Andrew Dunn

Drug prices are a notorious black box. But lately Washington policymakers have been scrutinizing more closely the role pharmacy-benefit managers play in the prices you pay at the pharmacy. Anna Mathews and I yesterday scooped that the Federal Trade Commission is preparing lawsuits against the Big 3 PBMs (CVS Health's CVS Caremark, Cigna Healthcare's Express Scripts, UnitedHealth Group's Optum Rx) challenging the way they negotiate discounts for drugs, including insulin. In addition, we broke the news that the trade cop is also eyeing the role of insulin makers (Eli Lilly and Company, Novo Nordisk, Sanofi) in pricing schemes. This comes after the FTC released results from a two-year investigation into whether PBMs steer patients away from low-cost drugs. The FTC in that report highlighted deals in which drugmakers paid more to PBMs in exchange for the PBMs excluding their generic competitors from preferred lists. The Agency said this "may impede and impair competition." The PBMs called the FTC's report flawed and said they save customers money. This comes amid a growing chorus of PBM skepticism on Capitol Hill. What do you think about the role of pharmacy-benefit managers in negotiating drug prices? Are policymakers right or wrong to eye them critically? https://lnkd.in/e8H5EekH #healthcare #PBMs #drugpricing #pharmaceuticals #insulin Remember to follow The Wall Street Journal on LinkedIn for more news.

18

7 Comments

This week in PublicSource: Democratic candidates seem to be increasingly focused on defining their foes as extremists on reproductive rights. We break down claims in dueling ads in a Pittsburgh-area swing congressional district https://lnkd.in/ewCvhE6p Energy, climate: Important issues, right? In Pa., the balance of power on those and other issues hinges on a few General Assembly races, including one in Allegheny County. So why aren’t the candidates talking about fossil fuels? https://lnkd.in/eeiJGiTe Back in blue, and back pay, too? A judge said no to a former Pittsburgh police officer’s bid to return to the force after tasering Jim Rogers, who died. A PublicSource analysis found that some fired cops beat the city to the tune of 6-figure checks https://lnkd.in/eBzQudWv Wilkinsburg’s governmental future will be on the ballot Nov. 5 — but not in the manner preferred by backers of annexation with Pittsburgh. Instead, voters will decide on home rule, which means a more powerful and better-paid mayor, and more https://lnkd.in/eXRiUCvu PublicSource strives to tell stories for a better Pittsburgh that wouldn’t emerge in media controlled by big money. But we need your help to do this. If you can pitch in: https://lnkd.in/eJgWUGBF Millions for clean air in the Mon Valley: Sounds good, right? If you want to share thoughts on how it should be spent, you have three opportunities, all in October, to do so https://lnkd.in/eYQ8Fdsx Sydney is not a survivor of sexual violence, but she carried a sign and marched with those who have experienced abuse, amid the dangerous “red zone” on campuses. “This is what I have learned as an advocate for survivors of sexual and domestic violence.” https://lnkd.in/eDDTjsWv

5

ICYMI, a bipartisan bill addressing false and misleading prescription drug #advertisements by social media influencers and telehealth companies would increase #FDA oversight, authority that my Bloomberg Law investigation found was unclear and slow in recent years. Sens. Dick Durbin (D-Ill.) and Mike Braun (R-Ind.) on Thursday introduced legislation that would require the Food and Drug Administration to issue warning letters, followed by fines for noncompliance, to social media influencers and telehealth companies that engage with false and misleading prescription drug promotions. Durbin and Braun in February called on the FDA to update its decade-old guidance on social media prescription drug promotion, as well as clarify when its laws apply to paid social media influencers. In that letter to the agency, the senators cited my investigation, which found examples of posts that led individuals to start taking medications, only to experience vomiting and other side effects they say the posts didn’t adequately warn them about. More on the bill in this story from Nyah Phengsitthy: https://lnkd.in/eHqUMpfC My December 2023 investigation here: https://lnkd.in/eJ23dwUZ

5

How AI firms and investors are funding and backing JD Vance & Trump in order to slash AI regulation. A must read - https://lnkd.in/eu4H9gpK

