Posts

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 (December 12th-18th, 2023)

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Summary

From the point of view of Biomedicine, The Lancet commemorates the 200th anniversary of the birth of Pasteur, the creator of the germ theory. Even today a high percentage of deaths are from infections. Promising results of an mRNA vaccine against melanoma, presented by Moderna and Merck.

As far as Global Health is concerned, it is worth highlighting the article published in Nature that says that without a strategy and global financing of vaccines, the world will be unable to successfully face new epidemics.

As for international health policy, the discouraging news of China’s abandonment of the covid-zero policy continues, when the country is not prepared and is most likely to suffer high mortality. The CDC quantifies the deaths from persistent covid in the USA. The conflict of nurses in the NHS continues, which coincides with the appearance of a report from the Institute for Fiscal Studies in the United Kingdom that attributes the problems of the NHS to underfunding of the system. New Zealand, the second country in the world to announce a ban on tobacco sales.

If we talk about national health policy (Spain), in terms of covid, the incidence continues to decrease, what has not completely decreased, or has decreased very slowly, is mortality (236 deaths in the last week). After confinement in a unit of the Regional Ministry of Health, the strike committee of primary care doctors in Madrid decided to continue the strike, extending the conflict to a demonstration, along the lines of the “white tides”.

In the field of companies, internationally, it seems that Jeff Bezos and Bill Gates are making an important bet in the field of neurotechnology with the company Synchron. As far as national news is concerned, perhaps highlighting that it seems that the hopes placed on the Spanish HIPRA vaccine are fading.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

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

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Summary

From the point of view of Biomedicine, an emotional farewell in the New York Times of the “young” (81 years old), Anthony Fauci, who had such a presence in our homes throughout the years of the pandemic. Without a doubt, his scientific contributions are notable, but it is not a minor merit that he has contradicted President Trump on several occasions in the honest exercise of his office, something unusual in our environment. A new type of biomarkers seems to open the doors to the possible diagnosis of different types of cancer at an early stage with a simple blood test.

With regard to Global Health, to highlight the serious problems of diabetes, which continues to grow; and suicide, which is increasing markedly among young Americans, although, as the WHO says, it is in Africa where there are the highest suicide rates in the world.

Regarding International Health Policy, China continues to distance itself from the covid-zero policy, although we will see the increasing consequences of covid mortality. Labor problems continue in the NHS, with several strikes announced. Macron promises free condoms for minors and young people up to 25 years of age. Several initiatives in the field of health of the European Union, which makes health more and more a European Union policy, without prejudice to the fact that the management of national health services is the responsibility of the Member States.

If we talk about National Health Policy (Spain), in terms of covid, the incidence continues to decrease, what has not completely decreased is mortality (314 deaths in the last week). The strikes continue in the Primary Care of Madrid, without it seeming that the negotiations are progressing. The results of the Third Wave (2022) of the Health Barometer appear, which well deserves a careful analysis. Spain is the European Union country that performs the most instrumental deliveries, according to the “European Perinatal Health Report” (2015-2019).

In the field of Companies, at the international level, an important initiative by Pfizer to increase production in Europe, something necessary as seen during the pandemic and the difficulties for Europe to fully depend on production in Asia. Spin off of GE Healthcare from General Electric. Regarding national news, it should be noted that Blackrock increases its stake in Grifols.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (September 26th-October 2nd, 2022)

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Summary

From the point of view of Biomedicine, to review the advances, still to be confirmed, in the treatment of two terrible diseases: ALS and Alzheimer’s.

Regarding Global Health, concerns continue about the evolution of polio, whose eradication was announced in 2019, but which is reappearing in several countries.

Regarding International health policy, it is worth noting the similarities between the covid-zero policy in China and the era of prohibition in the United States, something pointed out by The Economist. Very worrying is the “burnout” of doctors, a phenomenon highlighted by the New York Times in the United States, but which seems to be universal.

If we talk about National health policy (Spain), the debates on the Equity Law continue. The update of the RD on the minimum data set of the SNS leaves out the private sector, despite the opposition of the POP, IMAS Foundation, IDIS Foundation and ASPE. It is a modification of a 2010 RD, but in twelve years the private sector has developed a lot and it is no longer so easy to leave it out in certain decisions. The Senate rejects the PP’s motion to facilitate access to medicines and reduce the time it takes to join the SNS. Surely the motion of the PP was too vague and, at this point, it is necessary to explain very well the “what” and the “how” of any proposal.

