Posts

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

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Summary

From the point of view of Biomedicine, vaccines against cancer and heart disease, based on mRNA technology, which are looming on the horizon 2030, seem to be the next great advance in medicine, potentially saving millions of lives. The Economist dedicates an article and an editorial to demonstrate the weak evidence for the therapy of gender transitions in adolescents, especially when they include pharmacological or surgical medication. Contrary to what had been a very popular assumption, moderate alcohol consumption does not produce health benefits, according to a study of more than 40 years published by the JAMA Network Open. Rather the opposite is true.

As regards Global Health, the WHO, born after the Second World War, is celebrating its 75th anniversary. He has emerged from the pandemic with injuries and issues, but acutely aware of his mission, purpose, and need for change. One of the problems it encounters is the discrepancies between countries in the discussion of a treaty on pandemics, which it intends to be approved in 2024. The Lancet publishes several articles on the commercial determinants of health, a subject of great interest. interest. Four industries – tobacco, unhealthy eating, oil and fossil fuels, and alcohol – are responsible for a third of deaths each year globally.

As for International Health Policy, in the United States, a federal judge in Texas has just banned the use of an abortion drug, which had been approved by the FDA more than 20 years ago. In France, the citizens’ convention, made up of 184 citizens chosen by lot, has just ruled in favor of euthanasia and assisted suicide, although with certain “red lines”. Macron wants to discuss the bill before the summer.

If we talk about National Health Policy (Spain), surgical waiting lists set a new record, according to the report made public by the Ministry of Health, with data as of December 31, 2022. Almost 900,000 people waiting for a surgical intervention. An absolutely delegitimizing element of the system. As is well known, the Ministry only makes public the waiting lists for surgical intervention or specialist consultations, but not for special tests (radiology, radiotherapy, ultrasound, etc.), on which there are no national data, although there are some autonomous communities. Interesting article published in Gaceta Sanitaria on the economic impact of including dental care in public coverage. This is an issue that the majority political parties have been pronouncing in favor of for several years, but nothing has been done on it. Spain is possibly the European country with the least percentage of its health spending devoted to dental care. The declarations of the Minister of Health of Catalonia are surprising, justifying the dismissal of the nurses who criticized the Catalan C1. Since this type of statement about specific dismissals is not common among regional ministers, it is to be assumed that there is an important political background. The decision of Navarra and Asturias to launch public companies, one for medical transport and another for a hospital laundry, is also surprising. Wouldn’t there have been the possibility of resorting to private initiative to solve these needs, perhaps more efficiently than through a public company?

In the field of Companies, internationally, agreement between Medtronic and Davita to launch Mozarc. At the national level, it is worth noting the start of work on the Viamed hospital in Tarragona, and the separation of the “pharmacy” and “chemistry” areas of the company Esteve.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies

 

 

7 days in healthcare (February 27th-March 5th, 2023)

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Summary

From the point of view of Biomedicine, The Economist celebrates medicines against obesity as a great revolution, at a particularly opportune moment, since the WHO is continually warning of the global epidemic of this disease. Psychedelics appear to be making their way into treatments for mental illness. The WHO is working on a new vaccine against bird flu, fearing that this virus will “jump” to humans, which already seems to have occurred in Asia.

With regard to Global Health, the change of management in two entities such as the World Bank and Gavi, very promising. In this last body, for the first time, the representative of a country receiving aid (Nigeria) occupies the maximum responsibility. Solutions are sought for the global shortage of certain medicines. There may be many causes, but it seems that the concentration of production in the geographic area of India and China may be at the root of the logistical problems.

As for International Health Policy, in the United States the battle for abortion, after the ruling of the American Supreme Court, is even transferred to abortion pills, which are trying to be banned in certain states. In the United Kingdom, pharmaceutical companies ask the Government for a tax cut, something that the Government does not seem willing to grant. In Canada, certain establishments are authorized to sell cocaine, in an attempt, we’ll see if it’s effective, to curb overdose problems. Two new clinics for LGBT patients open in Tel-Aviv.

