Healthcare Huddle Summer Recap
3 JUNE 2023
Prior Authorization: Insurers’ Delight, Physicians’ Plight, and Patients’ Pain
UnitedHealthcare’s last-minute reversal from implementing a new prior authorization rule for non-screening endoscopies has stirred controversy. Initially backed by evidence of procedure overutilization, the rule faced staunch opposition from gastroenterologists concerned about potential patient harm and added physician stress. Delve into the intricate battle between cost-saving measures and patient care, and explore possible solutions to the growing challenges of the prior authorization system. (link)
10 JUNE 2023
I Was Right (and Wrong) About the Weight Management Space
Dive into my reflection on my 2022 predictions for the future of weight management, where groundbreaking advancements in anti-obesity medications have now entirely reshaped the landscape. Uncover the latest clinical trials that showcased remarkable results in weight loss and the surging startups capitalizing on these new treatments. Yet, challenges persist, from access disparities to reassessing the role of gastric bypass surgery in the fight against obesity. (link)
24 JUNE 2023
One Year After Dobbs: Unveiling the Far-Reaching Impact on Abortion Rights
In a year since the monumental Supreme Court ruling in the Dobbs case, the U.S. has seen a dramatic shift in abortion rights. Dive deep into how the decision has ushered an era of stringent abortion laws in many states, reshaping access to reproductive healthcare, and revealing the profound impact on medical training and alarming racial disparities in maternal mortality. Explore the contentious battleground of states’ responses, and uncover how telehealth for medication abortion is now at the legal forefront. (link)
01 JULY 2023
Medicare vs. Pharma: The Legal Fallout of the Inflation Reduction Act
As tensions rise following the Inflation Reduction Act of 2022, pharmaceutical giants and lobbying groups are suing the federal government, labeling the Act’s provision to let Medicare negotiate drug prices as unconstitutional. Critics argue the law violates their rights, potentially hampers drug innovation, and could challenge the future of medical breakthroughs. Dive into this in-depth analysis to unravel the balancing act between groundbreaking innovation and affordable healthcare, and see what’s at stake for both patients and the pharma industry. (link)
08 JULY 2023
Cost Plus Drugs: Key Updates from H1 ‘23
Mark Cuban’s Cost Plus Drug company is changing the pharmaceutical world with its rapid expansion, securing over 30 new partnerships with independent pharmacies and delivering brand-name and biosimilar drugs at significantly reduced prices—all in H1 ‘23. Recent studies have highlighted potential savings of billions for Medicare Part D beneficiaries if they adopted Cost Plus Drugs’ pricing. Dive into this article to discover the groundbreaking strides the company has made in just the first half of 2023 and the tantalizing prospects of a partnership with CMS or the VA. (link)
15 JULY 2023
Navigating the Digital Health Funding Landscape: Insights from H1 2023
Digital health funding for 2023 is poised to hit its lowest since 2019, with a shift in the landscape highlighted by 12 mega deals accounting for 40% of total funding in the first half of the year. Amidst a backdrop of reduced deal volume, Rock Health’s recent report emphasizes three booming sectors: non-clinical workflow, at-home care solutions, and value-based care enablement. Dive into the article to unravel the intricacies of these trends, their potential impact, and what this means for the future of the digital health ecosystem. (link)
22 JULY 2023
The Rise of Humira Biosimilars and the Adoption Challenge
After two decades of dominating the market, AbbVie’s Humira faces competition from a wave of biosimilars. But it’s not just about drug entry; it’s about navigating the intricate web of pharmacy benefit managers (PBMs) and the rebate system that can thwart cheaper drug adoption. Dive into the article to uncover how players like Cost Plus Drugs are sidestepping traditional hurdles to bring massive discounts to the biosimilar market. (link)
29 JULY 2023
Neko Health: A Unique Twist on Whole-body Scans
