Posts

7 days in healthcare (June, 10th-16th, 2024)

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Summary

Biomedicine

  • 40 years after the discovery of Helicobacter pylorii. The discovery of Helicobacter pylorii 40 years ago revolutionized the treatment of gastritis, peptic ulcer and stomach cancer, leading to Barry Marshall and Robin Warren being awarded the Nobel Prize in Medicine in 2005. This discovery transformed an incurable disease into one treatable with antibiotics. However, Helicobacter pylorii has a global prevalence of 35% among children and adolescents, especially in poor countries. This requires strengthening essential measures to reduce infection, such as hygiene education, water treatment and other health measures.
  • The Lancet Editorial: Taking persistent physical symptoms seriously. These complex symptoms are incorrectly treated by health systems. Recognizing that they were misguided by the traditional biomedical model, in 1977 the biopsychosocial model was proposed, which has been criticized. Now a new model is proposed, as a starting point for a correct approach to this problem.
  • The future of academic medicine. Academic medicine is in crisis globally, as demonstrated by commercial pressures and useless research and publications, which consume a lot of money. However, academic medicine is basic and science is the basis of medical practice and medical education. Evidence-based medicine, including research and practice, is the core element of academic medicine. The British Medical Journal launches a new global commission on the future of academic medicine.

Global Health

  • Hopes for a pandemic treaty, despite the failure to meet the deadline. Along with the extension of the Pandemic Treaty deadline to 2025, an important partial agreement was reached: the review of rules to prevent the global spread of some infections. Even in the global Treaty, much progress was made, which allows for a certain optimism.
  • Vaccine manufacturing is promoted in Africa. The African Vaccine Manufacturing Accelerator (AVMA), a new $1 billion+ initiative, an innovative financing mechanism designed by GAVI, offers African producers financial incentives to produce vaccines. The initiative will be launched at a high-level event in Paris.
  • 10 years after the 2014-2016 Ebola epidemic in Africa. The crisis initially affected Guinea, Liberia and Sierra Leone and it took months to identify the cause and almost three years to contain it, after claiming thousands of lives. The epidemic revealed weak health systems, poor detection mechanisms and inadequate response. Since then, work has been done on preparation for these risks, response mechanisms and international collaboration.

International health policy

  • Forecasts for 2023-32 healthcare expenditures in the United States. Healthcare spending is projected to grow faster than GDP growth over the next decade, reaching 19.7% of GDP in 2032 (from 17.3% in 2022). This indicates a large increase in the use of health services, linked to an increase in coverage that is estimated at 93.1% this year.
  • The King’s Fund summarizes the manifestos of the different parties (Labour, Conservative and Liberal-Democratic) on health ahead of the elections. The different proposals are analyzed in relation to: social care reform; access to hospitals; access to primary care and community services; access to dental care; additional funding commitments; investments in capital and buildings; social care funding; training and selection of personnel; support to social services personnel; international recruitment and migration; prevention, inequities and public health; mental health, learning disabilities and autism; cancer; maternity and women’s health services; medicines, research and life sciences; digital transformation and technology; and, other proposals.
  • “Aid in dying” in France. With the dissolution of the National Assembly, the “aid in dying” law is delayed indefinitely. With the call for elections, a very advanced legislative process declines, preceded by a great national debate with the personal intervention of President Macron.
  • Advanced practice nursing in Belgium. A Royal Decree establishes the functions of advanced practice nursing, in an attempt to define different profiles of nurses and make the profession more attractive. Maybe a good lesson for Spain.
  • Four industries responsible for 2.7 million deaths in Europe each year (7,400 per day): tobacco, alcohol, ultra-processed foods and fossil fuels.