At the corporate level, at the international level, big rise in Biogen shares, spurred by what appear to be hopeful results from its Alzheimer’s drug. At the national level, there are rumors that KKR and CVC could be trying to buy Quirónsalud, currently in the hands of the German group Fresenius, which has recently changed its CEO. The Murcian company Vócali develops the Inbox Medical software for transcription of medical reports.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (September 19th-25th, 2022)

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Summary

From the point of view of biomedicine, to review the articles in The Economist on advances in knowledge of the brain, which will have a great impact on the appearance of new drugs and pain therapy.

With regard to Global Health, the WHO report of September 21, which places cancers, cardiovascular conditions and diabetes as responsible for three quarters of global mortality.

In terms of international health policy, an important initiative in France to offer three preventive consultations free of charge by the public system: at 25, 45 and 65 years of age. The EU launches a plan for the elimination of tuberculosis in Europe.

If we talk about national health policy (Spain), great debate around the Equity Law. What should have been just a law to correct the access deficiencies of the Montón Law, is being flamboyantly called “Equity” (as if accessibility guaranteed equity, not having a single provision to improve equity), and It is used to introduce the aspirations of Unidas Podemos to annul Law 15/97, approved almost unanimously at the time. The IDIS Foundation has warned of the damage to assistance and, specifically, the waiting lists, if some precepts of the Law are approved. It seems that the Catalan consortiums are going to respect each other, which is important, but it is also important to preserve and reinforce public/private concerts throughout the national territory.

At the corporate level, from an international point of view, the shares of the large vaccine manufacturers (especially Moderna, BioNTech and Novavax) plummeted, as a result of President Biden’s announcement that “the pandemic has been feared”. In Spain, it should be noted that Moderna will install its first quality laboratory outside the United States in Madrid.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

7 days in healthcare (August 21st-28th, 2022)

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Summary

From the point of view of biomedicine, the very encouraging results of the polypill published by a Spanish group led by Valentin Fuster should be highlighted. The Economist underlines the great future of gene therapies in medicine, with a list of diseases for which there is a therapy or is in advanced study.

Regarding Global Health, The Lancet publishes a report with some conclusions and lessons regarding future pandemics.

As for International Health Policy, both monkeypox and covid are plummeting in Europe. The controversial annulment of the Roe v Wade ruling in the United States, which leaves the right to abortion to the criteria and regulation of the states, continues to be talked about. American companies, including Walmart, the largest American employer, introduce this benefit for women, regardless of the state where they work.

If we talk about National Health Policy (Spain), covid continues to drop and especially the number of cases in the ICU. The Government approves the bill that creates the Public Health Agency, probably the largest, if not the only, far-reaching measure after the pandemic. The text of the law is not yet public, and therefore important aspects such as governance and functions are not known. The location is not known either, although the Government has advanced that it would not be in Madrid, which is not without controversy either. Next week the government will approve the abortion law, according to a text promoted by Podemos.

In the field of companies, Moderna’s lawsuit against Pfizer and BioNTech has been shocked, which it accuses of plagiarism of its mRNA technology in the covid vaccine. Amazon closes its telecare service, which once again demonstrates the difficulties of the large technology platforms in finding an adequate strategy for health, a sector in which they want to be above all else. In Spain, the export of drugs manufactured in Spain grows by 60% in one year.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

 

7 days in healthcare (25th-31st July, 2022)

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Summary

From the point of view of biomedicine, it should be noted that the origin of acute childhood hepatitis has been discovered, it turns out to be due to a co-infection of two viruses, ruling out covid as the cause of this disease. Major advances by a group of Yale scientists in the treatment of brain tumors, specifically aggressive glioblastoma multiforme, using molecules that attack tumor DNA. Deep Mind (a company of the Alphabet group, parent of Google) launches an algorithm capable of identifying the structure of proteins. It seems that this advance may be of great importance for the discovery of new drugs.

As far as Global Health is concerned, air pollution is a public health emergency, according to the British Medical Journal. The WHO reaches an agreement on a treaty on pandemics, which should be agreed in May-2024.

Regarding international health policy, mention should be made of the declaration by the WHO of monkeypox as a global public health emergency, which is justified by the existence of more than 17,300 cases in more than 70 countries. It seems that it is confirmed that covid-19 originated in the live animal market in Wuhan (China).

