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7 days in healthcare (October 9th-15th, 2023)

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Summary

From the point of view of Biomedicine, after years of research, scientists have published an atlas of the brain, the most unknown organ and whose knowledge will allow great advances in biomedicine. This week 21 articles have appeared about the brain and its cells. The work is done under the BRAIN Initiative Census Network project. The objectives of this effort were three: first, to understand the cellular components of the brain; second, to know which cells are affected in neurological and psychiatric diseases; and, third, what makes the brain of Homo sapiens different from that of other animals. The brain is the most complex object in the universe and contains around 3,000 types of cells. Until recently it was believed that the human body, including the brain, had only 300 types of cells. Artificial intelligence, new therapeutic vaccines, xenotransplantations and quantum computing, in the focus of monitoring progress in medical sciences.

Regarding Global Health, The Lancet asks in several articles the impact on health of a world with a shortage of work, since until now a job in good conditions was considered important for health. The malaria community welcomes the WHO approval of the new vaccine. Malaria kills half a million children a year, mainly under five years old. This decision is expected to improve access to doses of the vaccine, especially in Africa. 28 African countries are going to introduce this vaccine as part of their immunization program.

Regarding International Health Policy, in the United States pharmaceutical companies agree to negotiate the price of medicines with Medicare, despite the fact that some maintain lawsuits against the American government. In the European Union, the shortage of amoxicillin, a widely used antibiotic, persists. There is also in the EU an increase in deaths due to mental disorders.

If we talk about National Health Policy (Spain), the government puts out to public consultation the draft Royal Decree for the evaluation of health technologies which, among other things, rethinks the economic evaluation of medicines, incorporating the participation of professionals and patients and attempting predictability and transparency in decision-making times.

In the field of Companies, at the international level, it is worth highlighting that the global cannabis market will reach 100 billion in 2030. At the national level, Sanitas is launching an educational experience, which is an example of the importance they give healthcare companies to the issue of training, aware that attracting and retaining talent will be the most important competitive advantage.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

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

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Summary

From the point of view of Biomedicine, Katalin Karikó and Andrew Weissman, awarded the Nobel Prize in Medicine, for their discoveries that allowed the implementation of the mRNA vaccine against covid. When Watson and Crick discovered the structure of DNA in 1953, RNA was not known, not discovered until 1961. DNA is the matrix for RNA and this is the matrix for proteins to be produced in ribosomes. mRNA was later discovered. Dr. Karikó immigrated to the United States from her native Hungary in 1968 to find a therapeutic role for messenger RNA. For 20 years she worked unsuccessfully in that attempt. At the University of Pennsylvania, where she worked, she met Dr. Drew Weissman. They had made RNA, injected it into mice but they got sick and died. After some chemical changes in the RNA they avoided rejection. They believed they were on the path to discovering a new way of making vaccines. They tried to publish it in “Nature”, but the prestigious magazine rejected the work. They published it in 2005 in the minor journal “Immunology”. Two biotechnology companies saw the therapeutic potential of RNA: Moderna, in the United States, and BioNTech, in Germany. In 2013 Katalin Karikó became vice president of BioNTech, there she developed the vaccine against covid that has saved so many lives. In 2022 she left BioNTech to devote more time to research. She has returned to Hungary as a professor at the University of Szeged. Andrew Weissman’s life is less eventful, he is a professor of medicine at the University of Pennsylvania and had worked with Anthony Fauci, the doctor who led American efforts against covid-19. In another vein, The Lancet magazine publishes an experimental work in which a blood test detects tumors in asymptomatic people. It is only a first step, but the day does not seem far away when we can diagnose the existence of a tumor through a blood test.

Regarding Global Health, the WHO approves the long-awaited second vaccine against malaria. It should be noted that the number of cholera cases has doubled between 2021 and 2022, according to the WHO.

Regarding International Health Policy, in the United States, a strike at the important integrated insurer Kaiser Permanente ended without an agreement. The FDA launches a program to accelerate the emergence of therapies against rare diseases. Let’s not forget that most rare diseases have no treatment by 2023. Prime Minister Sunak of the United Kingdom seems determined to set limits on the age at which people start smoking. The EFPIA (European medicines association) appeals in writing to the European Parliament to amend the European pharmaceutical reform, which is underway.

