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

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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

7 days in healthcare (December 26th, 2022-January 1st, 2023)

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Summary

From the point of view of Biomedicine, it is worth noting the ambitious project of the United Kingdom “Our Future Health”, which aims to place this country at the forefront of genomic research, and which seeks to carry out genetic analyzes of 5 million adult British volunteers, then looking at the correlation with lifestyles and medical records. Undoubtedly, this project will allow us to advance a lot in the knowledge of a wide variety of diseases.

With regard to Global Health, great concern in the world, since the large number of cases in China increase the probability that new variants will appear. There is no doubt that the covid – which had appeared, artificially or naturally, in China – has entered a new phase in which the epicenter is once again China.

Regarding International Health Policy, countries are preparing to put control measures at airports and borders against travelers from China, although the ECDC sees this type of control as unfounded and the EU has not adopted a common policy. Joschka Fischer (former – German Foreign Minister) publishes an in-depth article, whose conclusion is that, in contrast to what had previously been said that authoritarian regimes that do not depend on public opinion can impose drastic and effective measures in crisis situations such as covid, experience has shown that liberal democracies are more effective than autocracies in dealing with these situations. Great controversy in the European Union over the claim of the pharmaceutical industry to agree to produce new antibiotics, under the condition of increasing the patent term of certain drugs.

If we talk about National Health Policy (Spain), Spain has approved airport control measures to control travelers from China, which will be in force between December 31, 2022 and February 15, 2023. Primary Care doctors have opposed the hiring of doctors without MIR training, since this seems more like an opportunistic measure than addressing the underlying problems of Primary Care. The central government, so little fond of publishing and preparing expert analyzes on the covid management, instead presents a self-assessment on its management. According to this report “Cumpliendo” (“Fulfilling”) 64% of the health promises have already been fulfilled and 35% are in process. Bearing in mind that none of the structural healthcare problems have been addressed (personnel regime, management model, governance, accessibility and waiting lists, etc.) this self-assessment seems to us grated on complacency and even propaganda. Unless the promises -which are said to have been fulfilled- have nothing to do with the real problems of the sector. An interesting initiative from the private sector through the IDIS Foundation, which announces the start-up of a pilot on interoperability, should be highlighted. The fact that companies that compete with each other -both from the insurance and provisioning fields- agree on the interoperability of medical records is something that deserves to be highlighted.

In the field of Companies, the American Congress has taken an unusual decision: criticize the FDA for its inadequate collaboration with Biogen for the approval of the drug against Alzheimer’s. At the national level, Atrys continues its growth, both in Spain and abroad (United Kingdom, Middle East and Latin America).

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (October, 10th-16th, 2022)

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Summary

From the point of view of biomedicine, to review the advances in knowledge of the human organ that, to a large extent, remains a mystery, the brain: the implantation of human cells in mice, which can send signals and the creation of a kind of synthetic intelligence, by verifying that nerve cells in a dish can learn. In the United States, it is found that mortality from breast cancer has decreased a lot, due to early detection and better treatments. Something that is not exclusive to the United States and that surely also occurs in Spain.

As far as Global Health is concerned, the serious health problems, for very different reasons, in Pakistan, Somalia, Syria and Lebanon must be highlighted.

Regarding international health policy, there is great concern in the WHO and other organizations about the effects of persistent covid. Threat of hospitals in Germany by covid. The Economist introduces the debate on the legalization of cocaine, which it strongly defends, considering that the problems of an illegal market far outweigh those that could arise in a controlled market. Put the simile of whiskey and cigarettes.

If we talk about national health policy (Spain), the rise in the incidence of covid continues, although in Spain without notably affecting hospitals. Promising launch of the Neurotechnology Center in Madrid.

In the field of companies, at the international level, the WTO (World Trade Organization) continues with its efforts to free the patents of medicines related to covid. As far as Spain is concerned, HIPRA suffers a new delay in the approval of its vaccine by the EMA, which practically excludes it from the fourth dose vaccination campaign.

Biomedicine

Global Health

International health policy

  • European Union
    • A step forward towards a Europe of health. The reinforcement of the ECDC (European Center for Disease Prevention and Control), the EMA (European Medicines Agency) and the creation of the Health Emergency Preparedness and Response Authority, constitute important steps towards a European policy of health, something not contemplated in the founding European treaties (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01980-8/fulltext)
  • The debate on the legalization of cocaine
  • New Code of Medical Ethics
    • Approved the new International Code of Medical Ethics of the World Medical Association. After the initial version of this Code in 1949, a new wording has been approved at the General Assembly of the World Medical Association, held in Berlin in October 2022 (https://jamanetwork.com/journals/jama/fullarticle/2797507)

National health policy

Companies

 

 

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)