Posts

7 days in healthcare (July 8th-14th, 2024)

/in /by

Summary

Biomedicine

  • Four decades of orphan drugs. The Orphan Drug Act (ODA) was approved in the USA in 1983, due to the lack of commercial interest in the development of these drugs. The law that developed incentives for production, the duration of patents and research was a success and more than 800 indications have already been approved. However, many rare diseases remain untreated and prices are unsustainable. This is why a new strategy is proposed for the next four decades.
  • Gene therapy offers hope for autoimmune diseases. Use of CAR-T, originally intended for cancers, in lupus. The initial findings offer hope to millions of patients with autoimmune diseases, four in five of which are women.

Global Health

  • Vaccines save lives. The measles vaccine alone is estimated to have prevented 23 million deaths between 2000 and 2018. Globally, the vaccination rate has increased for many diseases. However, in 2022 (the latest figure available) there were still 14.3 million children with zero doses. A lack of access and high production and cost costs among the reasons for this situation. New strategies are needed to boost utilization.
  • Counting the dead in Gaza. According to a letter published in The Lancet, as of June 24, 37,396 people had been killed in the Gaza Strip since the Hamas attack and the Israeli response, according to the Gaza Ministry of Health, figures not accepted by Israeli authorities, although they are by the United Nations and the WHO. If we take into account that the indirect deaths are estimated to be between three and fifteen the number of direct deaths, a conservative estimate with a multiple of four gives 186,000 deaths attributable to the current conflict. This is why an immediate ceasefire is advocated.

International health policy

  • The NHS is broken: In his first official statement released on July 5, the new UK Health Minister (Wes Streeting) says that his department’s official position is that “the NHS is broken.” . He is surprised by this clarity regarding the recognition of problems, which is to be expected to be followed by profound reforms.
  • Official statement from the Labor Party on preparing the NHS for the future: cutting waiting lists with 40,000 more appointments each week; double the number of cancer scans; a new Dental Plan; 8,500 more mental health professionals; back to the family doctor.
  • Starmer turns to Alan Milburn, former Minister of Health, close to Tony Blair, to fix the problems of the NHS, which is interpreted as meaning that the private sector and consumer choice will be at the center of the plans.
  • The first official report on Covid management in the United Kingdom is published. After multiple surveys, it will be published next Thursday and promises to reveal serious deficiencies in the management of Covid. It will be interesting to compare this report with the disappointing and incomplete one published in Spain, carried out by three experts selected by the government.
  • European hospitals lose more than 170,000 beds in a decade, but Spain increases them, despite continuing to be one of the European countries with the fewest beds per 100,000 inhabitants.

National Health Policy (Spain)

  • The State Public Health Agency, in limbo. The creation of this Agency takes forever. It’s a bit frustrating, says Eduardo Satué, president of the Spanish Society of Public Health and Health Administration (SESPAS).
  • Various communities offer bonuses and incentives to doctors: to cover the deficit in Primary Care (Andalusia) or to cover the wings of the region (Asturias).
  • AESEG requests a price difference between generics and brands, which Farmaindustria opposes, a measure that is already applied throughout Europe except in Spain. The sector has 21 production plants in Spain and generates more than 40,000 direct and indirect jobs.
  • Private healthcare runs the risk of dying of success. Waiting lists are exploding for private health insurance (which 1 in every four citizens already have), but, due to low premiums, reaching up to 20 or 30 euros per month, it is not possible to provide a good service. A giant is being built with feet of clay.
  • Serious management problems in the health sector, according to FEDEA. Despite the significant increase in resources in the health field, since the level of spending has grown from 13.2% in 1999 to the current 14.5% of the total spending of Public Administrations. Real public spending per inhabitant has grown by 48% since 2003. This reality contrasts with the idea that healthcare has experienced significant cuts in recent decades, when the only falls in real spending per inhabitant only occurred between 2010 and 2013.

Companies

  • International
    • Pfizer wants to enter the anti-obesity drug market, having an advanced trial with a daily pill, with which it intends to enter the obesity market that promises to be worth 100 billion dollars a year.
  • National
    • It is possible that Grifols will cease to be a listed company. The Grifols family in talks with the Brookfield fund to take the company private.

