Posts

7 days in healthcare (January 8th-14th, 2024)

 

Summary

From the point of view of Biomedicine, it is worth highlighting the first results of the genomic studies of tumors carried out by the British public company, created in Cameron’s time, Genomics England, which will allow new therapeutic orientations in tumors. Certain hopes for patients with schizophrenia, a disease with a limited therapeutic arsenal. A Phase III trial gives promising results. It is expected that the drug can be approved in 2024 by the FDA. The WHO organizes a World Forum on Clinical Trials, establishing the four pillars for their development, which is of special interest to Spain, which is a power in clinical trials, a leader in Europe and only surpassed globally by the United States, China, India and Iran.

As far as Global Health is concerned, the WHO warns that a new pandemic will arrive and it will be more deadly.

In terms of International Health Policy, the growth of total health expenditures in the USA returns to pre-pandemic levels. They rose 4.1% in 2022, while in 2020 they had risen 10.6%. The New England Journal of Medicine publishes an interesting article on the “financialization” (non-financing) of health in the United States, distinguishing this from “corporatization” (the role of large corporations) or “privatization” (greater role of the private sector). “Financialization” refers to the greater role of financial or private equity companies in the healthcare world, in many cases as direct owners of healthcare companies, especially pharmaceutical and insurance companies. The effects of this phenomenon are not yet well analyzed. The FDA approves 55 drugs in 2023, up 48% from the previous year. Of those 55, 28 were intended for rare diseases. The Economist analyzes in an article that the British health system is acquiring a shape similar to that of the 1930s, with a large role of private companies and charities, when Aneurin Bevan created the NHS. It should be noted that the so-called generation Z (between 18 and 24 years old) are the largest users of private healthcare. The EU, through HERA, the body created as a result of Covid, will launch a vaccine development center.

If we talk about National Health Policy (Spain), the Ministry of Health agreed, in the face of the growth of the tripledemic, two measures: the first, the so-called “auto-sick leaves” (sick leaves of up to three days without prior medical report, by the exclusive decision of the worker); and, the second, the mandatory nature of masks in health centers. Both very controversial measures. The first was due to disagreements with the unions, employers and within the government itself, which speaks of improvisation on a very sensitive issue and which forced it to be postponed indefinitely. The second, with opposition from several communities and legal problems in its design. Measures continue to be taken to address problems such as pandemics without the expert advice of an organization such as the Public Health Agency, which has not yet been created, which could possibly have avoided or mitigated some of the problems that the Ministry has encountered. The Catalan government, faced with a growth in pharmaceutical spending, intends to control it with several measures. One of the requests is the transfer of the powers of the Interministerial Price Commission, in order to be able to negotiate the price of medicines with the laboratories at the community level. An issue that could threaten the necessary cohesion of the National Health System. Budgeted public health spending amounts to 89 billion in 2023, 29% more than in 2019, before the pandemic. The unions propose to the Ministry changes in the human resources policy and in the Framework Statute. Given the well-known aversion of unions to differentiation and individual and collective recognition, basic needs of the system, surely the approaches will not be very innovative.

In the field of Companies, on an international level, Goldman Sachs is making its debut in health, with a fund of 650 million dollars, in a line that seems to reinforce the idea of the “financialization” of health, discussed in the article this week from the New England Journal of Medicine. When it comes to national news, the highlight is the upheaval at Grifols, which has lost 3.2 billion euros in five days. After the Gotham Research City report, the company has not been able to convince shareholders of its reliability.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

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

 

 

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 (October, 3rd-9th, 2022)

 

Summary

From the point of view of biomedicine, to review the Nobel Prize in Physiology and Medicine, won by Svante Pääbo, a scientist who is recognized for his studies on the DNA of human ancestors, which allows us to better understand genetic evolution towards the “homo sapiens”. It seems that a study with Artificial Intelligence of the eye will help predict coronary risk in minutes, without the need for blood tests or other studies.

As far as Global Health is concerned, it is believed that malaria could be definitively eradicated from the world, with the help of new vaccines.

As for international health policy, alerts in Europe about avian flu and diphtheria, brought by immigrants from Africa and Asia. To highlight the changes in Portugal, which incorporate an independent team to the management of the SNS.

If we talk about national health policy (Spain), the rise in covid cases prevents the Interterritorial Council from approving the abolition of masks on public transport. The health items in the General State Budgets are analyzed with a magnifying glass in the professional press, despite the low weight of the expenses of the Central Administration in the total health expenses. However, it allows to detect some priorities for the Ministry, although the economic items are usually below the challenges: primary care, genomic portfolio, mental health, dental care, primary care infrastructure, etc. The CEOE charges against the Equity Law, which it describes as “unprecedented risk”. The debates and controversies continue in relation to the delays in the incorporation of pharmaceutical innovation in Spain. However, these debates do not usually consider that the approval by the EMA of a medicine does not mean automatic public financing in Spain, according to article 92 of the Law on Guarantees and rational use of medicines, which establishes the “financing selective and not indiscriminate” according to a series of criteria, which are established. AESEG and BIOSIM no longer agree with the plan approved a couple of years ago on generics and biosimilars, but want the new approaches to be included in the Guarantees Law.

