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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)

7 days in healthcare (8-14 November, 2021)

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ABSTRACT

 

From an international point of view, the appearance of two new drugs for COVID (Merck and Pfizer) is considered a milestone in the evolution of the pandemic. Both drugs are small molecule, easy to produce, and for oral use. The other great milestone of the pandemic was, at the time, the appearance of vaccines. Especially worrying are the high numbers of COVID in Europe, especially in the United Kingdom, Ireland, but also Germany and the Netherlands, without forgetting the special situation due to its seriousness in Romania and Bulgaria.

From the national point of view, the announced draft bill on Equity, Universality and Cohesion of the SNS is of great interest. Although the text of the preliminary draft is not known at the time of writing this note, from what was announced it could be said that the positive aspect is universality (provided that universality is not identified with equity) and the negative are the possible repeal of Law 15 / 97, on enabling new forms of management in the National Health System, the imposition of direct management compared to other more flexible forms of management and bad messages regarding co-payments. It seems that he wants to transfer the idea that “privatization” and “copayments” are the problems of the sector, which is absurd.

Regarding companies, the disappearance of large industrial business conglomerates, such as J&J and GE, is striking. It should be noted that in both operations one of the bets is health. This contrasts, instead, with the creation of tech giants (Google, Amazon, Apple, etc.).

 

INTERNATIONAL

 

  • The Economist forecast: COVID will most likely disappear by 2022. Success: vaccines and new drugs. Failure: immunity at terrible cost, 16.5 million deaths worldwide (The Economist, 8 Nov 21)
  • The Economist welcomes the extension of “assisted death” as a new and important right, started in 1995 in Australia and already legal in a dozen countries, most recently Portugal. It is not yet legal in the UK, but Parliament is discussing a law on the subject. In the Netherlands, 4% of deaths are assisted (The Economist, 13 Nov 21)
  • The new anti-COVID drugs represent a significant change in the pandemic (the first notable change was that of vaccines). The new drugs are malnupiravir (Merck) and paxlovid (Pfizer). Both are “small molecule” drugs, easy to produce and for oral use (The Economist, 12 Nov 21)
  • 100 Years of Insulin (Toronto, 1922), a therapeutic success, but a failure in its worldwide spread. The producing companies are Novo Nordisk, Eli Lilly and Sanofi. Now there is biosimilar (The Lancet, Nov 13, 21)
  • The 100,000 genomes project in the United Kingdom (Genomics England) has made it possible to catalog, and in some cases treat, many rare diseases (New England Journal of Medicine, 11 Nov 21)
  • The rise of the COVID epidemic in Germany (almost 500 cases in the last 14 days per 100,000 inhabitants), at the peak and rising, is considered an pandemic of the unvaccinated. Among the factors, the interim Merkel government is valued (NYT, 11 Nov 21). Merkel will meet with the “Länder” next week to take measures against the growth of the covid (El Mundo, 11 Nov 21)
  • The Netherlands imposes new restrictions, as COVID cases are very high (The Guardian, 12 Nov 21)
  • The governments of 42 countries (including the United States, the United Kingdom and Germany) ask to cut emissions from the healthcare sector. The sector’s emissions represent 5% of the total. If it were considered a country, the health sector would be the 5th emitter of CO2 pollution (NYT, 8 Nov 21)
  • The Economist analyzes the non-zero cost of China’s zero-COVID policy (The Economist, 13 Nov 21)
  • COVID vaccination will be mandatory for NHS staff starting next spring (FT, 9 Nov 21)
  • Waiting lists on the NHS soared. They grow by 100,000 people in a month. More than 5.8 million were waiting in September, with 12,500 awaiting treatment for more than two years (FT, Nov 11 21)

NATIONAL

 

  • The government approves the “preliminary draft of the Law by which various norms are modified to consolidate the equity, universality and cohesion of the National Health System” (reference of the Council of Ministers 8 Nov 21)
  • The Secretary of State for Health publishes a prior consultation on the draft bill of measures for equity, universality and cohesion of the National Health System, establishing the November 19 deadline for submitting opinions.
  • The Minister of Health, in public statements, mentions the laws that are going to be repealed or modified. Among those that will be repealed, “explicitly and expressly”, she mentions Law 15/97, on enabling new forms of management in the National Health System (El Periódico de España, 8 Nov 21)
  • The BOE publishes the agreement between the Government, certain autonomous communities and the Amando Ortega Foundation, for the implementation of 10 proton therapy equipment in the public system. A monitoring commission is created on the subject (BOE, no. 267, 8 Nov 21)
  • The health PERTE is presented on November 15. It is integrated into the five PERTES that the government has devised: cutting-edge healthcare, electric vehicle, new language economy, aerospace and smart and sustainable food chain. It appears that the health PERTE will have three components: 1. Innovative techniques and technologies for the diagnosis and prevention of diseases; 2. Development of advanced therapies; and, 3. Platform for the design and industrial production of medicines and vaccines (ConSalud, 11 Nov 21)
  • The autonomies claim to maintain the covid funds for 2022 (El País, 9 Nov 21)
  • The University of Washington predicts a sixth wave of covid in Spain (Vozpópuli, 8 Nov 21)
  • The cumulative incidence of covid grows in Spain to 71.5 cases per 100,000 inhabitants in the last 14 days. It is not comparable to the figures of other European countries, but it continues to rise slowly (ConSalud, 12 Nov 21)
  • The waiting list grows. The latest data published is from December 31, 2020 and the waiting time had passed, in relation to the previous record, from 121 to 148 days for interventions. Pending publication of the data corresponding to June 2021 (ConSalud, 8 Nov 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

 

  • J&J (Johnson & Johnson) will be divided into two companies: one dedicated to consumer products and the other to drugs and medical devices (NYT, 12 Nov 21)
  • GE (General Electric) will be divided into three companies: health, energy and aviation (FT, 9 Nov 21)
  • The Spanish pharmaceutical industry proposes a plan of 1.7 billion to produce essential drugs (CincoDías, 10 Nov 21)
  • Moderna rejects the claims of the American government to appear as a co-inventor of vaccine technology (FT, 11 Nov 21)
  • BioNTech shoots its profit up to 7,126 million euros in the first nine months of the year. (Floor Twelve, Nov 9, 21)
  • The Zendal hospital in the post-pandemic: 400 personnel for 38 patients (Diario.es, Nov 7 21)
  • Fresenius is interested, along with other investors, in InsudPharma, specialized in biosimilars and valued at 1,000 million euros (El Periódico de España, Nov 9, 21)
  • Advent gives gas to Vitaldent, with the purchase of Smysecret (dental aesthetic treatments) (PlantaDoce, 12 Nov 21)
  • Acciona will build a hospital in Chile (PlantaDoce, 11 Nov 21)
  • KKR enters fertility with the purchase of GeneraLife from Invesindustrial (Expansión, 10 Nov 21)
  • HIPRA will imminently begin the new phase of clinical trials for its vaccine (El Economista, Nov 8, 21)
  • Grifols liquidates the blood bag business and closes production in Brazil and Murcia (Cinco Días, Nov 12, 21)