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

• Scientists reprogram microbes in the search for new materials. It is done by applying genetic engineering to microbes, to develop a wide range of new products, from medicines to detergents or plastics (https://www.ft.com/content/19989e64-6f52-49ff-bcb6-124c7e41ca7f)
• Genome sequencing could promote new cancer treatments. The expansion of genomic sequencing of tumors demonstrates that some cancers have a genetic profile, which can guide therapeutic decisions. Works of the British public company Genomics England (https://www.ft.com/content/e5981f66-784e-46b8-b75e-05117f9c956e)
• Optimism in schizophrenia? There is a need for new medications for schizophrenia, the burden of the disease is high and the therapeutic arsenal is scarce. The Lancet publishes phase III results of a new drug, which significantly reduces psychotic symptoms in people with schizophrenia (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00047-3/fulltext)
• The future of a global ecosystem for clinical trials. The First WHO Forum on Clinical Trials was held in Switzerland (November 20-21, 2023), establishing the criteria for the global reinforcement of clinical trials, whose intensive use from the second half of the 20th century was one of the major advances in medicine (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02798-8/fulltext)
• Doctors as interpreters of diseases. Necessary reinforcement of the role of doctors as “interpreters of diseases” (https://www.bmj.com/content/384/bmj.q49)

Global Health

• To prepare for the next pandemic we must invest in tuberculosis and other major diseases, such as HIV, malaria, etc. (https://www.healthaffairs.org/content/forefront/prepare-next-pandemic-we-must-spend-now-tb-and-other-major-diseases)
• The WHO warns that a new pandemic will arrive and will be deadlier (https://www.elmundo.es/ciencia-y-salud/salud/2023/05/23/646c6b42e4d4d8ff7c8b45d2.html)

International health policy

• USA
  • The growth in healthcare spending in the USA in 2022 reached pre-pandemic levels. They rose 4.1%, higher than the 3.2% in 2021, but much lower than the 10.6% in 2020 (https://www.healthaffairs.org/doi/10.1377/hlthaff.2023.01360)
  • The “financialization” of health in the United States. “Financialization” is a different concept from “corporatization” (the growing role of large organizations in healthcare) or “privatization” (the increasing role of the private sector), but rather it speaks of the increasing role of financial entities and companies. of private equity in healthcare, with an increasing number of companies acquired directly by financial actors, especially pharmaceutical companies and insurance companies (https://www.nejm.org/doi/pdf/10.1056/NEJMms2308188)
  • Federal scientists recommend relaxing restrictions on marijuana because it can have medical uses and causes less harm than other drugs, such as heroin (https://www.nytimes.com/2024/01/12/health/marijuana-fda-dea.html#:~:text=1k-,Federal%20Scientists%20Recommend%20Easing%20Restrictions%20on%20Marijuana,harm%20than%20drugs%20like%20heroin.&text=Sign%20up%20for%20Your%20Places%3A %20Extreme%20Weather.)
  • The FDA approves 48.6% more drugs in 2023. 55 new drugs were approved in 2023, of which 28 were related to rare diseases (https://www.plantadoce.com/entorno/la-fda-aprob-486-more-drugs-in-2023#:~:text=The%20Administration%20of%20Food%20and%20Drugs%20of%20United States%20(FDA,New%20Drug%20Therapy%20Approvals% 202023.)

• United Kingdom and the National Health Service
  • Vaccination appointments can be obtained through an NHS app, which is established after detecting a drop in the vaccination rate in children in England (https://www.bmj.com/content/383/bmj.p2945)
  • The British health system resembles that of the 1930s, when Aneurin Bevan promoted the NHS and health care was offered by a group of private and charitable institutions. Some facts: private hospitals receive 1/3 of their income from the NHS; Since Covid, more hip replacements have been fitted in private hospitals than in the NHS; more patients pay for services directly, to avoid waiting lists; private insurance is increasingly seen as an important non-wage benefit by employees; Generation Z (between 18 and 24 years old), the one that makes the most use of the private system (https://www.economist.com/britain/2024/01/08/britains-health-care-system-looks-rather-as-it-did-in-the-1930s)
  • Challenges and changes that await the NHS in 2024 (https://www.kingsfund.org.uk/blog/2024/01/challenge-change-what-does-2024-hold-for-the-health-care-system )
  • NHS tensions are behind the growth of private insurance in the UK (https://www.ft.com/content/611fbbb5-9f68-40b0-b8b9-3992a04d2c8c)
  • Health inequalities caused 1 million premature deaths in England in the last decade, due to the combined effect of poverty, austerity and covid, according to the Institute of Health Equity (https://www.theguardian.com/inequality/2024/jan/08/england-deaths-inequality-poverty-austerity-covid-study-public-health#:~:text=Health%20inequalities%20%27caused%201m%20early%20deaths%20in%20England%20in%20last%20decade %27,-Exclusive%3A%20Review%20by&tex)

