Posts

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

/in /by

 

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

 

 

 

 

7 days in healthcare (July 31st-August 6th, 2023)

/in /by

 

Summary

From the point of view of Biomedicine, it seems that for the first time, apart from the complicated bariatric surgery, medicine will have a treatment for obesity, this disease that affects more than 1 billion people worldwide. With GLP-1 it seems that we are entering the phase of effective drugs against obesity. Generative AI, which is capable of generating new algorithms, based on the patterns and structure of the data, is called to play an important role in health care. It seems that cancer is growing at younger ages. The WHO declares the polypill, developed by the CNIC and Ferrer, as an “essential medicine”.

With regard to Global Health, a call by the editors of the most important scientific journals in the world, through a common article, for health professionals to get involved in the fight against the risk of nuclear war, since it seems that we are in a situation of risk not seen since the Cold War. The WHO detects progress in tobacco control in many countries, through the WHO Framework Agreement for Tobacco Control, signed 20 years ago.

Regarding International Health Policy, in the United States a cyberattack forces the paralyzation of the activity of several hospitals. In the United Kingdom, new diagnostic centers are being created to increase the capacity to carry out tests and reduce the waiting list. Of the 13 centers announced, 8 will be privately financed and managed. The waiting list is a political priority for Prime Minister Sunak.

If we talk about National Health Policy (Spain), the incidence of covid has risen since July. It is extremely striking that a new registry multiplies by four the official number of maternal mortality in Spain. Maternal mortality is precisely one of the indicators most taken into account when establishing the health of a country. The Health Accounts System document has been published, which updates the data with those of 2021. Between 2017 and 2021 there has been a 25% increase in health spending, including public and private. The MUFACE system is doubly threatened, firstly because of its high losses and, secondly, because the SUMAR program, Sánchez’s possible partner in a new government, is sponsoring its disappearance. The agreement signed in Aragon for the constitution of the new PP-Vox government contemplates resorting to public/private collaboration to address the waiting list. It should be noted that the integration of the workforce of the former Health Agencies of Andalusia has been completed, which affects 3,500 workers, who may be integrated as permanent statutory employees. An important regression, which reinforces the most rigid aspects of the public health system, precisely what the public hospitals with the configuration of public companies, unfairly called by the PP in Andalusia as “chiringuitos”, had tried to overcome with remarkable success. A blunder, not to use euphemisms, both from the Andalusian government and from the party that supports it. Information from the old management teams ensures that the deterioration is already taking place. If, rightly, an audit is required to see the results of the reversals of the concessions in the Valencian Community, something similar will have to be done in due course with these Andalusian hospitals.

In the field of Companies, internationally, Amazon launches a new documentation service based on generative AI. The pharmaceutical companies that had made cash with the covid vaccine are deflating, something that was already discounted by the market. At the national level, a new incursion of Magnum Partners into health, by buying the nutraceutical company Martínez Nieto. Apax acquires 50% of Palex, a company that had become a target for many funds, and which will surely herald a consolidation of the medical technology distribution sector.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (May 8th-14th, 2023(

/in /by

 

 

Summary

From the point of view of Biomedicine, it is worth pointing out the expanded “pan-genomic” base, which significantly increases the letters of the DNA, which, apparently, will make it possible to improve the typing and treatment of certain diseases. Promising results of mRNA technology in pancreatic cancer. Potential of stool transplants against some bacteria not sensitive to antibiotics.

As far as Global Health is concerned, although covid is no longer a global emergency, the truth is that, as the WHO itself shows, the disease continues to kill and change.

Regarding International Health Policy, it is worth highlighting the great news coming from the British government, which will allow pharmacies to prescribe certain medications, as well as the contraceptive pill. The objective of the measure is to significantly reduce the number of visits to the primary doctor. In France, patients, faced with overloaded doctors, turn to self-medication. Euthanasia is already legal in Portugal. Great battle in Chile between the Boric government and the Isapres (Chilean health insurers). In a bill, the government, in order to respond to an erga omnes ruling (of universal application) of the Courts, proposes the payment by insurers of alleged amounts for overpayments, which would make the model unfeasible. The Association of Isapres has reacted with a harsh note, answered no less harshly by government spokesmen. Health and specifically the role of the Isapres, at the center of the political debate in Chile.