If we talk about national health policy (Spain), two deaths in Spain as a result of monkeypox (in both cases due to encephalitis). At the present time there is only one other case of death from this disease in Brazil. The incidence of covid-19 drops very significantly, moving us away from the peak of the seventh wave.

In the field of companies, it should be noted that Fujijilm is going to be transformed into a health company. Teladoc’s notable financial losses. Vivalto Santé, an important French group, acquires the property of Ribera through the sale of Centene Corporation.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (June 20th-26th, 2022)

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Summary

From the point of view of biomedicine, to highlight the article in The Lancet that shows that the covid vaccine has saved 20 million lives in the first year of its use.

As far as Global Health is concerned, it is confirmed that covid 19 may be wreaking havoc in North Korea.

Regarding international health policy, it should be noted that the WHO has decided not to declare monkeypox an international health emergency. Strong rise in the incidence of COVID throughout Europe. Controversial annulment in the United States of the Roe v Wade ruling that declared abortion a constitutional right. Now abortion will have to be regulated by the States. Serious public health problems are expected, as in the pre-Roe v Wade era, although mitigated by the widespread use of the abortion pill, which can even be purchased online. For the first time in the history of the United States, an agreement is reached to limit, albeit in a very limited way, the use of weapons, with President Biden having signed a law in this regard. Instead, the Constitutional Court declared illegal any limitation on the display of weapons in public, as some States had legislated. More Americans are dying from drug overdoses than ever before. The European Medicines Agency approves the Valneva covid vaccine, the sixth covid vaccine approved in Europe (after Pfizer-BioNTech, Moderna, AstraZeneca, J&J and Novavax).

If we talk about national health policy (Spain), we are witnessing a growth in the incidence of covid, some speak of a seventh wave. Published in the Official Bulletin of the Congress of Deputies the project of equity law. Important statement from the Consorci Sanitari de Catalunya saying that more than the management model, we must focus on quality and results. The National Market and Competition Commission (CNMC) publishes a report on wholesale pharmaceutical distribution, which is considered a boost to the use of generics and biosimilars.

In the field of companies, it should be noted that Alphabet (Google’s parent company) is making a strong investment to become a powerhouse in health. Its fields of action will be: wearables, clinical records, artificial intelligence applied to health and extension of human longevity. The medical marijuana business is making its way.

Biomedicine

Global health

International health policy

National health policy

Companies

 

7 days in healthcare (June 13th-20th, 2022)

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Summary

From the point of view of biomedicine, to highlight the new therapy against a disease as terrible as ALS tested in Canada. Unfortunately there are doubts as to its effectiveness.

As far as Global Health is concerned, it is verified that it is the vaccine nationalism of the States that has led to the failure of COVAX, which failed to extend covid vaccination to poor countries in significant percentages.

Regarding international health policy, the approval in the United States of the covid vaccination for children under five years of age should be highlighted. Also the agreement of the World Trade Organization regarding the temporary suspension of patents on covid vaccines, something he was discussing for two years. We will see if this agreement translates into relevant measures. For now, the IFPMA (World Association of Pharmaceutical Manufacturers) has already spoken out against it. Hospitalizations for covid increase in Europe, specifically in France, Germany and the United Kingdom.

If we talk about national health policy (Spain), we must mention the controversial announcement by the Minister of Health of the fourth dose of covid for the entire population, something partially rectified by the Ministry itself and which has been rejected by many experts. Also the approval by the Government of the preliminary draft of the Equity Law. Great controversy with the private sector, since it tries to minimize and declare exceptional the collaboration of the private sector in the public service of the National Health System. But by declaring “direct management” as preferable in the SNS, it also positions itself against the more entrepreneurial development of public management, despite the fact that the benefits of legal personality and the labor regime are known in terms of greater efficiency than direct management. On the other hand, the draft may undermine the powers of the autonomous communities, since health management (and therefore the way of carrying it out) is a transferred matter. It is not surprising that very important Catalan institutions (such as UCH, CSC, ACES and Círculo de Sanidad) have taken a position against it. Important demonstration by nurses in the center of Madrid, highlighting the importance of the abandoned professional policy in the National System of Health.

