7 days in healthcare (January 1st-7th, 2024)
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
- Scientists celebrate a new antibiotic that can kill resistant bacteria. The drug, called Zosurabalpin, has been developed by Roche, is in phase 1 clinical trials and looks very promising (https://www.ft.com/content/3fe32a51-823a-4b83-8c36-57065544b55d)
- Nature magazine editorial: economics of new antibiotics must be fixed. Current economic incentives are insufficient for companies to take the risk of developing new antibiotics. “Push” solutions (strategies to reduce cost and may include government aid for the initial stages of research) and “pull” solutions (compensating companies that develop successful antibiotics) are proposed. The United Kingdom is a pioneer on this topic, with a “subscription” proposal (https://www.nature.com/articles/d41586-023-04086-z)
- What science will talk about in 2024: AI; the “twin” of a human brain; vaccines; “in vivo” gene editing; cell therapy in Parkinson’s (https://www.diariomedico.com/medicina/investigacion/hablara-ciencia-2024-avances-medicos-marcaran-ano.html)
- Promising results in “cancer vaccines” (https://elpais.com/salud-y-bienestar/2024-01-07/el-inmenso-desafio-de-las-vacunas-contra-el-cancer-thereare-promising-results.html)
Global Health
- Op-ed in the NYT: The world needs its own immune system to stop public health crises. Last May alone, the WHO detected 56 global health emergencies. Given the multiplicity of health crises (covid, Ukraine, cholera, polio, etc.), the author, who works at USAID, proposes a kind of global immune system to stop these public health crises. It would be a system of detection and immediate action. (https://www.nytimes.com/2023/12/25/opinion/global-immune-system-public-health.html#:~:text=Similarly%2C%20a%20global%20immune%20system,defense%20against%20danger%20is%20prevention.)
- Humanitarian requests for 2024 encounter problems. Reduction of aid by the United Nations and Red Cross (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00001-1/fulltext#:~:text=John%20Zarocostas%20reports.-,The%20UN%20and%20the%20International%20Committee%20of%20the%20Red%20Cross,and%20health%20epidemics%20in%202024.)
- Progress towards HIV objectives. According to a UNAIDS analysis, progress towards HIV goals is impressive. These objectives were 95-95-95. 95% of patients with HIV, diagnosed; 95% with antiretroviral treatment; and, 95% with viral suppression (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00002-3/fulltext#:~:text=An%20eclectic%20mix%20of%20countries,Tony%20Kirby%20reports.)
- The time has come to use economic incentives to boost vaccination. Despite vaccination campaigns in low- and middle-income countries, the vaccination rate in these countries is low. A trial carried out in rural areas in Ghana shows that this situation can be reversed through economic incentives (https://www.ft.com/content/5acb85b9-7115-4274-9c8d-07f7e409d49d)
- France or Ireland have banned vapes. The vapor from electronic cigarettes is not harmless (https://www.consalud.es/politica/francia-irlanda-paises-han-prohibido-vapeadores-en-espana-podria-fijarse_138414_102.html)
- How Egypt has eradicated a hepatitis C epidemic and now helps the rest of Africa (https://elpais.com/planeta-futuro/2024-01-03/como-egipto-ha-erradicado-una-devastadora-epidemia- of-hepatitis-c-and-now-helping-the-rest-of-africa.html)
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)
- United Kingdom and the National Health Service
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- NHS residents threaten new strikes unless they receive offers of higher pay (https://www.theguardian.com/society/2024/jan/03/junior-doctors-leaders-warn-of-more-strikes-unless-ministers-make-new-offer)
- The shortage of diabetes drugs will last until the end of 2024 (https://www.ft.com/content/30d5baa5-2bee-4a0c-85d5-7ff4016aae04)
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- France
- Initiatives are proposed to fight against social loneliness (https://www.lemonde.fr/idees/article/2024/01/04/pour-lutter-contre-les-mefaits-de-la-solitude-sur-la-sante-publique-creons-une-federation-francaise-pour-le-lien-social_6209038_3232.html)
- The attraction of general practitioners to the salaried formula (fixed hours and salary, teamwork), a sign of the crisis of the liberal system (https://www.lemonde.fr/societe/article/2024/01/06/l-attrait-des-generalistes-pour-le-salariat-symptome-de-la-crise-de-l-exercice-liberal_6209384_3224.html)
- 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)
- European Union
- Expired covid antiviral drugs (Paxlovid) will cost the EU 2.2 billion euros (https://www.ft.com/content/7ddd24bb-2394-4a63-96f0-464a3ccf6df6)
National health policy
- Flu epidemic
- Tripledemic of respiratory infections: covid, influenza A and RSV in children (https://www.elindependiente.com/vida-sana/salud/2024/01/06/la-tripledemia-sigue-su-escalada-no-hemos-learned-nothing-from-covid/#:~:text=No%20we%20have%20learned%20yet%20that,we%20have%20learned%20the%20lesson.)