If we talk about National Health Policy (Spain), the most important news is the proposals by various medical associations (IMAS Foundation, FACME, General Council of Medical Associations) for a decalogue of proposals to reform the SNS, which they consider in total crisis, before the next legislature. New governance; new management model; citizen/patient and professional participation; measurement of results and transparency; new care model; digital transformation according to the citizen’s digital clinical history model, are some of the most important measures. We only have to congratulate those responsible for this initiative, which contrasts so much with the limited and timid proposals put forward by the majority political parties. To those parties (PSOE and PP) the proposals were raised in a meeting. The only possible consideration is whether a reform of the public system is possible without mentioning a limited and selective co-payment, the absence of which we are the exception in Europe, as well as the non-consideration of the private sector in that reform. Looking the other way from the private sector has never produced good results. On the other hand, the document emphasizes its proposal for changes in the management and care model, governance, the participation of citizens/patients and professionals, and transparency. But he doesn’t mention financing at all. Although financing as an isolated reform (which is very common to consider) would not solve much, this issue has specific problems. Having made these qualifications, as a whole it is a splendid document, a must-read. The Constitutional Court publishes the ruling declaring the 2010 law on abortion deadlines legal. A study in Catalonia shows that the rich wait less on the lists of Catalan public hospitals than the rest of the population, something that had already been demonstrated in the UK on the NHS. The CEOE-union agreement includes the control of sick leave by Mutual Societies, something whose real scope will have to wait to see its effects. The truth is that absenteeism had increased a lot in recent times.

In the field of Companies, at the international level, drugs for weight loss point to an area of great economic interest for the pharmaceutical industry. In Spain, the most striking thing is Fresenius’s intention to get rid of the part of Quirón in Latin America, as well as the fertility company Eugin. Mutua Madrileña and El Corte Inglés launch medical insurance under the Adeslas brand.

Biomedicine

Global Health

International Health Policy

  • Chili
    • The Boric government against the Isapres (private health insurance companies in Chile). In a bill, the government, in order to respond to an erga omnes ruling (of universal application) of the Courts, proposes the payment by insurers of alleged amounts for overpayments, which would make the model unfeasible. Hard note from the Association of Isapres, which has obtained a no less harsh response from the Government. (http://www.isapre.cl/images/PDF/Declaracion_Prensa_19_abril_VFdocx_1.pdf)

National health policy

Companies

 

 

7 days in healthcare (April 17th-23rd, 2023)

/in /by

 

Summary

From the point of view of Biomedicine, this week, exceptionally, two important advances in Spain are mentioned. On the one hand, the important investigations of the team led by Dr. Obeso, at HM Hospitales, on how to “open” the blood-brain barrier, that barrier that, among other things, prevented the arrival of drugs to the brain. It seems that in this way possibilities could be opened for the treatment of Parkinson’s. On the other hand, at the Vall d’Hebrón Hospital in Barcelona, the first robotic lung transplant was approached through a small incision.

As far as Global Health is concerned, there is a great alarm, highlighted by UNICEF and The Lancet magazine, about the drop in immunizations in children after the covid. Although the covid highlighted the efficacy of the vaccines, it brought the side effect of this drop in immunizations globally. In Uganda, the new anti-homosexuality law takes repression against this sexual option to an extreme, endangering anti-HIV campaigns in that country. The G7, to be held in Japan in May, emphasizes various health issues, including the importance of universal health coverage and the need for resilient health systems.

Regarding International Health Policy, the WHO warns of the non-solution of the covid problem, since in the last 28 days there were 23,000 deaths and 3 million new cases globally, even with reduced test figures. High mortality in the USA, with around 245 deaths per day. In the United States, the government is preparing to finalize the guidelines for negotiating the price of drugs in Medicare in July, something totally new in that country and that is shocking the pharmaceutical industry. The American Supreme Court rectifies its previous decisions and allows the abortion pill mifepristone to continue to be used, amid abundant criticism of the Court, for having questioned something that the FDA had already authorized more than 20 years ago. According to The Economist, the annulment of the Roe v Wade ruling caused the number of abortions in the USA to drop by 6%. In the United Kingdom, the consequences in the NHS of the multiple and continuous strikes and conflicts of health personnel continue. The German government is clashing with other European governments in its efforts to reduce the timeframe for generics to appear, calling into question the pharmaceutical investment model, according to some.

If we talk about National Health Policy (Spain), the incidence of covid continues to rise, amid controversies about the advisability or not of suppressing masks where they are still mandatory (health centers, social health centers and pharmacies). Conflicts with health personnel continue in several autonomous communities. In public healthcare, quite important allocation of resources by the Ministry to primary care and mental health. In private health, in the first quarter of the year there was a growth of 7.5% in the policies of private health insurers. “Voting with your feet” is called that figure. The IDIS Foundation focuses, through an interesting publication, on an important problem: the mental health situation in our country. Since we have few problems, Catalonia insists on an artificial conflict: the use of Catalan in the healthcare system in that autonomous community. Both in Aragon and in Castilla-La Mancha, two initiatives of dubious utility and even suspected of electoralism are launched. In Aragon, a national debate on health is proposed through a very typical document of those that come out in the autonomous communities that could be summarized as “More money for health without reforms.” As for Castilla-La Mancha, a law on waiting lists is promoted, when the terminal state of the legislature suggests that it will not be approved.

In the field of Companies, internationally, Nestlé is accused of manufacturing unhealthy products, due to their high load of fat, sugar and salt. Merck makes a major investment buying Prometheus Biosciences for $11 billion. At the national level, Moderna opens a laboratory in Madrid.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

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

/in /by

 

Summary

From the point of view of Biomedicine, vaccines against cancer; precision surgery in lung cancer; the use of bacteriophage viruses against antibiotic resistant bacteria; stem cells for a wide variety of diseases; and micromotor robots, great promise in the development of new advances in medicine.

