Posts

7 days in healthcare (March 4th-11th, 2024)

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Summary

From the point of view of Biomedicine, the possibility of making replicas of fetal organs stands out, which could facilitate fetal treatments without putting the pregnancy at risk. The Lancet publishes an editorial and several articles on menopause, a natural state in the aging process of women, often overmedicalized. FDA delays approval of Lilly’s long-awaited Alzheimer’s drug.

As far as Global Health is concerned, there was a shortage of cholera vaccines, at a time with many outbreaks, even in countries where it had been eradicated. Great absolute growth in the global figures of the scourge of genital mutilation in women, especially in Africa, but also in Asia and the Middle East. First published evidence that nanoplastics harm human health. Big problem with the lack of health professionals in Africa, which is proposed to be compensated as a quick solution with community health workers.

Regarding International Health Policy, in the United States President Biden gave his fourth and final State of the Union address. Surprising was a particularly energetic and mentally agile Biden, who maintained the interest of a vibrant speech during its more than 60-minute duration, even interacting with the Republican seats. Much of his speech was dedicated to health, undoubtedly a star issue in the next elections: the price of medicines; women’s reproductive rights, abortion and in vitro fertilization; the extension of Obamacare, a law he defended, during his term; and care for the elderly, both at home and in nursing homes, were the topics discussed. In France, President Macron has decided to make abortion a constitutional right, surprising the enormous support obtained on the right and left in the National Assembly: 780 votes in favor compared to only 72 against.

If we talk about National Health Policy (Spain), In its “Declaration of Córdoba” the Popular Party presents 4 proposals regarding health. The rural environment is left without doctors, according to the Spanish Society of Family and Community Medicine, saying that of the 11,000 rural doctors, half will retire in the next 5 years and it does not seem easy the arrival of new doctors. A specific health problem of one of the great gaps in our country: that of the rural-urban world. The Minister of Health makes two big promises: the decarbonization of the health system and the creation of an observatory on corruption in health (in response to problems with the purchases of masks and equipment during covid). Interesting, but we will have to see if these promises become realities. The PP will bring the ELA law to Congress.

As for Companies, at the international level, it is increasingly clear that the Novo Nordisk-Lilly duopoly in addressing obesity will be broken, giving way to other agents, given the large number of clinical trials on the subject. According to IQVIA, pharmaceutical companies will lose 6 billion a year until 2028 due to the expiration of many patents, converting many of these medications to generics and biosimilars. This loss will try to be compensated with the launch of new drugs, since it is estimated that between 2024 and 2028 there will be 175 new launches, especially in the field of oncology and neurology. Regarding national news, Grifols has revalued on the Stock Market, after the publication of its audited accounts without qualifications. Loss of 600 million of the insurance companies that operate in MUFACE (Adeslas, Asisa and DKV) during the period of validity of the current three-year agreement. It is evident that public/private collaboration is unviable if it condemns the participating companies to losses without any prospects.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (February 19th-25th, 2024)

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Summary

From the point of view of Biomedicine, the mega-study of 250,000 genomes made public by the National Health Institutes of the USA stands out. This is in line with carrying out genome studies combining it with electronic medical record data from very large groups initiated in the United Kingdom by Genomics England and also developed in Iceland and Japan. A very promising way to improve knowledge of many diseases. New treatments for type 1 diabetes, based on the transplant of insulin-producing beta cells, obtained from stem cells, neutralizing the immune reaction. Gene therapy is the great promise for many rare diseases, currently without treatment. The problem to be solved is the high price of the treatments. At the present time, saying breast or prostate cancer is almost saying nothing. The treatment of tumors is no longer based on their anatomical origin, but rather on their molecular characterization. Bispecific antibodies that act on two targets at the same time, useful in hematological and solid tumors. The FDA approves a drug to prevent the amputation of fingers and limbs.

As far as Global Health is concerned, long covid was understood as a sequel to covid, but an article in The Economist states that covid is not the only infectious disease that leaves pathological conditions that are difficult to label. An article in Health Affairs places the solution to the obesity epidemic as a joint effort of prevention and treatment.

