Summary

Biomedicine

• The benefits of GLP-1 medications, beyond obesity. These medications may be useful in a wide variety of chronic conditions. There are multiple clinical trials underway. The next decade is likely to allow for greater potential for GLP-1 drugs.
• The fertility industry. Economic factors are delaying couples’ willingness to have children, which produces greater infertility in both men and women. 9% of births in advanced countries occur through in vitro fertilization (IVF), but the high cost of these treatments produces inequities in access, despite similar levels of infertility around the world. Better access is needed.

Global Health

• The H5N1 bird flu virus can cause a human pandemic. So far there is no evidence that the virus has adapted to growing among humans, but this may change quickly. When COVID19 appeared, there was no natural immunity, no medications or vaccines. These three things exist today for H5N1.
• The WHO and UNICEF warn of the high number of unvaccinated children. The goal of these institutions is to reduce the number of unvaccinated children by 2030, particularly in Africa, the Middle East and Asia.

International health policy

• The King’s Speech 2024 at the opening of the legislature. It is known that, in British protocol, the King expresses the government’s intentions. Key elements mentioned: 1. Waiting lists; 2. Focus on prevention; 3. Mental health, including a law change; 4. Increase in the age for authorization to purchase tobacco and limits on vaping; 5. Restrictions on junk food advertising.
• Module 1 of the covid survey appears, on the resilience and preparedness of the United Kingdom to the pandemic. Please note that this Module 1 will be followed by several others on: governance; sanitary system; vaccines and therapies; purchasing and distribution; testing and isolation programs; Young people and children; the economic response to the pandemic. The structure of the report is problems and recommendations. This accumulation of reports that deal with the different aspects of the management of the pandemic has nothing to do with the disappointing Spanish report commissioned by the government, in which so many elements of analysis were missing (behavior of the different autonomous communities, international comparison, purchasing aspects and distribution of materials, mortality of professionals, etc.).
• GPs (primary doctors) who use artificial intelligence improve the cancer detection rate by 8%. The application, called “C the Signs,” checks medical records. This software is used in 15% of healthcare facilities in England. The results were published in the Journal of Clinical Oncology.
• United Health, the controller of the Chilean insurer Banmédica, is leaving Chile. United Health is the largest health conglomerate in the world and the interpretation is that, since Latin America is a marginal business for them, they prefer to get out of the regulatory instability that currently affects the continent. Doubts about the appearance of a buyer for the insurer Banmédica.
• EU health priorities for the coming years. Van der Leyen sets the EU health agenda: mental health care, development of a critical medicines law and greater promotion of research with the development of a new technology law as well.

National Health Policy (Spain)

• Strategic Plan of the pharmaceutical industry. Health has already sent Farmaindustria the draft of the sector’s Strategic Plan, a long-promised and delayed Plan that will remain to be seen in what remains in practice.
• The government approves 172 million for Primary Care. Reaction: Primary care needs reform, not crumbs. That money is less than the one-year budget of many hospitals.
• Health OPEs advance. The autonomous communities are advancing in the health OPEs, including the Canary Islands, Madrid, Castilla y León, Castilla-La Mancha, Aragón,… This news should be good, but in fact it is quite bad, due to the way the OPEs are done, with the risk of distorting multiple medical services.
• Debate on doctors’ salaries in Spain. Statements by Antón Costas, president of the CES: “At the remuneration level, Spain does not fare badly in healthcare”, since Spain is among the countries where the remuneration is highest compared to the average salary (2.6 times in the case of those who practice general medicine and 3 times for those who practice other specialties). An interesting contribution to a debate that must continue. It is evident that to compare doctors’ salaries it is not worth doing so with absolute figures (as is done using Medscape reports), but rather with what they represent in the average salary of each country. However, it remains to be seen whether, even so, Spanish medical salaries withstand international comparison.On the other hand, it is proven that Spanish medical salaries fell in absolute numbers between 2011 and 2017.

Companies

• International
  • The main medications on the 2030 horizon: Oncology, CNS and obesity.

• National
  • Movements to take Grifols private continue. Grifols signs Morgan Stanley and Goldman before the takeover bid by the family and Brookfield.

Biomedicine

• Article in Science: The benefits of GLP-1 medications, beyond obesity. These medications may be useful in a wide variety of chronic conditions. There are multiple clinical trials underway. The next decade may allow for greater potential of GLP-1 drugs (https://www.science.org/doi/10.1126/science.adn4128)
• The Lancet Editorial: The fertility industry. Economic factors are delaying couples’ willingness to have children, which produces greater infertility in both men and women. 9% of births in advanced countries occur through in vitro fertilization (IVF), but the high cost of these treatments produces inequities in access, despite similar levels of infertility around the world. Better access is needed (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01484-3/fulltext#:~:text=Despite%20major%20advances%20in%20securing,in%20both%20males%20and%20females.)
• The United Kingdom, the first European country to approve lab-created meat (https://www.forbesindia.com/article/lifes/the-uk-becomes-the-first-european-country-to-approve-labgrown-meat/93681/1#:~:text=The%20UK%20becomes%20the%20first%20European%20country%20to%20approve%20lab%2Dgrown%20meat,-On%20July%202&text=The%20UK%20has%20bec)
• New anti-aging therapy extends the life of mice by 25%. The results reinforce hope for a better understanding of the role of individual genes and proteins in increasing lifespan in humans (https://www.ft.com/content/c9cc67cb-5dee-4005-a5b6-2a225091d1ee)
• Discovered a hormone that contributes to the strength of bones, even during breastfeeding. An American team has discovered a brain protein that allows female mice to recover the bone tissue they have lost after pregnancy, to benefit the mineralization of the fetus’s skeleton (https://www.lemonde.fr/sciences/article/2024/07/18/decouverte-d-une-hormone-qui-contribue-a-la-solidite-des-os-meme-pendant-l-allaitement_6251930_1650684.html#:~:text=Sa%20mission%20%3A%20preserver%20le%20capital,une%20perte%20de%20tissu%20osseux.)
• A new daily pill may work to prevent sexually transmitted diseases (https://www.nytimes.com/2024/07/18/health/doxycycline-sti.html#:~:text=A%20common%20antibiotic%2C%20doxycycline%2C%20greatly,every%20day%2C%20a%20study%20found.)
• The most severe types of endometriosis increase the risk of ovarian cancer (https://elpais.com/salud-y-bienestar/2024-07-17/los-tipos-de-endometriosis-mas-grave-elevan-el-risk-of-ovarian-cancer.html#)
• The gene that causes overweight has been discovered, it is a modification that inhibits the SMIM1 gene (https://www.larazon.es/sociedad/despósito-gen-que-provoca-sobrepeso_2024071566941525c53ff80001c0ae78.html#:~:text=El%20SMIM1%20es%20a%20newly,adverse%20reaction%20to%20a%20transfusion.)
• Lung cancer screening would reduce mortality from this tumor by up to 39% (http://diariomedico.com/medicina/oncologia/cribado-cancer-pulmon-reducia-mortalidad-tumor-39.html)
• How to predict Alzheimer’s with artificial intelligence. An AI tool developed by the University of Cambridge is capable of predicting which people with early signs of dementia will develop Alzheimer’s disease (https://www.eleconomista.es/tecnologia/noticias/12910179/07/24/como-predecir-Alzheimer’s-with-artificial-intelligence-in-people-with-memory-problems.html)
• Vaccines significantly reduce the risk of long covid, as recently published in a large study published in the NEJM (https://www.nytimes.com/2024/07/17/health/long-covid-vaccines.html#:~:text=The%20lowest%20rate%20of%20long,infected%20during%20the%20same%20period.). Access to the original article published in the NEJM: https://www.nejm.org/doi/full/10.1056/NEJMoa2403211
• A genetic map reveals mutations typical of the Asturian valleys that predispose to breast cancer, according to researchers from the Central University Hospital of Asturias (https://elpais.com/salud-y-bienestar/2024-07-20/un-mapa-genetico-revela-mutaciones-proprias-de-los-valles-asturianos-que-predispone-al-cancer-de-mama.html#) Access to the study published in Clinical Genetics: https://pubmed.ncbi.nlm.nih.gov/38922859/

