BY KIM BELLARD
My heart says I should write about Uvalde, but my head says, not yet; there are others more able to do that. I’ll reserve my sorrow, my outrage, and any hopes I still have for the next election cycle.
Instead, I’m turning to a topic that has long fascinated me: when and how are we going to recognize when artificial intelligence (AI) becomes, if not human, then a “person”? Maybe even a doctor.
Continue reading…I’m going to AHIP in Vegas next month and you should come too!
It’s time to be together again. It’s also time to save. Register for AHIP 2022 (formerly Institute & Expo), June 21 – 23 in Las Vegas with code THCB and save. Together, we’ll explore the ideas, innovations, and forward-thinking driving health care’s transformation. Check out the agenda and Register today with code THCB.
By JESSICA DaMASSA, WTF HEALTH
Otsuka Pharmaceuticals is expanding its mental health formulary – looking beyond traditional medications to psychedelics, and to the “intersection of technology and psychiatry” with digital therapeutics currently in clinical trials for Major Depressive Disorder. Kabir Nath, Senior Managing Director of Otsuka’s Global Pharmaceutical Business, lets us in on the thinking behind these bold moves, why the pharma co is even innovating to expand the spectrum of treatments available for mental illness in the first place, and how soon these new therapies will reach patients.
“Follow the science” is a key undercurrent of this conversation, particularly as we talk through Otsuka’s investments in psychedelic medicine start-ups Compass Pathways and, more recently, Mindset. Kabir says the body of clinical evidence for these therapies is building and we get his prediction on when they might become more mainstream and readily available.
We also get his take on digital therapeutics (DTx) and the work Otsuka is doing with Click Therapeutics in Major Depressive Disorder. Their clinical trial, done in partnership with Verily, is the first-ever fully remote clinical trial conducted in this space, and the hope is that it not only generates evidence to support the emerging DTx category, but that it also sets a precedent for a new, tech-enabled way to run clinical trials.
This is just the beginning. There’s lots more on the innovations changing pharma and the future of mental health care in this one. Watch now!
BY SAURABH JHA
If forced to choose Britain’s two biggest contributions to civilizations, I’d pick the Magna Carta and the vaguely instructional “fuck off.” If permitted a third, I’d choose “managerialism.” Brits are good at telling others what to do. Managerialism is how the Brits once ruled India. Buoyed by the colonial experience, British managers felt they could rule doctors.
The new Viceroy, the manager-in-chief, is the General Medical Council (GMC). The GMC is a physician watchdog, funded by doctors, which works for the public good and is answerable to…well, I’ll get to that later. Their relevance rose exponentially when the psychopathic Dr. Harold Shipman, a charming, clinically adept, general practitioner, killed over two hundred patients. Never again, said the managers. They promised to keep the public safe from dodgy doctors with aspirations of Jack the Ripper and Sweeney Todd.
Continue reading…You know what Jess just realized? We haven’t heard my opinion on Cerebral! Scandal! Firings! Intrigue! Legal Issues! Risk! Skyrocketing! Dying! Cerebral offers quite some food for thought. Check out the episode for my opinion on this incredibly fast-brewing story as well as more multi-million deals: Homethrive raises $20 million; Greater Good raises $10 million; Parallel Learning raises $20 million; Cayaba Care raises $12 million; Miga Health raises $12 million.
-Matthew Holt
BY MIKE MAGEE, M.D.
Arthur Sackler continues to demonstrate just how wealthy one can become by advantaging patients and their diseases.
He’s been dead since 1987, but his ghost continues to access your personal health data, pushes medical consumption and over-utilization, and expands profits exponentially for data abusers well beyond his wildest dreams. Back in 1954, he and his friend and secret business partner, Bill Frohlich, were the first to realize that individual health data could be a goldmine. That relationship would still be a secret had it not been exposed in a messy family inheritance feud unleashed by his third wife after Sackler’s death.
That company, IMS Health, was taken public and listed on the NYSE on April 4, 2014, transferring $1.3 billion in stock. I’ll come back to that in a moment. But in the early years, the pair realized that the data they were collecting would multiply in value if it could be correlated with a second data set. That dataset was the AMA’s Physician Masterfile which tracked the identity and location of all physicians in America from the time they entered medical school.