With regard to Global Health, it should be noted that 839 million people around the world cannot eat with dignity, for various reasons; the magazine Nature calls for a treaty against new pandemics, since it estimates that the covid represented “a catastrophic failure of the international community in achieving solidarity and equity”. The malaria pandemic is still active in more than 30 countries .

Regarding International Health Policy, in the United States the practices of certain pharmaceutical companies to prevent the entry of generics and biosimilars are denounced. International effort in the search for antibiotics to combat bacterial resistance.

If we talk about National Health Policy (Spain), the incidence of the covid has a small rebound, hopefully in a context of falling incidence, although high mortality persists. The Spanish Public Health Agency, whose bill has just been approved, possibly the most important consequence of the covid crisis. The conflict of public health continues, focused on Primary Care. The Constitutional Court recognizes the constitutionality of the abortion law of deadlines. AESEG and BIOSIM request modification of the reference prices and urgent measures along these lines, since many medicines are at the limit of economic viability.

In the field of Companies, at the international level, it should be noted that Sanofi and Merck MSD significantly increase their profits in 2022. At the national level, Quirónsalud announces the start-up of a new hospital in Valencia. For its part, Consentino, a company that had plans to go public, may see its intentions cut short for health reasons, given the high incidence of silicosis among its workforce.

Biomedicine

Global Health

International Health Policy

  • USA

National Health Policy

Companies

7 days in healthcare (January 2nd-8th, 2023)

/in /by

 

Summary

From the point of view of Biomedicine, it is important to highlight significant advances in the treatment of some diseases, such as Alzheimer’s, breast cancer (a project inspired in its day by José Baselga), brain tumors, including the dreaded glioblastoma multiforme, and resistant tuberculosis.

With regard to Global Health, the WHO warns of global health threats in 2023: the Ebola outbreak in Uganda, which fortunately already seems to be in recession; the drought in the Horn of Africa; cholera, endemic in 69 countries; non-communicable diseases (particularly cardiovascular, diabetes, respiratory diseases and cancer), as well as the global stagnation due to the pandemic in the fight against various diseases: HIV, malaria and tuberculosis. Science reminds us that wastewater analysis has proven to be extremely useful for monitoring infectious diseases.

As for International Health Policy, with regard to covid, global concern is not so much for the cases that may come from China (which seem to correspond to the omicron that we already know) but for the new variant (Kraken) of United States, much more contagious than omicron and already affects a high percentage of cases in that country. The serious problems of the end of covid zero in China continue, with the opening of the country on January 8, which has been closed for three years. An editorial in The Economist looks at how the grand reopening may affect the global economy. Once again, the WHO says that mortality from covid in China is underestimated, if official figures are taken into account. Big change in the United States, where the abortion pill can be purchased in ordinary pharmacies. The large pharmacy chains, willing to participate in this sale. It must be remembered that a high percentage of abortions in the United States are already pharmacological. Serious crisis in the British National Health Service, with staff strikes, long waiting lists, saturation of emergencies and statements by unions and the Prime Minister. Labor wants to pass NHS employees to GPs (primary physicians), something that is in contradiction with the founding political pact of 1948 for the creation of the National Health Service, in which Aneurin Bevan participated. In France, health is also at the center of the political debate, with some statements on January 6 by President Macron, who considered among the solutions nothing less than ending fees per act, which in France are big words.

If we talk about National Health Policy (Spain), the year opens with the prospect of regional elections in 12 autonomous communities (May 28) and general elections at the end of the year, as well as a change in the head of the Ministry of Health. Several laws have been announced, including some advanced (new framework personnel statute, abortion, equity law), others more delayed (Public Health Agency, law of guarantees, possible reform of the dependency law). The Platform of Patient Organizations (POP) makes 10 proposals for chronic patients. As for professionals, some health insurance companies (DKV) have reacted quickly and announced increases in rates for doctors, which is undoubtedly a response to the criticism they had received from some medical associations, which even have raised certain protest actions. A piece of news says that the Zendal hospital has only 56 patients, which speaks of the fact that it has not yet found its place in Madrid’s health system, not surprising, since it seems that this hospital was established without the corresponding and obligatory Functional Plan (which defines the service portfolio, the population to be served, the incardination in the rest of the system, technology, personnel needs and other basic issues). Biosimilars, under the leadership of BIOSIM and starting in Extremadura, delve into the experience of shared benefit.

In the business sphere, in the international arena, Moderna acquires a genomics company. On the other hand, the completion of the Da Vinci robot patent will change the prospects for robotic surgery. At the national level, Ribera assumes the management of the Cascais hospital in Portugal, which is good news for public/private collaboration in our country.

Biomedicine

Global Health

International Health Policy

National health policy

Companies