In terms of International Health Policy, more than half of USA’s rural hospitals do not offer childbirth services, which means that pregnant women have to be treated in centers located 30-40 minutes from their home, sometimes more. This is related to the high maternal and infant mortality in the USA, higher than that of most developed countries. The 4th anniversary of Brexit encourages the debate about whether it was good or bad for the National Health Service. The truth is that the NHS is worse now than before Brexit (waiting lists, professional strikes, etc.) and the difficulty of recruiting health professionals from the EU has increased. The investigation was also damaged. Increasing funding for the NHS was one of the arguments used by Brexiteers. France addresses the carbon footprint in the health system, within the general “France Nation Verte” program. Germany legalizes recreational cannabis, with one of the most liberal laws in Europe, after Malta and Luxembourg. More than controversial attempt in Germany to take control of non-communicable diseases from the Robert Koch Institute, one of the most prestigious organizations in German health, to give it to another organization, created as a result of covid. The European Medicines Agency recommends approving a drug against ALS.

If we talk about National Health Policy (Spain), as a result of a specific scandal, the entire problem of purchasing masks and other materials during covid is introduced into the national debate. Precisely everything related to the purchase of these materials was somewhat overlooked by the report “Evaluation of the Performance of the Spanish National Health System in the face of the covid-19 pandemic”, dated April 30, 2023, although published by the Ministry of Health in December of that year. It is already serious that an issue such as the problems of purchasing materials are not analyzed in the report, as if this had not been one of the most serious problems in the management of covid. The PNV requests the return of the text of the Public Health Agency law. That this law was going to have problems with the nationalist parties, always opposed to the creation of cohesion bodies in the National Health System, was something known. Surely this will mean delays in the appearance of the law and, what may be more serious, affect its content and functions. There is a risk that the announced Agency will be little more than an empty shell. The government creates the Extreme Temperature Observatory to analyze the health impact of climate change. The Basque Country approves a new Mental Health Plan 2023-2028. The EU denounces the high level of interim contracts in the Spanish public health system. At the current time, 43% of contracts are interim.

As for Companies, internationally, AstraZeneca reveals successes in the treatment of lung cancer. Indian drugmakers make versions of Novo Nordisk’s anti-obesity drug. At the national level, Sanitas intends to open a new hospital in Barcelona. Fever of construction of private hospitals in Valencia: Vithas, Quirón, IMED and Ascires in that race.

Biomedicine

Global Health

International health policy

  • United Kingdom and the National Health Service
    • Brexit and health. January 31, 2024 was celebrated as the 4th anniversary of the United Kingdom’s effective departure from the European Union. The Lancet asks whether or not that was good for the NHS, with two possible answers: the easy one, which says there is no evidence; and the difficult one, which confirms that the NHS is in fact worse now than before, as demonstrated by the long waiting lists and the continuous strikes by health professionals. What is certain is that it has become difficult to recruit doctors from the EU. At present, the majority of foreign doctors hired in the NHS are from outside the EU. Research plans were also negatively altered. (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00157-0/abstract)
    • The government changes its policy and plans to double the number of medical students in 2031 (https://ground.news/article/government-u-turn-on-plans-to-double-number-of-medical-students-in-england)

National health policy

Companies

7 days in healthcare (January 29th-February 4th, 2024)

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Summary

From the point of view of Biomedicine, the use of gene therapy based on CRISPR for the treatment of hereditary angioedema should be highlighted. Great debate regarding Elon Musk’s brain chip, in general the scientific community has expressed serious reservations about this initiative. Beginning of the first trials with mRNA-based therapy in cancers of different types in the United Kingdom.

As far as Global Health is concerned, the beginning of routine malaria vaccination can without exaggeration be considered a historic event, given the high mortality of this disease in children in Africa. The WHO warns about the prospects for great growth in cancer globally and the notable differences in its prognosis, especially in breast and cervical cancer.