If we talk about National Health Policy (Spain), in terms of covid, the accumulated incidence continues to rise slightly, with a fairly high mortality (around 100 patients a week). The medical conflict continues in several autonomous communities, but with special virulence in Madrid, where there is even a possible strike by hospital doctors, which would be a very important qualitative change. A group of Catalan healthcare workers resorts to the Government’s call to demand Catalan to be able to run for office, where had that bilingualism left off? The Amancio Ortega Foundation donates 30 million for the construction of the first pediatric palliative care center, which will be open to children from all Spanish communities. Despite how hard it is, there are children who are going to die and who are known to die. Those are the recipients of that center. Extremadura reaches an agreement with BIOSIM to promote biosimilars through profit-sharing programs. The wide diffusion of generics and biosimilars, critical for the permanent incorporation of innovation. Great presence at the Barcelona Mobile Fair of health technology, mainly surgical robots and telemedicine solutions.

In the field of companies, at the international level, BioNTech will open a center of excellence in mRNA technology in Israel. In Spain, Grifols takes full control of the biotech company Access Biologicals.

Biomedicine

Global Health

International Health Policy

  • COVID

National health policy

Companies

7 days in healthcare (February 13th-19th, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting the reference in the British Medical Journal on the questionable value of colorectal cancer screening, according to a double-blind study of the results of colonoscopy, with a large population followed up, without detecting reductions in the mortality from this type of cancer. The first vaccine against the syncytial virus, responsible for many deaths, both newborns and adults, is presented. The results of a test that detects prostate cancer with great precision, with a simple blood test, are published.

With regard to Global Health, the New England Journal Medicine published an article on the correct path to eradicate polio, which is once again a problem in many countries, defending universal immunization against polio, in instead of virus eradication strategies. The Lancet reviews the One Health strategy, this approach that links climate change, animal health and human health as something that cannot be addressed separately. It is detected that poor countries desperately need access to cheap generics, since in these countries, due to less competition between manufacturers, generics are more expensive than in developed countries. Malaria is spreading across Africa as climate change allows the geographic spread of the mosquitoes that transmit it.

Regarding International Health Policy, there is a great debate in the United States about the future of Social Security and Medicare, with very opposed positions between Democrats and Republicans. In the UK, the number of people waiting more than 18 weeks for treatment exceeds three million in England alone. In France, the very open debate on euthanasia continues with wide participation, with the involvement of President Macron himself. In Chile, the crisis in the private health sector threatens the entire Chilean health system. The collapse of the Isapres (Chilean health insurers) would mean that 3.2 million people would pass into the already congested public Fonasa system. Poland bans energy drinks for those under 18, a move welcomed by doctors in that country. The European Commission finalizes the European pharmaceutical strategy, with new approaches towards generics and orphan drugs. The EFPIA, the European employers’ association for pharmaceutical companies, criticizes what is becoming known about this reform, considering it harmful to competitiveness.

If we talk about National Health Policy (Spain), the cumulative incidence of covid continues to rise slightly. From a regulatory point of view, two important laws are approved: the so-called “trans law” and the new abortion law. From various sectors of the healthcare industry, objections had been made to certain elements of both laws, the consequences of which will have to be expected. As far as the medical conflict is concerned, it is increasingly clear that the conflict in Madrid is one thing and another in the other communities. Although the problems of Primary Care are national, and therefore the national government cannot inhibit itself as it is doing, what is specific to Madrid is the way in which the Community government approaches it, which simply attributes it to a “conspiracy of the left”, which contributes to its exacerbation, prolongation and expansion (it is also announces conflict among hospital doctors). Both the international press (Financial Times, Le Monde) and the national one (Zarzalejos in El Confidencial and others) strongly criticize this approach by the Community of Madrid, which has published a decalogue of excellence in Madrid’s healthcare, strongly criticized for its inaccuracies. In other communities, on the other hand, with all the difficulties, agreements are being reached. The national government also uses this conflict to enter into health, trying to neutralize criticism of the “yes is yes” law. Those who want politics out of healthcare don’t know what they’re saying. On the contrary, we need a political debate on high altitude and adult health. Just the opposite of what is happening. Private insurance policies are rising in price, something that the sector had been demanding for years.