Global Health

• The H5N1 bird flu virus can cause a human pandemic. So far there is no evidence that the virus has adapted to growing among humans, but this may change quickly. When COVID19 appeared, there was no natural immunity, no medications or vaccines. These three things exist today for H5N1 (https://www.economist.com/science-and-technology/2024/07/17/h5n1-avian-flu-could-cause-a-human-pandemic#)
• Childhood vaccinations: the WHO and UNICEF warn of the high number of unvaccinated children. The goal of these institutions is to reduce the number of unvaccinated children by 2030, particularly in Africa, the Middle East and Asia (https://www.lemonde.fr/planete/article/2024/07/15/vaccinations-infantiles-l-oms-et-l-unicef-alertent-sur-la-hausse-du-nombre-d-enfants-non-vaccines-dans-le-monde_6250035_3244.html)
• Food supplements for athletes can be dangerous to health and considered doping (https://www.europe1.fr/sante/complements-alimentaires-pour-sportifs-danger-pour-la-sante-et-spectre-du-dopage-alerte-lanses-4258729#:~:text=L’Agence%20nationale%20de%20sécurité,sous%20le%20coup%20du%20dopage.)
• Alcohol, a major and underestimated cause of ordinary violence (https://www.lemonde.fr/societe/article/2024/07/16/l-alcool-cause-majeure-mais-sous-estimee-de-la-violence-ordinaire_6250521_3224.html#:~:text=Selon%20une%20enquête%20de%20victimation,d’alcool%20ou%20de%20drug.)

International health policy

• China
  • China surpasses Europe for the first time as a creator of active ingredients (https://www.redaccionmedica.com/ultimas-noticias-sanidad/china-supera-por-primera-vez-a-europa-como-creadora-de-new-active-principles-according-to-a-report#:~:text=China%20has%20overtaken%20for%20first,the%20Pharmaceutical%20Industry%20(Efpia).)

• United Kingdom and the National Health Service
  • The King’s Speech 2024. Key elements mentioned: 1. Waiting lists; 2. Focus on prevention; 3. Mental health, including a law change; 4. Increase in the age for authorization to purchase tobacco and limits on vaping; 5. Junk food advertising restrictions (https://www.gov.uk/government/speeches/the-kings-speech-2024).
  • The King’s Fund reacts to The King’s Speech, generally celebrating the advertisements (particularly restrictions on tobacco sales and mental health advertisements) and considering that health depends on many actions, including housing, the environment and employment (https://www.kingsfund.org.uk/insight-and-analysis/press-releases/response-kings-speech#:~:text=Responding%20to%20the%20King’s%20Speech,strong%20health%20and%20care%20sector.)
  • Module 1 of the covid survey appears, on the resilience and preparedness of the United Kingdom to the pandemic. Please note that this Module 1 will be followed by several others on: governance; sanitary system; vaccines and therapies; purchasing and distribution; testing and isolation programs; Young people and children; the economic response to the pandemic. The structure of the report is problems and recommendations. Full report: https://covid19.public-inquiry.uk/documents/module-1-full-report/. Summary: https://covid19.public-inquiry.uk/reports/module-1-report-in-brief-summary-the-resilience-and-preparedness-of-the-united-kingdom/.
  • The Nuffield Trust responds to this report. It highlights the multiple failures of the health system and its inadequacy to respond to the pandemic. Insists on the poor state of NHS buildings and the problems of social services: https://www.nuffieldtrust.org.uk/news-item/nuffield-trust-response-to-the-first-covid-inquiry-report
  • Report on the King’s Fund integrated systems. Access the full report and executive summary: https://www.kingsfund.org.uk/insight-and-analysis/reports/integrated-care-systems-workforce
  • GPs (primary doctors) who use artificial intelligence improve the cancer detection rate by 8%. The application, called “C the Signs,” checks medical records. This software is used in 15% of healthcare facilities in England. The results were published in the Journal of Clinical Oncology (https://www.theguardian.com/technology/artificialintelligenceai/2024/jul/21/all)

