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7 days in healthcare (March 25th-31st, 2024)

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Summary

From the point of view of Biomedicine, it should be noted that possibly the next “boom” will be everything related to anti-aging therapies, an aspect to which the Financial Times dedicates an article, following the appearance of three books on the subject. . The Economist dedicates a lot of space in its latest issue to the issue of AI in healthcare, no less than an editorial and four articles. The conclusion is that AI will have a great impact on healthcare. However, as Eric Topol, the well-known cardiologist and health publicist, comments in another article in the Financial Times, “AI is very transformational, but these things always take longer than you initially think.” Nature magazine analyzes the reasons for optimism about cancer vaccines. Vaccines to treat, not to prevent.

Regarding Global Health, the WHO focuses on the millions of undiagnosed cases of tuberculosis, which compromise efforts to combat this disease. The WHO estimates that in 2023 there will be three million new cases not known to health services. Problems continue between developed and developing countries, which do not agree on the Treaty on the prevention of pandemics, proposed by the WHO as a goal for 2024.

In terms of International Health Policy, the King’s Fund and the Nuffield Trust, two prestigious British think tanks on health, analyze satisfaction with the NHS, which is the lowest in the entire history of this institution. Only 24% of citizens in England, Scotland and Wales are happy with the service, with waiting lists being the most common complaint. In France, the Sorbonne Faculty of Medicine and a former health minister propose “strong measures” to, they say, prevent the degradation of the health system in France. Of the three measures they propose, one of them has to do with the preservation of “medical time” (through non-medical assistants in consultation); and the other with the promotion of advanced practice nursing.

If we talk about National Health Policy (Spain), based on Primary Care analysis that is on the Ministry’s website, it is observed that people treated in primary health centers who earn less than 18,000 euros per year are medicalized more frequently, have prescribed more chronic drugs and consume more pills for pain, anxiety or depression. The Ministry of Health is studying allowing price competition between medicines so that generics can gain market share. This would affect generics and biosimilars, which would be cheaper than brand-name ones and it would be the patient who, if they wanted, would assume the difference. The situation in Spain of the same price for generics as for branded ones is unique in Europe. The objective is to stimulate the development of the generic and biosimilar industry and, ultimately, reduce the pharmaceutical bill for these medicines, in order to allow the incorporation of innovations. If it is carried out, it will be great news. Of note is the agreement signed between the Colleges of Pharmacists of the Basque Country and the Department of Health of that community, with the idea of facilitating the integration of community pharmacies as health agents in the health system. More than interesting is the article published in Human Resources for Health, and whose first signatory is Sara Calderón-Larrañaga, and which analyzes the reasons why primary doctors leave Spain. The work consisted of a survey, focus groups and interviews with 158 primary doctors who had left Spain. The causes of their departure were, in order of importance: insufficient salary, temporary employment, excessive workload, poor governance of primary care, lack of flexibility in the workplace and personal circumstances. There are the keys to a reform of Primary Care.

As for Companies, internationally, a cancer drug (Keytruda, from Merck-MSD), the best-selling drug in the world. In Spain, the historic achievements of Rovi, with a business approach that goes beyond covid. We must also highlight Vithas’ hospital commitment in Barcelona, where construction is underway.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (August 28th-September 3rd, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting how therapy with psychedelics is opening up among mental health professionals, especially for cases of depression, anxiety, post-traumatic stress, eating disorders and addictions.

As far as Global Health is concerned, a study of 18 clinical trials shows that screening for early detection of cancer does not make this population live longer than those who do not undergo this type of testing. WHO concern about blindness and vision disorders. More than 2.2 billion people globally have vision disorders, generally attributable to refractory disorders and cataracts.