At the Corporate level, at the international level, it is proposed that health information (largely from the NHS) be the basis of a British sovereign wealth fund, in the same way that a Norwegian sovereign wealth fund is based on information about oil. Grifols announces a savings plan that includes 2,300 layoffs, which has been highly received by the Stock Market, significantly raising the shares of this company.

Biomedicine

Global Health

International Health Policy

  • Chili
    • The crisis in the private sector threatens the entire Chilean health system. A 2010 court ruling prevents adjusting policies by age and sex. Although the measure had not been implemented, it seems that the government wants to do so. The collapse of the Isapres (health insurers in Chile) would mean that 3.2 million people would pass into the already congested public Fonasa system (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00321-5/fulltext)

National health policy

Companies

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

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Summary

From the point of view of Biomedicine, it is important to highlight significant advances in the treatment of some diseases, such as Alzheimer’s, breast cancer (a project inspired in its day by José Baselga), brain tumors, including the dreaded glioblastoma multiforme, and resistant tuberculosis.

With regard to Global Health, the WHO warns of global health threats in 2023: the Ebola outbreak in Uganda, which fortunately already seems to be in recession; the drought in the Horn of Africa; cholera, endemic in 69 countries; non-communicable diseases (particularly cardiovascular, diabetes, respiratory diseases and cancer), as well as the global stagnation due to the pandemic in the fight against various diseases: HIV, malaria and tuberculosis. Science reminds us that wastewater analysis has proven to be extremely useful for monitoring infectious diseases.

As for International Health Policy, with regard to covid, global concern is not so much for the cases that may come from China (which seem to correspond to the omicron that we already know) but for the new variant (Kraken) of United States, much more contagious than omicron and already affects a high percentage of cases in that country. The serious problems of the end of covid zero in China continue, with the opening of the country on January 8, which has been closed for three years. An editorial in The Economist looks at how the grand reopening may affect the global economy. Once again, the WHO says that mortality from covid in China is underestimated, if official figures are taken into account. Big change in the United States, where the abortion pill can be purchased in ordinary pharmacies. The large pharmacy chains, willing to participate in this sale. It must be remembered that a high percentage of abortions in the United States are already pharmacological. Serious crisis in the British National Health Service, with staff strikes, long waiting lists, saturation of emergencies and statements by unions and the Prime Minister. Labor wants to pass NHS employees to GPs (primary physicians), something that is in contradiction with the founding political pact of 1948 for the creation of the National Health Service, in which Aneurin Bevan participated. In France, health is also at the center of the political debate, with some statements on January 6 by President Macron, who considered among the solutions nothing less than ending fees per act, which in France are big words.

If we talk about National Health Policy (Spain), the year opens with the prospect of regional elections in 12 autonomous communities (May 28) and general elections at the end of the year, as well as a change in the head of the Ministry of Health. Several laws have been announced, including some advanced (new framework personnel statute, abortion, equity law), others more delayed (Public Health Agency, law of guarantees, possible reform of the dependency law). The Platform of Patient Organizations (POP) makes 10 proposals for chronic patients. As for professionals, some health insurance companies (DKV) have reacted quickly and announced increases in rates for doctors, which is undoubtedly a response to the criticism they had received from some medical associations, which even have raised certain protest actions. A piece of news says that the Zendal hospital has only 56 patients, which speaks of the fact that it has not yet found its place in Madrid’s health system, not surprising, since it seems that this hospital was established without the corresponding and obligatory Functional Plan (which defines the service portfolio, the population to be served, the incardination in the rest of the system, technology, personnel needs and other basic issues). Biosimilars, under the leadership of BIOSIM and starting in Extremadura, delve into the experience of shared benefit.

