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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 (13-19 December, 2021)

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Summary

From an international point of view, perhaps the most striking thing is the great growth worldwide of the “omicron” variant, already present in 89 countries. Although it is clear that it is much more transmissible than the Delta variant, it is not clear that the disease is milder. Some countries in Europe decree confinements. The effectiveness of COVID passports is demonstrated, in terms of increased vaccinations. Figures for healthcare spending in the United States are released in 2020, spending increased significantly, especially federal spending, related to COVID. It reaches 19.7% of GDP (which is said soon). It is also striking that for the first time in the history of the United States, public health spending exceeds private spending.

Regarding national news, great concern about the rapid expansion of the pandemic, which forces the President of the government to convene a Conference of Presidents, for two days before Christmas Eve, which prevents measures from being adopted for Christmas. The plenary session of the Interterritorial Council approves the “Primary and Community Care Plan 2022-2023”, a set of good intentions and the announcement of measures that, where appropriate, would have to be implemented by the autonomous communities. Once again you see how difficult “co-governance” without good governance.

In relation to the activity of companies and other agents in the sector, the activity of vaccine manufacturing companies continues. Two things are difficult to understand: the letter from the President of the Madrid Medical Association to the President of ASISA and the launch by DKV-Yoigo of a medical insurance for 20 euros. We believed, on the one hand, that health insurance companies were free to hire their medical staff; and, on the other hand, that it was difficult to continue lowering the price of health insurance in our country. It is true that in the United States and other countries online insurance, Oscar type, is emerging with cheaper policies than conventional insurance. But in Spain the policies are already very cheap and I do not think that it is about making policies for young and healthy people, who hardly consume health care.

International

  • The “omicron” variant advances at an incredible speed (The Economist, 18 Dec 21)
  • The ECDC warns that vaccination alone is not enough and calls for drastic measures (La Razón, Dec 15 21)
  • The “omicron” variant grows 70 times faster than the Delta in bronchial tissue (The Guardian, Dec 15 21)
  • The “omicron” variant is already present in 89 countries and is growing rapidly, according to the WHO (The Guardian, 18 Dec 21)
  • There is no evidence that the “omicron” variant is more benign than the delta (FT, Dec 17 21)
  • Seven people die in the United Kingdom from the “omicron” variant (El Independiente, 18 Dec 21)
  • The Netherlands decrees a new strict confinement until January 14 (El Periódico de España, Dec 18 21)
  • COVID passports have a positive effect on the number of vaccinated, according to an international study carried out in six countries (Denmark, Israel, Italy, France, Germany and Switzerland), (The Lancet, Dec 13 21)
  • The United States exceeds 800,000 deaths from COVID, the country with the highest mortality (The Guardian, Dec 15 21)
  • The scientific advances of 2021, according to the journal Science (the ease of identifying the structure of proteins, the most significant advance. In relation to medicine, several advances: treatments for COVID-19; psychedelic drugs versus some psychiatric disorders; artificial antibodies to infectious diseases; CRISP tools to modify genes within the body; Alzheimer’s medication, despite doubts about its efficacy) (Science, Dec 17, 219
  • The figures for healthcare spending in the USA in 2020 are published. The growth was 9.7% over the previous year, which had grown by 4.3%. The acceleration is due to the increase in federal spending, which grew 36%, especially in relation to COVID. The percentage of GDP dedicated to health reached 19.7%. The number of uninsured decreased. For the first time in US history, public health spending surpasses private spending (51% vs 49%) (Health Affairs, January, 22)
  • The repetition of epidemics due to different types of coronavirus (SARS, 2002 and 2003; MERS, since 2012 and COVID-19, since 2019) leads some to demand a kind of universal vaccine against coronaviruses. The article is signed, among others, by Fauci (New England Journal of Medicine, Dec 15, 2021)
  • Medicare Advantage for All, a potential pathway to universal coverage in the USA. Against Medicare for All, it would keep private insurers (JAMA, Dec 16 21)

