  • Big Pharma still needs successes in clinical trials to compensate for the loss of patents (https://www.ft.com/content/5870001c-4fa8-496b-961d-d7b95cfb839a)
  • A new version of Ozempic or Wegovy in pill form, why is Novo Nordisk hesitating about whether to sell it or not? Because the pill version requires much more semaglutide and would endanger the current distribution (https://cincodias.elpais.com/companias/2024-02-09/una-nueva-version-de-ozempic-o-wegovy-in-pill-because-novo-nordisk-doubts-about-whether-to-sell-it-or-not.html)
  • Lilly shatters its sales record thanks to its anti-obesity drug (https://elpais.com/economia/2024-02-06/lilly-pulveriza-su-record-de-ventas-gracias-a-su-farmaco-against-obesity-mounjaro.html#)
  • Investors focus on start-ups that are dedicated to developing psychedelic medications for mental health (https://www.ft.com/content/4a2e856c-4736-4b8b-9323-583bb1dbe8f4)

• National
  • Magnum launches a premium aesthetic medicine group (https://www.elconfidencial.com/empresas/2024-02-05/magnum-repite-apuesta-salud-lanza-grupo-medicina-estetica-premium_3823406/)
  • Sanitas wants to grow by opening collaborating offices with the help of the consulting firm mundoFranquicia. Sanitas is committed to providing comprehensive support to collaborating offices that want to place themselves under its umbrella (https://www.plantadoce.com/empresa/sanitas-quiere-crecer-con-la-apertura-de-oficinas-colaboradoras-junto-a-mundofranquicia#:~:text=a%20mundoFranquicia%20%7C%20PlantaTwelve-,Sanitas%20wants%20grow%20with%20the%20opening%20of%20offices%20collaborators%20ju)
  • The giant DomusVi puts the largest portfolio of nursing homes in Spain up for sale (https://www.elconfidencial.com/inmobiliario/inversiones-alternativas/2024-02-09/domusvi-venta-mayor-cartera-residencias-elderly_3826982/)
  • Spain will open a large plant to supply paracetamol to the entire European Union (https://www.eleconomista.es/salud/noticias/12655170/02/24/espana-abrira-una-gran-planta-para-surtir-from-paracetamol-to-the-entire-european-union.html)