3

ICYMI: This week turned out to be the most active week of the year for dealflow amongst #companiesforsale covered by PE Hub, with four announced acquisitions. Of those four deals, three were reported on exclusively by this news service as coming to the market: 1. On November 13, New Heritage Capital, LLC-backed Continental Services, a catering company, served up a tasty deal to be acquired by Morgan Street Holdings, a holding company and investment arm of the HAVI Group, a supply chain and distribution services provider which counts McDonald’s as an anchor customer. PE Hub reported Continental Services was actively for sale over the summer months in a process run by Lazard. 2. Announced the same day, Court Square Capital Partners reached an agreement to sell Advanced Diabetes Supply, one of the three largest distributors of continuous glucose monitoring (CGM) equipment, to Cardinal Health for undisclosed terms. In January, I reported Court Square was prepping a sale process for ADS, which is based in Carlsbad, California. The PE-backed medical equipment distributor enlisted Houlihan Lokey as sellside adviser. 3. Also this week, Charlesbank Capital Partners and KKR-backed MB2 Dental, a Dallas-based dental partnership organization, announced a recapitalization with Warburg Pincus agreeing to commit $525 million into the company. Back in July, I reported that MB2 was coming to the market by the Fall, with Moelis & Company engaged as sellside adviser. Sign up for PE Hub for more intel on companies coming to the market. https://lnkd.in/eYB59Xm6

7

Moderna’s Covid vaccine caused its stock price to soar and made it a pandemic hero. Its second product, a vaccine for RSV, faces a tougher path, including competition from two larger drug companies, GSK and Pfizer, and questions over how long it lasts. I wrote about Moderna’s post-pandemic future, which includes developing cutting-edge cancer treatments. With Covid demand falling, Moderna is counting on its RSV shot to help fund its ambitious pipeline. The vaccine is expected to get approval this month and will be a big test of whether Moderna — and mRNA technology — can make it in a post-Covid world. Read more here: https://lnkd.in/e7pydHQS

14

NEW: I really enjoyed this conversation in catching up with biotech's Renaissance man, Siddhartha Mukherjee. The oncologist not only runs a research lab at Columbia, has co-founded several ambitious startups like Vor Bio, Faeth Therapeutics, Myeloid Therapeutics, and Immuneel Therapeutics Pvt. Ltd., but he's also written epic, Pulitzer-winning books on medicine and science. In an interview for our Endpoints News Slack series, Mukherjee joined our secret Slack channel to discuss his scientist-writer mindset, the latest on AI and cancer research, and how he got into writing 600-plus page books. My latest:

132

4 Comments

When it comes to health care in the U.S., it feels like a Dickensian best and worst of times. We've seen amazing new drugs developed and are on the precipice of real technological breakthroughs that can improve care. Yet, the private-public partnership between payers, providers and the government is increasingly acrimonious and often winds up in the courts. Regulators and critics are going after the big for-profit vertically-integrated health firms charging that they've pushed smaller players out of the business when it comes to pharmacy benefits and drugstores, while creating more headwinds for providers to get their patients the care they need when it comes to health benefits. Right now, the FTC is suing the PBMs over insulin prices, and those same companies are suing the agency over prior biases. Meantime, some of those same players are also suing CMS over the recent stars ratings on Medicare Advantage plans. CMS has raised the bar for MA reimbursement rates, and that is causing profit headwinds for the big conglomerates, which has sparked more investor pressure for better performance. Those dynamics helped result in CVS Health's board replacing CEO Karen Lynch this week. Her departure follows a similar fate for Walgreens' Roz Brewer and RiteAid's Heyward Donigan. All three led the nation's largest drug store chains during the critical vaccine rollout during the pandemic. All three sought to leverage the chains' footprint for delivering primary care -- talk about gale force headwinds on that front at a time when the stores barely break even. There are no easy answers when it comes to our blended government and for-profit health care right now. The two parties are frenemies that can't work without one another. When I write things like that on social media, I get a litany of patient comments that amount to "a pox on both their houses!" But the fact is, we all need for them to work better together. If only Generative AI could give us a good solution...

42

3 Comments

Check out the latest edition of the Inside 340B Report podcast, where Ted Slafsky, William Newton, Bella Czajkowski and I talk about the latest fallout from J&J's rebate proposal, and how the election results could reshape 340B policy in Washington!

