Posts

7 days in healthcare (November 6th-12th, 2023)

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Summary

From the point of view of Biomedicine, Victor R. Fuchs, a pioneer of health economics and possibly the most recognized and prestigious health economist in the world, dies. He always defended universal health coverage for the United States, although he was very aware of the difficulties of its implementation, due, among other circumstances that he explained, to the heterogeneity of American society. And it must be said that he was not wrong in that. The FDA has just approved an oral drug based on the intestinal microbiome, a new horizon in medicine.

As far as Global Health is concerned, although tuberculosis is preventable and treatable, it continues to be the infectious disease with the most mortality globally, after a short period of time in which it was covid. But 40% of the world’s population with tuberculosis is not treated.

In terms of International Health Policy, it seems that the covid pandemic did not damage developed economies as much as initially thought. This seems to be deduced from studies of initials from the United Kingdom and Italy. The EFPIA, the pharmaceutical industry’s association, continues to complain that the new European legislation could end incentives for innovation and put Europe in an even worse relative position than the one it already has with respect to the USA and China. The OECD has just published “Health at a Glance 2023”, a must-read.

If we talk about National Health Policy (Spain), the agreements of the PSOE and Junts (and also those signed with the PNV for the Basque Country and with the BNG for Galicia) contemplate the transfer of powers over the MIR (and in the case of the Basque Country also of the issuance of titles). Some say that constitutional values and democratic principles have been subordinated in the investiture agreements. Obviously, this does not happen with the MIR, but an important value is put at risk: the cohesion of the National Health System, based, among other issues, on the uniformity of the training system and recognition of titles and specialties, being , on the other hand, a highly recognized system. 11 public hospitals appear to be starting a lung cancer screening program. Since this procedure is not recognized in the SNS service portfolio, the innocent question is: who pays for this? Or is it simply a pilot program with special funding? The Community of Madrid proposes a modification of the current Law of Good Government, which required the appointment of managers of health centers by competition and which at the time was approved by broad consensus, to another system that allows the direct appointment of these positions by part of the SERMAS Board of Directors.

In relation to Companies, at the international level, the battle between pharmaceutical companies in relation to obesity continues (the main players are NovoNordisk, Lilly and AstraZeneca). Amazon is relaunching in health, providing health services through One Medical to its premium customers. At the national level, great growth in the 22nd year of dental, ophthalmological and aesthetic clinics. The purchase of the Eugin assisted reproduction clinics from Fresenius by KKR and GED is completed. The latter retains the business in Spain, while KKR will integrate the international business into IVI RMA.

Biomedicine

Global Health

International health policy

  • United Kingdom and the National Health Service
  • OECD
    • The OECD publishes “Health at a glance 2023”. Main conclusions: healthcare systems are under severe financial pressure; there has been no complete recovery after covid; unhealthy lifestyles cause millions of deaths; Access barriers persist, despite universal coverage in most OECD countries; the quality of care is improving; digital health has immense potential (https://www.oecd.org/health/health-at-a-glance/)

National health policy

Companies

 

 

7 days in healthcare (June 26th-July 2nd, 2023)

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Summary

From the point of view of Biomedicine, clinical trials in humans begin with drugs developed by artificial intelligence, such as one for idiopathic pulmonary fibrosis. Álvaro Pascual-Leone, a prestigious Spanish neuroscientist based in the United States, announces that in about ten years the brain will be able to be manipulated . Surely at that time the manipulation of the brain will be something as normal as today the replacement of the crystalline lens for the cataract. A new world is coming.

In Global Health, two charities (the Gates Foundation and the Wellcome Foundation) set to fund a TB vaccine, which could save 8.5 million lives over the next quarter century. Gavi, the organization that provides vaccines to developing countries, approves a vaccine that protects against polio and five other diseases.

Regarding International Health Policy, the editor of the American Journal Medicine publishes in the last issue an article with the five great challenges of the American health system in the 21st century. However, from a reporting point of view, the most interesting news comes from the UK. The King’s Fund, a major British health think tank, publishes a comparative analysis of that country’s health system, which it analyzes together with 19 health systems, including the Spanish one. The analysis is very interesting, and the conclusion is that the NHS is efficient, but with big problems, not only with waiting lists, but also with results. It seems to imply a chronic underfunding of the NHS, when compared to systems in other countries. For its part, the NHS publishes for the first time a long-term plan on personnel. It basically deals with three things: training, retention and reform. The Guardian hails the report but says it is years overdue. For their part, both The Lancet and the British Medical Journal publish editorials on the 75th anniversary of the NHS, which coincides with its deep crisis. In both positions, political consensus is claimed as a key piece to fix the serious problems of the NHS. The WHO-Europe publishes a document with architectural recommendations on the hospitals of the future.

