CVS's Bold Leap Towards Transparent Drug Pricing

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🌐 Healthcare x News

Digital Pill" Tracks Vitals from Inside the Body

A new ingestible capsule developed by Celero Systems contains sensors to measure heart rate, breathing rate, and temperature from inside the stomach. Early testing in sleep apnea patients showed it can accurately detect disrupted breathing patterns.

The digital pill wirelessly transmits vitals over several days before passing safely. Future uses could include home monitoring for cardiac or respiratory conditions and even detecting opioid overdoses to trigger emergency alerts.

Though prior digital pills have faced adoption barriers, the ability to monitor patients remotely during high-risk periods may prove this device's advantage. Larger trials are underway, with plans to develop drug-delivery capabilities down the line. If successful, the pill could enable continuous invisible monitoring not possible with external wearables.

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FDA Approves First CRISPR Gene Therapy for Sickle Cell Disease

The FDA approved the first CRISPR gene editing treatment, called exa-cel, for sickle cell disease. Exa-cel was developed by Vertex and CRISPR Therapeutics. It edits the BCL11A gene to boost production of fetal hemoglobin, helping restore normal red blood cell structure and function.

In clinical trials, nearly all sickle cell patients had no pain for over a year after treatment. Longer follow-up is needed to confirm durability. Side effects were generally mild but risks of off-target DNA edits remain a concern.

Another gene therapy called lovo-cel from bluebird bio was also approved. While promising, costs likely exceeding $2 million per patient raise access barriers. Overall exa-cel represents an important first step in realizing CRISPR gene editing's transformative potential for sickle cell disease.

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Tracking Digital Health Innovation in 2024

Rock Health analyzed seven major digital health developments along an innovation maturity curve to identify opportunities and competitive threats in 2024.

Food as medicine and digital obesity care are nascent, with growing research, funding, and policy tailwinds. Caregiver solutions and AI in healthcare are emerging into growth stages, attracting adoption interest.

Meanwhile value-based care enablement, retailers as providers, and data interoperability are calibrating - working to scale more mature solutions.

In 2024, leaders must determine required partnerships and capabilities to keep pace, pursue early mover advantages in fledgling areas, and evolve existing assets for further growth despite market uncertainty. Though winter persists, digital health innovation marches on.

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💰  Healthcare x Startups

Seattle Children's Spins Out BrainChild Bio to Tackle Pediatric Brain Cancers

Seattle Children’s has spun out BrainChild Bio, a new biotech startup aimed at developing novel CAR T-cell therapies for incurable pediatric brain cancers.

Initially targeting deadly diffuse intrinsic pontine glioma (DIPG), BrainChild will leverage proprietary technology already demonstrating promising results in clinical trials. Backed by Seattle Children’s funding and led by veteran executives, the company aims to sustainably scale the personalized immunotherapies.

BrainChild’s focus on overlooked central nervous system tumors combined with faster regulatory pathways for rare pediatric diseases could enable rapid commercialization. If effective, the treatments could ultimately expand to adult cancers currently lacking options.

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🕰️ Blasts from the Past: This Week in Medical History

December 6, 1921 - First Successful Insulin Treatment. Frederick Banting and Charles Best successfully isolate insulin, leading to the first effective treatment for diabetes.

December 7, 1941 - Discovery of Penicillin. Alexander Fleming discovers penicillin, revolutionizing the treatment of bacterial infections.

December 8, 1993 - Birth of CRISPR Technology. Researchers reveal the revolutionary CRISPR gene-editing technology, allowing precise modification of DNA.

December 9, 1996 - Cloning of Dolly the Sheep. Scientists in Scotland announce the successful cloning of a sheep named Dolly, a breakthrough in cloning technology.

December 10, 1999 - Mapping the Human Genome. The Human Genome Project announces the completion of a rough draft of the human genome, a significant milestone in genetics.

December 11, 2019 - First Case of COVID-19. The first case of COVID-19 is identified in Wuhan, China, marking the beginning of a global pandemic.

December 12, 2000 - FDA Approval of the First Implantable Defibrillator. The U.S. FDA approves the first implantable cardioverter-defibrillator (ICD), a device that monitors and corrects irregular heartbeats.