In terms of International Health Policy, the NHS England initiative is especially interesting, allowing pharmacies to prescribe certain medications and carry out some care practices, which is expected to result in a decrease of 10 million primary care consultations. The results of this experience deserve to be followed, since it could be part of the solution to Primary Care also in Spain. EU document on cancer in Europe, highlighting inequities in its approach.

If we talk about National Health Policy (Spain), it is worth continuing to comment on the intervention of the Minister of Health in the Health Commission of Congress. Although now it seems that nothing is important, the truth is that this intervention is one of the most relevant of any minister who reaches her position. The intervention has some lights and many shadows. Lights: recovery of a certain will for strategic direction of the SNS and decision to address the great problem of waiting lists (this is notable, since it contrasts with other ministers, who used to rather assume that everything was transferred and , therefore, the role of the Ministry was minimal). Shadows: very negative, offensive and unacceptable mentions of private healthcare, with arguments and quotes that are intellectually inconsistent and lacking rigor; staunch defense of direct public management, compared to other forms of public management; Public Health Agency, apart from doubts about its real content (no one hides the fact that the Agency does not make the influential nationalist parties very happy), the Ministry of Health gets out of the way to decide the location, handing over the baton to the Ministry of Territorial Policy and Democratic Memory, as if it were not also a health decision; Framework Statute, where are the negotiations with professionals?; medicines, no mention of the Strategic Plan of the pharmaceutical industry (in which the President of the Government himself had committed himself); Oral health, where is the economic memory? What care model will be followed? Is the inclusion of glasses in public provision, given the financial strains of the system, a reasonable priority? Is there prior consensus with other agents on this measure? In another order of things, in the Valencian Community the reversion to the public sector of the Denia concession has been completed and that of Manises will soon be granted, something to which the Administration has every right, once the concession contract has ended. The mentions of the concept of “expropriation”, used by some concessionaire company, are extemporaneous. Now, the official press release from the Ministry announces a very notable increase in staff in that hospital in Denia. Logically, uncontrolled growth in health spending, if it is not justified, cannot be the public alternative to concessions. Notable growth in the price of health insurance premiums in Spain, although its price must probably continue to be low, compared to other European countries. Something to analyze.

As for Companies, on an international level, Novo Nordisk was surprised by the great demand in Europe for medicines against obesity. In terms of national news, the pharmaceutical distributor HEFAME has experienced great growth in recent years and is considering expanding throughout Spain. At Grifols, the board is considering excluding the family from the company’s strategic decisions.

Biomedicine

Global Health

International health policy

  • European Union
    • Document on inequalities in the EU regarding cancer: “Beating cancer inequalities in the EU” Emphasis on prevention and early detection (https://www.oecd.org/health/beating-cancer-inequalities-in-the-eu -14fdc89a-en.htm)
    • The EU fined the pharmaceutical industry 780 million for anti-competitive practices between 2018 and 2022 (https://www.elespanol.com/invertia/observatorios/sanidad/20240130/ue-multo-millones-industria-farmaceutica-practicas-anticompetitivas /828667294_0.html#:~:text=The%20European%20Commission%20investigated%20one, euros%20for%20the%20laboratories%20involved.)
    • Brussels calls to promote vaccines against human papillomavirus (HPV) and hepatitis B throughout the EU (https://elpais.com/sociedad/2024-01-31/bruselas-llama-a-impulsar-las -vaccines-against-human-papillomavirus-hpv-and-hepatitis-b-across-the-eu.html#:~:text=Brussels%20has%20launched%20this%20Wednesday, the%20Hepatitis%20B%20(HBV).)

