Posts

7 days in healthcare (January 22nd-28th, 2024)

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Summary

From the point of view of Biomedicine, highlight the article by Dr. Topol, famous American cardiologist and doctor, who says how generative AI can contribute to significantly reducing medical errors, which cause hundreds of thousands of deaths a year in the United States and around the world. An initial cancer screening seems to be making its way through a simple blood test, taking advantage of the sharing of certain molecular characteristics in all cancers. The University of Gothenburg in Sweden is developing a blood test for the early diagnosis of Alzheimer’s disease.

With regard to Global Health, an editorial in The Lancet refers to the economic problems in low- and middle-income countries in addressing health expenditures, given the great weight of debt interest, which is why it proposes as a solution its condonation. The first mass malaria vaccination begins in Africa. Universal healthcare in Tanzania. Universal coverage, long exclusive to Europe and high-income countries (with the exception of the United States), is now spreading to developing countries as well.

In terms of International Health Policy, the next American elections in 2024 already show what could be the priority issues during the campaign for Democrats and Republicans. For the former, reducing the high price of prescription drugs and women’s health (with pro-choice options); for Republicans, overcoming covid-19 and drug overdose. It does not seem that the repeal of Obamacare, which has reached a record of 21 million affiliates, is going to be a priority in the Republican campaign.

If we talk about National Health Policy (Spain), presentation by Minister Mónica García of her priorities in the Congressional health commission. Laws against alcohol consumption in young people and to protect direct public management in public healthcare. Announcement of the legalization of cannabis and increase in the portfolio of services in “dental” and “visual health”. The imminent approval of the Public Health Agency and the reform of the Framework Statute in 2024 are announced. In relation to this last point, it was announced that negotiations are being carried out with the unions and the communities. And what about the professionals? Don’t they have anything to say on this topic? Important announcement by the Ministry of the genetic portfolio of the National Health System, to be launched gradually throughout 2024. Health maps are being reformed and simplified in several communities: Aragón, Cantabria, Valencian Community and Asturias . It is striking that the reforms are promoted by PP governments in the first three communities, while the reform in Asturias, sponsored by a PSOE government, is opposed by the PP. Catalonia promotes the discussion of a National Health Pact. Among other issues, the elimination of the statutory personnel regime is proposed. Possibly this change cannot be made legally from an autonomous community, but the much-needed idea and the opening of the discussion are welcome.

As for Companies, at the international level, Novo Nordisk and Lilly find themselves with a new player in their battle regarding obesity: the Danish biotech company Zeland Pharma. When it comes to national news, the problems with Grifols continue. Interesting article in Expansión on professionalization and corporate governance in family businesses.

Biomedicine

Global Health

International health policy

  • USA
    • Article in JAMA: Focus on health problems in the 2024 American elections. It seems that health care is going to be very present in the American elections. Democrats’ issues are lowering prescription drug prices and women’s health (with pro-choice options); while the Republican issues are overcoming covid-19 and drug overdoses and border control policies in this regard. Despite Trump’s criticism of the Obamacare law, repealing the law is unlikely to be made a campaign priority (https://jamanetwork.com/journals/jama/fullarticle/2814471)
    • Obamacare enrollment boom, reaching 21 million in 2024 (https://www.nytimes.com/2024/01/25/us/politics/obamacare-open-enrollment.html)

National health policy

Companies

 

 

7 days in healthcare (August 14th-20th, 2023)

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Summary

From the point of view of Biomedicine, surely the most far-reaching news is the success obtained with a transplant to a brain-dead human of a genetically modified pig kidney, which worked perfectly, both from the point of view of renal function and of non-rejection. This represents great hope for transplants, especially in the United States where transplant waiting lists are very long. It is estimated that some 5,000 people in the USA die each year waiting for a kidney transplant. The idea is to request authorization from the FDA to carry out a clinical trial.

As far as Global Health is concerned, an interesting WHO summit in India on traditional medicine (which includes treatments as varied as Ayurveda, yoga, homeopathy and complementary therapies), although we don’t have to expect much from the results. The truth is that traditional medicine is followed by billions of people and the WHO wants to see how it integrates with conventional medicine. The Lancet comments that malnutrition is the greatest risk for tuberculosis. In fact between 1900 and 1940 the incidence of tuberculosis plummeted, in the absence of any effective treatment or vaccines, simply because of improved socioeconomic conditions.

As for International Health Policy, two Chinese manufacturers are making “copycats” of weight-loss drugs, threatening Western companies in their development in this huge obesity market. An international study (United States, Germany and Switzerland) warns of the “cancer premium” in the price of medicines, which reaches up to three times that of medicines for other diseases, this price not being justified either by the manufacturing process or by because of the research, but, fundamentally, because of the extreme concern and anguish in the face of this disease. Although the study refers to those countries, this phenomenon occurs in all nations, including Spain.