In terms of International Health Policy, the expected bomb exploded from the application of the “Inflation Reduction Law”, approved in the USA in August 2022, which included something prohibited until now: price negotiation between pharmaceutical companies and Medicare. . The American government made public the 10 drugs that will be negotiated in 2023 and affects the main companies: Pfizer, Lilly, Novartis, AstraZeneca, J&J, etc. Although the established system is very gradual, since 10 drugs will be negotiated each year for the next four, the truth is that this breaks the status quo of the pharmaceutical industry not only in the USA (the largest drug market) but in the world. It is difficult to counter Biden’s argument, which he plans to use in the 2024 campaign, that Americans do not have to pay two to three times more for medicines than the rest of the developed countries, such as in Europe. However, The Economist, which recognizes the need for this price negotiation, nevertheless sees problems in its application due to the appeals filed by large pharmaceutical companies and the risk that these companies will distance themselves from the necessary medicines and concentrate on others unrelated to price control. He also says that if R&D expenses are taken into account, the profitability of pharmaceutical companies is not extraordinary, when compared to the companies in the S&P 500.

If we talk about National Health Policy (Spain), the incidence of covid shoots up by 70% in just one week. The Ministry of Health recommends the fifth dose to selected groups: over 60 years of age, health personnel and the vulnerable. The Supreme Court faces a complex issue: the ruling on thousands of compensation payments to businessmen due to the pandemic. These are property claims to the State due to Covid-19 from businessmen and self-employed workers, who are awaiting compensation for the damage caused by the restrictions during the states of alarm that were later cancelled.

In the field of Companies, on an international level, the most notable is the abandonment of CENTENE from the United Kingdom, where it had a chain of primary care centers and the CIRCLE hospital network. The movement follows his departure from Spain with the sale of Ribera. A concentration in the American market, difficulties with the anti-privatisation movements of healthcare in Europe and problems with hospital integration may be at the origin of the problems, to which perhaps we should also add an underdeveloped growth strategy for this American company in Europe. In any case, a shame, since CENTENE is a great American insurance company, with a lot to teach in the European world. As far as national news is concerned, Spain is the only country that has purchased (31 million euros) several million vaccines from HIPRA, which is not updated for the new strains. Big problem for the Ministry if it decides to use it.

Biomedicine

Global Health

International health policy

  • USA
    • The American government reveals the 10 drugs on which price negotiations will take place with Medicare. Under the proposed reform the minimum price decrease will be 25%. According to the Congressional Budget Office, the savings to the public coffers will be $100 billion over a decade. The affected companies are BMS, Pfizer, Boeheringer, Lilly, J&J, Merck, AstraZeneca, Novartis, Amgen, AbbVie, Novonordisk (https://www.ft.com/content/fa9b0422-6f93-4703-9358-6396660f63b6)
    • The Economist, critical of the American government’s measure, although it recognizes that price negotiation was obligatory. He says that the prohibition on negotiation was nonsense, but the proposed negotiation system could have perverse effects. If R&D expenses are taken into account, pharmaceutical companies do not have extraordinary profits, compared to those of the S&P 500 (https://www.ecocom/leaders/2023/08/30/americas-new-drug-pricing-rules-have-perverse-consequences)
    • Biden makes the negotiation of drug prices one of the central axes of his campaign for 2024, despite the fact that the price reduction will not begin until 2026 and that is if the law resists all judicial attacks (https://www.nytimes.com/2023/08/30/us/politics/biden-medicare-drug-prices-2024-campaign.html)
    • Opinion article in FT: “The world needs to stop depending on the American pharmaceutical industry.” Americans pay up to three times more than other developed countries for medications. The American market is the main market for pharmaceutical companies. This policy is popular among Americans, but it may affect drug R&D globally. Pharmaceutical companies can orient themselves from the most needed medicines to those that escape price control (https://www.ft.com/content/0c20c518-60a8-4dd0-87be-f03adc8ec0e1)

National health policy

  • Judicial consequences of the pandemic
    • The Supreme Court faces the sentencing of thousands of compensations to businessmen due to the pandemic. These are property claims to the State due to Covid-19 from businessmen and self-employed workers, who are awaiting compensation for the damage caused by the restrictions during the states of alarm that were later cancelled. About 9,000 resources are expected. The sentence is very complex, due, among other things, to the high economic amount that it could represent (https://www.expansion.com/juridico/sentencias/2023/09/01/64f1cc47e5fdea09658b45ba.html)

Companies