• France
  • The Olympic Games under the threat of covid 19. The Olympic Games (July 26-August 11) and the Paralympic Games (August 28-September 8) could bring up to 15 million visitors to the Paris region, which could favor spread of the virus, in particular JN.1 (https://www.lemonde.fr/sport/article/2024/07/19/paris-2024-apres-le-tour-de-france-les-jeux-olympiques-sous-la-menace-du-covid-19_6252771_3242.html#:~:text=Malgré%20la%20vague%20de%20contaminations,toutefois%20intérêt%20à%20se%20protect.)

• Chili
  • United Health, the controller of the Chilean insurer Banmédica, is leaving Chile. United Health is the largest health conglomerate in the world and the interpretation is that, since Latin America is a marginal business for them, they prefer to get out of the regulatory instability that currently affects the continent. Doubts about the appearance of a buyer for Banmédica (https://www.theclinic.cl/2024/07/17/las-razones-del-controlador-norteamericano-de-isapre-banmedica-y-vida-tres-para-sell-your-operations-in-chile/)

• European Union
  • Van der Leyen sets the EU health agenda: mental health care, development of a critical medicines law and greater promotion of research with the development of a new technology law as well (https://diariofarma.com/2024/07/19/von-der-leyen-marca-la-agenda-sanitaria-ue-mental-health-critics-law-and-biotechnology)
  • A Court condemns the European Commission for hiding details of the purchase of covid vaccines. The contracts were made with vaccine providers, including Pfizer, AstraZeneca and Moderna (https://www.ft.com/content/36cc0a5c-6102-4ab5-839d-5dc3fea6ba3c

National health policy

• Central government initiatives
  • Health has already sent Farmaindustria the draft of the sector’s Strategic Plan (https://www.elespanol.com/invertia/observatorios/sanidad/20240719/sanidad-enviado-farmaindustria-borrador-plan-estrategico-sector/871413037_0.html#:~:text=%20some%20weeks%2C%20the%20minister,%20early%20of%20this%20week.)
  • Plan AMAT-I, the little brother of Inveat for unmet needs (http://www.diariomedico.com/medicina/politica/plan-amat-i-hermano-pequeno-inveat-da-respuesta-necesidades-cortas.html)
  • The government approves 172 million for Primary Care (http://www.diariomedico.com/medicina/politica/gobierno-aprob-distribucion-mas-172-millones-euros-atencion-primaria.html). Reaction: primary care needs reforms, not crumbs (https://www.larazon.es/salud/atencion-primaria-espana-necesita-reformas-migajas_20240721669c552546f97200013e6b6a.html)

• Initiatives and news from the autonomous communities
  • La Rioja and Murcia join the autonomous communities that already finance the rotavirus vaccine (https://www.elespanol.com/invertia/observatorios/sanidad/20240716/rioja-murcia-suman-ccaa-finan-vacuna-rotavirus-pronto-haran/870663083_0.html#:~:text=To%20these%20have%20%20beenadded,a%20value%20of%20249.600%20euros.)
  • Madrid begins to process a decree to improve pharmaceutical care at home (http://www.diariomedico.com/farmacia/comunitaria/madrid-empieza-tramitar-decreto-mejorar-atencion-farmaceutica-domicilio.html)
  • The autonomous communities advance in the health OPEs, including the Canary Islands, Madrid, Castilla y León, Castilla-La Mancha, Aragón,… (https://www.consalud.es/autonomias/ccaa-avanzan-contrarreloj-cumplir-exigencia-stabilize-your-healthcare-templates_146225_102.html)
  • The SAS will promote generics, but will not make their dispensation mandatory (https://elglobal.es/farmacia/el-sas-cede-se-promocionaran-los-genericos-pero-aclara-que-no-sera-obligatoria-his-dispensation/)

