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Three Stories. Three Challenges to Innovation.

Good morning. My colleague Sy Mukherjee has a trifecta of stories that speak to three critical issues in the healthcare revolution: (1) that innovation is global; (2) that innovation is meaningless without access; and (3) that the world’s long-time drug innovation machine has a problem.

Regarding the first, President Trump’s executive order yesterday yanking the U.S. out of the Trans-Pacific Partnership is likely to have major implications for drug makers and consumers everywhere. As Sy points out below, and will have a more extensive piece on this afternoon, TPP—what would have been the largest regional trade agreement ever—offered on paper some enhanced patent protections for the Pharma industry. Now, they’re back to square one. (One notable beneficiary of TPP’s demise: Those in the developing world who rely on cheap generic medicines may get a reprieve from any imminent price hikes that the pact, and its proposed IP provisions, would likely have engendered.)

Regarding the second issue, a new study published in the respected journal Cancer found that the death rate from cervical cancer was sharply higher in African-American women than even previously understood. The study, as Sy explains, raises some additional red flags as well—and further emphasizes the need for more women to get the HPV vaccine, which protects against viral strains known to be involved in the initiation of many cervical cancers. But the bigger, more glaring concern is the enormous racial disparity in outcomes. As I wrote in November (“Can Gwen Ifill’s Death Spur Cancer Innovation?”), this problem is as old as the war on cancer itself.

Dr. Otis Brawley, the chief medical officer of the American Cancer Society, rightly points out that when there’s equal treatment (and access to treatment), patients have equal outcomes. But by every measure, black and white patients do not, on the whole, get equal treatment and access to care—and that’s a worry that just got more urgent as Congress moves headlong to repeal the Affordable Care Act.

And finally, regarding the third issue, Sy weighs in on a new effort by the pharmaceutical industry’s trade group to win over American hearts and minds. A new multimillion-dollar PhRMA campaign called “GOBOLDLY” is supposed to convince us that all those years of price gouging and other slimy behavior were all in the name of medical progress and innovation. The campaign’s first video features a newborn infant, stirring music, and a deep-voiced guy reading a Dylan Thomas poem.

Nice to see they get it.

Clifton Leaf


Americans would be willing to switch doctors to get video visits. A new American Well telemedicine survey finds that there’s big demand for telehealth and remote doctor’s office visits. In fact, the majority of respondents said they’re looking for telehealth services and 20% said they’d even switch their physician if it meant gaining access to such services. The burgeoning popularity of video visits – American Well found that two-thirds of respondents would be willing to have a video visit – likely has a lot to do with the hassle and inconvenience of a traditional doctor’s office visit. For instance, American Well notes that it takes an average of 18.4 days for Americans who live in a city to get in to see a doctor after making an appointment. That can lead to either delayed or entirely deferred care (not to mention that patients who actually do make their appointments have to spend about two hours in transit, waiting, and consultation with the doctor). Compare that with the 15 to 20 minute total experience of a video visit, and it’s not hard to see why an increasing number of Americans are interested in the option.

Could a smartphone-based microscope bring down sequencing costs? The cost of genetic sequencing has plunged over the last 10 years, giving rise to more efficient clinical trials, more personalized drugs for patients, and more access to hereditary risk information. But a team of researchers from California NanoSystems Institute at UCLA, Stockholm University, and Uppsala University believe they can lower prices even more with an experimental technology that uses a standard smartphone camera as part of a microscope that can analyze DNA sequences within tissue samples. The camera is paired with a 3D-printed optical unit which can mimic the capabilities of a standard light microscope. “Oftentimes, advanced lab-based testing is performed at major hospitals, which is limiting, as not everyone has access to a hospital that can perform these tests,” said Mats Nilsson, one of the project’s leaders, in a statement. (MobiHealthNews)

Chan Zuckerberg Initiative to get an AI boost. Facebook chief Mark Zuckerberg and wife Priscilla Chan have some pretty lofty ambitions for their eponymous initiative, which aims to literally tackle all human ailments. Soon, it will be getting an assist from artificial intelligence firm Meta, which it’s snapping up for an undisclosed amount. The firm focuses on data analytics and machine learning technology that can be used in the health care industry to sift through the mountains of available medical research – a critical tool if the Initiative really wants to fight all human diseases. “Helping scientists will produce a virtuous cycle, as they develop new tools that in turn unlock additional opportunities for faster advancement,” wrote Meta CEO Sam Molyneux in a blog post about the deal. “The Chan Zuckerberg Initiative’s recognition of this ‘meta’ effect is why Meta can be a key piece of the puzzle to enable the future of human health that we believe to be possible within this century.” (Fortune)