If we talk about National Health Policy (Spain), as is known, the Government has authorized the increase in the number of places in Medical Schools. This initiative has been made against the opinion of the doctors and the Association of Medical Students. Obviously, the issue of health professionals requires planning, precisely what there has not been. Planning cannot be replaced with any measure if it is not well thought out and matured among the various agents of the health system. Andalusia takes a step to promote public/private collaboration, by approving 734 million euros to refer patients to private clinics. As for the Zendal Hospital, it seems that it the purpose of that hospital is already defined. After an investment of 50 million: the Zendal hospital will be a neurorehabilitation hospital. At one point it had been designed as a Covid hospital, something only seen in China and some other low-developed countries, not Europe. There was no functional plan for said hospital. We now do not know which studies have recommended its transformation into a neurorehabilitation hospital and whether the different agents (hospitals, scientific societies, expert groups, etc.) have been consulted.

In the field of Companies, on an international level, KKR finalizes the purchase of Eugin, to create a giant in assisted reproduction. At the national level, HM Hospitals announces the opening of its 9th hospital in Madrid. A story of undoubted success, based on a family initiative.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

7 days in healthcare (July 17th-23rd, 2023)

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Summary

From the point of view of Biomedicine, important editorial and several articles in The Economist on the problems of reproduction and in vitro fertilization. Since this technique began, 45 years ago, more than 12 million children have been born thanks to it. The issue is extremely important considering that one in six people suffer from infertility. IVF is experiencing an extraordinary “boom”. Important article from The New York Times on the demographic changes that will give rise to a whole new world in terms of population distribution. Some skepticism about the effects of Donamebad on the evolution of Alzheimer’s.

When it comes to Global Health, The Economist looks at why the malaria vaccine has taken so long to develop. This is apparently due to cycle changes of the Plasmodium parasite. Singapore is a world leader in the marketing of cultured meat, which is possibly called to change many things in our eating habits.

Regarding International Health Policy, the WHO in its weekly covid monitoring newsletter on covid warns that, although the number of new cases and mortality are falling, this disease continues to be a threat, which requires maintenance of surveillance systems and periodic reports. The National Health Service, despite its deep crisis, continues to be a benchmark in terms of reflections on health and health systems. This time the King’s Fund is publishing a report on the kind of participatory leadership needed in the healthcare system.

If we talk about National Health Policy (Spain), we want to highlight the interesting book “Conversations for better health”, which consists of deep and nuanced reflections on many topics, carried out by two consolidated values in Spanish healthcare arena (Jesús María Fernández Díaz and José Martínez Olmos): the importance of Public Health, the need for the Public Health Agency, the opacity of our system in terms of information on results and quality, financing, co-payment, the challenges of Primary Care, the necessary new care model, the contributions of digital health, etc. When improvisations and light comments abound, often made from advertising or simple communication, this conversation between two experienced experts, who treasure experience and knowledge, is a must read. It can be purchased on Amazon.

In the field of Companies, internationally, there are two great opportunities for the pharmaceutical industry, one in the short term, such as all medications against obesity and Alzheimer’s, and another in the longer term, such as anti-aging therapies.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

7 days in healthcare (July 10th-16th, 2023)

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Summary

From the point of view of Biomedicine, there is little doubt that Artificial Intelligence will revolutionize medicine: from diagnosis, to the robotic-AI combination for surgical procedures, rehabilitation aid, support in the fight against infectious diseases, development of new drugs, etc. There will be few areas of medicine that are not affected by the development of Artificial Intelligence.

As regards Global Health, The Lancet insists on the WHO-Europe notice on the need to decontaminate the air, since pollution contributes to the appearance of a large number of diseases and premature deaths. This time, 12 African countries are going to receive 18 million doses of the malaria vaccine. Now one can dream of the disappearance of malaria – that secular plague – from our planet.

