Not Vaccinating Children Is the Greater Risk – The New York Times

This New York Times article takes a step back on childhood immunizations and gives us an overview of the diseases and complications that could be avoided with vaccines.

As most of us already know, vaccines are probably one of the most important health and lifesaving advances of the last century. However, misinformation and scaremongering is damaging the perception and the adoption of that innovation.

When too many people opt out of immunizing, outbreaks of preventable diseases happen, with sometimes deadly consequences for some.

Childhood diseases could lead to serious complications doubled by debilitating infections.

It’s a shame not to use all the available technology to protect us and our loved ones from potentially deadly diseases. It’s like riding a motorbike without helmet.

Who would do it today?

Additional resources

History of Vaccines

Understanding Vaccines – Public Health

Vaccines & Immunizations – Centers for Disease Control and Prevention

Vaccines.gov – US Government

Vaccines & Autism – Science-Based Medicine

Australia takes a stand against anti-vaxxers with a proposed $11,000 penalty – Quartz – September 2015

732,000: American Lives Saved by Vaccination – The New York Times – September 2015

U.S. vaccination rates high, but pockets of unvaccinated pose risk – Reuters – August 2015

Here’s How the Anti-Vaxxers’ Strongest Argument Falls Apart – TIME – August 2015

Vaccine hesitancy: A growing challenge for immunization programmes – WHO – August 2015

How This South Dakota Nurse Convinced A Religious Community To Vaccinate – Huffpost – August 2015

Vaccine Safety: Examine the Evidence – American Academy of Pediatrics – April 2013

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The difficult implementation of value-based healthcare – The Commonwealth Fund

ValueBasedCare

“A new survey from The Commonwealth Fund and The Kaiser Family Foundation asked primary care providers—physicians, nurse practitioners, and physician assistants—about their experiences with and reactions to recent changes in health care delivery and payment.

Providers’ views are generally positive regarding the impact of health information technology on quality of care, but they are more divided on the increased use of medical homes and accountable care organizations.

Overall, providers are more negative about the increased reliance on quality metrics to assess their performance and about financial penalties. Many physicians expressed frustration with the speed and administrative burden of Medicaid and Medicare payments. An earlier brief focused on providers’ experiences under the ACA’s coverage expansions and their opinions about the law.”

Probably each start of a new system is painful and requires people to adapt to it. However, it will have to be carefully monitored as adoption by healthcare providers is crucial for the success of the new system. It will validate the concept of value-based healthcare.

Read more

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US healthcare coverage increased from 85 to 90% – TIME

In a little less than 4 years, US healthcare coverage increased from 85 to 90% according to a TIME article.

“Decreasing the number of uninsured is a key goal of the Affordable Care Act (ACA), which provides Medicaid coverage to many low-income individuals in states that expand and Marketplace subsidies for individuals below 400% of the poverty line.” as stated in an article of KFF.

However, it will be difficult to have a full coverage of the population as some individuals refuse to buy healthcare insurance as they do not see how they could take advantage of the money spent in it. Some of them could simply not afford to buy coverage despite the subsidies.

Moreover, some issues arise with the methodology used to count the number of insured/uninsured people (see the Health Affairs article at the end of the post for more details).

In conclusion and despite all the issues with people not willing to adhere or counting methodology, it is a real progress to expand coverage, especially because US were lagging behind some emerging countries (have a look at the OECD Publication “Health at a Glance 2013” on page 138-139).

And what’s really interesting is the impact of more coverage on global health as a blog post pointed out.

Additional information

Estimating the Affordable Care Act’s Impact on Health – The Commonwealth Fund – August 2015

Meet the Health-Law Holdouts: Americans Who Prefer to Go Uninsured – WSJ – June 2015

Survey: America’s Uninsured Rate Is Down To 10% – And Falling – Forbes – June 2015

Counting The Uninsured: Are We Getting It Right? – Health Affairs – May 2015

Key Facts about the Uninsured Population – Kaiser Family Foundation – October 2014

Is the Affordable Care Act Working? – The New York Times – October 2014

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MicroHealth Helps Patients Manage Chronic Illnesses

We know that chronic diseases account for the majority of health expenditures. Helping patients with digital tools improving the management of their condition is a great step forward!

Effect of price caps and reference pricing on generics entry – GABI

PillboxNew

A fascinating article on GABI Online and study written by researchers on the effect of price caps and reference pricing on generics entry. Another study is also available here.