Biomedicine

  • NEJM review: Four decades of orphan drugs. The Orphan Drug Act (ODA) was approved in the USA in 1983, due to the lack of commercial interest in the development of these drugs. The law that developed incentives for production, the duration of patents and research was a success and more than 800 indications have already been approved. However, many rare diseases remain untreated and prices are unsustainable. This is why a new strategy is proposed for the next four decades (https://www.nejm.org/doi/full/10.1056/NEJMp2401487)
  • Non-communicable diseases in reproductive care. New approach to gestational diabetes (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01298-4/fulltext)
  • Gene therapy offers hope for autoimmune diseases. Use of CAR-T, originally intended for cancers, in lupus. Initial findings offer hope to millions of patients with autoimmune diseases, four in five of whom are women (https://www.ft.com/content/a974f4c1-bb8a-4a1b-9d88-a2cf14be5c6e)

Global Health

International health policy

National health policy

Companies

 

 

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

/in /by

 

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

 

 

 

7 days in healthcare (February 21-27, 2022)

/in /by

SUMMARY

From the point of view of biomedicine, Bill Gates predicts another pandemic, although he estimates that he will catch us better prepared. Also to highlight the questioning of the traditional form of clinical trials. The latter is important, since Spain has become a power in clinical trials and it is important to analyze whether it is the right bet.

In terms of global health, it should be noted that COVAX has distributed exactly half of the COVID vaccines that it had as its objective. A great inequity in the distribution of vaccines in the world and, now, also of medicines against COVID.

As for international health policy, great controversy in the United Kingdom due to the lifting of all restrictions against COVID.

In national health policy (Spain), the incidence of COVID is low, although we continue with high mortality and without antivirals. The Ministry of Health takes the expansion of the service portfolio to a public hearing. Medical uneasiness before the reform of the Abortion Law, a BIOSIM proposal to promote the use of biosimilars and controversy over the financing of orphan drugs.

With regard to companies, it should be noted that the manufacture of Ventolín and Nolotil pollutes more than the automotive industry, which indicates how far the pharmaceutical industry has to go in implementing the United Nations Sustainable Development Goals. Also that Quirónsalud has exceeded the turnover of 4,000 million and Fresenius is open to incorporating new shareholders both in Quirónsalud and Eugin.

BIOMEDICINE

GLOBAL HEALTH

INTERNATIONAL HEALTH POLICY

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o The incidence of COVID continues to drop to 613 cases per 100,000 inhabitants (https://elpais.com/sociedad/2022-02-24/ultima-hora-del-coronavirus-hoy-en-espana-y-el-mundo-en-directo.html)

o 245 deaths in the sixth wave and still without antivirals (https://www.larazon.es/sociedad/20220225/3eq7hmpczjfe3ct7ruk3tz56wi.html)

o The subvariant of the stealthy “ómicron” accelerates its expansion in Spain (https://www.larazon.es/sociedad/20220224/3zfep56h6bf7jktf4fqvbnj3yq.html)

  • Political announcements

o The Ministry of Health takes out the draft order for the expansion of the service portfolio for a public hearing. Opinions in this regard can be sent via email informacion.publica@mscbs.es until March 10 (https://www.consalud.es/politica/sanidad-saca-audiencia-publica-orden-ministerial-actualiza-cartera-comun-sns_110420_102.html)

o AIReF announces a study on MUFACE spending in its plan for 2022 (https://www.airef.es/es/noticias/la-airef-publica-su-plan-de-actuaciones-2022-con-una-apuesta-clara-por-la-sostenibilidad-y-la-evaluacion/)

  • Other issues

o The medical groups, against the reform of the abortion law, propose the obligatory nature of performing it in public hospitals (https://www.larazon.es/sociedad/20220225/onwymfclwbbyfiamuan5il533e.html)

o Biosim presents 14 proposals to stimulate the use of biosimilars (https://www.diariofarma.com/2022/02/24/biosim-plantea-14-propuestas-para-fomentar-el-uso-de-los-biosimilares )

o Great controversy over the financing of orphan drugs, while the Ministry publishes a report with improvements in financing since 2016 (https://www.diariofarma.com/2022/02/23/sanidad-publica-un-analisis-sobre-la-financiacion-acceso-y-gasto-de-los-medicamentos-huerfanos-desde-2016) others insist that more than 50% of these medicines are not publicly funded (https://www.redaccionmedica.com/secciones/industria/el-50-de-los-medicamentos-huerfanos-estan-sin-financiar-en-espana-7267)

o The strategic health reserve today has 466 million masks and 955 respirators (https://www.elindependiente.com/espana/2022/02/27/la-reserva-estrategica-de-sanidad-cuenta-hoy-con-466-millones-de-mascarillas-y-955-respiradores/)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR