How are ‘digital therapeutics’ different than what we’ve already been doing in ‘digital health’? Eugene Borukhovich, Global Head of Digital Health for Bayer, talks about how he thinks eventually the term ‘digital health’ will just disappear. What’s behind this prediction? Listen in to find out.
Filmed at JP Morgan Healthcare Conference, San Francisco, January 2019.
Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.
Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.
Bayer’s G4A team launched their 2019 program today, so here’s a little help for anyone curious about the state of pharma startup investment and what it takes to land a deal there these days.
I had the chance to pick the brain of Bayer’s
Global Head of Digital Health, Eugene Borukhovich, during JP Morgan Healthcare
Week and pulled out these three gloriously thought-provoking soundbites from
our conversation to give you some insight as to the mindset over at big Bayer.
“Digital therapeutics are shining light on the convoluted, complex mess of digital health”
If you’ve wondered what lies ‘beyond the pill’
for Big Pharma, wonder no more. It seems the answer is digital therapeutics.
Eugene predicts that “within the next couple of years, ‘digital health’ as a
term will disappear,” and calls out organizations like the Digital Therapeutics
Alliance for their efforts to set standards around evidence-base and behavior
modification so regulators and strategic investors alike can properly evaluate
claims made by health tech startups. As time goes on, it looks like efforts to
‘pharma-lize’ the ways startups take their solutions to market will increase,
pushing them into more traditional go-to-market pathways that have familiar and
comforting guidelines in place. As Eugene says, “Ultimately, what we say in my
team, is that it’s about health in a digital world today.” Sounds like that’s
true for both the products he’s seeking AND the way pharma is looking to bring
them to market…
“These multi-hundred million [dollar] press releases are
great to a certain extent, but what happened to the start-up style mentality?”
When asked about Big Tech getting into Big
Health, in the end, it seems, Eugene shakes out to be in favor of the ‘Little
Guy’ – or, at least, in their approach. Don’t miss his comments about
“cockiness in our healthcare industry” and how Big Tech is working around that
by partnering up, but the salient point for startups is that big companies still
seem very much interested in buddying with smaller businesses. It’s for all the
same reasons as before: agility, the ability to iterate quickly, and the
opportunity to do so within reasonable budgets. Eugene offered this telling
rhetorical musing: “Just because it’s a combination of two big giants…do you
need to do $500 million? Or, do you give some…traction, milestone, [etc.]…to
prove it, just like a start-up would?”
“In large organizations, transformation equals time, and…we
don’t have time.”
“To me,” says Eugene, “the biggest challenge is
actually landing these inside the organization.” He’s talking about novel
health solutions – digital therapeutics or otherwise – after learning from
previous G4A cycles. Culture, precedent, and years of market success loom large
in big healthcare companies across the ecosystem, which is one reason why innovation
inside them is so challenging. Eugene says he’s “a big believer in a small team
– even in large organizations – to take something by the cojones, and get shit
done, and move it forward, and push the envelope from the bureaucracy and the
process.” There’s a sense of urgency to ‘innovate or die’ in the face of the
growing competition in the healthcare industry. “Back to this earlier
conversation around whether it’s tech giants or other companies,” he adds, “it
is a race to the speed of the organization. How quickly we learn and how
quickly we make the decisions. Bottom line, that’s it.”
There’s plenty more great insights and trend
predictions where these came from, plus the juicy details behind how G4A itself
has pivoted this year. Check out the full interview now.
It is commonly believed that deliberate, careful price regulation by enlightened technocrats trumps the haphazard and chaotic regulation of prices imposed by the free market—especially when the market is subject to greed and corruption.
A most interesting case study challenging that belief comes courtesy of the largest Democracy in the world: India.
In 2017, an arm of the Indian Government, the National Pharmaceutical Pricing Authority (NPPA) took action to control the price of coronary stents in India by capping their retail price. The problem that stimulated this action was their exorbitant price that made them unaffordable to many Indians.
The retail prices of US made drug-eluting stents ranged from Rs 80,000 – 150,000 (~$1000 – ~$2000), while the price of Indian made drug-eluting stents ranged from Rs 45,000 – 90,000 (~$600 – ~$1200). Considering that a good job for 90% of the Indian labor force pays about Rs 180,000 per year, these prices put most coronary stents out of the reach of a vast swath of the populace.
What regulators knew, however, was that the price point at which coronary stents were being imported into India was a fraction of the price being charged to Indians. The up-charge had everything to do with what happened after the stent was brought onto Indian soil: The Indian subsidiary of the US stent manufacturer would sell its product to a domestic distributor that would then employ all means necessary to ensure their stent was chosen by cardiologists to be implanted.
DNA testing companies like 23andMe have opened the genome market in the last decade, with adoption skyrocketing on both consumer and clinical sides. Now the trend is pushing even further, from genotyping technology to whole genome sequencing and the health implications are massive. While genotyping looks at less than half of 1% of your genome, whole genome sequencing looks at over 99% of your genome. That’s about 6.4 billion letters of DNA! With elite awards from MIT, Fast Company, and more, Veritas Genetics is not only designing great, user-friendly experiences for people to engage with their personal genome information, but taking it a step further by providing actionable insights that actually result in a healthier life.
Filmed at the JP Morgan Healthcare Conference in San Francisco, CA, January 2019.
Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.
Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.
Mental health chatbot startup, X2AI, uses a text-based chatbot to respond to people experiencing depression, addiction, and thoughts of suicide via customized text conversations. More than 4 million people have paid access to the service, which has been shown to reduce symptoms of depression by 13-18%. Founder Michiel Rauws talks about how machine learning helped develop the bot (called Tess) and what’s on tap next for his company.
Filmed at the JP Morgan Healthcare Conference in San Francisco, CA, January 2019.
Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.
Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.
Most will be surprised to learn that American Indians and Alaska Natives represent the only populations in the United States with a legal birthright to health care.[1] Even though Article 25 of the UN’s Universal Declaration of Human Rights declares, “everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including…medical care and necessary social services,” U.S. federal policy only guarantees this human right to enrolled tribal members. The source of this juridical entitlement is what the United States Supreme Court has defined as the federal trust responsibility.
Between 1787 and 1871, the United States signed nearly 400 treaties with Indian tribes, in which, for the exchange of millions of acres of tribal land, the U.S. government promised in perpetuity to respect their sovereignty and provide benefits, including housing, education, and healthcare. Argued in March 1983, United States v. Mitchell is the most recent Supreme Court case establishing this principle as a matter of law. This week marks the 36-year-anniversary of that seminal case, providing us the opportunity to discuss the federal government’s failure to adequately fund the healthcare institutions that serve American Indians and Alaska Natives despite its legal responsibility to do so.
The current life expectancy for American Indians and Alaska Natives is 73 years, 5.5 years less than that of the general population. American Indians die at higher rates from heart disease, cancer, diabetes, stroke, and kidney disease. When we consider why Native communities suffer from preventable and treatable diseases at disproportionate frequencies, we must first evaluate the inequity in Congressional funding for Indian Health Services (IHS), the national agency within the Department of Health and Human Services that is responsible for providing comprehensive healthcare to the country’s enrolled American Indians and Alaska Natives.
Jane Metcalfe founded Wired Magazine 25 years ago to talk about the tech revolution. Today, her new publication, NEO.LIFE is reporting from the the front lines of the “Neobiological Revolution.” From the most astounding developments in neuroscience, genome sequencing, and longevity to biohacking, synthetic biology, fertility, and human performance, NEO.LIFE covers the bleeding edge of health innovation. From that vantage point, we got Jane to weigh in on all the big questions…like how is today’s health tech scene reminiscent of the burgeoning tech scene of the 90’s? And, of course, why the f%$! are there still fax machines in hospitals?!
Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.
Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.
Today on Health in 2 Point 00, Jess and I are at 10th annual Health Datapalooza in Washington D.C.! Jess talks to me about Xealth’s $11 million round to develop out its company, and Change Healthcare is applying for a $100 million IPO. The big takeaways from Health Datapalooza are that many people and companies have integrated data into their systems, but they haven’t been able to gain many actionable insights from it. Also, if you haven’t heard of the complaint Andrea Downing, Fred Trotter, and David Harlow wrote to the FTC concerning the privacy and data that can be downloaded from Facebook’s groups, you better check it out. It details out the concern that Facebook is not protecting the data of patients as anyone can download sensitive data from the groups and use it — Matthew Holt
Within the ever-widening array of Democratic contenders for the Presidency, the “Medicare-for-all” debate continues to simmer. It was only six weeks ago that Kamala Harris’s vocal support drew fire from not one, but two billionaire political rivals. Michael Bloomberg, looking for support in New Hampshire declared, “I think we could never afford that. We are talking about trillions of dollars… [that] would bankrupt us for a long time.” Fellow billionaire candidate Howard Schultz added, “That’s not correct. That’s not American.”
Remarkably, neither man made the connection between large-scale health reform’s potential savings (pegged to save 15% of our $4 trillion annual spend according to health economists) and the thoughtful application of these newly captured resources to all U.S. citizens without discrimination. Bloomberg’s own 2017 Health System Efficiency Ratings listed the U.S. 50th out of 55, trailed only by Jordan, Columbia, Azerbaijan, Brazil, Russia. Yet he seemed unable to connect addressing waste with future affordability.
Schultz was similarly short sighted. While acknowledging that the
manmade opioid epidemic, mental health crises, and income inequality are
“systemic problems” and at levels “the likes of which we have not had in a long
time”, he failed to connect the cause (a remarkable dysfunctional and
inequitable health care system) with these effects.
As I outline in “Code Blue: Inside the Medical Industrial Complex” (Grove Atlantic/ June 4, 2019), today’s greatest risk to continued progress and movement toward universal coverage and rational health planning is sloppy nomenclature. To avoid talking past each other, we need to define the terms of this debate while agreeing on common end points.
According to healthcare leader Toby Cosgrove, THIS is “the year of telehealth.” Although Teladoc CEO Jason Gorevic would rather use the phrase ‘virtual care’ to describe the space, he’s pretty much on board with the idea that more consumers than ever will jump onto the virtual care bandwagon this year. How will Teladoc’s partnership with CVS play a role? Any other acquisitions on the horizon? Gorevic gets real about what’s impacting utilization rates and whether or not he’s worried about Teladoc competing with Apple, Google, and Amazon. (Hint: He’s not.)
Filmed at JP Morgan Healthcare 2019 in San Francisco, January 2019.
Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.
Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health.