The key points (quotes from the article):

Question: how the use of a price cap along with reference pricing affects the entry of generics after patent expiry?

Answer(s):

  • For reference pricing to stimulate generics entry, the price effect needs to be sufficiently small relative to the demand effect.
  • If price cap regulation is introduced, the negative effect of reference pricing on generics entry can be reversed, and that reference pricing is more likely to result in cost savings than under free pricing.
  • If the price cap is sufficiently strict, introducing reference pricing may actually increase the number of generic drugs on the market.
  • The reason for this is that binding price cap regulation reduces the brand-name price difference between reimbursement schemes with and without reference pricing. Generics makers may therefore obtain higher market shares under reference pricing. Reference pricing is more likely to stimulate generics entry and facilitate cost savings when prices are regulated than in the free pricing equilibrium.

These studies show the price dynamics in the pharmaceutical markets and the impact of price control tool ont generics entry.

 

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Big Pharma Q2 2015 Financial Results Wrap Up

In the following table, the top pharma companies (by 2014 annual sales) key stats for Q2 2015.

Currency  Q2 2015 sales
(bn)
Growth yoy
(CER)
 Q2 2015 operating profit (bn) Op Margin (%) Publication date
1 Novartis USD 12.69 6.0% 2.28 18.0% 21.07.2015
2 Pfizer USD 11.85 -7.0% 3.68 31.1% 28.07.2015
3 Roche CHF 11.75 7.0% 3.86 32.8% 23.07.2015
4 Sanofi EUR  9.38 4.9% 2.57 27.4% 30.07.2015
5 Merck & Co. USD 9.79 -11.0% 1.74 17.8% 28.07.2015
6 Johnson & Johnson USD 17.79 -8.8% 4.92 27.6% 14.07.2015
7 GlaxoSmithKline GBP 5.89 7.0% 1.35 22.9% 29.07.2015
8 AstraZeneca GBP 6.31 2.0% 1.81 28.7% 30.07.2015
9 Gilead Sciences USD 8.13 26.1% 5.62 69.1% 28.07.2015
10 Takeda JPY 446.30 6.1% 49.60 11.1% 30.07.2015
11 AbbVie USD 5.48 19.4% 1.85 33.8% 24.07.2015
12 Amgen USD 5.37 4.0% 2.08 38.7% 30.07.2015
13 Teva USD 4.97 -2.0% 1.61 32.4% 30.07.2015
14 Lilly USD 4.98 1.0% 0.80 16.1% 23.07.2015
15 Bristol-Myers Squibb USD 4.16 7.0% 0.05 1.2% 23.07.2015
16 Bayer Healthcare EUR 5.91 28.0% 0.95 16.1% 29.07.2015
17 Novo Nordisk DKK 27.06  25.0%  12.48  46.1% 06.08.2015
18 Astellas JPY 343.66 16.4% 67.82 19.7% 31.07.2015
19 Allergan
(former Actavis)
USD 5.73 Undisclosed  2.50 43.6% 05.08.2015

Notes:

– For Roche the operating profit figure is an estimate as the company only published sales for Q1.

– It should be named Q1 for Japanese companies as the majority of them has a fiscal year ending in March.

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10 thoughts from 5 great healthcare minds – Becker’s Hospital Review

5 important people gave their thoughts about our current healthcare system in this Becker’s Hospital Review article:

– Jonathan Bush, founder and CEO of athenahealth (Watertown, Mass.)

– Malcolm Gladwell, journalist and best-selling author

– Chuck Lauer, former publisher of Modern Healthcare, and author, public speaker and career coach

– Nancy Schlichting, CEO of Henry Ford Health System (Detroit)

– John Halamka, MD, CIO of Beth Israel Deaconess Medical Center (Boston)

My favorite thoughts in a nutshell:

– On healthcare’s sustainability: new infrastructure is essential. Obsolete systems are a burden and a brake when it comes to innovation and efficiency.

– On changing the practice of medicine: doctors will have to consider the patient as a whole and spend time taking care of all the aspects of his/her health.

– On high-price medicine: prices should be linked with the innovation the product brings to the patient and the other stakeholders including the health system.

– On sharing healthcare data: data sharing with the goal of improving the life of each patient by learning and analytics could be a game-changer in the next future.

All these quotes could inspire leadership styles and help us create, implement and deliver better care for the patients in need.

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Scientists are developing an x-ray pill you can swallow for colonoscopy

Less invasive technology is clearly the future. It will allow more cases to be diagnosed and treated early leading to better care and cure.