Neko Health, co-founded by Spotify’s Daniel Ek, has created a buzz with its unique approach to preventive healthcare through non-invasive whole-body scans. While the broader market of whole-body imaging raises eyebrows due to high false positives and limited evidence, Neko differentiates itself by focusing on primary care-like screenings at potentially more affordable rates. Dive into this article to discover how Neko might be revolutionizing preventive care, especially amidst the soaring out-of-pocket healthcare costs in places like the U.S. (link)
05 AUGUST 2023
HealthScribe: Amazon’s Gamble in Clinical Documentation
Amazon Web Services unveils HealthScribe, a revolutionary AI tool designed to transcribe and summarize patient-doctor dialogues for easy EHR integration. While the service positions itself uniquely, aiming to be integrated into larger healthcare platforms, it enters a fiercely competitive market dominated by focused health tech firms. Can Amazon’s new venture overcome the typical pitfalls faced by big tech in healthcare, or will specialized companies continue to lead the way? Dive in to find out. (link)
19 AUGUST 2023
The Wild West of Digital Health
The explosion of digital health companies during the pandemic has created a “Wild West” landscape, with many promising better healthcare outcomes without concrete evidence. The Peterson Health Technology Institute aims to bring clarity by offering an independent evaluation of these digital health solutions, considering factors like clinical benefits, economic impact, and user experience. As we move into the post-pandemic era, this evaluation will be crucial for purchasers, ensuring that investments in digital health are based on sound evidence and genuine value. Dive in to understand the future of digital health evaluation and its implications for healthcare. (link)
26 AUGUST 2023
The Unbundling: Is Blue Shield’s Big Move a PBM Game-Changer?
Blue Shield of California is shaking up the drug prescription world by severing its ties with CVS Health’s Caremark, prompting discussions about the future of pharmacy benefit managers (PBMs). This bold initiative aims to improve transparency and reduce costs, splitting the roles traditionally held by Caremark among five distinct entities. Dive in to explore the implications of this groundbreaking move, its potential to reshape the drug supply chain, and whether it truly marks the beginning of the end for dominant PBMs. (link)
02 SEPTEMBER 2023
CMS Takes the Reins: The Big Shake-Up in Medicare Drug Pricing
CMS is gearing up to negotiate prices for 10 key Medicare Part D medications, following the new permissions from the 2022 Inflation Reduction Act—a move that could reshape the prescription landscape. While these negotiations promise significant government savings, they have stirred a tempest of legal challenges and concerns about potential impacts on drug innovation. Dive deeper to uncover which drugs are on the negotiation list, the nuances of the act, and the potential ripple effects across the healthcare system and on patients’ wallets. (link)
1 JUNE 2023
Streamlining Healthcare Workflows with GPT: A Look at the Future of Clinical and Non-Clinical Processes
Watch my virtual event to explore GPT’s ability to streamline workflows, and hear from Dr. Dereck Paul, CEO of Glass Health, who will discuss Glass AI—a revolutionary platform that combines a large language model with a clinical knowledge database, providing reliable treatment plans in seconds and improving patient care. Read my primer here.
13 JULY 2023
Breaking Down Digital Health Funding Trends from H1 ‘23
Rock Health’s Adriana Krasniansky and I chatted about digital health funding trends of the digital health industry in the first half of 2023. With 2023 starting off as a rebound year, there was a lot of optimism in digital health. But, it seems the choppy waters of 2022 are not yet over.
22 AUGUST 2023
Millions Raised, but no proof: How can digital health companies focus on validation?
Lindsey Schapiro, Senior Manager at the new Peterson Health Technology Institute, and me had an insightful discussion on evaluating the clinical robustness of digital health startups. We explored the current state of digital health, the lack of clinical validation of digital health solutions, and a potential framework for evaluating the technical, clinical, usability, and cost aspects of digital health solutions.
Stay ahead in healthcare with my weekly Healthcare Huddle newsletter, covering digital health, policy, and business trends for 30,000+ professionals. Share with colleagues and subscribe here.