If we talk about National Health Policy (Spain), there are several news of interest: the Audit Office of Catalonia publishes an interesting report on waiting lists. It seems that 9% of the cases on the waiting list in Catalonia were not counted on the Department of Health website, which leads some to use the word makeup. With regard to private healthcare, the IDIS is starting a very interesting project to share the patient’s clinical history among various provider and insurer entities, only an initial but very important step in what is to come. In the course of the pre-election debate, the President of the Popular Party announces a new General Health Law and a State Pact on Health if it reaches La Moncloa. Interesting announcements since, as The Lancet says for the NHS, only a certain political consensus and a new partnership, will be able to solve the problems of the health system in our country.

At the Corporate level, internationally, GSK completes the acquisition of Bellus Health. As far as national news is concerned, we must highlight Roche’s investment in Sant Cugat.

Biomedicine

Global Health

International Health Policy

  • USA
    • The challenges of the American healthcare system in the 21st century, according to the editor of the American Journal Medicine. Five big challenges: 1. Insufficient insurance coverage; 2. Low health education among the population; 3. Prevention and management of chronic diseases; 4. Great disparities in quality and results; and. 5. Trust in doctors? (https://www.amjmed.com/article/S0002-9343(23)00035-9/fulltext)

National Health Policy

Companies

 

 

 

 

 

7 days in healthcare (May 29th-June 4th, 2023)

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Summary

From the point of view of Biomedicine, it is worth noting the death of the virologist Harald sur Hausen, whose name will not mean anything to many, but who 50 years ago discovered the relationship between papillomavirus and cervical cancer, initiating studies of the relationship between viruses and cancer. Reading the DNA of a large and highly varied number of primates allows us to better understand what a human person is and the origin of some diseases. An international consortium discovers that the nucleus of cells is metabolically active.

As regards Global Health, The Economist focuses on the decline in global fertility, due to a decrease in births, not an increase in deaths, a fact with great consequences in our societies. The WHO puts a target by means of cheap vaccines to the global vaccination against cervical cancer, which still produces a large number of deaths. The UN warns about the great sources of hunger in the world: Haiti, Mali, Burkina Faso and Sudan.

Regarding International Health Policy, Canada is preparing a regulation that will make it mandatory to carry warnings of negative health effects on each cigarette. The EU finalizes a regulation to remunerate plasma donations. The WHO celebrates the 76th World Assembly in Switzerland, in which several topics were discussed, among others, the next UN High-Level meeting on universal health coverage, to be held on September 23.

If we talk about National Health Policy (Spain), the call for early elections for July 23 paralyzes the processing of more than 60 laws in relation to health, including some as important as the Equity Law, the Framework Statute, the Law of the National Agency of Public Health or the Law of Guarantees and Rational Use of Medicines. In the Valencian Community, Mazón (the winning candidate of the PP in that Community and foreseeable new president) announces the freezing of the reversal process of the concessions of Manises, Denia and Elche, which had already started or were planned by the Ximo Puig government. He also doesn’t rule out launching new concessions. The Princess of Asturias Award for International Cooperation, awarded to the non-profit initiative Medicines for Neglected Diseases, which focuses not on rare diseases, but on highly prevalent diseases, especially in underdeveloped countries, such as Chagas disease, dengue fever, kala-azar or river blindness and which are considered to affect around 1,000-1,500 million people in those countries, without any research, industry or commercial effort commensurate with their importance.

In the field of Companies, internationally, China breaks the veto on Western vaccines and will allow Moderna to settle in that country. For its part, AstraZeneca defies geopolitical challenges and intends to grow in China. At the national level, Zurich joins forces with Google and DKV to launch digital health insurance. Quirónsalud intends to grow in telemedicine and closes a contract to serve university students.

Biomedicine

Global Health

International Health Policy

  • France
    • Tobacco use is stable in France, one in four adults smokes daily (https://www.lemonde.fr/sante/article/2023/05/31/avec-un-adulte-sur-quatre-qui-smoke-quotidiennement-le-tabagisme-reste-stable-en-france_6175491_1651302.html#:~:text=Tabac-,Tabac%20%3A%20avec%20un%20adulte%20sur%20quatre%20qui%20fume%20quotidiennement%2C% twenty)
  • Canada
    • Canada is going to require that a warning about the danger be printed on each cigarette, since it has been seen that young people start smoking when they receive the offer not of a pack, but of a cigarette (https://www.lemonde. fr/international/article/2023/05/31/le-canada-va-demiger-qu-un-avertissement-soit-imprime-sur-chaque-cigarette_6175630_3210.html)

National health policy

Companies

 

 

7 days in healthcare (May 1st-7th, 2023)

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Summary

From the point of view of Biomedicine, to point out the interest in certain therapies using viruses that engulf bacteria to address infections caused by antibiotic-resistant bacteria. Progress continues to be made in breaking the blood-brain barrier, which will make it possible to better treat certain brain tumors, which until now have not been reached by medication.