2

New this AM: General Catalyst is investing "well north" of $1b of its $8b in new capital in healthcare, Chris Bischoff tells me. Here's what one of the biggest #VCs in digital health is looking for, this time around. via Modern Healthcare https://lnkd.in/e2KBkBfQ

35

One of the biotech industry's star investors, the 38-year-old VC firm ARCH Venture Partners, uncorked its 13th fund on Thursday. The Chicago-based firm has another $3 billion to deploy into its large bets on neuroscience, AI, obesity, autoimmune diseases and other areas ripe for more precise treatments. “We’re trying to slow down, but not slowing down because there’s so much cool stuff right now,” managing director Bob Nelsen said Wednesday in an interview with Endpoints News. “Every time we think we’re going to slow down, AI happens or some other thing happens, so it’s an amazing environment to start companies, small ones or big ones, and we do both.” The firm has dished out larger checks and created more startups than most other biotech VC investors over the years. Its current roster includes Xaira Therapeutics, Mirador Therapeutics, Seaport Therapeutics and Metsera among dozens of others. “I’m very hopeful over the next 10 years, and certainly the life of Fund XIII, that we’ll continue to evolve the precision medicine models so that we can better serve patients with lupus, with rheumatoid arthritis, with metabolic disease, cardiovascular disease,” managing director Kristina Burow said in an interview. “Those aren’t just giant, lump diseases. We’re going to start to be able to parse different patients into different medicines.” #biotech #venturecapital #arch #biotechvc #vcfirm #lifesciences

391

1 Comment

Latest edition of our InnovationRx healthcare newsletter is here, with a few initial thoughts about how policy in a second Trump term might impact the industry. https://lnkd.in/gHTNMg5Y

5

This week in #medtech regulations and policy: > Much activity on the AI front, including advocacy on Capitol Hill, FDA updates AI/ML numbers, UK Medicines and Healthcare products Regulatory Agency AI Airlock launched > EU Med Device Coordination Group had a packed agenda this week > New notified bodies and.... one of the oldest notified bodies, BSI Medical Devices, discloses MDR/IVD capacity and lead times > China NMPA updates its device classification procedures > FDA joined the American Medical Association's CPT Editorial Panel > Remanufacturing guidance ...And a lot more in this week's #PathwaysPicks from Market Pathways: https://lnkd.in/eM6Mj8zg #AI #FDA #Medicare #EU #China #medicaldevices

12

Will the axe fall on healthcare mergers and acquisitions? We talked about it on the new episode of the 4sight Health Roundup podcast moderated by yours truly https://ow.ly/877E50RTWN4

5

This Gallup piece is interesting. On the one hand, it's disheartening, though not surprising, to see such a partisan gap in trust in media. Has anyone studied why this is? Can (should?) anything be done about this? On a perhaps separate note, it's encouraging is to see how Rs and Ds both seem to have a lot of trust in local government: https://lnkd.in/gKdePu-M. Maybe if you see government in action, you trust it. Would something similar be true for journalism? Genuine questions.

3

Talkspace is inching closer to profitability. It was able to get there for the first time on an adjusted basis in the first quarter. What worked for the company — bailing on the DTC model and getting payer contracts — could accelerate as it seeks to become the first scaled, national #digitalcare mental health company serving American seniors. #behavioralhealth #mentalhealth https://lnkd.in/gEnHjVn4

11

1 Comment

One of our clients is pioneering the use of AI for drug discovery -- one of the most important use cases today. Our case study below tells what they're doing and how we're helping them. #AI #drugdiscovery #medicine

2

Big story today from me: Last year, the healthcare startup Forward bet the house on its AI-powered doctor-in-a-box. The futuristic “CarePods” were supposed to let patients get a full doctor’s visit sans the doctor. Forward, which operated more than a dozen primary clinics and had raised $650 million in venture capital, grabbed $100 million in November 2023 to power its big push and place thousands of CarePods in malls and offices across the country. But last night, Forward sent an email to its patients announcing that the startup would be shutting down, effective immediately. I’ve been following Forward’s story all year. I spoke with eleven former employees who said Forward put all its chips into its CarePod bet with little to show for it a year later. The CarePods saw much less interest from patients than Forward hoped, cost millions to manufacture, and struggled with numerous technical issues (like self-service blood draws routinely failing, and patients getting stuck in the CarePods). All the while, Forward was cutting costs at its primary care clinics and quietly closing locations to focus on its CarePods. The startup seemingly only got around to launching three CarePods before its shutdown. When BI went to visit the location of Forward’s first CarePod a few weeks ago, the CarePod had been removed from the California mall. For Business Insider, this is the definitive story of how Forward’s style-over-substance pitch to revolutionize healthcare crashed and burned: https://lnkd.in/ebnHnksN

126

27 Comments