Failure to publish the results of all clinical trials is skewing medical science – The Economist

Truth

A recent article published in The Economist highlights the fact that more than half of all the clinical trials are never published.

In any situation, if we only know half of the truth, distorsions ocurr and could lead to inappropriate and harmful decisions. A US law was passed in 2007 to encourage pharmaceutical companies to register them on a website and give follow-up on the results.

But this is not always precisely executed. After the legal maximum of a year was up, the percentage of clinical trials which had had their results published:

– 17% of those paid for by industry;

– 8% of those sponsored by the National Institutes of Health;

– 6% of those paid for by other government agencies/academic institutions.

The quantity of missing trials is huge and hiding poor results is not what we expect from scientists.

It has to change as hidden or missing data could lead to the use of inappropriate drugs in some patients. There is hope: the website Alltrials (launched by Ben Goldacre) and the charity behind this initiative are leading the movement toward more transparency. The charity “Sense About Science is working on an index, to be published later this year, that will rate pharma firms according to the extent of their commitment to publish all trials”.

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Allergan & Teva – Two sides of one table

Deals

Allergan (former Actavis) is restructuring its operations with the divestment of its generics business to Teva for approximately USD 41 billion in cash and stock ($33.75 billion in cash and Teva shares valued at $6.75 billion, giving it a 10% stake in Teva).

But it’s not done. According to an interview with the Financial Times, the CEO, Brent Saunders, is eager to sign another mega deal with the proceeds from the sale mentioned above. Allergan can then be put on the list of serial deal makers.

On the other side of the table, Teva is about to join the club of the biggest pharmaceutical companies. According to a Business Insider UK article, “Allergan’s generic business is generally seen as a better fit than Teva’s previous target Mylan because it will improve Teva’s distribution channels and because Allergan is strong in so-called biosimilar drugs.”

In the generics market, Teva will stay one step ahead of Novartis Sandoz division (estimated proforma 2014 sales of USD 15.7 billion for Teva-Allergan vs. USD 8.5 billion for Novartis Sandoz division).

In this context, Teva will probably drop its pursuit of rival Mylan, which in turn will be able to focus on buying Perrigo.

Additional links:

Allergan signals appetite for new mega deal after $41bn disposal – Financial Times (Subscription required)

A $40.5 billion deal with Allergan will make Teva one of the biggest drug companies on the planet – Business Insider

Teva to Buy Allergan Generics for $40.5 Billion – WSJ

The Last-Minute Phone Call That Spurred Teva-Allergan Deal – Bloomberg

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Therapeutic Financing Rounds in 2015: Gene Therapy Outpaces Antibodies in Early Stage Investment

Great stats and insights on financing rounds up to now

Next Phase Newsletter

By Michael Quigley, Director of Research, LSN

mike-2

It is no secret that 2015 has been a highly active year for deal-making in the life science space.  However, what is often overlooked is exactly where in the space those deals are taking place. Life Science Nation’s financing rounds database contains detailed information on over 250 of these rounds that have taken place since January 1 of 2015. We track this data from a variety of sources however as many companies and investors chose not to disclose this information this should be viewed as a sample of the entire data set of financings. With this article will highlight what our data tells us about the rounds that have taken place thus far in 2015 for therapeutics companies around the globe.

The first cut worth examining is the types of technologies that received funding.

f1 Figure 1 | Source: LSN Financing Rounds Dataset |…

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The Venture Funding Boom In Biotech – Life Sci VC

One of my favorite blogs recently posted an excellent article on the funding boom currently taking place in the biotech sector.

I think that this article really deserves a read. Why? Because it goes deeper into the fundamentals of the industry destroying some myths about the figures, very often misunderstood by the crowd.

According to Bruce Booth, despite the gigantic amounts invested in the sector:

– it is not always VC funding;

– it is not equally distributed;

– it is not linked to an increasing number of biotech companies getting financed;

– it is not leading to an increase in the the number of new companies created.

Moreover, after this analysis, the author wonders about the current situation (overfunding?) and what would happen in the next few months when investors would switch to other sectors… Another crucial question also emerges: will the number and quality of new ventures be sufficient to refresh the current ecosystem?

 

Additional material:

Venture Capital Investing Exceeds $17 Billion For The First Time Since Q4 2000 – PWC – July 2015

Torrid pace of VC investing in H1 sets a new biotech record – FierceBiotech – July 2015

Biotech Investing Hits An All-Time High–But Is It A Bubble? – Forbes – July 2015

Biotech: The Forgotten Bubble – Barrons – July 2015

Should The Biotech Bubble Be Feared? – Bloomberg – June 2015

 

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Pager is an “Uber/Amazon for Healthcare” – Forbes

Several new innovative and internet-linked services are emerging every day.