In the field of companies, it is worth noting the birth of the largest pediatric oncology center in Spain and one of the largest in Europe: the one located in the Sant Joan de Deu Hospital in Barcelona. Expansión highlights that the remarkable growth of health insurance is compatible with a loss of its operating profitability.

Biomedicine

Global health

International health policy

National health policy

• Monkeypox

• COVID

• Regulatory announcements

• Other themes

Companies

7 days in healthcare (April 4-10, 2022)

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SUMMARY

From the point of view of biomedicine, it is worth highlighting the fact, highlighted by the journal Nature, that the WHO took more than two years to recognize the airborne transmission of covid. A new generation of vaccines that prevent cancer can make tumors disappear before they appear, according to an article in Science. The natural experiment from South Korea and Hong Kong shows that the “omicron” variant can be fatal in unvaccinated people.

As far as Global Health is concerned, the situation in Ukraine gives us difficult lessons in global health, explains the editor of The Lancet. It should be noted that the black American population already exceeds the white population in mortality from opioids. Until now, deaths from this cause occurred mainly in “non-colleged educated” whites.

Regarding international health policy, the European health agencies (EMA and ECDC) say that it is too early for the second “booster” of the covid vaccine. Ten years of “Choosing Wisely” the revolution in medical practice that tries to minimize worthless or low value health interventions.

If we talk about national health policy (Spain), the appearance of the 2022 Health Barometer (First wave) is important. It should be noted that waiting lists are the main concern of the population; the delay in a high percentage of cases to see a primary care physician; and that the positive perception of the public system decreases, while that of the private system increases. Report on health professionals, which says that within five years there will be a shortage of 9,000 doctors.

In the field of companies, from the international point of view, Moderna’s agreement with the non-profit entity IAVI to apply mRNA technology to various diseases should be highlighted. SpainCares confirms that Spain is not in an advantageous position with regard to health tourism.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

  • COVID

o The United States donates more than 100 million doses of covid vaccine for children (https://www.ft.com/content/3e5f9359-67a5-4f24-971e-51761119899b)

o Shanghai residents beg for food and medicine as authorities lock down the city (https://www.ft.com/content/3e439a10-860b-4ae6-9070-ad8546da8850)

o Olaf Scholz, German Chancellor, fails in Parliament with his plan to make the vaccine mandatory (https://www.ft.com/content/7d0610bf-3cf9-4edd-a392-e9d97dc9fade)

o COVID deaths rise in the UK, with infections at record highs (https://www.theguardian.com/world/2022/apr/05/covid-related-deaths-rise-england-infections-record-high )

o The European health agencies (EMA and ECDC) say that it is too early for the second covid vaccine “booster” (https://www.nytimes.com/2022/04/06/world/europe/covid-second- booster-europe.html)

  • Other themes

o Ten years of “Choosing Wisely”, which revolutionized medical practice based on recommendations of “do not do”, to reduce low-value health care (https://www.nejm.org/doi/full/10.1056/ NEJMp2200422)

o Life expectancy in the US continues to decline in 2021, despite covid vaccines (https://www.washingtonpost.com/health/2022/04/07/life-expectancy-covid/)

o Oklahoma passes one of the toughest anti-abortion laws in the US, following a Republican strategy (https://www.ft.com/content/cee6a170-fa23-47cb-b554-d457d68f225b)

o Important report by the Nuffield Trust on the recovery of health systems after covid, analyzing the situation in several countries (https://www.nuffieldtrust.org.uk/research/health-system-recovery-from-covid-19- international-lessons-for-the-nhs)

o Great impact in the United Kingdom of the Ockenden Report, on maternity care, with the detection of serious problems, published by the British Government (https://www.gov.uk/government/publications/final-report-of- the-ockenden-review/ockenden-review-summary-of-findings-conclusions-and-essential-actions)

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o Decrease in the incidence of covid: up to 420.17 cases per 100,000 inhabitants over 60 years of age, according to the new measurement method (https://www.redaccionmedica.com/directo/coronavirus-ultimas-noticias/20220410)

o The mask will no longer be mandatory indoors on April 20 (https://www.elmundo.es/ciencia-y-salud/salud/2022/04/06/624d770121efa0ed708b45bb.html)

o COVID only worries 30% of Spaniards, according to the COSMO Spain study, coordinated by the Carlos III Health Institute (https://www.actasanitaria.com/salud-mental/covid-19-solo-pretrabajo-30 -spanish-two-years-pandemic_2002232_102.html)