Regarding International Health Policy, the American regulator approves the first contraceptive pill that will be dispatched (in pharmacies, supermarkets and online) without the need for a prescription. Although the “pill” could be used in the USA for 50 years, until now it was always under medical prescription. It is believed that this measure will contribute to reinforcing women’s reproductive rights, which were so affected by the US Supreme Court ruling that repealed the previous interpretation of the federal constitutional right to abortion, leaving this regulation in the hands of the states. Great controversy as a result of the WHO declaration of the possible carcinogenic effects of aspartame, a sugar substitute widely used in many beverages, including Coca-Cola. The WHO statement is not without controversy.

If we talk about National Health Policy (Spain), to highlight the private health agreement in Madrid, with a rise of 15% in four years. The private provision employers address a decalogue of petitions to the new government. One of them is not addressed so much to the government as to health insurers, by requesting that relations between insurers and health centers be regulated in writing. The Coordinates Institute reveals the very different development of the right of choice in health in the national territory. On the other hand, the Minister of Health presents the new citizen folder. According to him “with one click you can access the medical history”. This of presenting a project of this magnitude a week before the elections cannot be taken very seriously.

In the field of Companies, internationally, Moderna has established itself in China. As for national news, Quirón announces a new hospital in Badajoz and Viamed the expansion of its hospital in Zaragoza. The funds, interested in radiodiagnostic companies, a sector so far very fragmented. ALSA, the bus company of Asturian origin, together with the Asturian health transport company Trasinsa, agree to launch a new health transport operator: SANIR.

Biomedicine

Global Health

International Health Policy

  • USA
    • The American regulator (FDA) approves the first contraceptive pill for sale without a prescription. It is called Opill and it will be available in pharmacies, supermarkets and online from 2024. The manufacturer is Perrigo, an American-Irish consortium. This pill can be used with a prescription for 50 years. The change is that, from now on, it is freely dispensed (https://www.nytimes.com/2023/07/13/health/otc-birth-control-pill.html)

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 (December 20-26, 2021)

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Summary

From an international point of view, possibly the most interesting is the summary of the year 2021 by The Lancet; also the studies that seem to show that the “omicron” variant is not only more contagious (which was already known), but that it produces a milder form of disease; the NEJM analyzes Amazon’s health offering; and finally, Israel’s attempts to move forward with the fourth dose.

As for national news, the most relevant thing is the great increase in the pandemic in Spain, which fundamentally translates into pressure on Primary Care and Emergencies, not so much in hospitals; the attitude of the central government in the Conference of Presidents of not imposing restrictive measures, in contrast to what is being done in other European countries; and the failures of the strategic reserve in health, which is causing a great shortage of antigen tests at this time.

With regard to companies and other agents in the sector, it is important to highlight that Europe approves the Novavax vaccine, which would already be the fifth vaccine approved in Europe. Also the authorization of the Merck pill by the FDA for high risk covid. From the point of view of corporate movements, perhaps the most relevant is the purchase of CERNER by Oracle, which may revolutionize the field of hospital informatics.

International

 

  • Farhat Yaqub summarizes for The Lancet the most notable events of 2021 in health: the COVID-19 pandemic, which had produced 3.3 million deaths globally as of December 10, 21, more than in 2020; COVID vaccination, with more than 8.4 billion doses administered through December 11; Biden instead of Trump, one of Biden’s first actions was to sign the executive order for the US to return to the WHO; the health impact of the conflict in Ethiopia; the effects of the decline in UK development aid; the COP 26 meeting in Glascow, which put climate change on the health agenda; the crisis in Afghanistan, the most serious current humanitarian crisis; abortion laws: legal in Argentina, banned in Honduras, severe restrictions in Texas; restrictions also in China; the approved malaria vaccine; severe shortage of midwives (The Lancet, Dec 18 21)
  • Three studies (England, Scotland and South Africa) show that the “omicron” variant produces milder COVID, with much less chance of being admitted to hospital (British Medical Journal, 23 Dec 21)
  • A NEJM article looks at Amazon’s healthcare offering: a combination of telemedicine and home care. Three main actions: mobile app; home assessment by a nurse; distribution of medication at home in two hours. A hybrid experience online and in person (NEJM, 23 Dec 21)
  • COVID vaccines are less effective against the “omicron” variant, says the EMA (FT, Dec 20 21)
  • Israel May Give Fourth Vaccine Dose, Despite Expert Reservations (NYT, Dec 23 21)
  • The “omicron” variant responsible for 75% of the cases in the USA (FT, Dec 21, 21)
  • The “omicron” variant has revealed a world not yet prepared for pandemics (FT, Dec 22 21)
  • US military announce SpFN, a valid vaccine against all variants of the coronavirus, including “omicron” (La Razón, Dec 22 21)
  • The “omicron” variant causes the cancellation of almost 5,000 flights around the world during the days of Christmas Eve and Christmas (CincoDías, 25 Dec 21)

