Empowered Patient Podcast

Dr. Mark Campbell, Chief Pharmacy Officer at RxBenefits, a prescription benefit optimizer that works with self-funded employers to help them get the best clinical and economic value from their pharmacy benefit manager relationships. As the healthcare landscape has become more complex with the rise of specialty and high-cost drugs, a significant portion of an employer's pharmacy costs can be impacted by a small population. A key challenge is managing the volatility introduced each year by changes in the health of employees and their families while also managing costs for the broader covered population.

Mark explains, "The landscape for prescription benefits has shifted a lot over the course of my career. In 1998, for example, 35% of the prescriptions were generic, and 65% were branded. There was no appreciable amount of specialties at that time. And the average cost for a plan was probably in the mid-thirties per member per month. But with the shift we've seen where generics have grown to roughly 88% of the prescriptions for most of our groups, now the remaining 12% of brand and specialty drugs make up about 85% of the cost."

"And you could narrow that even further to say that roughly 2% of the members make up about 65% to 70% of the cost of a plan. And now we're getting into conditions, diabetes, and the non-specialty realm, which is a very large influence on the overall cost for a plan. Also we are getting into specialty therapies for a variety of conditions, whether it's inflammatory conditions like rheumatoid arthritis, psoriasis, ulcerative colitis, or certain types of cancers where we have new therapies that we didn't have several years ago."

"Even in many orphan conditions, we've seen new products come to market. That can be a significant benefit for patients who have either had limited or no therapy options for them in the past. So, beginning to help employers understand how to address that 2% of their population in a way that will get an elegant response for the member, getting the right drug for the right patient, and getting it at the right cost is where a lot of our emphasis is."

#RxBenefits @RxBenefits @MarkCampbell #PharmacyBenefit #PharmacyBenefitOptimizer #PBO #PrescriptionDrugCost #HighCostDrugs

rxbenefits.com

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Dr. Mark Campbell, Chief Pharmacy Officer at RxBenefits, a prescription benefit optimizer that works with self-funded employers to help them get the best clinical and economic value from their pharmacy benefit manager relationships. As the healthcare landscape has become more complex with the rise of specialty and high-cost drugs, a significant portion of an employer's pharmacy costs can be impacted by a small population. A key challenge is managing the volatility introduced each year by changes in the health of employees and their families while also managing costs for the broader covered population.

Mark explains, "The landscape for prescription benefits has shifted a lot over the course of my career. In 1998, for example, 35% of the prescriptions were generic, and 65% were branded. There was no appreciable amount of specialties at that time. And the average cost for a plan was probably in the mid-thirties per member per month. But with the shift we've seen where generics have grown to roughly 88% of the prescriptions for most of our groups, now the remaining 12% of brand and specialty drugs make up about 85% of the cost."

"And you could narrow that even further to say that roughly 2% of the members make up about 65% to 70% of the cost of a plan. And now we're getting into conditions, diabetes, and the non-specialty realm, which is a very large influence on the overall cost for a plan. Also we are getting into specialty therapies for a variety of conditions, whether it's inflammatory conditions like rheumatoid arthritis, psoriasis, ulcerative colitis, or certain types of cancers where we have new therapies that we didn't have several years ago."

"Even in many orphan conditions, we've seen new products come to market. That can be a significant benefit for patients who have either had limited or no therapy options for them in the past. So, beginning to help employers understand how to address that 2% of their population in a way that will get an elegant response for the member, getting the right drug for the right patient, and getting it at the right cost is where a lot of our emphasis is."

#RxBenefits @RxBenefits @MarkCampbell #PharmacyBenefit #PharmacyBenefitOptimizer #PBO #PrescriptionDrugCost #HighCostDrugs

rxbenefits.com

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Dr. Vicky Demas, CEO of identifeye HEALTH, is using AI-powered diagnostic algorithms and automation to improve the accessibility and quality of retinal imaging, focusing on the early detection of diabetic retinopathy. The identifeye technology makes it easier for patients to get screened for eye conditions in primary care or retail settings. The goal is to leverage the information from retinal scans to detect other eye conditions and identify biomarkers for other systematic diseases.

