Digital health news update: Healthcare policy in transition and the cure for what ails pharma

Author: Matt Arnold, Principal Analyst

• In presidential transition news, names floated for FDA include Scott Gottlieb, a well-regarded GOP healthcare policy hand, and Jim O’Neill, a colleague of Trump pal and tech kingpin Peter Thiel who has some, um, interesting views on drug approvals and other topics, and also wants to create a floating libertarian utopia. Biotech industry figures and even some conservative health policy hands are expressing reservations. Meanwhile, contra Wall Street’s bet that a Trump Administration will forget about The Donald’s campaign promise to rein in drug prices, Trump told Time Magazine: “I’m going to bring down drug prices. I don’t like what’s happened with drug prices.” That’s pretty nonspecific, but it was enough to trigger a selloff in biotech stocks. Allergan’s Brent Saunders warned his industry peers last week to expect a populist like Trump to wield the bully pulpit against companies taking big price hikes, and Novo Nordisk promptly vowed to limit price increases.

• And the popularity of Obamacare seems to be rising as the Obama Era draws to a close – a new poll shows that only a quarter of Americans want total repeal of the law. You could read that as an indication of how closely opposition to the ACA has been bound up in opposition to Obama himself – and perhaps as a sign that Trump voters covered under the law are now worried that they’ll lose that coverage – or that it’s only just beginning to dawn on them that all that repeal talk was more than a rhetorical device. GOP strategists are now puzzling over how (or whether) to repeal the legislation for fear of locking many of their constituents out of the insurance market, and one report estimates that as many as 59 million could be newly-uninsured under a partial repeal scenario. Stat has a look at what it all means for pharma, one which covers some of the same ground as mine from a couple weeks ago but is an easier read!

• Meanwhile, the Senate passed the 21^st Century Cures Act, a massive and important-for-pharmas legislative package that will, among other things, fund cancer and personalized medicine research initiatives and open the door to the use of real world evidence in some types of approvals. The President is expected to sign it, and John Mack has some thoughts on what the law could mean for pharma marketers. The Senate also approved a bill nationalizing a New Mexico pilot telehealth program, Project ECHO, that aims to improve care in rural and underserved areas by connecting specialists at academic medical centers remotely to primary care physicians.

• The CDC published bombshell data showing that average US life expectancy declined last year for the first time since 1993. The death rate rose on many fronts – among them, opiate abuse, which the 21^st Century Cures Act is meant to address – but the causes remain unclear.

• At the same time, US healthcare spending rose 5.8% in 2015, the fastest rate in eight years, driven in large part by expanded coverage and by pricey specialty drugs.

• The AMA and the AHA are among a quartet of organizations that have formed a “multi-stakeholder collaboration, Xcertia,” that will evaluate the quality, safety and effectiveness of mobile health apps. The initiative will not certify mHealth apps but will develop guidelines meant to serve as “a trustworthy resource to support consumer and clinician choice of mobile health apps.”

• Lilly is thinking about how to market to physicians through the EHR. Key learnings so far: give them something that adds value and keep your messaging short and to the point.

• Fierce has a piece looking at Lilly Oncology’s Journey Connections, an HCP portal for accessing local patient support resources that has been described as “Yelp for cancer patients.”

• And Lilly is backing their Trulicity weekly type 2 diabetes drug with a branded app aimed at addressing adherence. They’re promoting the app directly to doctors by bundling it with sample packs. In addition to medication reminders, the app includes a demo of the Trulicity pen, videos and a live chat function. 

• Merck is backing Keytruda with an unbranded campaign urging non-small cell lung cancer patients to get tested for biomarkers – Keytruda is indicated for first-line use in patients with the PD-L1 gene. The digital-centric campaign, dubbed “Test. Talk. Take Action,” includes a website housing a doctor discussion guide and video content featuring Scandal star Bellamy Young talking about her father’s cancer.

• And Biogen has refreshed its Reimagine MySelf campaign for Tecfidera, shifting it from print and TV to digital with a new website featuring celebrity bloggers Jamie-Lynn Sigler and Jeannie Mai.

• Sanofi is cutting one in five sales and marketing posts as it struggles through a wave of patent losses for key diabetes and cardiovascular franchise products. AstraZeneca is making deep cuts, too, eliminating 700 US commercial jobs amid genericization of longtime blockbusters Nexium and Crestor. Mylan and Endo and Lilly are also downsizing. All in all, a pretty brutal couple of weeks for pharma sales reps. Happy holidays/Bye, 2016!

• The Kevin behind KevinMD writes that “The days of the drug rep have come to an end.” Doctors, he says, are just too busy to meet with them, too immersed in their EHRs, and have access to digital information anyway.

• Speaking of Mylan, CEO Heather Bresch addressed the controversy over EpiPen pricing, but not before Congress. Speaking at the Forbes Healthcare Summit, Bresch blamed high-deductible plans and a lack of price transparency for the furore. “We’re the best shoppers in the world,” she said, but “There’s a lack of understanding of where the full list price goes and how it is divided in the system. The pharmaceutical pricing system was not built on the idea of customer engagement.”

• Merck’s Ken Frazier had a lot of smart things to say about the value of prescription drugs and the “natural arc of innovation,” and regarding immunotherapy, he said “We are now at the equivalent stage where we were at when we had the first breakthroughs in HIV drugs. Maybe we’re not at the top of the first inning in immunotherapy, but we’re at the bottom of the first inning.”

• For all the talk about what’s slideware and what’s not at Verily, the moonshots unit of Google’s Alphabet, they’ve now produced at least one very cool product – the Liftware Level, a robotic spoon that compensates for severe tremors and lets people with neurological disorders like Huntington’s feed themselves.

• Consumer advocacy groups are prodding the FTC to crack down on paid promotion by “micro-influencers,” sub-Kardashian-class KOLs who leverage their social media followings to plug products without disclosure.   

• Fake news isn’t Facebook’s only problem – the Godzilla of digital ad inventory conceded problems with how it was calculating two advertising metrics. Advertisers have long complained of Facebook’s opacity, which makes measuring ad effectiveness tricky. On the upside, at least one bank thinks their new mobile video tab will take a bite out of the TV ad market.

• Three out of every four new advertising dollars will go to digital next year, according to a projection by WPP media buying leviathan GroupM.

• Here’s Microsoft’s Bill Gates talking to rockstar physician author Dr. Siddhartha Mukherjee, who just wrote the book on genomic medicine, The Gene.

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