• France
  • Law on the end of life: the concern is to avoid semi-measures, which do not satisfy anyone (https://www.lemonde.fr/idees/article/2024/01/11/loi-sur-la-fin -de-vie-l-enjeu-est-d-eviter-une-demi-mesure-qui-laisserait-a-tous-un-gout-d-inacheve_6210208_3232.html#:~:text=L%27enjeu%2C% 20pour%20l%27,la%20«%20peur%20des%20dérives%20».)

• Brazil
  • Brazil warns that dengue may affect 5 million people as extreme weather arrives (https://www.ft.com/content/2f3b9b80-7b9a-42d4-bf7f-ea8492a8da24)

• India
  • India modifies the regulation for the production of pharmaceutical products (https://www.plantadoce.com/entorno/india-modifica-las-medidas-de-regulation-para-la-fabricacion-de-los-productos-farma)

• European Union
  • The EU will create a European vaccine development center, within HERA, the body for the prevention of health disasters, created as a result of the covid pandemic (https://www.consalud.es/politica/agencia-emergencias-health-eu-create-central-european-development-vaccines_138751_102.html)
  • Europe launches into deciphering the brain with a boost to digital neuroscience (https://elpais.com/salud-y-bienestar/2024-01-09/europa-se-lanza-a-descifrar-el-cerebro-with-a-new-impulse-to-digital-neuroscience.html)

National health policy

• Tripledemic (influenza A, covid-19 and RSV)
  • The Ministry of Health proposes a three-day autobaja to avoid saturation of health centers (https://www.eldiario.es/sociedad/sanidad-propone-autobaja-tres-dias-evitar-saturacion-centros-salud_1_10818742.html)
  • The implementation of autobajas is delayed for more studies, after misgivings from employers, unions and the government itself (https://www.elespanol.com/invertia/observatorios/sanidad/20240109/division-gobierno-autobajas-medicas-proposals-monica-garcia-cases-epidemia/823417980_0.html)
  • The Ministry of Health will impose the mandatory mask in hospitals and health centers (https://elpais.com/sociedad/2024-01-08/sanidad-estudia-implantar-la-autodeclaracion-responsable-de-las-bajas-the-first-three-days-to-unclog-the-primary.html)
  • Monserrat says that Spain is late to the measures due to the tripledemic after the EU alarm in December (https://gacetamedica.com/politica/montserrat-denuncia-que-espana-llega-tarde-a-la-respuesta-to-the-tripledemic-after-the-eu-notice-in-December/)
  • The flu epidemic is beginning to subside, but tension is growing in hospitals (https://elpais.com/sociedad/2024-01-11/la-epidemia-de-gripe-comienza-a-bajar-pero-crece-tension-in-hospitals.html)

• Pharmaceutical expense
  • The PP increases pharmaceutical spending in Andalusia by 29% in five years, up to 2.5 billion a year. The average growth of the communities was 20% (https://elpais.com/espana/2024-01-10/el-pp-dispara-el-gasto-farmaceutico-en-andalucia-un-30-hasta-the-2500-million-per-year.html#)
  • The Department of Health of Catalonia seeks to reduce pharmaceutical spending that exceeds 3,000 million. The Catalan government claims nothing less than the powers of the Interministerial Price Commission, to directly negotiate prices with the laboratories (https://www.lavanguardia.com/vida/20240113/9495879/salut-busca-bajar-gasto-farmaceutico-exceeds-3-000-millions.html)

• Public spending on health in Spain
  • The Administrations promote public spending on health in 2023 that is close to 89,000 million euros. Compared to 2019 (before the outbreak of the pandemic), spending has grown by 29%, in absolute terms close to 20 billion euros (https://www.plantadoce.com/publico/las-administraciones-propulsan-en-2023-public-spending-on-health-that-closes-to-89000-million#:~:text=In%202023%2C%20the%20budgeted%20spending,previous%20year%2C%20the%20ninth%20consecutive.)