National health policy

  • Appearance of the Minister of Health before the health commission of the Congress of Deputies, on January 26, 2024
    • Lights and shadows in the appearance. Lights: recovery of a certain will for strategic direction of the SNS and willingness to address the great problem of waiting lists. Shadows: very negative and unacceptable mentions of private healthcare, with intellectually inconsistent arguments and quotes; staunch defense of direct public management, compared to other forms of public management; Public Health Agency, the ministry gets out of the way to decide the location, as if it were not also a health decision; Framework Statute, where are the negotiations with professionals and patient associations?; medications, no mention of the Strategic Plan of the pharmaceutical industry; Oral health, where is the economic memory?; Is the inclusion of glasses in public provision, given the financial strains of the system, a reasonable priority? Is there prior consensus with other agents on this measure? (https://www.youtube.com/watch?v=xlGfsMiuQDo)

Companies

 

7 days in healthcare (January 1st-7th, 2024)

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Summary

From the point of view of Biomedicine, scientists celebrate a new antibiotic, currently undergoing Phase 1 clinical trials, that can kill resistant bacteria. The magazine Nature publishes precisely an editorial in relation to the need to encourage the appearance of new antibiotics against resistant bacteria. The problem is that the current business model in the pharmaceutical industry does not introduce incentives to companies for investments in this field. This is why it proposes “push” solutions (strategies to reduce the cost that may include government aid for the initial stages of research) and “pull” (compensating companies that develop successful antibiotics).

As far as Global Health is concerned, we should mention an interesting article in The New York Times about the need to set up a kind of global immune system against multiple health threats. It would consist of a system of detection and immediate action. Great progress towards the objectives in relation to HIV, almost reaching the aspiration of achieving 95-95-95 (95% of patients with HIV, diagnosed; 95% with antiretroviral treatment; and, 95% with viral suppression).

In terms of International Health Policy, Case and Deaton’s theory in the United States of deaths due to despair (alcohol, drugs and suicide) seems to be dismantled, which would affect mainly white American men without university studies and who had reached relate even to Trump’s victory. Recent studies show that these deaths are not limited to this population, but affect all social classes. Also in the United States, the authorization by the FDA of the importation of medicines from Canada by the State of Florida is of great significance. The price is substantially cheaper for these medications than the one currently in force in the USA. Pharmaceutical companies have cried foul, since this is the first time this has happened in the USA. Litigation is more than assured. The tripledemic (respiratory infections of influenza A, covid and RSV in children) is spreading throughout Europe, with Spain and Italy being precisely the most affected countries.

If we talk about National Health Policy (Spain), the Interterritorial Council of the SNS will address next Monday (January 8) the measures against the tripledemic, in particular the possible mandatory nature of masks in health centers, something already imposed by some communities . The overcrowding in hospital emergencies highlights the absence of demand management: more role for Primary Care; less face-to-face activity  and online attention; and more paper for nursing. The El Español Health Observatory makes public a document of proposals for the health system, the result of the symposium held between October 2-5, 2023, with the participation of more than 150 speakers. The common genetics portfolio of the SNS will be presented on January 23, in what appears to be a great advance for the system. The Ministry of Health of Andalusia announces measures against waiting lists, based on what they call “restructuring the bases of activity.” Without a specific budget, trying to act on productivity without adequate management tools and avoiding agreements with the private sector, we dare say that the measures are doomed to failure.

In the field of Companies, on an international level, what stands out as a novelty is that Lilly is entering B2C, launching in the United States a website for direct sales of medicines to the public and even with a direct home delivery service. A very innovative experience, of which we will have to see the results. As far as Spain is concerned, Domus Vi sells five residences.

Biomedicine

Global Health

International health policy

  • USA
    • The theory of “deaths of despair” (Case and Deaton) no longer holds. This theory, which caused a lot of impact, said that in the USA deaths due to despair (alcohol, drugs and suicide) mainly affected whites without university education. This has changed and today it is known that they affect practically all social classes, without special predominance of the groups indicated by Case and Deaton (https://www.economist.com/united-states/2023/12/23/the-deaths-of-despair-narrative-is-out-of-date)
    • The FDA approves the first mass importation of medicines from Canada to Florida. The price is much lower than that of medicines in the USA, pharmaceutical companies are opposed and it is believed that the PhRMA (representative of American pharmaceutical companies) will file an appeal. Florida says it will save $150 million with the program in the first year alone. It is the first time that something like this has happened in the USA (https://www.nytimes.com/2024/01/05/health/drug-imports-canada-florida.html)
    • The rise in rates and costs drives the bankruptcy of healthcare companies. 18 healthcare companies went bankrupt in the last year. (https://www.ft.com/content/65dfbc81-2641-48fa-a40a-647076943194)
  • Europe
    • Europe fights against the tripledemic of respiratory infections. Tripledemic is the coexistence of covid, influenza A and RSV in children. Spain and Italy, the most affected countries. Also Germany and France. The term means that all three infections coexist, not that individuals have more than one disease. In fact, there are few cases of co-infection (https://www.ft.com/content/449c4748-ef63-4f0a-b26e-4e528889fac4)

