Posts

7 days in healthcare (August 5th-11th, 2024)

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Summary

Biomedicine

  • How to reduce the risk of dementia. A healthy lifestyle can prevent or delay at least half of cases. The Lancet article adds two risk factors to the 12 already identified in 2020: untreated vision loss and high cholesterol levels. Modifiable factors include tobacco, obesity, physical inactivity, high blood pressure, diabetes and excessive alcohol. No one doubts that the prevalence of dementia will increase as the population ages, although, adjusted for age, the incidence is falling.
  • It seems clear that women are better doctors than men. This is demonstrated by a broad review of 1.5 million medical records of adult patients.
  • The increasing number of cancers in young people points to the responsibility of the environment. Many of the cases are gastrointestinal, and could point to microplastics, as well as other risk factors, such as a sedentary lifestyle, a change in diet, as well as higher rates of obesity and diabetes.
  • Type 2 diabetes remission. According to a paper published in The Lancet, initial studies show that this type of diabetes can be put into remission with a “total diet replacement” (TDR) program. The issue is important, given the increasing prevalence of type 2 diabetes.
  • A new biomaterial capable of regenerating damaged joint cartilage is developed. As is known, cartilage does not regenerate. This new potential therapy may help address a serious and unmet clinical need. The new bioactive material successfully regenerated high-quality cartilage.

Global Health

  • Why the war on childhood obesity is failing. Since 1990, obesity rates have doubled among adults and quadrupled among children. In 2019, this caused 5 million deaths, 20 times more than malnutrition. No country has succeeded in reducing obesity: the problem is too complex to be solved with public health measures or drugs. Behind it there is a set of biological, economic and social factors.
  • The evolution of mortality under 5 years, a call for urgent action. Since 2000, the global incidence of mortality in children under five years has decreased by more than 50%. But the global community must not forget that millions of preventable deaths in children under five years of age occur every year. From 2000 to 2022, 162 million children under five years of age died.

International health policy

  • A study estimates the cost of cancer screening in the USA at 43 billion dollars. The study focuses on five cases in which screening is recommended: breast, cervical, colorectal, lung and prostate.
  • NHS England advocates four-year medical studies. In most countries, the studies are at least five years old, although in the USA and Canada they are already four years old.
  • The WHO triples the number of viruses and bacteria that threaten the world. The previous report was from 2018 and there were only a dozen pathogens; while the current report includes a total of 32 groups of microbes.
  • The EUDA, the new agency that will fight against drugs in the EU. Its mission would be to monitor drug trends, warn of emerging threats and share science-based knowledge.

National Health Policy (Spain)

  • The debate continues on the new financing system of Catalonia and its impact on the SNS. The government’s crossroads: raise taxes, cut benefits or increase the debt further. FEDEA considers that the Catalan agreement will allow the Generalitat to receive up to 13.2 billion from the common fund, which is detrimental to the income of other communities and a minimization of solidarity, which is what can be deduced from the PSC-ERC agreement. Although Illa’s arrival to the presidency of the Generalitat has encouraged a certain “do-goodism”, as if everything had already been resolved, the truth is that the problems with this agreement are of great magnitude, given the high price paid for it. Salvador Illa’s management at the head of the Ministry of Health does not contribute to optimism either. As Jordi Sevilla says, very critical of the agreement, “how can we believe that there will not be a referendum in Catalonia?” (https://www.elespanol.com/espana/politica/20240805/jordi-sevilla-carga-pacto-psc-erc-creernos-no-referendum-cataluna/875912880_0.html)
  • Massive incorporation of teachers to MUFACE. The incorporation of almost 36,300 teachers is expected.
  • Abuse of caesarean sections in the private health sector. One in three births in private health care ends in a caesarean section, much more than the WHO considers advisable (15%). In public health, it is performed in 22.4%. The organisation of the centres, the absence of midwives and the characteristics of the patients are some of the reasons given.

Companies

  • International
    • Mergers and acquisitions are booming in the pharmaceutical industry. Largely due to the loss of patents.
  • National
    • Spain, the fourth European market for medicines. Behind Germany, France and Italy.
    • Ribera is committed to sustainability. It reduced its carbon footprint by 13% in 2023.
    • Mapfre, the insufficiency of the premium is taking its toll on health insurance in Spain. Despite having increased turnover in 2024, the results of health insurance are negative (- 1.6 million, in the first two quarters of 2024). This is due to the increase in claims. The measures that are intended to be taken include reviewing rates and coverage, being strict in contracting and seeking maximum operational efficiency. Although it is clear that raising premiums and improving operational efficiency can be part of the solution, there is no solution for quality health insurance in our country without considering the interaction of the private insurance system with the public system (as happens in Germany, Switzerland, Holland and other countries), something that is apparently still taboo in our country.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (October 24th-30th, 2022)

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Summary

From the point of view of Biomedicine, it is worth highlighting the studies that show that certain types of breast cancer, which respond to chemotherapy, will not require surgery. The link between Alzheimer’s and certain viruses is surprising. As for proton therapy, it seems that an increase in its indications (prostate, lung, etc.) is in sight.

As far as Global Health is concerned, the WHO study on a prioritized list of fungal threats should be noted. Cases of resistant tuberculosis, on the rise, which is a big problem with high mortality. Shortage of cholera vaccines. “Nature” magazine considers the possible second term of Bolsonaro in Brazil as a threat to science, democracy, the environment and the world. Said alarm had already been launched by this magazine as a result of his first term.

As for International Health Policy, monkeypox is in clear recession and covid is apparently less serious, possibly due to increased immunity. The truth is that mortality and cases requiring hospitalization are falling. Plan in the United Kingdom so that pharmacies can collaborate in the treatment of minor disorders (hypertension, high cholesterol, etc.)

If we talk about National Health Policy (Spain), a surprising proposal from ASPE to the Ministry of Health for the homologation of foreign doctors through a kind of two-year express MIR. The problem is surely more complex and it should be considered that we are one of the countries with the most doctors per 1,000 inhabitants and the most Faculties of Medicine. To analyze the shortage by areas and specialties, as well as the expansion of nursing work. It is doubtful that exporting quality doctors after an excellent MIR and importing foreign doctors with an express MIR is the solution. Perhaps the salary and working conditions of Spanish doctors should also be considered. Also striking is the new approach of the PSOE in terms of the Trans law, which tries to involve judges in changing sex between 12 and 15 years, compared to the bill approved by the Council of Ministers, which did not contemplate this possibility. AESEG, very willing to increase the use of generics, through regulatory and price changes.

In the field of Companies, at the international level, the extensive job cuts at Philips are striking, after its withdrawal of devices for sleep apnea. As for Spain, Sanitas publishes a study on mental health, which shows that the private health sector is agile in its response to a serious problem, which has become more evident after covid. Orange’s agreement with Mapfre confirms the great interest of telecommunications platforms in the world of health and their need to ally with traditional operators.

Biomedicine

Global Health

International health policy

National health policy

Companies