• Public pharmaceutical company
  • Agustín Santos (president of the Congressional Health Commission, of Sumar) defends a public pharmaceutical industry (https://www.consalud.es/politica/agustin-santos-defiende-imperiosa-necesida-farmaceutica-publica_138689_102.html)

• Human Resources
  • The unions demand that the Ministry rethink the human resources policy in the SNS (https://diariofarma.com/2024/01/11/los-sindicatos-demandan-a-monica-garcia-un-replanteamiento-de-los-rr-hh-del-sns)

• Medical transport
  • The tender for Catalan ambulances underway, for 2,000 million. The tender will go out in 2024, with the idea of starting service in 2025. There are clauses to favor multiple successful bidders (https://www.expansion.com/catalunya/2024/01/07/659b0754e5fdea66358b462a.html#)

• Common insurance-hospital protocol
  • ASPE (the health care employer association), launches the initiative for a common protocol between insurers and hospitals by 2024 (https://www.redaccionmedica.com/secciones/privada/protocolo-comun-hospitales-aseguradoras-para-una-complete-collaboration–8649)

Companies

• International News
  • PYC Therapeutics partners with Google to develop precision medicine supported by AI (https://www.plantadoce.com/empresa/pyc-therapeutics-se-alia-con-google-para-desarrollar-medicina-de-precision- with-the-help-of-AI#:~:text=PlantaTwelve-,PYC%20Therapeutics%20parties%20with%20Google%20to%20develop%20medicine%20of,%20ten%20million%20)
  • MSD acquires the Harpoon Therapeutics laboratory (https://www.consalud.es/salud35/internacional/msd-adquiere-harpoon-therapeutics-por-620-millones_138699_102.html)
  • Goldman Sachs debuts in health with a fund of 650 million dollars (https://www.plantadoce.com/empresa/goldman-sachs-se-estrena-en-salud-con-un-fondo-de-650- millions of dollars)
  • The Ambrx Biopharma laboratory soars on the stock market after being bought by J&J (https://www.elconfidencial.com/mercados/2024-01-08/el-laboratorio-ambrx-biopharma-se-dispara-un-100_3807362/)
  • Juan Carlos Gil (CEO of Moderna in Spain) says that the company plans to launch 15 vaccines in the next five years (https://www.larazon.es/salud/juan-carlos-gil-proximos-cinco-anos-we-planned-to-launch-15-vaccines_20240111659d3c7567d53e0001dae8ab.html)

• National
  • Grifols’ tragic week in which it 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 (https://www.elindependiente.com/economia/2024/01/13/semana-tragica-grifols-perdido-millones-cinco-dias/#:~:text=The%20catalana%20pharmaceutical%20has%20fallen,almost%2020%20million%20of%20euros.)
  • Creu Blanca announces the opening of a new hospital in Mataró. Creu Blanca has been in prevention for more than seventy years and has four centers in Catalonia and two in Aragon (https://www.plantadoce.com/empresa/creu-blanca-anuncia-la-apertura-de-su-nuevo-hospital-en-mataro#:~:text=Creu%20Blanca%20expands%20her%20footprint,next%20Monday%2015%20of%20January.)
  • Ribera acquires the Fouz clinic in Viveiro (https://www.lavozdegalicia.es/noticia/amarina/viveiro/2024/01/13/grupo-ribera-dueno-hospital-polusa-adquiere-clinica-fouz-viveiro-dota-servicios/00031705151582716115540.htm#:~:text=The%20centro%20medical%20liveirense%20willpass,through%20de%20sus%20networks%20soc)