National Health Policy (Spain)

  • Public Management and Integrity Law. Competence doubts complicate the processing of this Law, which is surely good news, given the government’s intentions.
  • Approved the law creating the Andalusian Health Institute. This is a new entity that brings together the Andalusian School of Public Health (EASP), the Progreso y Salud Foundation, as well as the General Secretariat of Public Health and R&D&I of the Ministry of Health, and will take the legal form of an agency. administrative and will have the nature of a public research organization. The headquarters will be in Seville, in the Ministry. Although we do not know the effects that this reform will have, the PP’s history in Andalusia of making public health companies disappear does not allow us to conceive much hope, on the contrary.
  • Adeslas threatens to leave MUFACE if conditions do not improve. Given that Adeslas does not usually make statements lightly, it must be considered that there is a real risk of the system disappearing.
  • Controversy over waiting for medications. Spain increases the wait for medicines, but improves availability, according to the WAIT report, prepared by the consulting firm IQVIA for the European Federation of Pharmaceutical Industries. The report says that in two years Spain has gone from 53% to 62% availability (compared to 88% in Germany or 77% in Italy), but the waiting time has gone from 629 to 661 days, almost two years of delay. On the other hand, César Hernández, general director of the Common Portfolio of the SNS and Pharmacy, criticizes the report and says that we are the country with the most access. The report does not take into account access through the mechanism provided for in RD 1015/2009, as well as medicines that arrive through clinical trials. Although the situation of access to medicines can surely be improved – and not only by the Ministry, but also by the intervention of the autonomous communities and hospitals – it does not seem that this issue is one of the most serious problems of the system, compared to what some they proclaim.
  • Public Health Agency. The Health Commission of June 19 will not address the State Public Health Agency, which will not be analyzed by this Commission until after the summer. This is interpreted as another milestone in the long history of delays of this initiative.
  • Center for Minority Diseases in Barcelona. Agreement between the Sant Joan de Deu Hospital and the Amancio Ortega Foundation for the launch of this center that will have financing of 60 million euros and will have a space of 14,000 square meters in a six-story building. With various genomics, metabolomics and radiomics platforms. The center will be part of the Red Única, a network made up of 30 hospitals throughout Spain and promoted by the Sant Joan de Deu Hospital and the Spanish Federation of Rare Diseases. Another great success for the Sant Joan de Deu Hospital, which many of us are already accustomed to.

Companies

  • International
    • Approved a new drug against Alzheimer’s. FDA panel approves Lilly’s Alzheimer’s drug. The modest benefits of Lilly’s drug donanemab outweigh the risks, the panel unanimously concludes.
  • National
    • Ribera incorporates the Covadonga Hospital in Gijón, with this incorporation there will now be six Spanish communities in which Ribera is present (Valencian Community, Murcia, Madrid, Galicia, Extremadura and Asturias).
    • Terafront Pharmatech, the Spanish semi-public pharmaceutical company, will have its own factory. Terafront will manufacture its own therapies and has chosen to build its own facilities, compared to other options being considered.

Biomedicine

Global Health

International health policy

National health policy

  • CSIC Biomedicine Strategic Plan
    • The CSIC presents its Strategic plan in Biomedicine. This plan is based on 10 strategic axes, among which are: strengthening internal communication and collaboration between researchers; create new collaborative structures with companies, hospitals and universities; increase the presence of the CSIC in key international organizations; improve knowledge transfer to industry and the health sector; attract or retain young talent: Key actions: the creation of a Rare Diseases Network; the creation of a OneHealth Bassoon Library; the creation of the Biomed Transfer Services Network (https://www.consalud.es/saludigital/innovacion-tecnologica/csic-presenta-plan-estrategico-biomedicina-liderar-innovacion-en-salud_144755_102.html)
  • Center for minority diseases in Barcelona
    • Agreement between the Sant Joan de Deu Hospital and the Amancio Ortega Foundation for the launch of this center that will have financing of 60 million euros and will have a space of 14,000 square meters in a six-story building. With various genomics, metabolomics and radiomics platforms. The center will be part of the Red Única, a network made up of 30 hospitals throughout Spain and promoted by the Sant Joan de Deu Hospital and the Spanish Federation of Rare Diseases (https://www.diariomedico.com/medicina/investigacion/primer-step-creation-pioneer-center-minority-diseases.html)

Companies

7 days in healthcare (June 3rd-9th, 2024)