National News

  • The incidence of COVID shoots up to 911 cases per 100,000 inhabitants in the last 14 days (El País, 23 Dec 21)
  • Germany declares Spain as a high-risk territory due to COVID (El País, 23 Dec 21)
  • Sánchez prioritizes the economy in the sixth wave and avoids any restrictive measure in the Conference of Presidents, apart from the mandatory nature of outdoor masks and certain possibilities of hiring professionals without recognized degrees (La Razón, Dec 24 21)
  • Feijóo, Moreno, Urkullu and Aragonés consider that the mask on the street is not enough (El Confidencial, Dec 22 21)
  • Harsh criticism from the General Council of Medical Associations in the absence of measures against COVID: “they seek formulas to avoid the burden of responsibility and fear to implement measures that contradict or further anger citizen-voters” (La Vanguardia, Dec 24 21 )
  • The ICUs of ten communities are already at “high risk” due to patient occupation (Aragon, Asturias, Balearic Islands, Cantabria, Castilla y León, Catalonia, Valencian Community, Navarra, Basque Country and La Rioja) (Vozpópuli, Dec 24 21)
  • The sixth wave will leave 9,000 dead in Spain, according to a study by the University of Washington (IHME, Covid 19 Results Briefing, Spain, December 23, 21)
  • The strategic health reserve falls short and does not alleviate the shortage of tests (El Periódico de España, Dec 25 21)
  • Spain has practiced a hundred euthanasias since the approval of the new law (The Objective, Dec 18 21)
  • Strong statements by President Díaz-Ayuso: “In some health centers, not everyone wants to work and pitch in” (El País, Dec 21, 21)
  • SEMERGEN demands that Díaz-Ayuso reconsider her statements about primary care (ConSalud, Dec 22 21)

Companies, employers and main health actors

 

  • Europe approves the Novavax vaccine. It would be the fifth COVID vaccine approved in Europe, after those of Pfizer-BioNTech, Moderna, AstraZeneca and Janssen (FT, Dec 20 21)
  • Biogen cuts the price of its Alzheimer’s drug in half, due to low sales and divisions by experts about its benefits (FT, Dec 20 21)
  • Merck’s COVID pill is FDA cleared for high-risk adults (NYT, Dec 23, 21)
  • FENIN report on the hospital technological profile, with data updated to December 2020. FENIN has been conducting this study since 2009 (FENIN, Dec 21)
  • “MiQuirónsalud”, the portal that the hospital group makes available to its patients, exceeds four million users (ConSalud, Dec 21 21)
  • Oracle buys CERNER for more than 28,000 million euros to grow in health (PlantaDoce, Dec 22 21)
  • Atrys Health acquires 100% of Simm Molecular, which is dedicated to medical diagnosis in nuclear medicine (PlantaDoce, Dec 17 21)
  • Health in code and the Portuguese Algarve Biomedical Center sign an agreement for genetic diagnosis (PlantaDoce, Dec 22 21)
  • MBA (a medical technology company very oriented to orthopedics-traumatology and based in Asturias), until now owned by Alantra, is acquired by the Swedish group Addlife for 111 million euros (Medical Writing, 23 Dec 21)
  • Viamed, owned by the Macquarie fund, acquires the Fuensanta hospital in Madrid, until now owned by the Merina family. With this, Viamed now reaches 12 hospitals in Spain (PlantaDoce, 23 Dec 21)