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7 days in healthcare (January 8th-14th, 2024)

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Summary

From the point of view of Biomedicine, it is worth highlighting the first results of the genomic studies of tumors carried out by the British public company, created in Cameron’s time, Genomics England, which will allow new therapeutic orientations in tumors. Certain hopes for patients with schizophrenia, a disease with a limited therapeutic arsenal. A Phase III trial gives promising results. It is expected that the drug can be approved in 2024 by the FDA. The WHO organizes a World Forum on Clinical Trials, establishing the four pillars for their development, which is of special interest to Spain, which is a power in clinical trials, a leader in Europe and only surpassed globally by the United States, China, India and Iran.

As far as Global Health is concerned, the WHO warns that a new pandemic will arrive and it will be more deadly.

In terms of International Health Policy, the growth of total health expenditures in the USA returns to pre-pandemic levels. They rose 4.1% in 2022, while in 2020 they had risen 10.6%. The New England Journal of Medicine publishes an interesting article on the “financialization” (non-financing) of health in the United States, distinguishing this from “corporatization” (the role of large corporations) or “privatization” (greater role of the private sector). “Financialization” refers to the greater role of financial or private equity companies in the healthcare world, in many cases as direct owners of healthcare companies, especially pharmaceutical and insurance companies. The effects of this phenomenon are not yet well analyzed. The FDA approves 55 drugs in 2023, up 48% from the previous year. Of those 55, 28 were intended for rare diseases. The Economist analyzes in an article that the British health system is acquiring a shape similar to that of the 1930s, with a large role of private companies and charities, when Aneurin Bevan created the NHS. It should be noted that the so-called generation Z (between 18 and 24 years old) are the largest users of private healthcare. The EU, through HERA, the body created as a result of Covid, will launch a vaccine development center.

If we talk about National Health Policy (Spain), the Ministry of Health agreed, in the face of the growth of the tripledemic, two measures: the first, the so-called “auto-sick leaves” (sick leaves of up to three days without prior medical report, by the exclusive decision of the worker); and, the second, the mandatory nature of masks in health centers. Both very controversial measures. The first was due to disagreements with the unions, employers and within the government itself, which speaks of improvisation on a very sensitive issue and which forced it to be postponed indefinitely. The second, with opposition from several communities and legal problems in its design. Measures continue to be taken to address problems such as pandemics without the expert advice of an organization such as the Public Health Agency, which has not yet been created, which could possibly have avoided or mitigated some of the problems that the Ministry has encountered. The Catalan government, faced with a growth in pharmaceutical spending, intends to control it with several measures. One of the requests is the transfer of the powers of the Interministerial Price Commission, in order to be able to negotiate the price of medicines with the laboratories at the community level. An issue that could threaten the necessary cohesion of the National Health System. Budgeted public health spending amounts to 89 billion in 2023, 29% more than in 2019, before the pandemic. The unions propose to the Ministry changes in the human resources policy and in the Framework Statute. Given the well-known aversion of unions to differentiation and individual and collective recognition, basic needs of the system, surely the approaches will not be very innovative.

In the field of Companies, on an international level, Goldman Sachs is making its debut in health, with a fund of 650 million dollars, in a line that seems to reinforce the idea of the “financialization” of health, discussed in the article this week from the New England Journal of Medicine. When it comes to national news, the highlight is the upheaval at Grifols, which has lost 3.2 billion euros in five days. After the Gotham Research City report, the company has not been able to convince shareholders of its reliability.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

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 12th-18th, 2023)

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Summary

From the point of view of Biomedicine, to point out that human embryos have been produced without eggs or sperm, using stem cells, which raises far-reaching ethical questions. Joseph Alpert, editor of the American Journal of Medicine, recounts the 10 advances in clinical medicine he has seen since he was an intern in 1969-70. A whole different world, from the mortality of myocardial infarction, the evolution of HIV, the approach to leukemia, the possibilities offered by ICUs, the treatment of tuberculosis, etc. From that point of view, there is no doubt that the world is better than fifty years ago.

