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Twins For Everyone!

By KIM BELLARD

I have lived my entire life as a twin, and, while it isn’t an unalloyed blessing, on balance I’d recommend it.  Most of you, though, probably aren’t twins and have missed the experience.  Don’t worry: you may still get a chance – with a digital twin. 

It could have profound implications for your health and for healthcare generally.

A digital twin, in case you are not familiar with the concept, is a virtual representation of a physical object.  It is created from data about that physical object, and is fed ongoing data (e.g., via IoT) about it to keep the model accurate. 

The concept is not new, often attributed to Michael Grieves at the Florida Institute of Technology in 2002.  Dr. Grieves saw the value of the concept for manufacturing; for example, GE’s Aircraft Engines has been using them to make their engines safer and more efficient.  Other applications include building maintenance, data centers, and even creating a digital twin of the whole planet.

People have seen the potential of digital twins for healthcare for years.  Back in 2016, GE’s Digital CEO Bill Ruh predicted:

I believe we will have a digital twin at birth, and it will take data off of the sensors everybody is running, and that digital twin will predict things for us about disease and cancer and other things. I believe we will end up with health care being the ultimate digital twin. Without it, I believe we will have data but with no outcome, or value.

We’re not there yet, not nearly, but it’s coming.

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#Healthin2Point00, Episode 216 | Datavant acquires Ciox, plus deals for AllyAlign, Cerebral & more

Today on Health in 2 Point 00, Jess is trying to replace me with the other Matthew Holt. But on Episode 216, I am still around to talk about some deals. First, Datavant acquires Ciox Health in a $7 billion deal, aiming to create the nation’s largest health data ecosystem. Next, Avenue Health is a new company that has just been launched, working on seamless, end-to-end data integration and blockchain, and AllyAlign Health raises $300 million as a new Medicare advantage plan. Finally, Cerebral raises $127 million – this is like a Ro or Hims but specifically for mental health. —Matthew Holt

Why “Radiopharmaceutical” Should be Part of your Healthcare Vocabulary

By JAY T. RIPTON

Not to sound too alarmist, but the radiopharmaceutical industry is on the verge of an explosion. But don’t worry; it’s not the type of explosion one often associates with nuclear materials… I love those movies too! It’s the beginning of a new wave of innovation for the diagnosis and treatment of certain cancers and other diseases.

This new radiopharmaceutical boom quite literally has the life sciences industry in a nuclear arms race of sorts, as companies like Y-mAbs, Novartis and others are pushing through clinical trials for the next blockbuster for the treatment and detection of hard-to-treat diseases like medulloblastoma and metastatic castration-resistant prostate cancer. But all this excitement has many wondering, “what are radiopharmaceuticals anyway?”   

Radiopharmaceuticals are simply a group of pharmaceutical drugs containing radioactive isotopes. They are being used primarily for the treatment and detection of certain types of cancers, but they are also being developed for cardiac disease as well. And what makes radiopharmaceuticals so unique is that they can be targeted to extremely precise areas in the human body.

Although gaining ground with more precision today, this type of therapy actually began in the 1940s with I-131 – which has become an important agent for the treatment of benign and malignant thyroid disease. The development of radiolabeled antibodies began in the 1970s, and Radium-223 dichloride was approved by the FDA in 2013 for the treatment of castrate-resistant metastatic prostate cancer. Lu-177 PSMA is one of several recent developments that are making their way through FDA approvals.

“The radiopharmaceutical industry has actually been around for some time, but today it is at a tipping point,” says SpectonRx president Anwer Rizvi. “Over the next few years, it is estimated that our industry will triple. With more radiopharmaceuticals making their way through clinical trials and FDA approval, we are starting to see more data that highlight their effectiveness. This is why we are now starting to see more life sciences organizations committing real resources to radiopharmaceuticals.”  

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#Healthin2Point00, Episode 215 | Monogram, LetsGetChecked, Transcarent, Lenus, and Ada

Amazon Cares already has customers, Clover has become a meme stock, Transcarent has got a Series B that they closed already, and OneDrop has hit 25 billion biometric data points – what the hell is going on in digital health? Today on Health in 2 Point 00, we still have lots of deals to cover. Monogram, an end-stage kidney disease company, raises $160 million. LetsGetChecked raises $150 million in a Series D – all of these at-home testing companies are getting a push because of COVID. Next, Lenus raises €50M in a Series A, making it the biggest ever single A round in Denmark. Transcarent gets $58 million in a Series B already, and Ada Health raises $90 million for their symptom assessment chatbot. —Matthew Holt

UpHealth Hits the NYSE: CEO & President on SPAC Merger Completion, Virtual Care Competition & More

By JESSICA DaMASSA, WTF HEALTH

Another virtual care company hits the New York Stock Exchange as UpHealth ($UPH) emerges from the combined merger of UpHealth Holdings and Cloudbreak Health with the GigCapital2 SPAC. We’ve got UpHealth’s CEO Ramesh Balakrishnan and President Jamey Edwards here on “Listing Day” to catch us up on the strategic developments and integrations that have occurred since UpHealth’s SPAC IPO was first announced at the end of 2020.