Nationals

  • Spain is at a very high risk of contagion, after exceeding an incidence of 500 per 100,000 in the last fourteen days (El País, 17 Dec 21)
  • Sánchez calls the conference of presidents for next week, given the worsening of the pandemic (El País, 18 Dec 21)
  • Announcement on TV on Sunday, December 19, by Sánchez of the presidents’ conference for Wednesday, December 22, without advancing any measures. Logically, due to the date, there is no possibility of organizing measures for Christmas (El Mundo, 19 Dec 21)
  • Navarra and the Basque Country among the five regions with the most COVID in Europe (El Español, Dec 16 21)
  • Third dose for people over 40 and vaccinated with AstraZeneca (El Confidencial, Dec 16 21)
  • Spain is at the forefront of Europe in excess of mortality, according to the EuroMoMo (The Objective, 19 Dec 21)
  • On December 15, the plenary session of the Interterritorial Council approved the “Plan for Primary and Community Care 2022-2023”, continuation of the “Strategic Framework for Primary and Community Care”, approved in 2019 and never implemented. The plan is a set of promises, which to a large extent have to be implemented by the autonomous communities (such as the finalist budget, telemedicine and others). The plan is strongly criticized by SEMERGEN (Spanish Society of Primary Care Physicians and by FADSP (Federation of Associations for the Defense of Public Health) (Infolibre, Dec 16 21)
  • Antigen test: pharmacies appear to be short of supplies (El País, 19 Dec 21)
  • The Government (Ministry of Social Affairs and Agenda 2030) proposes to limit the residences for the elderly to a maximum of 50 places, as well as some ratios of staff per resident. The text must be consensual, which seems difficult (Infolibre, Dec 17 21)

Companies, employers and other agents in the sector

 

  • María Vila, elected President of FENIN (El Español, Dec 14 21)
  • Ana Polanco, reelected President of ASEBIO (Planta Doce, 16 Dec 21)
  • Letter from the President of the College of Physicians of Madrid to ASISA, reproaching him for the dismissal of doctors for the MUFACE system (Sanifax, Dec 15 21)
  • Spain has already manufactured 380 million vaccines for COVID (CincoDías, Dec 17, 21)
  • Catalonia creates a venture capital fund to promote scientific entrepreneurship (PlantaDoce, Dec 16 21)
  • The European Medicines Agency approves Pfizer’s anti-COVID pill (El Debate, 16 Dec 21)
  • Pfizer’s (Paxlovid) anti-COVID pill works well against the “omicron” variant, the company confirms (NYT, Dec 14 21)
  • The WHO and the EMA could approve the American vaccine NOVAVAX next week (FT, Dec 16 21)
  • Oracle, about to buy CERNER for US $ 30,000 million (FT, Dec 17 21)
  • The CDC discourages the use of the J&J vaccine, due to some clot problems (NYT, Dec 16 21)
  • Sanofi intends to request approval of its vaccine again (FT, Dec 15 21)
  • The IMED healthcare group invoices 12% more and its profit almost doubles, reaching 6 million (Valencia Plaza, Dec 15, 21)
  • The CEU and ASISA sign an agreement for the training of students at the HLA Moncloa hospital (El Debate, 18 Dec 21)
  • Venture capital is pushing for the formation of MIRs. The CVC fund studies buying MIR Asturias (El Periódico de España, 19 Dec 21)
  • Vivanta requests a ransom of 40 million euros from SEPI (PlantaDoce, Dec 16 21)
  • Quirón proton therapy successfully treats its first 100 children (ConSalud, Dec 14 21)
  • Philips expands its portfolio with the purchase of Vesper Medical (PlantaDoce, Dec 15 21)
  • Modern: agreement to bring a mRNA vaccine factory to Australia (PlantaDoce, Dec 14 21)
  • Company health insurance will become more expensive by 7.2% in 2022 (PlantaDoce, Dec 14 21)
  • Grifols sells VCN Biosciences for 66 million euros (PlantaDoce, Dec 15 21)
  • CSL acquires Vitor Pharma for 11.7 billion dollars (PlantaDoce, Dec 16 21)
  • Asistensi and Clínica de Navarra, agreement to export health insurance to immigrants (PlantaDoce, Dec 16 21)
  • Ysios enters the Dutch Northsea leading a round of 77 million euros (El Economista, Dec 17 21)
  • Biontech investors are studying buying Sandoz (El Economista, Dec 14 21)
  • Atrys Health acquires Simm molecular (Expansión, Dec 17 21)
  • DKV and the telephone company Yoigo launch a family health insurance for less than twenty euros (El Economista, 9 Dec 21)
  • The Savana company, founded in 2014, with an ecosystem of 160 hospitals in Europe and America, intends to lead the “healthcare data lake” (El Economista, 18 Dec 21)
  • Rovi receives the European recommendation for its own research antipsychotic (CincoDías, 17 Dec 21)
  • Almirall wins the rights to a drug against autoimmune diseases (CincoDías, Dec 14 21)