In the field of companies, in the international arena, BioNTech signs an agreement with Australia, for the establishment of research centers in that country. As for national news, the growing weight of online pharmacy (prescription drugs excluded by law). HM reinforces itself in Andalusia, incorporating four hospitals in Malaga into its network.

Biomedicine

Global Health

International health policy

National health policy

  • General State Budgets (impact on health)

Companies

 

7 days in healthcare (March 14-20, 2022)

 

SUMMARY

From the point of view of biomedicine, to highlight the new treatment for malaria in children; the new variant “Delatacron”, similar to the “ómicron”; and, the possibilities of artificial intelligence to accelerate the appearance of new medicines. We would like to underline the studies promoted by Valentín Fuster on ultrasound of the neck and groin arteries and their possibilities of detecting the risk of myocardial infarction and stroke to be promising, although it is a topic that has been talked about for a long time without much results.

Regarding Global Health, an interesting editorial in the British Medical Journal, entitled climate change, pandemic and war: an uncontrolled multi-crisis, since it seems that in this decade of the 21st century all the problems have accumulated; the verification that the low level of vaccinations in Africa is not so much due to the low level of vaccines, but rather due to the difficulties of reaching the population; interesting report on Nigeria and the problems of its health system.

In terms of international health policy, the problems of Asia’s “covid zero” strategy are noteworthy, which gave so much political return to the Chinese regime, presenting its low mortality successes and comparing them with the high mortality rates of other countries in the world ( United States, Brazil, United Kingdom, India, etc.). It seems that the “ómicron” variant, due to its contagiousness, is not easily approachable with the “covid zero” strategy, since that would lead to massive confinements in China. Resurgence of covid cases in Europe and Asia, which coincides with a relaxation of control measures.

If we talk about national health policy (Spain), it should be noted that the incidence of covid is growing, while the measures are relaxed, although there is concern in the Ministry of Health about a possible new wave of covid at the gates of Easter. Very important COFARES report on the pharmacy sector, proposing many innovative measures, which contrasts with the usual narcissism and laudatory speeches about the “Mediterranean model of pharmacy”, so liked by some professional representatives. Primary Care is trying to get back to normal, although with a thousand fewer doctors than before the pandemic. The birth rate in Spain is at historic lows, which is a serious problem. The Council of Dentists, in reporting that 34 million Spaniards have cavities, presents us with the reality of poor dental care in our country. A revolution in the use of biosimilars is coming, given the large number of biological medicines that will lose their patent in the coming years.

In the field of companies, it should be noted that Pfizer and BioNTech have requested authorization in the United States for a second “booster” for older Americans. Grifols bets on a vaccine against Alzheimer’s. HIPRA, the veterinary pharmacy company until now, hopes to start marketing its vaccine against covid in June.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

  • COVID

o The “ómicron” variant is changing China’s “zero covid” strategy, at the moment more than 40 million Chinese are suffering some type of confinement, which is tolerated by the remaining 1.4 billion who lead normal lives. The legitimacy of the party is given by the low mortality. We’ll see if that can be sustained with the “omicron” (https://www.economist.com/china/2022/03/19/omicron-is-changing-chinas-covid-strategy)

o China reports the first deaths from covid in more than a year (https://www.nytimes.com/live/2022/03/18/world/covid-19-mandates-cases-vaccine)

o Shanghai, possible confinement, after the discovery of 150 new cases of covid (https://www.ft.com/content/659a5337-681b-4ef2-a9ac-db9aaaa78cef)

o Concern that new lockdowns in China may disrupt supply chains (https://www.economist.com/finance-and-economics/will-chinas-covid-lockdowns-add-to-strains-on-supply- chains/21808193)

o Resurgence of covid cases in Europe and Asia, infections have risen 8% worldwide, but they are skyrocketing in Vietnam and Germany (https://www.larazon.es/sociedad/20220317/z4bkdrxn2vddtcbvhi5equn45e.html)

  • Other issues

o According to an American study (Health Affairs), hospitals differ in their services depending on whether they are for-profit, non-profit or government-owned, with the former tending to offer more profitable services and discontinue the others (https://www.healthaffairs. org/doi/epdf/10.1377/hlthaff.2021.01115)

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o Latest report: the incidence of covid rise and 287 deaths, in Friday’s report (since Tuesday) (https://www.consalud.es/pacientes/especial-coronavirus/covid-19-espana-registra-64597 -cases-287-deaths-ia-upload-44580-points_111800_102.html)

o The new plan against covid will put an end to the isolation of positives (https://www.lavanguardia.com/vida/20220319/8136758/nuevo-plan-covid-pondra-aislamientos-positivos.html)

o The Ministry of Health fears the arrival of a new wave of covid at the gates of Holy Week (https://www.elespanol.com/espana/20220314/sanidad-llegada-septima-covid-puertas-semana-santa/656934435_0 .html)

o Paxlovid, the anticovid treatment promised by Sánchez, has not yet reached patients (https://www.elmundo.es/ciencia-y-salud/salud/2022/03/17/623244e021efa054348b458d.html)