If we talk about National Health Policy (Spain), denounce the low rates of insurers with doctors. Although the matter will surely have many nuances, the truth is that the low rate of insurers (20 euros on average for a first consultation and 10 for a subsequent one) make this model of care provision very unstable. La Rioja proposes with the new government of the PP to have a Faculty of Medicine. The map of the Faculties of Medicine in Spain has been highly denounced both by the Association of Medical Students and by the Medical Deans’ Conference. We have a ratio of medical schools per population that is second only to South Korea, of course much higher than that of France, the United Kingdom and Germany, which should be our benchmarks. The peculiar distribution of powers between the State, the communities and the Universities has led to this certainly anomalous situation. The pharmaceutical industry has become the leading export sector in Spain, ahead of the automobile industry, which traditionally led the ranking. A complete success for this industry, of which there are 173 production plants, most of them in Catalonia, followed by Madrid.

In the field of Companies, at the international level, Novartis plans to separate from Sandoz (its division for generics and biosimilars), following the same path as Pfizer with its Upjohn generic business, which it merged with Mylan to form Viatris. Various private equity firms interested in the operation. At the national level, it is worth highlighting the large increase in Ferrer’s profit.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

7 days in healthcare (August 21st-28th, 2022)

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Summary

From the point of view of biomedicine, the very encouraging results of the polypill published by a Spanish group led by Valentin Fuster should be highlighted. The Economist underlines the great future of gene therapies in medicine, with a list of diseases for which there is a therapy or is in advanced study.

Regarding Global Health, The Lancet publishes a report with some conclusions and lessons regarding future pandemics.

As for International Health Policy, both monkeypox and covid are plummeting in Europe. The controversial annulment of the Roe v Wade ruling in the United States, which leaves the right to abortion to the criteria and regulation of the states, continues to be talked about. American companies, including Walmart, the largest American employer, introduce this benefit for women, regardless of the state where they work.

If we talk about National Health Policy (Spain), covid continues to drop and especially the number of cases in the ICU. The Government approves the bill that creates the Public Health Agency, probably the largest, if not the only, far-reaching measure after the pandemic. The text of the law is not yet public, and therefore important aspects such as governance and functions are not known. The location is not known either, although the Government has advanced that it would not be in Madrid, which is not without controversy either. Next week the government will approve the abortion law, according to a text promoted by Podemos.

In the field of companies, Moderna’s lawsuit against Pfizer and BioNTech has been shocked, which it accuses of plagiarism of its mRNA technology in the covid vaccine. Amazon closes its telecare service, which once again demonstrates the difficulties of the large technology platforms in finding an adequate strategy for health, a sector in which they want to be above all else. In Spain, the export of drugs manufactured in Spain grows by 60% in one year.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

 

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

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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

 

7 days in healthcare (January 31-February 6, 2022)

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SUMMARY

As far as biomedicine is concerned, the report on the value of death by The Lancet stands out; also the development of the nasal vaccine against COVID; the new horizon of transplants, derived from the possibilities of genetic editing of animal organs; and, the revolution that the new cancer vaccines based on mRNA technology may entail.

In terms of global health, the AstraZeneca vaccine is the most widely used worldwide, due to its contribution to COVAX. More than 2,500 million doses have been placed globally.

In international health policy, the most striking is the study by Johns Hopkins University, which minimizes the effectiveness of confinement, which contrasts with previous studies; the 900,000 deaths from COVID in the United States and the 500,000 in India; the WTO continues to request the release of vaccine patents. In Europe, it is worth highlighting the new clinical trial system approved by the European Union and its new approach to cancer.

National health policy continues to be dominated by COVID. The numbers of cases are decreasing, which speaks of the decline of the “sixth wave”. However, deaths are still very high. The announcement that oncological biomarkers will be included in the portfolio of the National Health System is very important. Cancer mapping in Spain presents very striking results, with a high concentration of cancer incidence in certain geographical areas. Subject to study and act.

In company news, the leading role of venture capital companies is notable, with the large operations underway by Sandoz (a generic and biosimilar branch of Novartis) and IVI (a Spanish fertility company). The interest of private equity companies is concentrated around these companies. Also the acquisition of MIR Asturias by CVC and the Alfonso X University. The attempt by Correos to enter pharmaceutical distribution will bring a tail.

BIOMEDICINE

  • Report on the value of death: while in developed countries there is hypertreatment around death, in most countries death occurs without access to basic pain treatment (The Lancet, January 31, 22)
  • The nasal vaccine may be better for successive doses. There are a dozen such vaccines in development in phase 3 trials (NYT, February 2, 22)
  • The “stealth” variant (stealth) does not generate alarm, but it can slow down the decline in the number of cases (NYT, January 31, 22)
  • The sub-variant “ómicron” BA.2, more contagious than the original (FT, 31 January 22)
  • The new variant BA.2, already present in 57 countries, according to the WHO (FT, February 3, 22)
  • New variant of the HIV virus, discovered in the Netherlands (FT, February 3, 22)
  • Genetic editing of pig hearts: a new horizon for transplants (FT, February 2, 22)
  • Cancer vaccines: the new mRNA revolution (El País, Vozpópuli, February 4, 22)
  • Amidst the wide debate on abortion, a simple pill seems the most viable option (The Economist, 5 February 22)