National health policy

  • Recruitment of doctors in the Basque Country
    • After requiring Basque from doctors, it is now proposed to hire foreigners without requiring it (https://www.eldebate.com/sociedad/20240105/pais-vasco-queda-medicos-imponerles-euskera-ahora-contratara-extranjeros-exigirselo_164608. html – :~:text=The Government of the Basque Country, first time to non-EU personnel.)

Companies

 

 

7 days in healthcare (November 27th-December 3rd, 2023)

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Summary

From the point of view of Biomedicine, the New England Journal of Medicine begins a series on the usefulness of wearable technology, the set of devices or instruments that are worn and transmit information about health, which could be useful in monitoring , diagnosis and treatment of various diseases or clinical situations. There is every impression that this technology will be part of the future and what the NEJM intends is to clarify its usefulness and indications in various diseases and specialties, starting with diabetes. Regarding CAR-T therapies, until now used in hematological processes, it is envisioned that they could also be useful in solid tumors.

Regarding Global Health, great prominence of the issue of health in the COP28 meeting, from two perspectives: the reduction of CO2 emissions, which can be harmful to health; and the emissions from the health system itself, which is a major polluter. It is confirmed in a new and extensive study carried out in Australia that the younger generations have worse mental health.

Regarding International Health Policy, in the United States an executive order by President Biden on AI, not specifically directed at the health sector, will, however, have an impact on this sector and the Ministry of Health is already preparing specific regulations. In China, it seems to be ruled out that the increase in respiratory infections is due to a new virus, but rather to common bacteria and viruses. The United Kingdom’s genetic database, UK Biobank, is about to reveal results, which seem to have an impact on new therapies. In France the price of a pack of tobacco is rising, despite this country’s failures in the fight against smoking. The new conservative government of New Zealand annuls the 2022 law, which prohibited the sale of tobacco from 2027. Austria launches a new health reform, which reinforces the digital route as access to the health system. Concern of several health groups in Argentina, given the health announcements of the new president-elect, Javier Milei.

If we talk about National Health Policy (Spain), the government of the Generalitat of Catalonia reactivates the results center, a model initiative in terms of transparency in the health sector, which had been largely paralyzed since the “procés”. All the data until 2022 has already been presented. Biosim demands new forms of purchasing and management adapted to biosimilars. Problems in the last research institute recognized by the Carlos III Health Institute, that of Asturias. Strong tensions for months between the management of ISPA (the Health Research Institute of the Principality of Asturias) and FINBA, a Foundation with a majority of private companies, which seeks to exercise control over ISPA. Unusual proposal from the Catalan medical colleges, which aims to introduce a “quota” for non-Catalans who aspire to study medicine in Catalonia.

In the field of Companies, on an international level, AstraZeneca is allying itself with AI Biologics. The linking of pharmaceutical companies with AI companies seems to be a general trend. At the national level, Vivanta confirms an ERE.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

7 days in healthcare (November 6th-12th, 2023)

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Summary

From the point of view of Biomedicine, Victor R. Fuchs, a pioneer of health economics and possibly the most recognized and prestigious health economist in the world, dies. He always defended universal health coverage for the United States, although he was very aware of the difficulties of its implementation, due, among other circumstances that he explained, to the heterogeneity of American society. And it must be said that he was not wrong in that. The FDA has just approved an oral drug based on the intestinal microbiome, a new horizon in medicine.