Continue reading…Will Boeglin is CEO of TimeDoc Health. It’s one of a new breed of companies supplying the capability for physician groups and health systems (including FQHCs) to deliver CCM (chronic care management) and RPM (remote patient monitoring). Both of those services are now reimbursed by Medicare, and some private plans, but rolling them out and tracking all that activity–not to mention accounting and billing for it–is non-trivial for practices. That is where TimeDoc comes in. Will started the company as part of a med-school project and just raised $48m to really get it going. He showed me how it worked, and gave an extensive and interesting demo–Matthew Holt
BY KIM BELLARD
I know, I should be writing about hot topics like monkeypox or the baby formula shortage, but, c’mon, Congress held hearings last week about UFOs – the first in 50 years! I mean, I followed Project Blue Book in the 1970’s, watched “The X-Files” in the 1990’s, and have seen UFO videos on YouTube. If Congress is starting to take UFO’s seriously, how could I not?
And for those of you who don’t see any possible connection to healthcare (except for those unpleasant alien probes…), let me put it to you this way: by 2050, is it more likely that:
I thought so.
Continue reading…BY JESS DaMASSA, WTF HEALTH
What are the BIG questions a BIG healthcare company like CVS Health is trying to answer when it comes to virtual care and creating the healthcare business model of the future? I’ve got Dr. Creagh Milford, CVS Health’s Head of Enterprise Virtual Health, who’s purview covers both CVS Pharmacy (9,000+ stores including 1,100 Minute Clinics) and Aetna, which provides health insurance to 39 million people.
Creagh’s big concern right now: how to weave together existing care models with virtual so 1) the consumer has a single front door and 2) the provider workforce – which includes everyone from pharmacists to primary care docs and beyond – is coordinated and working together. As you’ll hear, there’s a lot of thinking about “pivot points,” or where the patient and provider meet in the virtual-and-in-person ecosystem. The goal is to make those interactions easy and seamless – for both patient and provider alike – and we get into the strategic thinking, clinical operations, and tech underpinnings that are evolving to make those transitions possible.
Long-term, Creagh believes that healthcare consumers have “voted with their fingertips” and that virtual care is here to stay, but as part of a hybrid model in which questions about quality and cost are still being worked out. Will incentives ultimately realign to make virtual care more enticing across the healthcare system? What types of technology will be next to augment the hundreds of thousands of virtual visits a year coming out of Minute Clinic, or happening as part of an Aetna plan benefit? Here’s how one of the biggest healthcare companies in the country is driving virtual care forward. Watch now!
Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt
For today’s health care tidbits, the elephant in the room has truely come home to roost, and now it’s landed on the phone wire, it’s close to breaking it. OK, I have stretched that metaphor to death but you’ll get my point. Writing on THCB earlier this month Jeff Goldsmith and Eric Larsen picked up on something I’ve been saying for a while –the fall in valuation of publicly traded digital health companies will have a knock effect on private companies.
It took a while–those public companies stock prices started falling from their heights 14 months ago–but in the last month the venture capital scene has gone quiet. The days of sub $20m ARR companies getting mutli-hundred million dollar valuations are over for now. They will be back at some point in the future, as that’s how Silicon Valley has always worked, but it’ll be a while and in the meantime everyone is going to have to figure out what to do in the new world.
The “What to do?” question is getting harder as the data starts to come in, and it’s getting ugly. On the one hand the two fastest growing digital health companies ever have both had their comeuppance. Livongo was a tremendous exit for its investors and ended up trading at 20 times future revenue before it got acquired by Teladoc for $18bn mostly in stock. This quarter Teladoc wrote off much of its investment in Livongo and the whole company is now only worth $5bn. Clearly those “synergies” between telehealth and chronic care management didn’t work. The other rocket ship was Cerebral, which went from nothing in Jan 2020 to by Jan 2022 having over 100,000 patients and thousands of providers on its system as it raised over $300m from Softbank et al. Its aggressive & expensive customer acquisition costs, with its controversial controlled medication prescribing patterns, brought it way too much controversy. Its young CEO is gone, and it’ll be a slow climb back with bankruptcy and collapse the likeliest of outcomes.
But the part of digital health that’s trying to replace the incumbents is not the only place showing ugliness. The technologies and services being rolled out are often not working. Exhibit A is a randomized controlled trial conducted a Univ of Pennsylvania. One set of heart patients was set up with connected blood pressure cuffs, a pillbox that tracked their Rx adherence and lots of coaching help. The others were sent home with the proverbial leaflet and told to call if they had problems. You’d assume many more deaths and hospital readmissions in the second group. You’d be wrong. There were no differences.
So digital health needs to see if it can produce services companies that move the needle on costs and outcomes. The advantage is that they are eventually competing with hospital systems whose DNA doesn’t allow them the ability to let them cross the chasm to the new world. The bad news is that those systems have huge reserves which they can use to subsidize their old world activities.
I’m hoping digital health’s impact in the next 2 years will be as big as it was in the past 2, It’s by no means dead or over, but I am pessimistic.
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