Posts

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

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Summary

Biomedicine

  • Anniversary of IVF. The first in vitro baby turns forty years old, with the technique becoming the new normal. After 40 years of development and 12 million children born thanks to it, the technique has reached maturity, with less invasive techniques, more effective procedures and a change in the patient profile.
  • “Common Sense Oncology”. This association wants to provoke a public debate about a worrying trend in oncology. Although many cancer treatments have saved the lives of many patients or have prolonged their lives with well-being, there are more and more that offer small benefits for a very high price, a lot of toxicity and keeping patients in the hospital for a long time. time at the end of life.
  • Not everything is good at Ozempic. Harvard researchers link it to an increased risk of blindness.

Global Health

  • Political courage needed to prevent the next pandemic. In May 2021, the Independent Panel for Pandemic Preparedness and Response recommended a set of actions to make Covid-19 the latest pandemic with similar devastation. Three years later, progress is very limited, even though the threats are there.
  • 50% of the population will have myopia in 2050. Experts say that the abuse of screens and little outdoor activity favor this pathology.
  • The approval of a vaccine does not necessarily mean its dissemination. Although the malaria vaccine was approved in 2015, it was not included in vaccination programs in Africa until 2024.

International health policy

  • Biden calls on NovoNordisk and Lilly to lower the price of their slimming products. Both the President and Senator Bernie Sanders ask these companies to lower the price in a joint article published in USA Today, since they estimate that the cost is $1,100 per month.
  • Labour considers strengthening Whitehall (government) control over the NHS. It seems that Alan Milburn, former Minister of Health (1999-2003) under Tony Blair, who defends a greater role for the private sector, is playing an active role in the NHS plans. We will have to be very attentive from Spain to the movements in the NHS.
  • Australia against recreational vaping. In this pioneering country in the fight against smoking, vapes can only be purchased in pharmacies.
  • Thailand: the successes of universal coverage in a developing country. Life expectancy is 80 years (which must be compared with 73 in South East Asia). Last year 99.5% of the population of 72 million people was covered by health insurance. The GDP per capita is 11 times less than that of the USA.

National Health Policy (Spain)

  • The government approves the specialty of Urgencies and Emergencies. This ends an unprecedented situation in Europe. Currently, most of these professionals came from Primary Care, aggravating the crisis that this specialty is experiencing. The training of the new four-year specialty will be done in accredited teaching units. Infectious and Genetics are now the specialties awaiting recognition.
  • A Pact for Health is in sight in Balares and the Basque Country. In the absence of progress on a national plan, these regional pacts are welcome.
  • Health barometer (April-May 2024). Citizens’ assessment of public health has improved in the last year, although it is still below what it was before the pandemic. The grade for primary care is 6.29, compared to 6.19 a year ago, while hospitals and the care received in them continue to be the most valued by citizens: 7.51 points for emergencies and 7 .14 ​​points for “hospital care”. Regarding waiting lists, the percentage of citizens who consider that they have worsened is reduced by more than four points, from 39.2% to 34.6%.

Companies

  • International
    • Aging is the new horizon for investors. In 2050, 16% of the population will be over 65 years old, up from 9% today. In the United States and Europe this figure will be 27%. Healthcare is an obvious beneficiary. The universe reaches to pharma, implants and devices and services related to dental and eye care. Aside from treatments, financial services and hospital providers will play a greater role.
    • The FDA approves Lilly’s new drug (Kinsula, scientifically donanemab) against early Alzheimer’s. Lilly enters that market after Biogen and Eisai. The drug slows the development of Alzheimer’s, which causes memory loss, dementia and other cognitive impairments. The price will be $32,000 per year of treatment, 20% more than its rival Leqembi. Both treatments act on amyloid plaque in the brain.
  • National
    • Two new biopharmaceutical companies will operate in España. These are the American Dr. Ferrer and the German Bionorica.
    • HM hospitals increase their billing significantly. HM hospitals grow by 50% in billing in 2023 and exceed 650 million.

Biomedicine

Global Health

International health policy

  • Brazil
    • New abortion law in Brazil. Thousands of protesters have protested against what they consider an attack on women’s rights. The new law makes abortion after 22 weeks equivalent to homicide. In Brazil there are three situations in which abortion is permitted by law: fetal anencephaly, life-threatening pregnancy for the mother, and pregnancy resulting from rape (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01392-8/abstract)
  • Thailand

National health policy

Companies

7 days in healthcare (December 11th-17th, 2023)

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Summary

From the point of view of Biomedicine, CRISPR therapy, which begins with sickle cell anemia, is great hope. In the end, the FDA approves two gene therapies for this disease, which affects 7.7 million people globally and is a chronic, debilitating disease that causes pain and reduces the quality and expectancy of life. New approved therapies include extraction, genetic modification and reinfusion into patients of their own hematopoietic stem cells. The problem is that these patients live mainly in sub-Saharan Africa and India, which are far from having the infrastructure to apply this therapy. The price of these therapies is about 2 million euros per patient, which again raises the problem of the problems of universalization of precision medicine. Ozempic, Alzheimer’s drugs and malaria vaccines among the scientific milestones of 2023 for Science magazine. For its part, Nature magazine chooses a non-human among its scientists of the year: ChatGPT.

As far as Global Health is concerned, in the end, an international agreement is reached on the end of fossil fuels. COP28 was the first global conference on the subject after the Paris agreement in 2015 (COP21) in which a global limit to temperature growth was established at 1.5º. On December 13, 2023, the agreement on net zero emissions by 2050 will be reached. Fossil fuels generate a lot of wealth, but they are also the bulk of CO2 emissions. The problem is that there is no system that forces governments to meet that objective. A global treaty on plastics is proposed by the United Nations General Assembly (March, 2022). Plastic pollution is a global threat, since plastic is persistent and less than 10% is recycled, almost 6 billion tons now pollute the planet. This contains more than 10,500 chemicals, which includes carcinogens, neurotoxicants, etc.