As far as Global Health is concerned, although tuberculosis is preventable and treatable, it continues to be the infectious disease with the most mortality globally, after a short period of time in which it was covid. But 40% of the world’s population with tuberculosis is not treated.

In terms of International Health Policy, it seems that the covid pandemic did not damage developed economies as much as initially thought. This seems to be deduced from studies of initials from the United Kingdom and Italy. The EFPIA, the pharmaceutical industry’s association, continues to complain that the new European legislation could end incentives for innovation and put Europe in an even worse relative position than the one it already has with respect to the USA and China. The OECD has just published “Health at a Glance 2023”, a must-read.

If we talk about National Health Policy (Spain), the agreements of the PSOE and Junts (and also those signed with the PNV for the Basque Country and with the BNG for Galicia) contemplate the transfer of powers over the MIR (and in the case of the Basque Country also of the issuance of titles). Some say that constitutional values and democratic principles have been subordinated in the investiture agreements. Obviously, this does not happen with the MIR, but an important value is put at risk: the cohesion of the National Health System, based, among other issues, on the uniformity of the training system and recognition of titles and specialties, being , on the other hand, a highly recognized system. 11 public hospitals appear to be starting a lung cancer screening program. Since this procedure is not recognized in the SNS service portfolio, the innocent question is: who pays for this? Or is it simply a pilot program with special funding? The Community of Madrid proposes a modification of the current Law of Good Government, which required the appointment of managers of health centers by competition and which at the time was approved by broad consensus, to another system that allows the direct appointment of these positions by part of the SERMAS Board of Directors.

In relation to Companies, at the international level, the battle between pharmaceutical companies in relation to obesity continues (the main players are NovoNordisk, Lilly and AstraZeneca). Amazon is relaunching in health, providing health services through One Medical to its premium customers. At the national level, great growth in the 22nd year of dental, ophthalmological and aesthetic clinics. The purchase of the Eugin assisted reproduction clinics from Fresenius by KKR and GED is completed. The latter retains the business in Spain, while KKR will integrate the international business into IVI RMA.

Biomedicine

Global Health

International health policy

  • United Kingdom and the National Health Service
  • OECD
    • The OECD publishes “Health at a glance 2023”. Main conclusions: healthcare systems are under severe financial pressure; there has been no complete recovery after covid; unhealthy lifestyles cause millions of deaths; Access barriers persist, despite universal coverage in most OECD countries; the quality of care is improving; digital health has immense potential (https://www.oecd.org/health/health-at-a-glance/)

National health policy

Companies

 

 

7 days in healthcare (October 23rd-29th, 2023)

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Summary

From the point of view of Biomedicine, Nature magazine analyzes the great impact of Artificial Intelligence in medicine. Interesting article from the New York Times about the possible addictive nature of social networks.

Regarding Global Health, the WHO adds 6.9 million deaths from covid, although warning that the global figure could triple. Major humanitarian and health crisis in Gaza, which is the subject of WHO concern.

In terms of International Health Policy, the NEJM wonders if the introduction of the American government’s law that requires negotiating the price of drugs for Medicare will delay the appearance of new cancer drugs. The conclusion is that, although pharmaceutical companies will look for ways to maintain their profits, delaying the appearance of medications does not seem to be the best strategy, due to the ethical, reputational and financial considerations inherent to the operation. The Economist analyzes how it seems that healthcare has ceased to be the bottomless pit for public accounts, as it was for many years, in which, year after year, its relative weight in the countries’ GDP increased. Although health expenditure increased its share of GDP in the years 20-21, due to the joint effect of health expenditure due to the pandemic and the decline in GDP, it has since fallen to reach 2008 levels. In the United Kingdom, It seems highly unlikely that Prime Minister Sunak will deliver on his promises on NHS waiting lists.