In the business sphere, in the international arena, Moderna acquires a genomics company. On the other hand, the completion of the Da Vinci robot patent will change the prospects for robotic surgery. At the national level, Ribera assumes the management of the Cascais hospital in Portugal, which is good news for public/private collaboration in our country.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (September 5th-11th, 2022)

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Summary

From the point of view of Biomedicine, to highlight the work that shows an association between artificial sweeteners and increased cardiovascular risk. Also that air pollution causes lung cancer.

As far as Global Health is concerned, apart from the serious humanitarian crises in Pakistan and Somalia, the most promising is the new malaria vaccine, which could be operational as early as 2023.

Regarding international health policy, assisted suicide and euthanasia are news in Canada (where the rate of euthanasia is very high and there is concern) and in France (which is considering passing a law). Macron has launched a major national debate on this issue, following a report to appear next week from the Ethics Committee. This great debate on such a delicate subject was missed in Spain. Certain issues should not be subject only to conjunctural parliamentary majorities, but should be preceded by a great national debate. It is also worth mentioning that Chile rejected the draft Constitution in a referendum. According to an article published in El País, doubts about the possibility of choosing the health system (the continuity of the ISAPRES, as health insurers are called in Chile), is one of the causes of this rejection.

If we talk about national health policy (Spain), it should be noted that Aragón proposes a great debate on the efficiency of the National Health System, a brave and valuable initiative. It will first analyze the Aragonese health system, and then share that analysis with the rest of the autonomies. Also that the Ministry of Health promises to change the law to favor the local manufacture of medicines. It is also worth underlining the pronouncement of the Catalan Evaluation Agency, on the need for a state policy for the digital transformation of the health system and the promotion of telemedicine.

In the field of companies, from the international point of view, to mention the purchase of Signify a home care group by CVS (an American pharmaceutical chain), in a process in which Amazon also showed interest. In terms of news at the national level, to highlight the great investment of Novartis in our country.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (6th-12th June, 2022)

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Summary

From the point of view of biomedicine, the article in the journal Cell stands out, in which MIT researchers design a complete functional map of genes in human cells. Also the possibilities of liquid biopsy, which will make it possible to diagnose cancers at an early stage through a simple blood test. It is also necessary to highlight the controversy over the transmission of monkeypox, some say that the transmission could be aerial, while the CDC denies it. This is important in terms of vaccination strategy.

As far as Global Health is concerned, the humanitarian problems of the Ukraine war should be highlighted, which will not only be local but global.

Regarding international health policy, it is worth highlighting the Health Affairs article that shows that mortality from covid is higher in counties with a Republican vote than in those with a Democratic vote. Incredible conclusion, although this can be explained by a greater rejection of masks, social distance and vaccination in Republican environments. Health and its preventive orientation declared a priority by Macron. We will see what this translates into in practice.

If we talk about national health policy (Spain), it should be mentioned that 15 new CAR-T centers are approved in several hospitals. Impressive and accurate title of a talk by Rafael Bengoa: “SNS: 500,000 competent professionals in an incompetent model.” It rightly puts the emphasis on management and organization. This contrasts with the poverty and lack of news and prioritization of the programs of both the PP and the PSOE in the Andalusian elections. The PP program introduces the nonsense of making the 9,000 hired by the public health companies statutory, one of the successes of the PSOE in health. As for the PSOE program, it is a very long program, without any prioritization, and full of reflections against collaboration with the private sector, as if the so-called “privatization” were the problem of the system.

At the corporate level, the promising advances of BioNTech in pancreatic cancer and AstraZeneca-Daiichi in breast cancer should be noted.

Biomedicine

Global Health

International health policy

National health policy

Companies