As regards Global Health, an unexplained increase in the incidence of cancer has been detected in people under 50 years of age, with this trend particularly affecting the population between 25-29 years of age. The Lancet denounces what it considers pressure from the pharmaceutical industry in the pandemic treaty, currently under discussion at the initiative of the WHO, according to a draft that was leaked on May 22 and published. It would be good if this treaty corrected the major failures that occurred during the covid pandemic in access to vaccines in developing countries, particularly in Africa.

Regarding International Health Policy, according to the weekly WHO report, covid is declining in both the number of cases and deaths in all regions of the world. Forecasts of health spending in the USA are published. Although growth will be moderate in the coming years, it will reach 20% of GDP in 2023, more than any country in the world. The National Oncology Plan in Italy is published. The European Monitoring Center for Drugs publishes its report for 2023. Cannabis, followed by cocaine, are the most widely used illegal drugs in Europe.

If we talk about National Health Policy (Spain), the incidence of covid is decreasing, which makes the government consider removing the mandatory use of masks in pharmacies and health centers. Madrid, the autonomous community with the shortest waiting list for non-urgent surgery. Although our country has a low birth rate, the use of in vitro fertilization is skyrocketing.

At the Business level, internationally, Philips has serious problems with faulty respirators. A collective accuses this company of involuntary manslaughter. The 10 largest pharmaceutical companies have more than 110,000 million dollars available for operations to purchase other companies, a move that is undoubtedly spurred on by the loss of patents in many of them. Lobbyists linked to tobacco companies are accused of advertising vaping online, against the recommendations of the WHO, with many reservations about this practice, considering it harmful to health. On a national level, Quirón presents its new hospital project in Badalona. Grifols will refinance its debt after divesting from its business in China. Asterion, the largest Spanish fund, breaks into health, by buying a health transport company.

Biomedicine

Global Health

International Health Policy

  • Europe
    • The European Monitoring Center for Drugs publishes the report on Drugs 2023: Trends and development. Cannabis (marijuana or hashish) is the most widely used illicit drug in Europe, followed by cocaine. Heroin is the most widely used opioid and the one that causes the most health problems (https://www.emcdda.europa.eu/publications/european-drug-report/2023_en)

National Health Policy

Companies

7 days in healthcare (March, 20th-26th, 2023)

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Summary

From the point of view of Biomedicine, the journal Nature reveals the role of mitochondria in the process of tumor growth.

Regarding Global Health, editorial of The Lancet on Water and Health. Although in developed societies this may seem like a secondary issue, the truth is that a quarter of the world’s population suffers tensions with water and it is an area in which governance over water management is needed. Tuberculosis is rebounding throughout the world, as has not been seen for more than ten years.

Regarding International Health Policy, despite the fact that the covid has caused many problems (including 6.7 million deaths, confinements of entire countries and serious economic problems), this has not affected the global happiness of humanity, according to an international study on the subject. Mysteries of human nature. The American transplant system with long waiting lists, which permanently affects more than 100,000 Americans, of whom about 17 per day die waiting. In this field, Spain could probably teach some lesson. The health of adolescents, a great concern for the American Surgeon General, since the cases of suicides between 10 and 19 years have risen in a very striking way in recent years. China approves the first covid vaccine with mRNA technology, after permanently denying permission to the Moderna and Pfizer-BioNTech vaccine. In France, a bill is being discussed to protect children from screens. New health law in Croatia, which introduces concepts such as integration of care, complex patients, coordinated care and hospital without walls, as well as a reinforcement of Primary Care.

If we talk about National Health Policy (Spain), the incidence of covid drops slightly. Darias is preparing to leave the Ministry without having fulfilled the commitment to publish the report on the management of the pandemic, in contrast to what has been happening in many other countries, without going any further in the United States. A true national shame. In the motion of no confidence debated this week, the candidate Ramón Tamames favors a refounding of public health and pleads for something similar to what the Abril Martorell Report represented in 1981, thus joining many opinions in the sector. Demonstrations on public health continue, this time in Asturias, Andalusia and Madrid. The Complutense University, under the auspices of ASPE, publishes a report on the consequences of what it calls “low cost” health insurance. The real problem is that practically, to a greater or lesser degree, all health insurance is “low cost” and is based on low compensation for hospitals and doctors, which makes the system very unstable. The Roche Institute, which is directed by Federico Plaza and which is making so many valuable contributions to the health system, publishes an interesting report on the Health of the Future and Personalized Precision Medicine. The Supreme Court endorses the euthanasia law. However, seen with hindsight, it contrasts the scant citizen and professional debate that took place on this law in Spain, comparing it with what is happening in France with something similar, with the involvement of President Macron himself. It seems that this time the biomarkers are going to be introduced into the National Health System, without which there can be no advances in precision medicine.

