Posts

7 days in healthcare (May 6th-12th, 2024)

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Summary

Biomedicine

  • The enigma of the brain: The Economist highlights the enigma that the brain represents, made up of hundreds of trillions of cells that generate precise electrical impulses, which influence thoughts, memory and emotions, recommending 8 books on the subject, of which two They refer to the contributions of Ramón y Cajal, whom he compares with Darwin and Pasteur. The brain will be the focus of scientific advancement in the next 30-50 years.
  • CAR-T therapies, beyond blood cancer: Experiments in mice with this therapy manage to improve survival in brain, pancreas and lung tumors.

Global Health

  • One Health, from slogan to action plan: A group of European agencies, led by the ECDC, which includes the EMA, manage to transform the idea of One Health into an action plan, establishing five major strategic objectives.
  • The WHO Pandemic Treaty advances: WHO member states are about to reach an agreement on the response to pandemics, an agreement that, in principle, should be approved in May 2024.

International health policy

  • The great problem of hospital infections: The ECDC releases a report that shows that more than four million Europeans contract infections each year due to hospital admissions. This confirms the old criterion of hospital ethics: “Do not admit anyone unless it is strictly necessary and, if admitted, let them be in the hospital for the shortest possible time.”
  • Whooping cough is increasing in Europe: The ECDC publishes a report that warns of the increase in whooping cough cases in the European Union.

National Health Policy (Spain)

  • The government proposes new benefits in the SNS: condoms, sun creams and glasses: It is more than doubtful that with the financial tensions of an already very generous system (wide portfolio of services with hardly any co-payment), introducing new benefits without a debate in depth is a priority. Arguably, this has more to do with the political use of the system than with health policy.
  • The Catalan Generalitat will supervise the use of Catalan in its hospitals: CatSalut publishes exhaustive 9-page instructions on the subject. Same comment regarding political use of the system and health policy.
  • 18 patients die every day in Spain from hospital infections: According to a large study presented at the congress of the European Society of Clinical Microbiology and Infectious Diseases, four times more than those who died from traffic accidents. More than half of infections are considered preventable.
  • Workplace accidents increase: 56% in ten years. Both workplace accidents and the number of deaths increase in this period (452 deaths in 2012; 716 in 2022).
  • Innovative medicines take more than 800 days to reach patients in Spain: 621 days pass from the time a therapy is authorized by the European Commission until the Ministry of Health includes it in the list of approved treatments, according to the consulting firm. IQVA. To this figure we must add seven months or a year, depending on autonomy, until the treatment reaches the patients’ hands. In total, around 830 days.

Companies

  • International
    • The reengineering of addiction and the tobacco industry: For decades the tobacco industry has manipulated the design and composition of cigarettes to its benefit. Researchers and policy actors should be prepared to anticipate the tobacco industry’s response, given its long history of exploiting regulatory loopholes, according to an extensive article in the New England Journal of Medicine.
    • BioNTech looks to the future: It hopes that 2026 will be its debut in oncology with mRNA vaccines against cancer.
  • National
    • Vithas has a quality policy: The International Joint Commission accredits the Vithas Hospital of Almería, the fourth accredited hospital in this group.
    • Sanitas leaves the Manises hospital: Public reversal in this hospital. Sanitas leaves with discretion and elegance and leaving behind great management. How these things should be done.
    • Mutua Madrileña warns that Adeslas could leave MUFACE: Mutua Madrileña (50.01% shareholder of Adeslas, along with CaixaBank) warns that it will leave MUFACE if the government does not clearly improve conditions. The three companies that participated in the MUFACE model in these three years (Adeslas, Asisa and DKV) lost 600 million in this period. Logically, the possible departure of Adeslas would be a definitive death blow for the MUFACE model.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (February 13th-19th, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting the reference in the British Medical Journal on the questionable value of colorectal cancer screening, according to a double-blind study of the results of colonoscopy, with a large population followed up, without detecting reductions in the mortality from this type of cancer. The first vaccine against the syncytial virus, responsible for many deaths, both newborns and adults, is presented. The results of a test that detects prostate cancer with great precision, with a simple blood test, are published.

With regard to Global Health, the New England Journal Medicine published an article on the correct path to eradicate polio, which is once again a problem in many countries, defending universal immunization against polio, in instead of virus eradication strategies. The Lancet reviews the One Health strategy, this approach that links climate change, animal health and human health as something that cannot be addressed separately. It is detected that poor countries desperately need access to cheap generics, since in these countries, due to less competition between manufacturers, generics are more expensive than in developed countries. Malaria is spreading across Africa as climate change allows the geographic spread of the mosquitoes that transmit it.