Regarding International Health Policy, design by the European Union of a Plan to avoid shortages of more than 260 critical medicines, which includes storage and incentives for production

If we talk about National Health Policy (Spain), one in ten Spaniards on the waiting list, record numbers in health. At this moment there are 820,000 people to undergo surgery, a figure never reached. The Ministry of Health wants to raise this problem with the communities at the in-person meeting of the Interterritorial Council in Asturias on December 21. In theory there are two solutions: either self-concertation (the disdainfully called “peonadas”) or agreements with the private sector. In both cases money is needed. It is also necessary to review the indications, circuits and priorities. The CIS Barometer is released (3rd wave, October 2023). 57.5% value positively the functioning of the National Health System, which means a great setback with respect to previous editions. In an article in El País whose first signatory is Félix Lobo, it is proposed to strengthen the Ministry of Health. In 45 years there have been 28 ministers. And organizations with a clear health component have been separated from the Ministry, such as the Carlos III Health Institute, the Government Delegation for the National Drug Plan and the Food Safety and Nutrition Agency (AESAN). Although this reinforcement is necessary, it must surely be complemented with what we could call “cohesion bodies”, among which could be HISPANICE, also proposed by FUNCAS.

In the field of Companies, on an international level, Cigna renounces creating a health insurance giant in the USA, by becoming part of Humana. AstraZeneca enters the world of vaccines. Regarding national news, Quirón advances in the construction of its hospital in Gijón (Asturias) and receives from the Ministry of Defense the management of the hospital on Isaac Peral Street (former Generalísimo Franco), closed for more than 30 years. Good results from Miranza and Ribera, the latter contemplating three new projects.

Biomedicine

Global Health

International health policy

National health policy

  • Waiting lists
    • One in ten Spaniards on the waiting list, record figures in healthcare. At this moment there are 820,000 people to undergo surgery, a figure never reached. The Ministry of Health wants to raise this problem with the communities at the in-person meeting of the Interterritorial Council in Asturias on December 21. In theory there are two solutions: either self-concertion (the so-called “peonadas”) or conciliation with the private sector. In both cases money is needed. It is also necessary to review the indications, circuits and priorities (https://www.eldiario.es/sociedad/diez-espanoles-lista-espera-cifras-record-sanidad-quiere-atajar_1_10708957.html)
  • It is proposed to strengthen the Ministry of Health
    • In an article in El País whose first signatory is Félix Lobo, it is proposed to strengthen the Ministry of Health. In 45 years there have been 28 ministers. And organizations with a clear health component have been separated from the Ministry, such as the Carlos III Health Institute, the Government Delegation for the National Drug Plan and the Food Safety and Nutrition Agency (AESAN) (https://elpais.com/society/2023-12-11/potenciar-el-ministerio-de-sanidad.html)

Companies

 

7 days in healthcare (September 18th-24th, 2023)

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Summary

From the point of view of Biomedicine, Nature magazine in an article returns to artificial intelligence as an accelerator of the introduction of new medicines, also making the process less expensive. A second patient is implanted with a genetically modified pig heart. The prospects for transplants with animal organs are opening up more and more. Google (Deep Mind) identifies millions of mutations in proteins capable of generating disease, which will allow a much better understanding of numerous diseases.

Regarding Global Health, article in Science about the eradication of polio, which was a goal for the year 2000, but not yet achieved. Despite the success of vaccination campaigns, polio is still present in Afghanistan and Pakistan. Nature magazine warns of the danger that the pandemic treaty will not be concluded by 2024, as was the objective. The need to make vaccines accessible to everyone in all countries and the protection of intellectual property through patents, in contradiction, hinders progress.

Regarding International Health Policy, JAMA reviews the historic negotiation by Medicare of the price of prescription drugs, exposing the reservations of pharmaceutical companies and the different demands presented by each of them to the American government. Prime Minister Sunak is considering the possibility of banning the use of tobacco for new generations, in a way similar to that implemented in New Zealand. A report from the Institute for Public Policy Research (IPPR) states that in the United Kingdom there were 240,000 deaths in the period 2010-2020, which could have been avoided if standards of care on the European average had been applied. This is largely attributed to difficulties in access (in other words, waiting lists).

If we talk about National Health Policy (Spain), after an attempt at regional rebellion, the Ministry has had to withdraw the measure that provided for vaccination of health workers with the Hipra vaccine, not adapted for the new strains. Although the Ministry has not yet made public the announced report on the management of Covid, commissioned from four well-known experts, a group of prestigious academics has just published a valuable report on healthcare at the post-Covid crossroads. Changes in health are announced in both the Community of Madrid and Valencia. Time will tell if these changes address the real problems or remain cosmetic changes, to which some politicians are so accustomed. In Madrid, the final destination of the Zendal hospital does not seem to be clear, apart from its temporary use as a center for ALS. It is the consequence of building a large center without an adequate functional plan. The valuable EPINE report shows that more than 7,000 deaths occurred each year in Spain as a result of nosocomial infections. The conflict between doctors and health insurers, which began in Seville, threatens to spread to other communities, including Madrid.

In the field of Companies, on an international level, Abbot plans to acquire Bigfoot Biomedical at the end of 2023. On a national level, Novo Nordisk plans to open a technological and digital headquarters in Spain, which, if confirmed, would be excellent news.

Biomedicine

Global Health

International health policy

National health policy

Companies