Vicky explains, "In general, we leverage AI and automation to solve workflow problems to make, first and foremost the capturing of good-quality retinal imaging. It's really easy to make sure that, for example, we can remove the barriers and access for that. We don't need to be at a specialist office for a lot of the screening conditions. Very specifically too, for our first application, we're focusing on diabetic retinopathy, which is a huge problem and one where accessibility to good quality screenings and early detection or early detection is a huge problem that we're hoping to help with."

"What it comes to is not about the camera or the resolution. Still, it is really about making sure that the capturing is of good quality, high quality. I'll call it an image that can be analyzed and interpreted. It can be done with someone with very little training upfront. Also, the information that you have to retain to run an exam is low. So, if you didn't run the device and are not operating it routinely, you don't have to remember what menu I opened and where the data is. And now I'm going to go and open this. We have used consumer product development principles to bring in usability and intuitive design, and of course, all powered by AI to automate all of that work."

#identifeyeHEALTH #HealthcareInnovation #DigitalHealth #PrecisionMedicine #DiabeticRetinopathy #VisionHealth #Biomarkers

identifeye.health

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Dr. Vicky Demas, CEO of identifeye HEALTH, is using AI-powered diagnostic algorithms and automation to improve the accessibility and quality of retinal imaging, focusing on the early detection of diabetic retinopathy. The identifeye technology makes it easier for patients to get screened for eye conditions in primary care or retail settings. The goal is to leverage the information from retinal scans to detect other eye conditions and identify biomarkers for other systematic diseases.

Vicky explains, "In general, we leverage AI and automation to solve workflow problems to make, first and foremost the capturing of good-quality retinal imaging. It's really easy to make sure that, for example, we can remove the barriers and access for that. We don't need to be at a specialist office for a lot of the screening conditions. Very specifically too, for our first application, we're focusing on diabetic retinopathy, which is a huge problem and one where accessibility to good quality screenings and early detection or early detection is a huge problem that we're hoping to help with."

"What it comes to is not about the camera or the resolution. Still, it is really about making sure that the capturing is of good quality, high quality. I'll call it an image that can be analyzed and interpreted. It can be done with someone with very little training upfront. Also, the information that you have to retain to run an exam is low. So, if you didn't run the device and are not operating it routinely, you don't have to remember what menu I opened and where the data is. And now I'm going to go and open this. We have used consumer product development principles to bring in usability and intuitive design, and of course, all powered by AI to automate all of that work."

#identifeyeHEALTH #HealthcareInnovation #DigitalHealth #PrecisionMedicine #DiabeticRetinopathy #VisionHealth #Biomarkers

identifeye.health

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Felicia Janovich is a founding member of the American IV Association, which advocates for safe and effective IV therapies, including hydration, vitamin infusions, and treatments to support patients with chronic conditions or undergoing chemotherapy. While there is limited research on the effectiveness of these IV therapies, AIVA is working to collect and analyze clinical data to understand better the impact these therapies might have on individuals to help with recovery and overall health.

Felicia explains, "Right now, in our space, we struggle with clear guidelines. And there's kind of misunderstanding that there's a bunch of IV cowboys out there, and they're just starting IVs, and they don't have regulations. It's just entirely untrue. The IV Association and its members bring in this amazing opportunity to collaborate, not compete, which is huge within this IV industry because it is relatively new, so we need all the data, all the information, and all the science to back it up. What AIVA has done is welcome all these other business owners who are doing the absolute best they can without having a clear-cut rule book, if you will."

"But the main thing we all share is that it's intravenous, so we supply our nutrients and medications through an IV line directly to work on the cell at the cellular level. So, there might be different variations depending on the treatment, the goals, and what the provider and that client are trying to obtain, but the similarity is it's all going through an intravenous line."

#AIVA #IVTherapy #VitaminInfusions #IntravenousTherapy

americaniv.com

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Felicia Janovich is a founding member of the American IV Association, which advocates for safe and effective IV therapies, including hydration, vitamin infusions, and treatments to support patients with chronic conditions or undergoing chemotherapy. While there is limited research on the effectiveness of these IV therapies, AIVA is working to collect and analyze clinical data to understand better the impact these therapies might have on individuals to help with recovery and overall health.