As regards Global Health, the WHO declares the end of the emergency due to the covid pandemic, although not the covid, which is still with us. Since its inception this disease has caused more than 20 million deaths globally. Gavi reveals his plans for a malaria vaccine, another major global plague.

As for International Health Policy, he has highlighted the rise in the price of tobacco in France (a good measure against smoking), and Australia wants to limit the use of electronic cigarettes. The ECDC brings out an interesting report with the lessons of the pandemic: “More investment, improvement of surveillance systems, improvement of risk communication, community participation and greater participation between countries” could be the summary.

If we talk about National Health Policy (Spain), in the update of the Stability Program 2023-2026, the % of GDP dedicated to public healthcare spending does not change, remaining at 6.9%. It is evident that only increasing spending does not solve the problems of our health system, but it is difficult to see how they can be solved without increasing spending, as the government proposes. The Spanish Association against Cancer, through the mouth of its president, denounces that Spain has the cheapest tobacco in Europe: “the tobacconist of Europe” calls for this situation. Interesting article by Juan Abarca Cidón, who presents a decalogue to avoid the collapse of our health system. The measurements are very clear and direct. It will be possible to qualify or even disagree with some, but there is no doubt that the problems are addressed. Not like the framework programs of the majority parties for the 28-M elections, which seem to try not to raise any suspicion, by saying nothing.

At the Corporate level, at the international level, Lilly presents a new drug that slows down the progression of Alzheimer’s. The birth of a large market linked to Artificial Intelligence in health is in sight, according to the report by Siemens Financial Services. As far as our country is concerned, Cofares reaches a sales record in 2022. Grifols enters the field of leukemia.

Biomedicine

Global Health

International Health Policy

National health policy

  • Interesting article with a decalogue of reforms in our health system
    • Article by Juan Abarca Cidón, the proposals range from a political agreement; increase general spending on health; finalist financing with certain objectives; reduce costs, considering the co-payment; new governance model at all levels; new care organization model with a greater role for nursing; deal with patient problems, such as waiting lists; address the problems of professionals; normalize the activity of the private sector; and promote the Public Health Agency (https://www.elespanol.com/edicion/20230430/decalogo-reformas-evitar-colapso-sanidad/760293970_12.html)

Companies

 

 

7 days in healthcare (April 24th-30th, 2023)

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Summary

From the point of view of Biomedicine, to mark the 70 years since the discovery of the structure of the DNA molecule, which was to revolutionize the field of biology and medicine, allowing in 2003 the development of the human genome and in 2023 the approval of the first drug based on gene therapy. Nature warns that the gene therapy revolution may be threatened if cost is not discussed, proposing regulatory changes and new intellectual property laws.

With regard to Global Health, a Fund was created (similar to that for HIV, tuberculosis or malaria) to fight against hepatitis, that great plague that worldwide causes more than a million deaths a year. Great repercussion of the conflict in Sudan on the health situation in that unfortunate country.

As for International Health Policy, any other international news pales in comparison to the importance of the new proposals from the European Commission regarding the new pharmaceutical regulation. They propose changes to fundamental rules that had worked without modification for more than twenty years. It is difficult to pronounce, given the great weight of the interests at stake: those of patients, those of pharmaceutical research in Europe, those of the pharmaceutical industry, those of the Member States that want to see their pharmaceutical bills reduced. The texts of the new Directive and new Regulation are still proposals, but they will give people talk.

If we talk about National Health Policy (Spain), the new Minister of Health pronounces himself saying that the waiting lists “are not the responsibility of the Government”, a statement that could be considered unacceptable, since someone might think that the Ministry has more responsibilities apart those of compiling and disseminating the lists. The IDIS Foundation publishes its annual report, now in its 13th edition, on “Private healthcare: providing value”, which has become essential in the sector, due to the transparency it gives to the situation of the private sector. The data from the WAIT report are not favorable for Spain, in terms of the average time elapsed since the approval of medicines by the European Agency and their availability in Spain. Our country is among those that accumulate the most delays in this process.

In the field of Companies, at the international level, spectacular news is the purchase by Kaiser Permanente (a giant on the American West Coast) of Geisinger (a smaller operator on the East Coast) to found a customer service system. non-profit community health. In Spain it seems that the INCOSOL model wants to be replicated outside of Spain.

Biomedicine

Global Health

International Health Policy

National health policy

  • Pharmaceutical policy
    • The WAIT 2022 report, which has just appeared, establishes the delays in different European countries, including Spain, for the incorporation of medicines. Spaniards have to wait an average of 629 days from the approval by the European Agency until they are available in Spain. Spain in the range of countries with the longest wait. The least expected countries are Germany and Denmark (https://www.abpi.org.uk/media/news/2023/april/efpia-wait-indicator-survey-2022-launches/)

Companies