  • Other themes

o Spain was left out of the top 10 in public health spending in 2020, according to a report made public by Eurostat and spent an average of 600 euros less per inhabitant than the EU average (https://www.consalud.es/politica/espana- top-10-ue-public-expenditure-health-2020_111467_102.html). To access the Eurostat report: https://ec.europa.eu/eurostat/databrowser/view/GOV_10A_EXP__custom_2243551/bookmark/table?lang=en&bookmarkId=8df11907-86e8-4f5b-a62e-a7d09828e303)

o Important COFARES report: pharmacist skills in the 21st century, proposing digitization, home delivery, legal changes and the sustainability of the pharmacy model (https://www.consalud.es/profesionales/profesionales-analizan- evolution-pharmacy-role-pharmacist_111660_102.html)

o The Ministry of Health and the regions coordinate health care for refugees from Ukraine (https://www.diariofarma.com/2022/03/18/sanidad-y-las-cc-aa-garantizan-la-atencion- health-for-refugees-from-ukraine)

o The Ministry of Health puts the average time to approve a drug at “9 months” (https://www.consalud.es/politica/ministerio-sanidad/sanidad-asegura-la-media-espana-aprobar-medicamento-9- months_111648_102.html)

o The flu enters Spain with force (https://www.lavanguardia.com/vida/20220317/8130742/gripe-fuerza-espana.html)

o Primary Care is trying to get back to normal, with a thousand fewer doctors than before the pandemic (https://elpais.com/sociedad/2022-03-20/la-atencion-primaria-intenta-volver-a-la- normality-with-a-thousand-less-doctors-than-before-the-pandemic.html)

o The birth rate in Spain, at lows not known in several centuries, according to a study by the San Pablo CEU University (https://www.eldebate.com/sociedad/20220315/pandemia-apenas-pasa-factura-natalidad-espana. html)

o A total of 34 million people in Spain have cavities, according to the General Council of Dentists (https://www.actasanitaria.com/politica-y-sociedad/total-34-millones-personas-en-espana-tienen- caries_2001822_102.html)

o The Ombudsman receives 2,300 health complaints in 2021, according to the report presented (https://www.defensordelpueblo.es/informe-anual/informe-anual-2021/)

o La Paz, on October 12 and Gregorio Marañón among the 100 best hospitals in the world, according to the classification prepared by Newsweek magazine (https://www.elmundo.es/madrid/2022/03/14/622e4da7e4d4d894118b45c8.html )

o Incorporating 6,000 doctors in primary care would cost 358 million euros, according to the Collegiate Medical Organization (https://www.elmundo.es/ciencia-y-salud/salud/2022/03/14/622df5e7fc6c83c80d8b4583.html)

o Mariano Esteban’s covid vaccine will not continue the clinical phase in Spain (https://www.diariomedico.com/medicina/enfermedades-infecciosas/empresas/la-vacuna-de-la-covid-de-mariano-esteban -csic-will-not-continue-the-clinical-phase-in-spain.html)

o Spain needs a plan for the second revolution in biosimilars, since one hundred biological drug patents expire between 2024 and 2029 (https://cincodias.elpais.com/cincodias/2022/03/16/companias/1647452966_841014.html)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

  • International News

o Moderna supplies 70 million additional doses of its vaccine to Japan (https://www.plantadoce.com/empresa/moderna-suministra-70-millones-de-dosis-addicionales-de-su-vacuna-anti-covid- 19-a-japan.html)

o Pfizer and BioNTech request authorization for a second “booster” for older Americans (https://www.nytimes.com/2022/03/15/us/politics/pfizer-second-booster-shot-older-americans.html )

o AstraZeneca, prepared not to continue with the efforts to obtain authorization in the USA for the covid vaccine (https://www.ft.com/content/e1edb2b2-0e12-4c83-9257-eeeb2ba29267)

  • National News

o Grifols bets on the Alzheimer’s vaccine and ends phase II of clinical trials (https://www.plantadoce.com/empresa/grifols-apuesta-por-la-vacuna-contra-el-alzheimer-finaliza-la- phase-ii-trials-of-abvac40.html)

o The Danish A.P. Moller Holding completes the purchase of Unilabs (https://www.plantadoce.com/empresa/la-danesa-ap-moller-holding-completa-la-compra-de-unilabs.html)

o The founders of Rovi sell 5% after the success of the Moderna vaccine (https://www.europapress.es/economia/noticia-fundadores-laboratorios-rovi-venden-capital-empresa-1808-millones-20220315082314.html )

o Hipra hopes to market its covid vaccine in June (https://www.businessinsider.es/vacuna-hipra-covid-comercializar-junio-primera-espanola-1029741)