Felicia explains, "Right now, in our space, we struggle with clear guidelines. And there's kind of misunderstanding that there's a bunch of IV cowboys out there, and they're just starting IVs, and they don't have regulations. It's just entirely untrue. The IV Association and its members bring in this amazing opportunity to collaborate, not compete, which is huge within this IV industry because it is relatively new, so we need all the data, all the information, and all the science to back it up. What AIVA has done is welcome all these other business owners who are doing the absolute best they can without having a clear-cut rule book, if you will."

"But the main thing we all share is that it's intravenous, so we supply our nutrients and medications through an IV line directly to work on the cell at the cellular level. So, there might be different variations depending on the treatment, the goals, and what the provider and that client are trying to obtain, but the similarity is it's all going through an intravenous line."

#AIVA #IVTherapy #VitaminInfusions #IntravenousTherapy

americaniv.com

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Michael McFadden is the CEO of Alpha Cognition, a biopharmaceutical company focused on developing treatments for brain diseases such as Alzheimer's, ALS, and traumatic brain injury. Their drug ZUNVEYL, recently approved by the FDA, is an oral treatment for mild to moderate Alzheimer's that improves symptoms such as memory loss, mental processing speed, and mood changes. A key feature of the drug is fewer gastrointestinal side effects compared to other Alzheimer's drugs coming onto the market.

Michael explains, "ZUNVEYL is a class of medications known as acetylcholinesterase inhibitors. It's the second oral compound approved by the FDA to treat Alzheimer's disease in the last decade. So, it is a momentous accomplishment by our company, and it is an accomplishment that will serve patients and physicians well. It's designed to treat symptoms of mild to moderate Alzheimer's disease that many patients suffer from. These are things like memory loss, mental health processing speed, ability to solve problems or remember short-term and long-term things. Also, it affects or allows patients to manage changes in mood or personality that often accompany Alzheimer's disease. So, these are drugs that are used very commonly to treat Alzheimer's disease. We think this drug will have a lot of utility in helping patients and offering physicians a new choice."

"About 55% of patients who take a drug for Alzheimer's disease will have some side effect that's so significant they have to stop taking their medicine. So side effects are a primary reason that patients cannot stay on their therapy. The side effects that are most common are GI-related side effects, GI side effects, diarrhea, nausea, or vomiting. We are excited about our compound because we believe if you can't tolerate a medicine, the medicine certainly can't be efficacious for the patients."

#AlphaCognition #Alzheimers #AlzheimersDisease #AlzheimersDrug #ZUNVEYL #Dementia

alphacognition.com

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Michael McFadden is the CEO of Alpha Cognition, a biopharmaceutical company focused on developing treatments for brain diseases such as Alzheimer's, ALS, and traumatic brain injury. Their drug ZUNVEYL, recently approved by the FDA, is an oral treatment for mild to moderate Alzheimer's that improves symptoms such as memory loss, mental processing speed, and mood changes. A key feature of the drug is fewer gastrointestinal side effects compared to other Alzheimer's drugs coming onto the market.

Michael explains, "ZUNVEYL is a class of medications known as acetylcholinesterase inhibitors. It's the second oral compound approved by the FDA to treat Alzheimer's disease in the last decade. So, it is a momentous accomplishment by our company, and it is an accomplishment that will serve patients and physicians well. It's designed to treat symptoms of mild to moderate Alzheimer's disease that many patients suffer from. These are things like memory loss, mental health processing speed, ability to solve problems or remember short-term and long-term things. Also, it affects or allows patients to manage changes in mood or personality that often accompany Alzheimer's disease. So, these are drugs that are used very commonly to treat Alzheimer's disease. We think this drug will have a lot of utility in helping patients and offering physicians a new choice."

"About 55% of patients who take a drug for Alzheimer's disease will have some side effect that's so significant they have to stop taking their medicine. So side effects are a primary reason that patients cannot stay on their therapy. The side effects that are most common are GI-related side effects, GI side effects, diarrhea, nausea, or vomiting. We are excited about our compound because we believe if you can't tolerate a medicine, the medicine certainly can't be efficacious for the patients."