If we talk about National Health Policy (Spain), given the evolution of the negotiations for the investiture and the possible continuity of Sánchez in the government, the national news of the week is the publication of the document “Spain advances”, which contains the agreements of the PSOE with SUMAR on different topics. The general tone of the document is more about promises than progress in certain necessary reforms and this same philosophy permeates the health part. On the other hand, the document does not cover all the topics (it does not talk about Defense, very little about foreign policy or other relevant issues). It gives the impression that this is the part in which SUMAR would intervene. From this point of view, as the health part is developed in some detail, it is assumed that a strong intervention by SUMAR in health is expected, regardless of whether the Ministry of Health is handed over to it. In summary, what is promised is to continue the processing of the Equity Law (which establishes direct public management as the preferred form of management in the SNS), a law is proposed with maximum times for waiting lists and there is talk of new benefits in mental health, oral health (although it seems to limit it to children and adolescents) and visual health. We consider the emphasis on the preferential nature of direct public management negative (there is multiple evidence of the good results of public companies and foundations or health concessions) and regarding the law on the waiting list it will surely not be the best way to solve this problem. We have already seen laws and regulations in some communities that had no effect. Both the PP, in the political sphere, and ASPE and ACES, in the world of health representation, have been against these measures.

In the field of Companies, on an international level, Amazon is torn between promises and realities in healthcare. Although large technology platforms will surely have an increasing role in healthcare (as in the financial world), it seems that they are finding it difficult to enter. Roche reaches an agreement to buy Telavant. At the national level, Ribera reaches an agreement with Microsoft to promote innovation and AI in healthcare. It seems that Grifols is making progress in its therapy against Alzheimer’s.

Biomedicine

Global Health

International health policy

National health policy

Companies

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 (September 25th-October 1st, 2023)

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Summary

From the point of view of Biomedicine, The Economist raises the issue of how research on aging makes the prospect of living to 120 years less unimaginable.

Regarding Global Health, The Lancet publishes a study prepared with information from 185 countries that shows how a more “feminist” approach could have saved hundreds of lives of women with cancer. Surprising news from COVAX, the body created to distribute covid vaccines to developing countries: billions of its budget unspent.

Regarding International Health Policy, the pharmaceutical industry warns against the possible harms of the application of the European Union’s pharmaceutical policy, in this case the reduction of medicines against rare diseases. The pharmaceutical policy has not yet been approved, so this sounds like putting the bandage before the wound.

If we talk about National Health Policy (Spain), the news of the week was the failed investiture of Feijóo. In his speech he addressed health problems. Although logically in a discourse of this type the sectoral details must necessarily be brief and what is interesting is the general tone, the poverty of the health discourse is surprising. The proposals are reduced to a shock plan for Primary Care and new medical calls, in addition to a “commission of experts” to address the problems of the sector for which no initial proposal is launched. It does not seem that there is a mature reform program in the PP when it comes to health. The news of the approval of a catalog of biomarkers in the SNS, which will be published electronically, seems like good news.

In the field of Companies, at the international level, the EU’s talks with Moderna for the new supply of covid vaccines should be highlighted. At the national level, Sanitas is reinforced in Andalusia with a new center in Malaga; an Austrian company will create a wellness center in Marbella; and, Atrys Health continues its expansion in Mexico, through an agreement with BUPA.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (August 28th-September 3rd, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting how therapy with psychedelics is opening up among mental health professionals, especially for cases of depression, anxiety, post-traumatic stress, eating disorders and addictions.

As far as Global Health is concerned, a study of 18 clinical trials shows that screening for early detection of cancer does not make this population live longer than those who do not undergo this type of testing. WHO concern about blindness and vision disorders. More than 2.2 billion people globally have vision disorders, generally attributable to refractory disorders and cataracts.