- The Ministry of Health and the autonomies will address next Monday, January 8, the return to masks in health centers (https://www.elperiodico.com/es/sociedad/20240104/sanidad-autonomias-abordaran-lunes-medidas-96548285)
- Valencia, Catalonia, Aragon and Murcia are moving forward in making masks mandatory in health centers (https://www.diariomedico.com/medicina/politica/valencia-primera-autonomia-implantar-obligatorio-mascarilla-centros-sanitarios.html)
- Emergency doctors ask not to go to the hospital if it is not necessary (https://www.epe.es/es/sanidad/20240105/sos-urgenciologos-piden-acudir-hospital-necesario-almacenes-pacientes-96573927)
- Proposals in healthcare
- El Español proposes 143 health measures. Result of the Health Observatory Symposium, organized between October 2 and 5, 2023, with the participation of more than 150 speakers (https://www.elespanol.com/invertia/observatorios/sanidad/20240107/espanol-promueve-measures-convert-healthcare-efficient-system-dedicated-patient/822668018_0.html). Access to the full document: https://s1.elespanol.com/2024/01/06/actualidad/Cambios_Sanidad.pdf
- Nurse prescription
- The Ministry of Health allows nurses to prescribe ibuprofen and paracetamol to treat fever (https://www.levante-emv.com/videos/sociedad/2024/01/04/sanidad-permite-hoy-enfermeros-recetar-ibuprofen-paracetamol-96521660.html#:~:text=The%20decision%20arrives%20in%20full,health%20by%20the%20respiratory%20viruses&text=A%20start%20of%20now%20San)
- More agility for health OPEs
- The Ministry headed by Escrivá wants more agile OPE’s and with “recalls”, in principle this will affect the staff of the General State Administration, although it is believed that the autonomous communities will take similar measures (https://www.redaccionmedica.com/sections/employment/the-government-subscribes-new-health-operations-more-agile-and-with-recalls–9724)
- 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.)
- Medicine shortage
- Almost a thousand drugs with supply problems (https://www.epe.es/es/sanidad/20240104/farmacias-arrancan-ano-millar-medicamentos-problemas-suministro-96490328)
- Ceuta and Melilla
- Problems due to lack of doctors. These cities have the lowest rate of doctors per 1,000 inhabitants in Spain and the workforce is aging (https://www.larazon.es/sociedad/ceuta-melilla-uci-sanitaria-falta-medicos_202401036594e1ba67d53e0001c81fa6.html)
- Genetics portfolio in the SNS
- The Ministry of Health will present the update of the genetics portfolio on January 23, through the presentation of the “new common catalog of genetic tests” and a computer tool will be presented to facilitate its implementation in the SNS (https:// elglobal.es/politica/sanidad-presentara-la-updacion-de-la-cartera-comun-de-servicios-de-genetica-el-proximo-23-deenero/#:~:text=El%20Global-,Health%20willpresent%20the%20update%20of%20the%20portfolio%20common%20of%20services,the%20next%)
- News in Primary Care
- High resolution Emergency Centers in Primary Care in Asturias (https://actualidad.asturias.es/-/la-consejería-de-salud-impulsa-tres-nuevos-centros-de-alta-reolucion-de-urgencias-of-primary-care#:~:text=The%20Gobierno%20of%20Asturias%20will,Calzada%20II%20and%20Roces%20Montevil.)
- 84.2% of Primary Care teams in Catalonia perform clinical ultrasounds. The Health Quality and Evaluation Agency of Catalonia (AQuAS) has just confirmed this fact (https://www.diariomedico.com/medicina/medicina-familiar/cataluna-842-equipos-primaria-ecografias-clinicas.html#:~:text=Community%20Technology%20sanitary-,Catalonia%3A%20el%2084%2C2%25%20of%20teams%20of%20primary%20do,to%20power%20be%20more%20res)
- Waiting lists
- The SAS seeks to reduce waiting lists by “restructuring the bases of its activity”, by increasing productivity, reorganizing ordinary activity, additional afternoon shifts and self-concerts (https://www.plantadoce.com/publico/sas-seeks-to-reduce-waiting-lists-by-restructuring-the-bases-of-its-activity)
Companies
- International News
- NovoNordisk signs agreements with American biotech companies worth $1 billion in the race for anti-obesity drugs (https://www.ft.com/content/ee322048-a7f1-4762-8533-a700262c8409)
- Lilly will beat NovoNordisk in the anti-obesity medicines market (https://www.elespanol.com/invertia/observatorios/sanidad/20240102/lilly-ganara-batalla-novo-nordisk-mercado-farmacos-obesidad/820668146_0 .html)
- Mergers and acquisitions in the pharmaceutical industry will move up to 248,000 million euros in 2024 (https://www.elespanol.com/invertia/observatorios/sanidad/20240102/fusiones-adquisiciones-industria-farmaceutica-moveran-millones-euros/ 820668147_0.html#:~:text=And%20in%202024%20will%20continue%20this%20trend.&text=In%20accordance%20with%20the%20forecast,and%20248)
- Lilly launches a website (LillyDirect) for direct sales to patients with obesity, migraine and diabetes. It will be operational in the United States and includes a direct home delivery service. With this initiative Lilly joins B2C (https://www.plantadoce.com/empresa/eli-lilly-lanza-una-web-de-venta-directa-a-pacientes-con-obesidad-migrana-y-diabetes )
- National
- DomusVi sells five residences for 30 million euros (https://brainsre.news/threestones-compra-cinco-residencias-a-domusvi/#:~:text=La%20gestora%20de%20fondos%20luxembuguesa,according to%20informa %20the%20daily%20Expansion.)