#AlphaCognition #Alzheimers #AlzheimersDisease #AlzheimersDrug #ZUNVEYL #Dementia

alphacognition.com

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George Pappas, CEO of Intraprise Health, works with various healthcare organizations across the healthcare industry and healthcare ecosystem to help address cybersecurity risks. While recent cyber attacks have raised awareness about the need for better cybersecurity measures, the complexity of healthcare IT systems creates significant challenges for comprehensive risk management. Proactive measures, including employee training, enhanced identity confirmation, and limiting access, are critical to mitigating the risk of cyber attacks.

George explains, "The net situation is that these large technology companies that serve healthcare and hospital systems and large medical practices change are clearinghouses, revenue cycle managers, and manage real-time price transparency. What medication management companies manage is so complicated, and they have so many ways that something can be attacked. As you mentioned at the beginning, the attackers are getting very clever and sharing a lot of their methods, so you have to do a comprehensive continuous review of your entire cybersecurity posture. Because if you don't, there are invariably going to be challenges and small things that are small at the time that end up not being small and being the way that an attacker got in."

"And in the case of Change, it was a multifactor authentication problem accessing a certain system through a certain technology stack that was rather old. But these things exist in companies this size. They have tens of thousands of machines and have accumulated different companies they acquired over time with different technology systems that don't all work together. So, the vulnerabilities are there, and they require comprehensive risk management and some candidly, more investment than we've seen to address fully."

"I'll give you another example. So maybe it helps your listeners place this a little better. If you think about someone who has a home and is trying to protect their home from all the various threats or things that can happen. Well, their home insurance company requires them to have a smoke detector and carbon monoxide sensor. They get a credit on their policy. If they have a burglar alarm system, they might have a ring doorbell camera or any number of things like that. What you see across the industry is these large hospital systems, small hospital systems, doctor's offices, and they're doing those basic things. But here's the issue. In that same house that I mentioned, you could have 30 windows, the roof might be a little old, you might have a ground floor, and a door that has glass could be easily broken if someone tried to break in."

#IntrapriseHealth #HealthcareCybersecurity #PatientDataProtection #CyberThreats #HITRUSTCompliance #RiskManagement #DataPrivacy

intraprisehealth.com

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George Pappas, CEO of Intraprise Health, works with various healthcare organizations across the healthcare industry and healthcare ecosystem to help address cybersecurity risks. While recent cyber attacks have raised awareness about the need for better cybersecurity measures, the complexity of healthcare IT systems creates significant challenges for comprehensive risk management. Proactive measures, including employee training, enhanced identity confirmation, and limiting access, are critical to mitigating the risk of cyber attacks.

George explains, "The net situation is that these large technology companies that serve healthcare and hospital systems and large medical practices change are clearinghouses, revenue cycle managers, and manage real-time price transparency. What medication management companies manage is so complicated, and they have so many ways that something can be attacked. As you mentioned at the beginning, the attackers are getting very clever and sharing a lot of their methods, so you have to do a comprehensive continuous review of your entire cybersecurity posture. Because if you don't, there are invariably going to be challenges and small things that are small at the time that end up not being small and being the way that an attacker got in."

"And in the case of Change, it was a multifactor authentication problem accessing a certain system through a certain technology stack that was rather old. But these things exist in companies this size. They have tens of thousands of machines and have accumulated different companies they acquired over time with different technology systems that don't all work together. So, the vulnerabilities are there, and they require comprehensive risk management and some candidly, more investment than we've seen to address fully."

"I'll give you another example. So maybe it helps your listeners place this a little better. If you think about someone who has a home and is trying to protect their home from all the various threats or things that can happen. Well, their home insurance company requires them to have a smoke detector and carbon monoxide sensor. They get a credit on their policy. If they have a burglar alarm system, they might have a ring doorbell camera or any number of things like that. What you see across the industry is these large hospital systems, small hospital systems, doctor's offices, and they're doing those basic things. But here's the issue. In that same house that I mentioned, you could have 30 windows, the roof might be a little old, you might have a ground floor, and a door that has glass could be easily broken if someone tried to break in."

#IntrapriseHealth #HealthcareCybersecurity #PatientDataProtection #CyberThreats #HITRUSTCompliance #RiskManagement #DataPrivacy

intraprisehealth.com

Download the transcript here