Several years ago, Amazon was selling books online, then it became a one-stop shop for many other things; Google expanded its traditional search engine business into a variety of other activities; Apple as well as other mobile phone producers launched smartphones only few years ago.., we can go on forever with examples.

Healthcare is one of the last area reached by digitalization. But the trend is now more than settled.

Recently a new startup named Pager raised USD 14 million for making your medical appointments instant and for a flat fee during extended hours (from 8:00am to 10:00pm).

A Forbes article drew some parallel with Uber for taxi ordering:  “The service finds and verifies doctors for its network and bills you automatically over a linked credit card”. However the CEO, Gaspard de Dreuzy, compared the company with Amazon instead: “Pager is focused on delivering a broader range of care options on demand than exist today. It could be a tele-consult via phone or messaging, or an in-person visit in the home, or a referral to the right specialist. We like to think of ourselves as the Amazon for healthcare.”

The service is only currently available in New York, but the company will soon expand its operations with the funds raised.

Other companies like ZocDoc or Doctors on Demand are also facilitating life for patients or people looking for health services quickly.

Below an pic from WSJ (see the related article in the Additional material section):

OnDemandDoctors-WSJ2015

Additional material:

Startups Vie to Build an Uber for Health Care – WSJ – August 2015

The Best Digital Business Models Put Evolution Before Revolution – Harvard Business Review – January 2015

There’s Now A Seamless For When You’re Feeling Sick – Huffington Post – December 2014

9 Healthcare Tech Startups To Watch – InformationWeek Healthcare – December 2014

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Why Are We Failing To Fund Mental Health Research?

Insightful post on the reasons of mental health underfunding.

Snackable Science

Everyone is affected by mental illness in some capacity, either directly or through those that we know. Around a quarter of the population experience a mental health condition each year and this high prevalence has considerable repercussions, both socially and economically. Indeed, many would be surprised to hear that on top of obvious human suffering, mental illness is estimated to cost the UK an eye-watering £105 billion a year once healthcare expenses and lost productivity have been taken into account.

With mental illness disrupting the lives of so many and harming the economy to such an extent, I was genuinely surprised to hear of the funding gap that exists in mental health research. Compared to other diseases that place a similar burden on society, publicly funded research into mental health is disproportionately low. Cancer research provides some of the strongest evidence of this effect, receiving around 20% of total UK research expenditure, almost four times more than the amount invested…

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With Big Data & Digital Health – New Collaborations are Emerging in the Pharma Industry – PWC

TeamWork

A newly published report by PWC reveals novel collaboration models for improved value of medicines

“Driven by empowered consumers and connected technology, the New Health Economy is shifting business incentives from volume to value with a focus on health outcomes beyond the clinic.”

Big data together with EHR (electronic health records) and wearables drive patient empowerment. Today, more and more, people have their say in treatment choices. Actually, health benefits and prices are crucial criteria for decision, especially as patients face today higher out-of-pocket expenses than ever before. We all well know that expensive treatments are financially disastrous for patients as mentioned in one of my previous posts.

Currently, increased focus is put on drug cost effectiveness as we switch progressively from a fee-for-service to an outcome-based world. Every treatment should be precisely calculated in order to be sure that it is optimized for all stakeholders from all points of view. In this context, already last year, PWC highlighted the beginning of a new system: the New Health Economy, where outcomes and quality are rewarded (instead of volume). It is the continuum of what has been started by Michael E. Porter several years ago.

All these changes have essential meanings. Therefore business models need to adapt to current trends: digital is unavoidable; purchaser perspective is necessary; patients need to become partners; regulatory changes have to be anticipated.

Adapting business models is fantastic but not sufficient. Novel collaborations are needed to optimize them for long-term success. All the stakeholders have to be integrated and blended by the biopharma companies: government agencies, insurers (payers as a whole), new entrants, consumers. Beyond collaborations, a consensus on the value of new medicines should be agreed on. Additionally, consumer and patient health information should be leveraged to improved personalization and precision of treatments.

In one word, several changes will flow the industry and challenges will pave the way to success. But it will become much more exciting to develop drugs in this context than ever before!

Report: PWC-21st-century-pharmaceutical-collaboration-July2015

 

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