💌 🏥 ‘Exceptionally weak’
| Good morning! This is week 2 of the Hospitalogy x Healthcare Huddle crossover send. As a reminder, this Sunday edition is written 99% by Jared Dashevsky, and I've added a section below about what to expect for Hospitalogy in the week ahead. Let us know what you think as this will continue to be an iterative process. Work with us here! You can subscribe to Healthcare Huddle by itself to get the industry news, insights, and analysis you need every Sunday by clicking here. Huddle up for:
Was this email forwarded to you? SPONSORED BY SYNAPSE MEDICINE As a med student (me, Jared), my job is to bring good vibes to the team and do thorough medication reconciliations on patients. The former is easy to do, the latter is hard, time-consuming and inefficient. Med students know this and doctors know this. Synapse Medicine’s platform is streamlining the medication reconciliation process. They’re a physician-first platform, providing physicians with a unique solution to prescribe quickly and safely, especially for complex prescriptions. Synapse Medicine is hosting a webinar, diving into how their medication reconciliation platform improves patient safety and fosters coordinated care. We can all benefit from a more streamline med rec process. Join Synapse Medicine on May 17th @ 11 AM ET. For every attendee Synapse Medicine will donate $10 to Carbonfund.org. POLICY "Roe was egregiously wrong"Leaked documents from the Supreme Court reaffirmed what many expected but wished would never happen: a strike down of the Roe v Wade decision.
Recall that Roe v Wade established a constitutional right to abortion before fetal viability (around 23 weeks) and prevented states from banning abortion. Catch Up The lawsuit quickly moved through the courts, landing on the Supreme Court’s desk. Based on the arguments in November, it seemed most Supreme Court justices would vote to uphold the Mississippi law, thereby striking down the Roe v Wade decision. My Thoughts An abortion procedure is care that is simple, extremely safe and way more common than you think. For example, around one in five pregnancies in the U.S. end in induced abortion. While you may expect abortion rates to decrease once the Supreme Court releases its final draft, they won’t decrease. People will continue to get abortions—it’s just a matter of safety. This is problematic from a health and equality standpoint. Abortion restriction laws are inherently pro-inequality. Take Texas’s heartbeat ban: pregnant people needing an abortion face a 20-fold increase in driving distance to reach the nearest abortion clinic. That’s assuming everyone has access to the transportation (and funds) needed to travel such distances and can afford to take off from work. Companies like Apple, Salesforce and Amazon are being proactive, offering to cover expenses for abortion procedures if the employee has to travel out of state. But, it’s unlikely these employees fall under the “low income” group, missing the populations who’ll suffer the most from restrictive abortion bans. My Predictions I have two predictions:
HOSPITALOGY THIS WEEK Hospitalogy's Week AheadBe on the lookout for the Hospitalogy sends this week (Tuesday morning & Thursday mid-day)! Tuesday I'll be following up on staffing firm's earnings reports to see if they match up with hospitals' contract labor narrative that I covered in last Thursday's send. I'll also be diving into the other biggest healthcare stories from the week. Then, assuming there's no insane, crazy story that drops this week, on Thursday I'll be taking a dive into the care platform landscape, starting with Privia, ApolloMed, agilon, and P3 Health Partners. It's a space I want to learn more about too, so let's dive in together to understand the economics of their platforms. See ya Tues & Thurs, Hospitalogy fam. PHARMA Biogen Throws in the TowelBiogen’s CEO Michel Vounatsos is stepping down after a five-year run. Biogen needs a turnaround. The company’s “revolutionary” Alzheimer’s drug, Aduhelm, was a massive flop, putting a dent in the company’s financials. The Deets Biogen originally priced the drug at $56,000 for one year of treatment but slashed the price in half to $28,000/year after continuous complaints from hospitals (and much of the medical society) that the drug’s high cost was not worth its benefits. To hammer the nail in the coffin, CMS announced it would restrict Aduhelm coverage to patients only in clinical trials, citing insufficient evidence that its use is reasonable and necessary. Biogen’s plan to shake things up in the company, including cutting the Aduhelm commercial team, is expected to save the company around $1B. My Thoughts Unfortunately, Alzheimer’s is only becoming more prevalent in society: the number of people living with the disease is expected to triple from 5.8M to 14M by 2060. Read: an Alzheimer’s drug is desperately needed. My Predictions DIGITAL HEALTH Cerebral: Digital Health's IcarusMental health startup Cerebral is under a federal investigation for excessive prescribing of controlled ADHD medication. While their story sounds eerily similar to Purdue Pharma’s, I do think Cerebral had/has the potential to do good for patients. Catch Up The Deets Given the DEA’s relaxed prescribing rules, Cerebral was able to hire DEA-registered clinicians to evaluate patients for ADHD and prescribe them medication like Adderall. And boy did they (and other similar companies) prescribe:
I can’t imagine, though, the true incidence of ADHD diagnoses jumped like that, too. Something’s up. Anyway, Cerebral employees started speaking out, saying the company’s prescribing practices were unethical. The company also aggressively marketed how easy it was to get ADHD treatment (my Instagram was filled with Cerebral marketing). ADHD diagnoses were being made within short, 30-minute appointment slots, and over 50% of patients who subscribed to the company’s service with concerns they had ADHD left with an ADHD diagnosis. That’s a pretty high hit rate, in my opinion. Pharmacies like CVS, Walmart and Truepill started catching on to Cerebral’s prescribing practices and recently cut off Adderall prescriptions being sent from the company. My Thoughts But now, the company is being scrutinized for essentially being an “Adderall Mill.” Like opioids, Adderall is a class 2 substance because of its high risk of misuse and addiction. Also, like opioid drug makers, Cerebral aggressively marketed its ADHD service. We don’t have any data yet regarding the increased misuse of Adderall. Still, if it mirrors what happened with OxyContin, I’m sure we’ll see something soon regarding its (negative) impact on health. My Predictions Cerebral will likely increase their focus on depression and anxiety, which they say has been the money maker for them, not so much ADHD. So maybe that will be their secret sauce—an increase in focus on depression and anxiety? Lastly, I imagine the demand for psychiatrists will skyrocket, especially if the DEA doesn’t extend its relaxed prescribing rules post-public health emergency. A trained psychiatrist will do a better job of making an ADHD diagnosis in a clinical setting, especially after sufficient history taking and testing (as opposed to Cerebral’s in-and-out 30-minute visit). OUTSIDE THE HUDDLE
HUDDLE HITS
HEALTHCARE JOBS Here are some jobs that I’m curating for the healthcare industry. Use this link to submit your role to be featured if you’re looking to hire. Senior Growth Manager of Health Services, Hinge Health Hinge is looking for someone who has Health Plan relationship management experience as a management consultant, vendor or other partner to lead their growth efforts. If you’re interested in health care and making a difference in people’s lives, and passionate about the intersection of technology and healthcare, then this is for you. Regional Medical Director, Teladoc: Teladoc is looking for someone who will support the Senior Medical Director with implementing and directing policies and procedures, ensuring exceptional medical quality and service is delivered to patients. Represents focused leadership in the creation of an employed model supporting provider needs, process innovation and provider mentoring. Senior Manager, Compensation and Analytics, Virta Health: This role is an opportunity to lead the design and refinement of foundational compensation and people analytics practices, policies and processes in partnership with Virta’s leadership for an organization that is focused on impactful work such as variable compensation standardization. THE WEEK AHEAD
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