In terms of International Health Policy, the expected bomb exploded from the application of the “Inflation Reduction Law”, approved in the USA in August 2022, which included something prohibited until now: price negotiation between pharmaceutical companies and Medicare. . The American government made public the 10 drugs that will be negotiated in 2023 and affects the main companies: Pfizer, Lilly, Novartis, AstraZeneca, J&J, etc. Although the established system is very gradual, since 10 drugs will be negotiated each year for the next four, the truth is that this breaks the status quo of the pharmaceutical industry not only in the USA (the largest drug market) but in the world. It is difficult to counter Biden’s argument, which he plans to use in the 2024 campaign, that Americans do not have to pay two to three times more for medicines than the rest of the developed countries, such as in Europe. However, The Economist, which recognizes the need for this price negotiation, nevertheless sees problems in its application due to the appeals filed by large pharmaceutical companies and the risk that these companies will distance themselves from the necessary medicines and concentrate on others unrelated to price control. He also says that if R&D expenses are taken into account, the profitability of pharmaceutical companies is not extraordinary, when compared to the companies in the S&P 500.

If we talk about National Health Policy (Spain), the incidence of covid shoots up by 70% in just one week. The Ministry of Health recommends the fifth dose to selected groups: over 60 years of age, health personnel and the vulnerable. The Supreme Court faces a complex issue: the ruling on thousands of compensation payments to businessmen due to the pandemic. These are property claims to the State due to Covid-19 from businessmen and self-employed workers, who are awaiting compensation for the damage caused by the restrictions during the states of alarm that were later cancelled.

In the field of Companies, on an international level, the most notable is the abandonment of CENTENE from the United Kingdom, where it had a chain of primary care centers and the CIRCLE hospital network. The movement follows his departure from Spain with the sale of Ribera. A concentration in the American market, difficulties with the anti-privatisation movements of healthcare in Europe and problems with hospital integration may be at the origin of the problems, to which perhaps we should also add an underdeveloped growth strategy for this American company in Europe. In any case, a shame, since CENTENE is a great American insurance company, with a lot to teach in the European world. As far as national news is concerned, Spain is the only country that has purchased (31 million euros) several million vaccines from HIPRA, which is not updated for the new strains. Big problem for the Ministry if it decides to use it.

Biomedicine

Global Health

International health policy

  • USA
    • The American government reveals the 10 drugs on which price negotiations will take place with Medicare. Under the proposed reform the minimum price decrease will be 25%. According to the Congressional Budget Office, the savings to the public coffers will be $100 billion over a decade. The affected companies are BMS, Pfizer, Boeheringer, Lilly, J&J, Merck, AstraZeneca, Novartis, Amgen, AbbVie, Novonordisk (https://www.ft.com/content/fa9b0422-6f93-4703-9358-6396660f63b6)
    • The Economist, critical of the American government’s measure, although it recognizes that price negotiation was obligatory. He says that the prohibition on negotiation was nonsense, but the proposed negotiation system could have perverse effects. If R&D expenses are taken into account, pharmaceutical companies do not have extraordinary profits, compared to those of the S&P 500 (https://www.ecocom/leaders/2023/08/30/americas-new-drug-pricing-rules-have-perverse-consequences)
    • Biden makes the negotiation of drug prices one of the central axes of his campaign for 2024, despite the fact that the price reduction will not begin until 2026 and that is if the law resists all judicial attacks (https://www.nytimes.com/2023/08/30/us/politics/biden-medicare-drug-prices-2024-campaign.html)
    • Opinion article in FT: “The world needs to stop depending on the American pharmaceutical industry.” Americans pay up to three times more than other developed countries for medications. The American market is the main market for pharmaceutical companies. This policy is popular among Americans, but it may affect drug R&D globally. Pharmaceutical companies can orient themselves from the most needed medicines to those that escape price control (https://www.ft.com/content/0c20c518-60a8-4dd0-87be-f03adc8ec0e1)

National health policy

  • Judicial consequences of the pandemic
    • The Supreme Court faces the sentencing of thousands of compensations to businessmen due to the pandemic. These are property claims to the State due to Covid-19 from businessmen and self-employed workers, who are awaiting compensation for the damage caused by the restrictions during the states of alarm that were later cancelled. About 9,000 resources are expected. The sentence is very complex, due, among other things, to the high economic amount that it could represent (https://www.expansion.com/juridico/sentencias/2023/09/01/64f1cc47e5fdea09658b45ba.html)

Companies