December 13, 2006 - FDA Approval of HPV Vaccine. The U.S. FDA approves the first vaccine for human papillomavirus (HPV), a major step in preventing cervical cancer.

🧠 Healthcare x AI

InpharmD Raises $6M to Expand AI-Powered Clinical Decision Support

Atlanta-based InpharmD, an AI-powered clinical decision support company, secured $6.05 million in funding led by 645 Ventures.

InpharmD provides personalized, evidence-based answers to doctors' drug information and treatment queries by leveraging a network of pharmacists and a large repository of medical research. Its solutions aim to facilitate data-driven care and cost savings.

The new funding will help InpharmD expand its operations, client base, and machine learning capabilities. By optimizing search and summaries for clinicians, the company saves providers time while enabling better informed prescribing.

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Healthcare x Obesity

Roche Bets $2.7B on Obesity Drug Developer Carmot

Roche agreed to acquire obesity drug startup Carmot Therapeutics for $2.7 billion upfront. Carmot's lead candidate CT-388 is a weekly GLP-1/GIP receptor agonist injection for weight loss, similar to top sellers from Novo Nordisk and Lilly.

CT-388 has shown promise in early trials and will now be tested in large Phase 2 efficacy studies. Roche aims to differentiate through superior weight loss, tolerability, and dosing convenience.

The deal marks Roche's big return to the GLP-1 field after previous failures. With the multi-billion dollar obesity drug market booming, Roche and other pharmas are making bold bets to compete with segment leaders. If successful, CT-388 could launch in 2030s and generate billions in peak sales.

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🌎  Healthcare x Pharmacy

CVS Overhauls Drug Pricing: A Transparent Prescription for Change

CVS Health has unveiled a groundbreaking move to transform the prescription drug pricing landscape. The company, acknowledging the longstanding lack of transparency and inflated costs in the traditional model, plans to implement its new reimbursement strategy, CVS CostVantage, on January 1, 2025.

What You Need to Know:

1. CVS CostVantage Unveiled: CVS's novel model marks a departure from the convoluted system determining pharmacy reimbursements and patient costs. Set to roll out in 2025, the approach aims to align drug pricing economics with what consumers pay at the pharmacy counter.

2. Costs May Shift: While the new model could alter the prices of certain medications, CVS executives clarify that not all drug costs will necessarily decrease. The impact will vary, with some seeing reductions while others may experience an increase. The overarching goal is to bring about a net reduction in prescription costs for consumers, employers, and insurers.

3. Transparency at the Core: CVS commits to increased transparency and a streamlined process. CVS CEO Karen Lynch emphasizes the shift toward understanding drug pricing, making it more transparent and accessible for consumers.

4. CVS CostVantage Mechanics: The plan revolves around a sustainable and transparent formula. Pharmacies, numbering over 9,000, will be reimbursed based on the drug's cost, a clearly defined markup, and a fee covering handling and dispensing prescriptions. The new model contrasts with the complex existing system involving various intermediaries like insurers, drug manufacturers, and pharmacy benefit managers (PBMs).

5. Challenges and Responses: CVS faces challenges, including skepticism and ongoing scrutiny. Billionaire Mark Cuban's similar venture, Cost Plus Drugs, initiated a parallel model, triggering changes in the industry. The CVS move comes amid growing scrutiny of PBMs and a broader push by the Biden administration to negotiate drug prices within the Medicare program.

Industry Impact: CVS's proactive approach aligns with broader efforts to reshape drug pricing, responding to consumer demands for clarity and fairness. The evolving landscape, influenced by innovative models and government initiatives, aims to create a more accessible and equitable healthcare environment.

Key Players Respond: Billionaire Mark Cuban, a player in the evolving drug pricing landscape, maintains a neutral stance on CVS's initiative. Cuban's venture, Cost Plus Drugs, has already influenced other companies, including a major insurer like Blue Shield of California, to explore alternative partnerships.

Government Action: The Biden administration's steps toward medication price negotiations within the Medicare program, coupled with ongoing scrutiny of PBMs, indicate a broader shift toward addressing rising healthcare costs and enhancing affordability for consumers.

CVS's bold move signifies a significant step towards a more transparent, consumer-centric prescription drug pricing model, setting the stage for potential industry-wide shifts.

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That’s all for this week.
The Pulse Disruption Team

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