PhRMA launches multimillion dollar campaign to save its reputation. What do you do when your industry is being slammed left, right, and center for one of its most common practices? Well, if you’re the pharma lobby, you launch a massive PR effort to win over hearts and minds (and, more importantly, the sympathy of lawmakers). The Pharmaceutical Research and Manufacturers Association (PhRMA) launched the GOBOLDLY campaign on Monday – an advertising and lobbying onslaught that aims to highlight groundbreaking innovation in the life sciences over the ubiquitous drug price hikes that have come to define the industry in the public’s eye. PhRMA CEO Steve Ubl argues that there’s been too much focus on figures like Martin Shkreli and not enough on innovators in lab coats and the value of life-saving medications. (Shkreli has already hit back hard over the scapegoating, launching a new website chronicling drug makers’ pricing skeletons.) The question is whether the well-oiled marketing effort will be enough to detract critics like President Donald Trump, who has been advocating for drug price bidding in Medicare. (Fortune)

How will pulling out of TPP affect drug makers? President Donald Trump issued an executive order yesterday pulling the United States out of the Trans-Pacific Partnership, the wide-ranging and controversial Pacific trade deal. Asian nations are already scrambling to save the agreement now that the U.S. is out; but there are plenty of unanswered questions about what happens next, especially for drug makers. TPP included several crucial drug IP provisions, including set exclusivity periods for pricey branded biologic drugs. While industry trade groups like BIO and PhRMA had originally hoped for stronger protections than those included in the draft TPP agreement, those provisions are still stronger than what currently exists in a number of relevant countries. I spoke with a Goodwin Procter partner about what Trump’s move means for drug makers last night – stay tuned.

Actelion’s failed trial may not be enough to scuttle J&J buyout. Actelion, Europe’s biggest (and, recently, most sought-after) biotech, has been in buyout talks with potential acquirer Johnson & Johnson for weeks now. And it appears that a key clinical trial failure for one of Actelion’s flagship therapies may not do much to derail the proceedings. The treatment in question is Opsumit, a drug to treat the deadly condition pulmonary arterial hypertension (PAH). Actelion has been aiming to widen the drug’s approved uses to include even sicker PAH patients with certain other conditions in a bid for more market share. But even though a placebo actually wound up besting the therapy in the study, analysts predicted that it wouldn’t take much of a toll on the buyout talks given that it’s already slated to be an extremely successful drug. (Endpoints)


Cervical cancer may be killing far more American women than we thought. A sobering new analysis finds that American women’s mortality rate from cervical cancer may actually be considerably higher than originally thought. Researchers modified the conventional mortality rate calculation to exclude women who had hysterectomies, since removal of the cervix precludes the possibility of getting and dying from cervical cancer. With those tweaks in place, the morality rate for white women spiked one and a half times while the mortality rate for black women actually doubled, highlighting that the well-established racial disparity in cervical cancer mortality was also being underestimated. The racial gap points to a number of failures in the American health system, including disparate access to care for lower-income and minority populations. (Fortune)

Trump reinstates “global gag rule” on abortion. President Donald Trump has reinstated the “Mexico City” policy that bars U.S. foreign aid to non-governmental organizations (NGOs) which perform or “promote” abortion services in any way (even with non-U.S. funding sources). While this is a policy that is routinely reversed every time the White House changes party hands, NPR reports that Trump’s order actually goes further than even Ronald Reagan’s original policy by extending the restrictions to “global health assistance furnished by all departments or agencies,” rather than just family planning assistance furnished by USAID. (NPR)

Health experts want to know if Tom Price is a staunch vaccine defender. President Donald Trump has made some controversial statements about vaccine safety, questioning whether or not the current vaccine schedule gives children too heavy a dose of immunization at too young an age (note: public health researchers say that spreading out the vaccine schedule would make children more susceptible to infectious diseases). And his reported decision to name noted vaccine skeptic Robert Kennedy Jr. to a commission on vaccine safety alarmed the medical community. Now, the American Academy of Pediatrics and a number of other medical associations are asking whether Trump’s nominee to lead the Department of Health and Human Services, Congressman Tom Price, shares in those views. Price is drawing scrutiny, not just for his association with the Trump administration, but his membership in the conservative-libertarian doctor’s society the Association of American Physicians and Surgeons, which disagrees with mandatory vaccine policies that force parents to immunize their children. (Huffington Post, Fortune)


Here’s Why You Can’t Stop Hitting the Snooze Buttonby Martha C. White

Is This the Most Innovative Brand in Fitness? by Polina Marinova

These Countries Are All Scrambling to Save the TPP After Donald Trump Pulled Outby Reuters

Why Yahoo CEO Marissa Mayer’s $141 Million Payday Is Safe From the Hack Cover-Upby Jen Wieczner

Produced by Sy Mukherjee

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