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7 days in healthcare (15-21 November, 2021)

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ABSTRACT

From the international point of view, the plan of the American Democrats to negotiate the price of medicines and its possible impact on innovation continues to be discussed; Europe is once again the engine of the pandemic, with demonstrations in some European cities against confinements and COVID passport measures; and finally, the United States reach a peak in mortality from opioid as the covid pandemic continues.

At the national level, four elements of interest: 1. Spain exceeds 100 cases per 100,000 inhabitants, although the situation is worrying, nothing to do with that of other European countries; 2. The state-of-the-art health PERTE is presented, doubts regarding its reformist impact; 3. Publication of the draft law that aims to consolidate the universality and equity of our National Health System; 4. The waiting lists are published as of June 30, 2021.

In terms of company news, perhaps most relevant is that both Merck and Pfizer’s COVID therapies will be available in generics for low- and middle-income countries.

INTERNATIONAL

  • Request for action in Afghanistan, given the food emergency, by the director of the World Food Program. Disaster is the consequence of conflict, economic collapse and drought (The Lancet, Nov 20 21)
  • Intense debate in the USA about the consequences for pharmaceutical innovation of the regulatory framework on the price of drugs that the Biden Administration wants to approve (NEJM, Nov 18, 21)
  • Democrats in the USA have a plan to reduce the price of drugs, without harming innovation (The Economist, Nov 20 21)
  • A year after the decision of the British NHS to move towards zero carbon emissions by the health system, another 13 countries, including Spain, have joined this approach, which entails important changes, especially in supply chains (The Lancet, Nov 17 21)
  • Europe is once again the engine of the pandemic, with the extremely worrying situation in Austria, Germany, the Netherlands, Belgium, the United Kingdom, Ireland, Hungary, Romania and Russia, among others (Le Monde, 17 Nov 21)
  • Austria returns to lockdown (The Guardian, Nov 18 21)
  • Thousands of people protest in Vienna against confinement and mandatory vaccination (El País, 20 Nov 21)
  • Germany tightens restrictions on the unvaccinated and will force health workers and nursing home workers to be vaccinated (El País, 18 Nov 21)
  • Bavaria cancels Christmas markets, given the growth of the pandemic (The Guardian, 19 Nov 21)
  • The third dose can be extended to all adults, says British Health Minister Sajid Javid (The Guardian,
  • The majority of the European population, in favor of COVID passports (The Guardian, 19 Nov 21)
  • The use of masks reduces the incidence by 53%, according to an international study published in the British Medical Journal (The Guardian, 18 Nov 21)
  • In the USA, mortality from opioid overdose reaches record growth, while the pandemic continues (NYT, Nov 17, 21)
  • Fauci says the pandemic may be under control in 2022, with more third doses (The Guardian, Nov 17, 21)
  • Europe will prioritize the local manufacture of drugs to gain autonomy. This coming week the new EU pharmaceutical strategy will be approved (El Economista 21 Nov 21)

NATIONAL

  • Spain exceeds 100 cases per 100,000 inhabitants for the first time in two months (El País, 18 Nov 21). Comment: although the situation is worrying, it has nothing to do, however serious, with that of other parts of Europe. It seems that the high immunization, the fifth wave and the high percentage of vaccination are at the origin of this situation. However, we do not know if this differential is going to be maintained or we are heading towards a situation similar to that of most of the rest of Europe.
  • The autonomous communities denounce that they once again lack legal tools in the face of another wave of the pandemic (El Mundo, Nov 21, 21)
  • The state-of-the-art health PERTE is presented, which entails 1,489 million investment until 2023 (diariofarma, 15 Nov 21). Comment: there is no transformation in the sense of reforming the health system (which they consider good) and it is an investment aimed at the biotechnology industry. Mentions of primary care are imprecise. In summary: facing the transformation of the health system and to what extent European funds can help, including digitization, is an issue that remains to be seen
  • Published the Draft Law that modifies various regulations to consolidate equity, universality and cohesion of the National Health System, which seeks to prevent co-payments and promote direct management (Diario Médico, Nov 16 21)
  • Waiting lists published as of June 30, 2021: 121 days on average to undergo surgery and 75 days to visit a specialist. 661,162 people, waiting for an intervention. The lists are close to those in 2019 (La Vanguardia, Nov 26 21)
  • ASPE offers its collaboration to end the waiting lists (Medical Redaction, Nov 18 21)
  • Summer-22 is set as the limit to reform the Framework Statute in the summer of 2022, for which it is announced that there will be minor changes to adapt to the Basic Statute of Public Employees and the labour conditions of residents (Diario Médico, Nov 18, 21)
  • The Public Health Center will go to the Council of Ministers soon (Consalud, 19 Nov 21)

COMPANIES, EMPLOYERS AND MAIN ACTORS IN HEALTH

  • Pfizer’s anticovid pill will be sold as a generic drug in 95 low- and middle-income countries, mainly in Africa and Asia, although the agreement excludes some countries hit hard by the pandemic. Previously, Merck had announced something similar (NYT, Nov 16 21)
  • European regulators, with serious doubts about Biogen’s Alzheimer’s drug (FT, Nov 17 21)
  • DKV remains in the MUFACE system (company declarations)
  • The EMA launches the emergency authorization process for the NOVAVAX vaccine, which would be the first vaccine with recombinant proteins developed in the European Union (Expansión, 18 Nov 21)
  • Quirónsalud launches two new phase I clinical trial units in Madrid and Barcelona, ​​following an agreement with Next Oncology (Diario Médico, 19 Nov 21)
  • Prim improves its profit by 90% in the first nine months of the year, to 12 million (PlantaDoce, Nov 15, 21)
  • Moderna appoints new general manager for Spain and Portugal, Juan Carlos Gil (PlantaDoce, Nov 16 21)
  • Miranza expands its presence in the Basque Country and opens a new center in Bilbao (PlantaDoce, 15 Nov 21)
  • The German biotechnology company CureVac will begin second-generation vaccine trials (ConSalud, 19 Nov 21)
  • Rovi expects to reach growth forecasts for 2023 this year (CincoDías, Nov 16, 21)
  • Pfizer, BioNTech and Moderna expect to bill 62,000 million euros in 2021 with their vaccines (CincoDías, 15 Nov 21)
  • The Spanish HIPRA vaccine will prove its effectiveness as a booster injection for Pfizer vaccinated (Expansión, 16 Nov 21)
  • USA will pay 4,650 million euros to Pfizer for 10 million anti-covid treatments (CincoDías, Nov 18, 21)
  • Almirall collapses on the stock market, after losing 40 million euros (Expansión, 15 Nov 21)

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)