31 de març 2022

Addiction goods and innovation failure

When Innovation Goes Wrong: Technological Regress and the Opioid Epidemic 

The medical use of opioids to treat pain will always involve costs and benefits, and the optimal level of opioid prescription is unlikely to be zero. The mistake that  doctors and prescribers made in recent decades was to assume overoptimistically that a time release system would render opioids non-addictive. Thousands of years of experience with the fruits of the poppy should have taught that opioids have never been safe and probably never will be. The larger message of the opioid epidemic is that technological innovation can go badly wrong when consumers, professionals, and regulators underestimate the downsides of new innovations and firms take advantage of this error. Typically, consumers can experiment with a new product and reject the duds, but with addiction, experimentation can have permanent  consequences.

A must read, by Cutler et al.

 Robert Doisneau

29 de març 2022

Practical negotiation strategies

SPLIT THE PIE. A Radical New Way to Negotiate

A practical approach that identifies what’s really at stake in any negotiation and ensures you get your half—so you can focus on growing the pie


25 de març 2022

The current health labour market fiasco

 Informe Oferta-Necesidad de Especialistas Médicos 2021-2035

In 2028, in Spain there will be 196.347 physicians, according to estimates, so from that year to 2035 18.098 physicians will be incorporated. However, there are currently 192.484 professionals, so in the next seven years only 3.863 will be hired.

The total number of active physicians in Spain currently represents a ratio of 406,13 specialists per 100.000 inhabitants. Private employment would concentrate 30 percent of the total number of physicians, with an increase of 7 percent since 2018, while the fall in public employment is 1.7 percent (?).

2027 will be a turning point. In that year there will be a global deficit of about 9.000 physicians at least, which is mainly due to a lack of Primary care physicians.

We are closer to the great fiasco, now it is time to make decisions to avoid it.

PS. There is a "minor" issue, the estimates are wrong.   The report takes into account only physicians, and there are specialties where most positions are filled by health professionals, biologists, chemists, ....  and the report forgets it. The mismatch is larger and the coming crisis a chaos.

Can you imagine that after 5 reports, after 15 years!, nobody cares about it?

The dark future health labour market

24 de març 2022

Free our genes

 The Genome Defense Inside the Epic Legal Battle to Determine Who Owns Your DNA

Further reading

Outline of this great book on gene patents:


Chapter 1   Who Can We Sue?

Chapter 2   The World in the Helix

Chapter 3   The Gene Queen

Chapter 4   Mr. Lincoln’s Boat

Chapter 5   The ACLU Way

Chapter 6   Product of Nature

Chapter 7   On the Hill

Chapter 8   Speaking of Patents

Chapter 9   The Power of Pink

Chapter 10 We’ve Got You Covered

Chapter 11 BART

Chapter 12 Patents and Plaintiffs

Chapter 13 Pulling the Trigger


Chapter 14 The Big Guns

Chapter 15 SDNY

Chapter 16 Chicken and Egg

Chapter 17 We’re from the Government

Chapter 18 Splitting the Baby

Chapter 19 The Patent Court

Chapter 20 Magic Microscope

Chapter 21 Last Man Standing


Chapter 22 Déjà Vu All Over Again

Chapter 23 Air Force 1

Chapter 24 With Friends like These

Chapter 25 Oyez, Oyez, Oyez!

Chapter 26 9–0

Chapter 27 Aftermath

Appendix: The (Legal) Meaning of Myriad

Principal Characters

A Note about Sources


22 de març 2022

Cancer Economics

 Regulatory and Economic Aspects in Oncology


Cost of Cancer: Healthcare Expenditures and Economic Impact

Oncology from an HTA and Health Economic Perspective

Heterogeneous Recommendations for Oncology Products Among Different HTA Systems: A Comparative Assessment

Patient-Reported Outcomes in Oncology, Beyond Randomized Controlled Trials

Patient-Reported Outcomes in Health Economic Decision-Making: A Changing Landscape in Oncology

Approaches to Capturing Value in Oncology

Orphan Drugs in Oncology

Recent Developments in Health Economic Modelling of Cancer Therapies

Drug Pricing and Value in Oncology

Regulatory and Evidence Requirements and the Changing Landscape in Regulation for Marketing Authorisation

Prioritization not Rationing in Cancer Care

10 de març 2022

Stop misuse of antibiotics

 Antimicrobial Resistance in the EU/EEA: A One Health Response

Misuse of antibiotics is among the main drivers underpinning the development of antimicrobial resistance (AMR). Resistance to last-line antibiotics also compromises the effectiveness of life saving medical interventions such as intensive care, cancer treatment and organ transplantation. 

Overall consumption of antibiotics in humans in the European Union/European Economic Area (EU/EEA) decreased by 23% between 2011 and 2020, especially during the Coronavirus Disease 2019 (COVID-19) pandemic (between 2019 and 2020, the mean total consumption of antibiotics dropped by almost 18%). However, relative use of broad-spectrum antibiotics has increased and significant variability across countries suggests that reductions are still possible.

Efforts to reduce unnecessary use of antibiotics in food-producing animals have resulted in a 43% decrease in use between 2011 and 2020 in 25 countries with consistent reporting.

Despite reductions in antibiotic consumption in both humans and food-producing animals, AMR in bacteria from humans in the EU/EEA has increased for many antibiotic-bacterium combinations since 2011. Particularly worrisome is the rise in resistance to critically important antibiotics used to treat common healthcare-associated infections. 

While recent trends have been encouraging, resistance to commonly used antibiotics in bacteria from food-producing animals remains high (>20% to 50%) or very high (>50% to 70%), and there is significant regional variation across the EU/EEA region. 


08 de març 2022

Public health genomics

 From public health genomics to precision public health: a 20-year journey

Public health genomics focuses on effective and responsible translation of genomic science into population health benefits. We discuss the relationship of the field to the core public health functions and essential services, review its evidentiary foundation, and provide examples of current US public health priorities and applications



Adolf Mas exhibition at KBR

03 de març 2022

Value based health care (2)

 Evaluación de resultados en salud: valor y sostenibilidad para el Sistema Nacional de Salud

Capítulo I. Evaluación de resultados en términos de salud: por qué, ¿cómo, cuándo y para qué?

Capítulo II. Resultados comunicados por los clínicos

Capítulo III. Resultados percibidos por los pacientes

Capítulo IV. Resultados en salud percibidos y comunicados por los observadores: ¿qué son y cómo se miden?

Capítulo V. ¿Cómo incorporar las medidas de resultados en salud a la evaluación económica?

Capítulo VI. Principales técnicas estadísticas y parámetros para medir resultados en salud

Capítulo VII. Metodología disponible para obtener resultados en salud en el mundo real

Capítulo VIII. Resultados en salud a evaluar en diferentes patologías: enfermedades infecciosas

Capítulo IX. Resultados en salud en la infección por VIH

Capítulo X. Resultados en salud en pacientes con hepatitis C crónica

Capítulo XI. Resultados en salud en reumatología

Capítulo XII. Resultados en salud en dermatología

Capítulo XIII. Resultados en salud en aparato digestivo: enfermedad inflamatoria intestinal e intestino irritable

Capítulo XIV. Resultados en salud en esclerosis múltiple

Capítulo XV. Beneficio clínico en oncología: una compleja pregunta

Capítulo XVI. Evaluación de resultados en salud: hematología

Capítulo XVII. Resultados en salud: patología cardiovascular

Capítulo XVIII. Resultados en salud a evaluar en enfermedades raras

Capítulo XIX. Investigación de resultados en salud en niños y adolescentes