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Summary

Biomedicine

  • Scientists who have revolutionized the treatment of obesity win the Princess of Asturias Award. This is the Canadian Daniel J Drucker; by the Danish Jens Juul Holst; and the Americans Jeffrey M Friedman, Joel F Habener and Stevlana Mojsov, whose research has culminated in several drugs to combat diabetes and obesity, such as Ozempic, an injectable drug whose sales are generating billions of euros each year.
  • Need to integrate scientific advances with the clinic and the community. Despite great progress in biomedical research in the USA, the health of Americans seems to be getting worse every day. This suggests that research should be integrated into clinical care and community settings.
  • Persistent Covid. A new report from the National Academies of the USA identifies up to 200 symptoms in persistent covid, to the point of making work difficult and lasting for months or years.

Global Health

  • Failure, after two years of negotiations, of the Pandemic Treaty. Pharmaceutical companies had opposed part of the deal. Oxfam International blames rich countries for lack of agreement.
  • Regional hub for the production of mRNA vaccines in Africa. Rwanda is positioned as the future regional hub in the production of mRNA vaccines. BioNTech wants to develop this technology in this country, totally devoid of a pharmaceutical industry.

International health policy

  • The American Cancer Society begins a prospective study with 100,000 black women. A large long-term study of cancer in black women begins. The American Cancer Society aims to enroll 100,000 black women to follow them for three decades and reach conclusions about the cause of more cancers and greater mortality.
  • AI-based hospital in China. China inaugurates the world’s first AI hospital that can treat 3,000 patients a day. The hospital, called Agent Hospital, will be the world’s first hospital fully powered by artificial intelligence and consists of a virtual clinic that employs AI-generated doctors and nurses to treat patients in a simulated environment. It is expected to diagnose diseases and establish treatment plans with an accuracy of 93.06%. Despite having only 14 doctors and 4 nurses, it is expected to be able to care for about 3,000 patients a day.
  • “Less medicines” program in France, promoted by the pharmaceutical industry. “The pharmaceutical industry launches a campaign to promote sobriety of medications from the age of 65. It is surprising that this initiative comes from an industry whose business model is based on selling medicines.
  • Portugal launches a general emergency program to transform the health system. The government publishes an emergency and transformation plan for health. The plan is structured into five strategic axes: 1. Response on time and hours; 2. Safety for babies; 3. Urgent and emergent care; 4. Nearby and family health; and, 5. Mental Health. For each of the strategic axes, urgent measures, priority measures and structural measures are established. Apart from that, five transversal programs are defined: 1. Contingency programs; 2. Evaluation programs; 3. Efficiency programs; 4. Medication programs; and, 5. Priority clinical programs.
  • Guarantee of waiting lists in Sweden. Sweden had passed a law guaranteeing waiting times already in 2010, which was never complied with. The new law reduces maximum waiting times and offers the patient the possibility of going to a center outside their region, at no extra cost.

National Health Policy (Spain)

  • Allegations continue to be known about the announced Public Management and Integrity law: News continues about the allegations presented to this public consultation, in this case those of the IMAS Foundation, which insists on general measures on public management, not only those of management by private companies. Regarding the CSC’s allegations, they focus on defending the Catalan healthcare model, in this case the consortia.
  • Covid. Covid cases have doubled in Spain in the last fifteen days.
  • Steps are taken to launch semi-public pharmaceuticals. The company called Terafront Pharmatech will have initial capital of 74 million euros, half public capital and the rest private. According to Minister Morant, the aim is that, being leaders in clinical trials, the patents do not end up being purchased by foreign companies.

Companies

  • International
    • Sanofi spin-off. Sanofi is going ahead with the spin-off of the consumer division for 20 billion euros.
  • National
    • New university hospital in Madrid. Hospitén lays the first stone of its future university hospital in Madrid. The hospital will mean a total investment of 200 million euros, it will have 160 hospital beds, twelve ICU beds, twenty emergency beds and 22 for a day hospital. It will have 17 operating rooms.

Biomedicine

Global Health

International health policy

National health policy

Companies