Regarding International Health Policy, there is a great debate in the United States about the future of Social Security and Medicare, with very opposed positions between Democrats and Republicans. In the UK, the number of people waiting more than 18 weeks for treatment exceeds three million in England alone. In France, the very open debate on euthanasia continues with wide participation, with the involvement of President Macron himself. In Chile, the crisis in the private health sector threatens the entire Chilean health system. The collapse of the Isapres (Chilean health insurers) would mean that 3.2 million people would pass into the already congested public Fonasa system. Poland bans energy drinks for those under 18, a move welcomed by doctors in that country. The European Commission finalizes the European pharmaceutical strategy, with new approaches towards generics and orphan drugs. The EFPIA, the European employers’ association for pharmaceutical companies, criticizes what is becoming known about this reform, considering it harmful to competitiveness.

If we talk about National Health Policy (Spain), the cumulative incidence of covid continues to rise slightly. From a regulatory point of view, two important laws are approved: the so-called “trans law” and the new abortion law. From various sectors of the healthcare industry, objections had been made to certain elements of both laws, the consequences of which will have to be expected. As far as the medical conflict is concerned, it is increasingly clear that the conflict in Madrid is one thing and another in the other communities. Although the problems of Primary Care are national, and therefore the national government cannot inhibit itself as it is doing, what is specific to Madrid is the way in which the Community government approaches it, which simply attributes it to a “conspiracy of the left”, which contributes to its exacerbation, prolongation and expansion (it is also announces conflict among hospital doctors). Both the international press (Financial Times, Le Monde) and the national one (Zarzalejos in El Confidencial and others) strongly criticize this approach by the Community of Madrid, which has published a decalogue of excellence in Madrid’s healthcare, strongly criticized for its inaccuracies. In other communities, on the other hand, with all the difficulties, agreements are being reached. The national government also uses this conflict to enter into health, trying to neutralize criticism of the “yes is yes” law. Those who want politics out of healthcare don’t know what they’re saying. On the contrary, we need a political debate on high altitude and adult health. Just the opposite of what is happening. Private insurance policies are rising in price, something that the sector had been demanding for years.

At the Corporate level, at the international level, it is proposed that health information (largely from the NHS) be the basis of a British sovereign wealth fund, in the same way that a Norwegian sovereign wealth fund is based on information about oil. Grifols announces a savings plan that includes 2,300 layoffs, which has been highly received by the Stock Market, significantly raising the shares of this company.

Biomedicine

Global Health

International Health Policy

  • Chili
    • The crisis in the private sector threatens the entire Chilean health system. A 2010 court ruling prevents adjusting policies by age and sex. Although the measure had not been implemented, it seems that the government wants to do so. The collapse of the Isapres (health insurers in Chile) would mean that 3.2 million people would pass into the already congested public Fonasa system (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00321-5/fulltext)

National health policy

Companies

7 days in healthcare (January 16th-22nd, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting, as the Science article does, the celebration of a decade of CRISPR gene editing technology, whose impact on medicine is only just beginning. Janssen withdraws from the HIV vaccine, a new failure in the attempt to discover a vaccine against this disease. Moderna, on the other hand, presents positive results with a vaccine against bronchiolitis. A new report points to wastewater analysis as fundamental to monitoring threats from a wide variety of diseases, not just covid.

As regards Global Health, The Lancet in an editorial underlines the importance of the One Health concept, this idea of the interdependence between human, animal and ecosystem health. The Economist publishes an editorial and an article on the problems of health systems that are in crisis everywhere in the post-covid era (even in Switzerland!), which is making mortality in Europe have been in the last year 10% higher than in a normal year.

Regarding International Health Policy, in the USA the opponents of abortion are manifested. Problems continue in the NHS, with Sajid Javid, former health secretary, proposing something as unusual in the UK as a co-pay in Primary Care and Emergency. He says an overly religious view of the NHS prevents reforms. Important debate and tensions about the price of medicines in the European continent (UK and EU) in relation to prices in the USA. Pharmaceutical companies, very reluctant to price controls, when they are also in the USA with the application of the Inflation Act, which gradually imposes a negotiation of the price of medicines between the Medicare Administration and pharmaceutical companies.

If we talk about National Health Policy (Spain), the incidence of covid continues to drop. Medical conflicts extend to various autonomous communities (Madrid, Catalonia, Navarra, etc.). The agreement in Aragon should be highlighted, which indicates that it is possible to reach agreements, possibly when they are well negotiated. The Ministry, completely absent from this problem. As for the public system, the statements by Lasquetty, Madrid’s Treasury Councilor, who points to “my own place” as one of the great rigidities of the public system, are very interesting. Conflict also in private health between doctors and insurers, raised in Seville. Abortion enters the national debate, following the picturesque proposals of Vox in Castilla y León, never applied. The Constitutional Court opens its new session with the debate on the recourse to the Law of deadlines presented in its day by the PP. The CIS survey presents health as the second problem that worries the Spanish.

In the field of Companies, internationally, Pfizer’s initiative to sell medicines at cost prices in 45 poor countries must be highlighted. At the national level, the launch by DKV of an insurance product that allows choosing a family doctor is notable. In a context in which insurers actually forget about Primary Care, this is something that deserves to be highlighted.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies