I Don't Care

Some Cancer-fighting compounds for kids gather dust on Big Pharma’s lab shelves. Children’s Tumor Foundation President Annette Bakker, Ph.D., won’t stand for that. She shared her efforts to rescue these assets with I Don’t Care’s Kevin Stevenson.

In her fight to end neurofibromatosis, an incurable condition that causes tumors to grow on the brain and spinal cord, Bakker is pioneering game-changing ideas in disease research.

Through Bakker’s experience in the pharmaceutical and biochemistry industries, she learned how separate the two ecosystems were. “The motivations that drive academic researchers are publications,” Bakker said. “The motivations that drive pharmaceutical companies is to develop those drugs, but in the meantime also to fuel the development of new drugs they need to patent. So, they need to keep the stuff secret. The very different systems these two worlds are living in make it difficult to translate discoveries into better treatments for patients.”

Bridging the gap in science politics to ensure discoveries lead to better treatments is the space where Bakker lives. “It’s about bringing the models to the drugs,” Bakker said. “It’s about bringing the different stakeholders together and creating that ecosystem.”

What led Bakker from her background in biochemistry to the pharmaceutical world was the desire to take great discoveries and make sure they were getting used. And what ultimately led her to The Children’s Tumor Foundation (CTF) was to be a part of the solution in bridging the gaps, cutting through the red tape, and connecting the right people to make real change. “My philosophy is always, ‘move the foot,’ Bakker said. “Don’t blame anyone; incentivize them to change their behavior and feel good about it.”

Buyers and sellers are avid users of open marketplaces. They can apply to any product or service, including healthcare. I Don’t Care host Kevin Stevenson spoke with Scott Carson, Founder and CEO of Powered by MRP, on the topic.

Carson’s backstory includes work as the lead inventor of eBay Healthcare Marketplace. After that venture, he saw an opportunity to create a fair marketplace for clinicians to access aesthetic devices at GPO-level pricing. That concept is now Powered by MRP.

“I helped structure and model the eBay Healthcare Marketplace, but they became nervous about regulations around preowned assets. No one was successful, but I realized it’s a highly emotional marketplace,” Carson said.

In the last few years, Powered by MRP has “cracked the code” on device sales. The company’s objective is to create an ecosystem for all healthcare services eventually. Carson noted, “We’ve learned that aesthetics is a great pollinator for growth.”

Carson explained why marketplaces are the future. “There’s going to be a massive reduction of field-based representatives. COVID accelerated this, but there are also new clinicians that grew up with technology. It’s no longer a barrier.”

Carson further explained that this old model has a lot of waste. “It adds 25% to the sales cost, and it doesn’t need to be there.”

Platforms like Powered by MRP have transparent pricing and provide all the information to the purchaser. Additionally, the company offers service contracts with the manufacturer so these assets can continue to perform.

When asked what’s next for the company, Carson answered, “An aggregation of buying power bringing clinicians together to purchase pharma or anything else that evolves naturally.”

This week on I Don't Care, Host Kevin Stevenson sits down with an author that has made it his mission to teach people how to navigate the healthcare system and to be armed with the proactive education needed to be able to shop around for the best healthcare options and prevent uneccessary or overly costly treatments.

After 28 years working within the American healthcare system, Dr. David Wilcox has seen enough in the medical field to realize that it truly is a “business” as opposed to the kind-hearted healing service that most people might imagine it to be.

His new book reveals some unsettling facts and offers information, facts, and tips for patients and family members who are navigating through this morass. Along with revealing what he has learned over the last 28 years, he also offers helpful hints on how patients can avoid becoming victims of an industry that seems intent on profiting at all costs rather than providing quality care for its clients. 

 This book is a wake-up call for all of us who are taxpayers, or soon will be. It provides the tools needed to avoid being caught in this system that unfairly targets certain groups and takes away our rights as consumers without providing necessary care.

Clinical trials can save lives and provide new ways to treat disease. The industry estimates that 85% of all clinical trials face delays due to patient enrollment. Understanding that challenge and finding ways to minimize it is the pursuit of Jeeva Informatics. The company’s founder and CEO, Dr. Harsha Rajasimha, joined Kevin Stevenson on I Don’t Care to discuss the issue.

Dr. Rajasimha has a long history of clinical research experience, working as a data scientist and software engineer. After several personal tragedies, he wanted to apply his knowledge to helping clinical research trials overcome logistical burdens to bring new treatments to market faster.

“The biggest barrier in clinical trials is delays in the timeline associated with patient recruitment. Traditionally, those enrollees must be within 50 miles of the lab,” Dr. Rajasimha explained. That narrows down access considerably. “Only 1.2% of cancer patients in the U.S. are in a clinical trial.”

The other challenge is the logistics. Patients must travel to sites for treatment or simply just exchanges with physicians. “It’s a travel burden for patients and their caregivers,” Dr. Rajasimha noted.

To change the clinical trial ecosystem, Dr. Rajasimha said that the paradigm of the four walls of the lab must evolve. “Clinical trials have been slow to adopt digital channels, but the pandemic forced this.”

By digitizing and automating repetitive manual tasks, the burden of participation shrinks for the patient. “The pandemic showed that there is a demand for flexibility in decentralizing clinical trials. With the right tools, this is possible,” Dr. Rajasimha explained.

By leveraging technology, clinical trial producers can maximize diversity, equity, and inclusion. With more communication and interaction, patients in trials are also more likely to adhere to medication instructions and be more trusting of the process

When the legend becomes fact, print the legend. In the case of Branislav Vajdic, Ph.D., CEO, and Founder of HeartBeam, this legend truly is fact. Vajdic arrived in the US in the late 1970s and got his Ph.D. in electrical engineering. He then worked for Intel, designing the first flash memory and eventually the design manager for Intel’s Pentium chips. I Don’t Care’s Kevin Stevenson spoke with Vajdic about his latest undertaking, HeartBeam, whose mission is to detect heart attacks before they become fatal. So, how does a legendary chip designer become a cardiovascular insider?

“Back in Europe, my father was a well-known physician/surgeon, and one afternoon he did not feel well,” Vajdic explained. “He had this chest pain, discomfort, etc. Despite his medical background, he did what most people do; he disregarded the symptoms. He said, well, it’s going to be okay; it’s nothing serious. Unfortunately, that was a heart attack in process, and we lost him. That stuck with me all these years, and when I left Intel, I decided I’m going to turn my career to solving the problem of heart attack detection."

In 2015 Vajdic began an in-depth search for a solution that could help a patient distinguish between something as minor as indigestion or a pulled muscle versus the patient having an actual heart attack.

“There was nothing out there that could be with a patient 24/7,” Vajdic said. The solution needed to be effortless for the patient and small enough that they could always carry around with them. “It turned out to be a very difficult technical problem, and I paired with two nuclear physicists. And we started looking at this problem that was deemed to be unsolvable. How do you with a credit card-sized device capture enough information from the heart activity to detect a heart attack?”

But unsolvable problems never stopped Vajdic before, and they were not about to stop him now. HeartBeam’s portable medical-grade heart attack detection device is that solution.

The world-renowned Thoracic Oncologist, Dr. Gerold Bepler, joined I Don’t Care’s Kevin Stevenson for a conversation that was no less than inspirational. Dr. Bepler, President and CEO of the Karmanos Cancer Institute, has a mission; to eradicate cancer. It’s more than a dream for Dr. Bepler; he believes it will be a reality one day.

Dr. Bepler arrived from Germany to the United States in 1983. Following a post-doctoral fellowship at the National Cancer Institute, the starting point for his journey into lung cancer research. This career path took Dr. Bepler through many stops along the way, and in 2010 he joined the Karmanos Cancer Institute.

The mission to eradicate cancer got a boost in 1971 with the National Cancer Act, and Dr. Bepler said there’s tremendous progress towards this goal since that point. “People now diagnosed with cancer have hope,” Dr. Bepler said. “And many of them get cured of the disease and have a good quality of life. That all wouldn’t have been possible without the National Cancer Act.”

Much of the progress made to eradicating cancer at the Karmanos Cancer Institute owes a debt of gratitude to that 50-year-old law for providing necessary funding that makes such research possible.

“The Karmanos Cancer Institute became one of the NCI designated cancer centers,” Dr. Bepler said. “Very quickly, the National Cancer Institute realized just having one cancer institute in Bethesda, Maryland alone wouldn’t be able to achieve that high goal of eradicating cancer. This network established cancer centers throughout the United States.” What started as a couple of centers in the 1970s is now more than 50 comprehensive cancer centers.

The world now possesses many drugs and treatments to treat cancer through the dedication and research of institutes like the Karmanos Center. And some research led to treatments for other diseases. Dr. Bepler mentioned the Karmanos Center developed three of the first FDA-approved AIDS drugs. 

U.S. insurance is privatized, which presents a host of challenges. Michelle Zettergren, Chief Sales and Marketing Officer of Brighton Health Plan Solutions and Nick Stefanizzi, CEO of Northwell Direct, spoke with Host Kevin Stevenson about opportunities to eliminate the standard middleman of health insurance.

Direct contracting is when employers partner with organizations that provide care for employees without an intermediary between the two. This saves money and ensures access to quality, tailored programs for a better workforce experience. “Judgements are made based on what the clinical needs of that patient are, what’s going to get them the best outcome, and not around how are we going to get the highest return on dollar to our shareholders,” Stefanizzi explained.

With direct contracting, businesses meet employers at a place consistent with the culture. This may involve providing onsite services such as flu shot or telemedicine campaigns. “The employers that are going to win the war for talent are those being seen as making investments in the health, safety, and resiliency of their workforce,” said Stefanizzi.

Brighton supports direct contracting by connecting with employers partnering with integrated delivery systems. They provide claim processing, benefit grids, and customer service to create transparency for the employer and members, which removes the health insurance middleman that often causes fragmented care.

Direct contracting programs are successful because they support and improve the patient-provider relationship, whereas in traditional settings, carriers don’t make data available to allow programs to be successful. Northwell has access to this data and makes it actionable. “The patient is hearing directly from their provider, and the level of adherence is going to be so much higher, the satisfaction so much higher, and it improves the outcome overall,” Zettergren stated. 

On this episode of I Don’t Care, Host Kevin Stevenson talked with Dr. Dean Mitchell, a board-certified allergist specializing in food allergies. Mitchell has been in practice for 30 years and became well regarded around the country as one of the first board-certified allergists to embrace sublingual allergy immunotherapy, also called allergy drops.

Mitchell did his medical residency in Internal Medicine at St. Lukes-Roosevelt Hospital (now Mount Sinai West) during the height of the AIDS epidemic. He also did a fellowship at the same institution in Allergy, Infectious Disease, and Immunology department. When he went into private practice, he really enjoyed working on allergies, as it meant he could work more with families.

“I probably would have been an old-time family practitioner because I love taking care of families,” Mitchell said. “And allergy was one of the few specialties - I like specialties, too and the science behind it - where I got to take care of children, adults, and that turned out to be a lot of the time families.”

Over the years, Dean Mitchell became known for his work with allergies and asthma. He even authored a book on the subject, “Allergy and Asthma Solution: The Ultimate Program for Reversing Your Symptoms One Drop At A Time.” The book details his personal discovery of sublingual allergy drops to treat environmental allergies.

But, he was on a larger quest. The holy grail of allergies is treating the food allergy epidemic, according to Mitchell, and this is what he wanted to do. He kept hearing stories of dangerous interactions with food, so he dug into the research and decided it was time to use sublingual allergy drops for food.

Dr. Dean Mitchell also hosts the podcast The Smartest Doctor in the Room.

Challenges in healthcare impact every player—payers, providers, and patients. What’s the modern-day answer to rising costs and better care? It’s a complex answer, and Steve Neeleman, Founder & Vice Chairman of HealthEquity, spoke with I Don’t Care host Kevin Stevenson on the topic.

After working for Southwest Airlines, Neeleman graduated from medical school and served as a trauma surgeon. At the same time, he started HealthEquity. “The question was why don’t we treat our customers, patients, the same way we did at Southwest. The notion became consumer-directed healthcare, opening up opportunities for them to make better choices.”

Personal health issues also sparked the ideas around managing health savings accounts (HSAs). He and his daughter faced these, with high out-of-pocket costs. Something that many insured people experience every day.

“HIPAA had a pilot program for HSAs and then extended it. It’s your money, and you don’t pay taxes on it. It functions like a 401K,” Neeleman explained.

Neeleman described the future of HSAs and healthcare spending, citing its need to connect with centers of excellence. He recalled that after passing his surgical boards, he wasn’t an expert at every surgery because medicine is complicated. “Centers of excellence have completed a procedure many times. If you marry that with consumer-directed healthcare, payers will direct patients there because it saves money, and the quality of care is better.”

Educating patients about HSAs and concepts of navigating their healthcare is part of the equation. Neeleman also speaks to doctors about them. “Doctors are trying to embrace consumerism. They didn’t use to have to be attractive to get patients.”