You might remember this deal as the one that brought together six different companies across four of the fastest growing areas of digital health: global telehealth, integrated care management, digital pharmacy, and behavioral health. The story there is still the same, but the value proposition around the combined offering has gelled. UpHealth views itself as a partner to local healthcare providers around the world who need a hand building the integrated digital care model needed to meet growing patient demands and economic realities of a “digitally transformed” healthcare experience. How is this different than what we’re seeing from other publicly-traded telehealth companies like Amwell, Teladoc, and Hims? Or, what about those telehealth-empowered retail giants like Amazon, Walmart, and CVS Health who, like UpHealth, see a lot of upside in the duality of both making care more convenient digitally, while also seamlessly integrating with local in-person care centers? We’ve got all the talk you’ll want about UPH’s positioning, business model, revenue guidance (still $180M-190M for 2021) AND even some client name dropping (Amazon? Really?!) as the stock hits the market.

Bonus: Want to go deeper into this deal? For more on UpHealth, check out our earlier chat with Chairman Chirinjeev Kathuria, Jamey Edwards, and Al Gatmaitan from February 2021. The link is right here: https://youtu.be/50PIVdUjnPU

THCB Gang Episode 57 – Thurs June 10

Episode 57 of “The THCB Gang” will be live on Thursday, June 10, 1pm PT 4pm ET. Matthew Holt (@boltyboy) will joined by regulars: medical historian Mike Magee (@drmikemagee), THCB regular writer Kim Bellard (@kimbbellard) and futurist Ian Morrison (@seccurve). And we have a special guest, health care equity analyst at Hedgeye, Emily Evans (@HedgeyeEEvans)

You might guess that the latest meme stock Clover Health (CLOV) might make an appearance! But that won’t be all!

The video is below. If you’d rather listen, the audio is preserved as a weekly podcast available on Fridays on our iTunes  & Spotify channels

Hey, How About Starship Earth?

By KIM BELLARD

I missed the job announcement on the company website.  I missed it again when the company posted the job on Linkedin.  I missed it when Eric Ralph tweeted that the posting was “probably the coolest job posting I’ve read in years.”  Fortunately, though, I follow Isaac Kohne (MD, PhD), and I did see his tweet:

Yes, I’m talking about SpaceX.  Yes, the job is for a “Starship Medical Engineer.”  Yes, it’s to help SpaceX’s mission to Mars, whenever that might be.  Who knows, the job might even entail going to Mars, although that’s not spelled out. 

I am not, of course, remotely qualified for such a job.  In fact, I don’t even know anyone who might be.  But I agree with Mr. Ralph that it’s probably the coolest job posting I’ve seen in years, maybe ever.  And I even more agree with Dr. Kohne: it could be an “opportunity to rethink a bigger broken system.”

Hint: I don’t think he’s talking about just the SpaceX mission. 

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#Healthin2Point00, Episode 214 | One Medical acquires Iora, plus funding for HumanFirst & many more

Today on Health in 2 Point 00, Jess pokes fun at me because my primary care provider has acquired a Medicare provider – One Medical buys Iora Health for $2.1 billion in stock. This deal is curious because these are two very different organizations. Next, HumanFirst (formerly Elektra Labs) raises $12 million in a Series A, bringing their total to $15 million, working on distributed clinical trials. Medallion raises $20 million in a Series A to address barriers for digital health providers around state licensing rules, and Aunt Bertha raises $27 million working on the social determinants of health and getting social care resources to patients. Finally, Grand Rounds and Doctor on Demand acquire Included Health, an LGBTQ+ focused care navigation platform. —Matthew Holt

The Art of Medicine is Not an Algorithm

By HANS DUVEFELT

The Art of Medicine is such a common phrase because, for many centuries, medicine has not been a cookie cutter activity. It has been a personalized craft, based on the science of the day, practiced by individual clinicians for diverse patients, one at a time.

Unlike industrial mass production, where everything from raw materials to tools to manufacturing processes are standardized and even automated or performed by robots, physicians work with raw materials of different age, shape and quality in what is more like restoration of damaged paintings or antique automobiles.

The Art of Medicine involves knowing how and with which tools to take something damaged or malfunctioning and make it better. There are general principles, but each case is different to at least some degree. In many cases there are different ways to improve something that is malfunctioning, but patients may prefer fixing certain aspects of a complex problem because of their individual needs.

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Matthew’s health care tidbits, week ending Jun 5

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

In this week’s health care tidbits, I can’t quite leave the $3.5bn Babylon Health SPAC investor document alone. Yes, it’s crazy but not as crazy as you might think. Essentially it’s saying that it’s going to be a better tech enabled version of Oak Street or Agilon. Babylon has put less effort into the medical group management side of the puzzle than Oak Street or Agilon but it hasn’t done nothing. It’s been running GP clinics in the UK for years and now has two Medicare Advantage networks in California w 52k lives. It only did $79m in rev in 2020 but that was presumably mostly in software. They’re aiming for $320m in rev in 2021 (presumably mostly from the medical groups) & $710m in 2022.

In comparison Oak Street’s forecast is $1.3bn in 2021 and $2bn in 2022. So Babylon is shooting to be 25% of its size. Today’s Oak Street market cap is ~$14,5bn, so 25% of that is close to the $3.5bn Babylon is trying to get investors to pay.

Then there’s the story, which is that the bot tech can reduce all types of patient health spend which will increase the margin. Of course their actual mileage may vary. I do love the chart from their investor prez, which not only assumes that they can reduce medical spend abut also that they get to keep those savings long term. I’m not sure the “Partner” in the chart below will be as convinced.

This was the cause of much hilarity on this week’s #THCBGang.

As I said crazy but not completely crazy. And you never know, maybe better care?

assetto corsa mods