• Health professions
  • Only with incentive measures will the “medical deserts” in Spain and Europe be covered. Report presented by the European Junior Doctors (http://diariomedico.com/medicina/profesion/medidas-incentivadoras-copiaran-desiertos-medicos-espana-europa.html). Access to the text of the report: https://www.juniordoctors.eu/sites/default/files/2024-07/FMM_FINAL.pdf
  • Doctors demand up to 7,000 euros more salary to go to rural areas (https://www.redaccionmedica.com/secciones/medicina/los-medicos-demandan-hasta-7-000-euros-mas-de-sueldo-to-go-the-rural-area-9368)
  • Statements by Antón Costas, president of the CES: “At the remuneration level, Spain does not fare badly in healthcare”, since Spain is among the countries where the remuneration is highest compared to the average salary (2.6 times in the case of those who practice general medicine and 3 times for those who practice other specialties) (https://www.redaccionmedica.com/secciones/sanidad-hoy/anton-costas-a-nivel-retributivo-espana-no-goes-bad-stop-in-health–4385#:~:text=A%20nivel%20retributivo%2C%20Spain%20no%20sale%20very%20bad%20stop.,of%20who%20exercise%20other%20specialties)

• Health insurance
  • Health insurance is close to car insurance, billing 6,091 million euros (https://www.redaccionmedica.com/secciones/privada/el-seguro-de-salud-se-acerca-al-de-automovil-billing-6-091-millions-5482#:~:text=The%20insurance%20of%20Salud%20is,millions%20of%20euros%2C%20es%20thatis.)

• Fall of Microsoft
  • Half of the SNS, affected, while pharmacies are saved. The failure comes from using the tool called “Crowstrike”. The SNS and private groups, such as HM, Vithas and the CUN, were affected. The incident was resolved shortly (http://www.diariomedico.com/medicina/profesion/mitad-sns-afectado-caida-microsoft.html)

• Work Medicine
  • The National School of Occupational Medicine will close due to lack of teaching and administrative staff. This institution depends on the Carlos III Health Institute and trains doctors and nurses in occupational health (http://www.diariomedico.com/medicina/profesion/escuela-nacional-medicina-trabajo-cierra-falta-medios.html#:~:text=Profession%20Training-,The%20School%20National%20of%20Medicine%20of%20Work%20closes%20due to%20lack,the%20hallway%20of%20a%20hospital.)

Companies

• International News
  • Oncology, CNS and obesity, main medications, on the 2030 horizon (https://elglobal.es/industria/oncologia-snc-y-obesidad-seran-las-areas-que-aglutinen-los-principales-farmacos-en-2030/)
  • Novartis warns that the price of prostate cancer drugs will remain high (https://www.ft.com/content/1a1910e5-fd95-45f9-b8fd-adc4d7b3c8e7)
  • Merck buys the French healthtech Unity-SC for a minimum of 155 million euros (https://www.plantadoce.com/empresa/merck-compra-la-healthtech-francesa-unity-sc-por-un-minimum-of-155-million-euros)

• National
  • Esteve concludes the purchase of HRA Pharma Rare Diseases for up to 275 million euros (https://www.plantadoce.com/empresa/esteve-concluye-la-compra-hra-pharma-rare-diseases-por-hasta-275-millions-of-euro#:~:text=Grifols%20GSK-,Esteve%20concludes%20the%20purchase%20HRA%20Pharma%20Rare%20Diseases%20by%20until,a%20double%20digit%20in%202023.)
  • Grifols signs Morgan Stanley and Goldman in response to the takeover bid by the family and Brookfield (https://www.expansion.com/empresas/2024/07/19/669ac1f5e5fdeaf3338b458c.html)