In the field of companies, internationally, the effect of the release of some pharmaceutical patents is estimated at 30 billion euros. In Spain, the beginning of the evaluation of the authorization of the HIPRA covid vaccine stands out, which will be called “Bimervax”. AstraZeneca is going to make a very significant investment in research in Barcelona. The doctors of the Vizcaya IMQ are massively inclined towards the sale to Adeslas, which will control 75% of this insurer.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

7 days in healthcare (September 19th-25th, 2022)

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Summary

From the point of view of biomedicine, to review the articles in The Economist on advances in knowledge of the brain, which will have a great impact on the appearance of new drugs and pain therapy.

With regard to Global Health, the WHO report of September 21, which places cancers, cardiovascular conditions and diabetes as responsible for three quarters of global mortality.

In terms of international health policy, an important initiative in France to offer three preventive consultations free of charge by the public system: at 25, 45 and 65 years of age. The EU launches a plan for the elimination of tuberculosis in Europe.

If we talk about national health policy (Spain), great debate around the Equity Law. What should have been just a law to correct the access deficiencies of the Montón Law, is being flamboyantly called “Equity” (as if accessibility guaranteed equity, not having a single provision to improve equity), and It is used to introduce the aspirations of Unidas Podemos to annul Law 15/97, approved almost unanimously at the time. The IDIS Foundation has warned of the damage to assistance and, specifically, the waiting lists, if some precepts of the Law are approved. It seems that the Catalan consortiums are going to respect each other, which is important, but it is also important to preserve and reinforce public/private concerts throughout the national territory.

At the corporate level, from an international point of view, the shares of the large vaccine manufacturers (especially Moderna, BioNTech and Novavax) plummeted, as a result of President Biden’s announcement that “the pandemic has been feared”. In Spain, it should be noted that Moderna will install its first quality laboratory outside the United States in Madrid.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

7 days in healthcare (September 5th-11th, 2022)

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Summary

From the point of view of Biomedicine, to highlight the work that shows an association between artificial sweeteners and increased cardiovascular risk. Also that air pollution causes lung cancer.

As far as Global Health is concerned, apart from the serious humanitarian crises in Pakistan and Somalia, the most promising is the new malaria vaccine, which could be operational as early as 2023.

Regarding international health policy, assisted suicide and euthanasia are news in Canada (where the rate of euthanasia is very high and there is concern) and in France (which is considering passing a law). Macron has launched a major national debate on this issue, following a report to appear next week from the Ethics Committee. This great debate on such a delicate subject was missed in Spain. Certain issues should not be subject only to conjunctural parliamentary majorities, but should be preceded by a great national debate. It is also worth mentioning that Chile rejected the draft Constitution in a referendum. According to an article published in El País, doubts about the possibility of choosing the health system (the continuity of the ISAPRES, as health insurers are called in Chile), is one of the causes of this rejection.

If we talk about national health policy (Spain), it should be noted that Aragón proposes a great debate on the efficiency of the National Health System, a brave and valuable initiative. It will first analyze the Aragonese health system, and then share that analysis with the rest of the autonomies. Also that the Ministry of Health promises to change the law to favor the local manufacture of medicines. It is also worth underlining the pronouncement of the Catalan Evaluation Agency, on the need for a state policy for the digital transformation of the health system and the promotion of telemedicine.

In the field of companies, from the international point of view, to mention the purchase of Signify a home care group by CVS (an American pharmaceutical chain), in a process in which Amazon also showed interest. In terms of news at the national level, to highlight the great investment of Novartis in our country.

Biomedicine

Global Health

International health policy

National health policy

Companies