GLOBAL HEALTH

  • AstraZeneca, the most distributed vaccine through COVAX, has already given 2,500 million doses worldwide (ConSalud, January 31, 22)
  • Humanitarian groups denounce that sanctions against Mali may have very adverse health consequences (The Lancet, February 5, 22)

INTERNATIONAL HEALTH POLICY

  • COVID

o A study by Johns Hopkins University (Applied Economics Studies magazine) questions the effectiveness of confinement in reducing mortality, which contrasts with the analysis published in Nature in June 2020, which estimates that three million deaths have been prevented in Europe by confinement, 450,000 in Spain (El Independiente, February 3, 22)

o The UK approves the Novavax vaccine (FT, 3 February 22)

o The American army begins to fire its members who refuse the vaccine (The Guardian, February 2, 22)

o The New Zealand border will be reopened in phases from the end of February, the Prime Minister announces (The Guardian, 2 February 22)

o The United States reaches 900,000 deaths from COVID (The Guardian, February 4, 22)

o India exceeds 500,000 deaths from COVID (The Guardian, February 4, 22)

o Europe facing a “long period of tranquility” in the pandemic, says the WHO, due to the lesser severity of the “ómicron” variant, the high percentages of immunization and the good weather (The Guardian, February 3, 22)

o The WTO (World Trade Organization) wants an agreement to release vaccine patents this month (El Español, February 1, 22)

o The German Vaccine Commission recommends the fourth dose for vulnerable and health groups (El País, February 3, 22)

o Beijing seals off several communities for two cases of COVID (The Guardian, January 31, 22)

o The COVID vaccine is already mandatory in Austria, with a great social fracture (Expansión, February 5, 22)

  • Other issues

o New clinical trial system in Europe, which Farmaindustria sees as an opportunity (diariofarma, February 1, 22)

o The EU will act against inequalities against cancer (ConSalud, February 3, 22)

NATIONAL HEALTH POLICY (SPAIN)

  • COVID

o The sixth wave is being left behind, the cases and hospitalizations are slowing down, although not the deaths that already exceed 6,000 since November (El País, February 5, 22)

o The mask outdoors will no longer be mandatory from next Thursday (El País, February 4, 22)

o Health has not yet closed the purchase of 344,000 doses of Paxlovid (El Español, February 3, 22)

o The AEM authorizes the HIPRA vaccine to go to phase 3 of clinical trials (The Objective, February 1, 22)

  • Political ads

o The new public health center, affected by the decentralization of public offices (diariofarma, February 1, 22)

o The approval of oncological biomarkers, announced as a pending objective of the expansion of the NHS portfolio (diariofarma, February 1, 22)

o The Minister of Health says that the Anti-Tobacco Law needs to be updated (ConSalud, February 4, 22)

  • Other issues

o 27% of pharmaceutical innovations approved in 2021, subject to special financing conditions (diariofarma, February 1, 22)

o Access to new cancer drugs takes more than 19 months in Spain, while in Germany it takes two months, according to doctors and patients (La Vanguardia, February 2, 22)

o Health plan to make rural pharmacies more viable (ConSalud, January 28, 2022)

o The private e-prescription is consolidated (diariofarma, February 2, 22)

o The cartography of cancer in Spain has been published, with very striking results, according to the “Atlas of Cancer Mortality in Portugal and Spain” (El Periódico de España, February 5, 22)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

  • American pharmaceutical companies (J&J and three of the largest drug distributors in the United States) agree to pay 590 million dollars to Native Americans for the opioid crisis (El País, February 1, 22)
  • Pharmaceutical cold distribution, new Correos service (Redacción Médica, February 2, 22)
  • Pfizer-Biontech requests authorization from the FDA for the approval of the vaccine for children under 5 years of age (El País, February 1, 22)
  • Private equity companies consider offers of more than 25,000 million dollars for the generics unit of Novartis, Sandoz, Blackstone, Carlyle and EQT, among the most interested (FT, February 1, 22)
  • KKR, CVC, Permira, Bain, Carlyle and PAI outline their bids to take over the fertility company of Valencian origin IVI, the bids range from 1,500 million euros (CincoDías, January 31, 22)
  • Atrys enters the continuous market, as of February 7 (PlantaDoce, February 3, 22)
  • Sanitas gains ground and plans to open 7 rehabilitation centers in 2022 (PlantaDoce, February 1, 22)
  • Adeslas and Caixabank extend their agreement in the Bankia network for 650 million euros (CincoDías, January 27, 22)
  • MIR Asturias acquired by CVC and Alfonso X University (La Nueva España, February 3, 22)
  • Quirón acquires Clínicas Vida and strengthens its care network in Tenerife (PlantaDoce, January 28, 22)
  • Vitaldent expands throughout Andalusia and opens a new clinic in Benalmádena (PlantaDoce, February 3, 22)
  • Group 5 opens a residence for serious mental disorders in Madrid (PlantaDoce, February 3, 22)
  • Prim is reinforced with the purchase of Herbitas laboratories (Expansión, February 4, 22)
  • Pharmamar leads a consortium of companies for the development of advanced therapies (El Economista, February 3, 22)