  • Other themes

o The 2022 Health Barometer (First wave) appears (https://datos.cis.es/pdf/Es3357mar_A.pdf). Some data of interest: the waiting lists, the worst valued by the Spanish (https://www.lavanguardia.com/vida/20220407/8184215/listas-espera-peor-valorado-espanoles-barometro-sanitario-2022.html ); 55% of patients take more than 7 days to get an appointment with their family doctor (https://www.lavanguardia.com/vida/20220408/8185940/55-pacientes-tarda-mas-7-dias-conseguir- family-doctor-appointment.html); lowers the positive perception of the public system and increases that of the private (https://www.diariofarma.com/2022/04/07/cis-baja-la-percepcion-positiva-del-sistema-publico-y-aumenta-la-de-la-privada)

o Within five years there will be a shortage of almost 9,000 doctors (https://www.lavanguardia.com/vida/20220404/8174200/cinco-anos-faltaran-9000-medicos.html), according to the report “Supply-need for medical specialists 2021- 2035”, prepared by Patricia Barber and Beatriz González López-Valcárcel (https://cgcom.es/sites/default/files//u395/2022informeofertanecesidadespecialistasmedicos2021_2035.pdf)

o “Case of masks” a loot of 2,000 million for the purchase of material during the state of alarm (https://elpais.com/espana/2022-04-10/caso-mascarillas-un-botin-de-2000-millones -in-the-law-of-the-jungle.html)

o WAIT Report: Spain falls in time for access to new medicines (https://www.diariofarma.com/2022/04/06/espana-ha-autorizado-el-53-de-los-farmacos-aprobados -in-europe-between-2017-y-2020), to see the WAIT report: https://www.efpia.eu/media/602652/efpia-patient-wait-indicator-final-250521.pdf

o Published the “Report on the initial budgets of the Public Administrations” (AIREF, April 7, 2022) (https://www.airef.es/wp-content/uploads/2021/04/PRESUPUESTOS-INICIALES/Informe-Ptos -initials-2021-.pdf)

o Spain leads the world consumption of benzodiazepines (https://www.elperiodico.com/es/sociedad/20220402/espana-lidera-consumo-mundial-benzodiazepinas-13438583)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

  • International News

o Moderna reaches an agreement with IAVI (non-profit association) to apply mRNA to various diseases (https://www.plantadoce.com/empresa/moderna-llega-a-un-acuerdo-con-iavi-para-aplicar -mRNA-for-various-diseases.html)

o Pfizer buys the British biotech company ReViral for 481 million euros (https://www.expansion.com/empresas/industria/2022/04/08/624fd580468aebc31f8b46bb.html)

  • National News

o David Medina (Spaincares): “In the tourism-health binomial, we are not in the top ranking” (https://www.plantadoce.com/adn/david-medina-spaincares-en-el-binomio-turismo-salud -we-are-not-at-the-top-of-the-ranking.html)

o Savana closes a round of 23 million euros, hand in hand with Conexo Ventures (https://www.plantadoce.com/empresa/savana-cierra-una-ronda-de-23-millones-de-euros-de- the-hand-of-connected-ventures.html)

o Sanitas shoots up sales of health insurance by 47%, with 377,000 new policies (https://cincodias.elpais.com/cincodias/2022/04/07/companias/1649322015_528839.html)

o PharmaMar and CNIO allocate 1.2 million euros to testing breast cancer drugs (https://www.plantadoce.com/empresa/pharma-mar-y-el-cnio-destinan-12-millones-de- euros-to-test-drugs-against-breast-cancer.html)

o Miranza underpins its expansion, reaching 80.6 million euros (https://www.plantadoce.com/empresa/miranza-apuntala-su-expansion-tras-incrementar-sus-ventas-un-35-hasta-806 -millions-of-euros.html)

o Farmasierra celebrates its 25th anniversary, reinforcing R&D (https://www.diariomedico.com/farmacia/industria/empresas/farmasierra-celebra-su-25-aniversario-advancing-towards-a-model-industria-40. html)

o Pfizer will export gene therapies from Spain to America (https://www.eleconomista.es/salud/noticias/11706685/04/22/Pfizer-exportara-a-America-terapias-genicas-desde-Espana.html)