THCB Reader -- Nov 27, 2021





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THCB Reader

November 27 · Issue #136 · View online

Everything you always wanted to know about the health care system. But were afraid to ask.

OK we are back to our usual Saturday drop day for the THCB Reader. I hope you all enjoyed the Thanksgiving Holiday. Our thanks go out to everyone appearing on, writing for, reading or watching THCB.
This week, Marie Dunn argues that we should consider climate change when thinking about improving our health system, Jeff Goldsmith discusses how health care costs did not contribute to the current outburst of inflation in the US economy, Ben Wheatley writes on 988 - a new lifeline for mental health emergencies, and Kim Bellard reflects on children’s health and how people are reluctant to have kids in today’s climate.
Scroll down for interviews galore! On WTF Health, Jess DaMassa chats with Vida Health’s CEO Stephanie Tilenius about what she’s hearing from payers, providers, and employers about at-risk value-based models and the shift to virtual care. On THCB Spotlight, I interview Maya Said, CEO of patient empowerment program Outcomes4Me, and Chris Gervais, the CTO of Kyruus, which began in the world of fixing scheduling for hospital systems. I also chat with Wellthy’s CEO Lindsay Jurist-Rosner to talk about the health care system’s need to support caregivers. We’ve also got an episode of Health in 2 Point 00 for you this week, in which we cover lots of deals with Papa, Sword Health, and others, along with some “leadership issues” at Talkspace.
Finally last week’s #THCBGang featured delivery & tech expert Vince Kuraitis (@VinceKuraitis), the double trouble of vaunted futurists Ian Morrison (@seccurve) & Jeff Goldsmith, and Consumer advocate & CEO of AdaRose, Lygeia Ricciardi (@Lygeia).
Don’t forget to listen any time—you can subscribe to #THCBGang and #Healthin2Point00 podcasts with an easy click on Apple or Spotify.

For my health care tidbits this week, I am going to talk drug pricing. Anyone who gets basically any health policy newsletter has seen some of the cash PhRMA has splashed trying to make it seem as though the American public is terrified of drug price controls. But as Michael Millenson on a recent THCB Gang pointed out, when Kaiser Health News asked the question in a rational way, those PhRMA supported numbers don’t hold. 85% of Americans want the government to intervene to reduce drug prices.
Big pharma whines about innovation and how they need high prices to justify R&D spending but health care insiders know two things. First, for ever Big Pharma has spent about twice as much on sales and marketing as it’s spent on R&D. This was true when I first started in health care thirty years ago and it’s still true today. Second, the “R” done by big pharma is resulting in fewer breakthrough drugs per $$ spent now compared to past decades. Which means that they should be increasing that share spent on R&D and need to improve the “R” process. But that’s not happening.
Finally, pharma is very good at increasing prices of branded products and extending their patent protection. Lots of dirty games go on here. Look into it and you can expect a lot of discussion about insulin pricing or discover how Humira is still raking in $16bn a year in the US, despite the fact its original patent expired in 2018.
With 85% of the American public in favor, you’d think then that a Democratic Congress would leap at the change to pass a bill that might save the taxpayer $50bn a year in drug costs. But of course that’s not going to happen. There is about $30bn a year in savings in the House version of Build Back Better that passed last week, but there’s little chance of much of that being in the Senate version given Joe Manchin’s daughter’s role running a drug company, and Krysten Sinema being a recent recipient of PhRMA’s largesse. And that’s assuming any version of #BBB gets through the Senate.
Instead hope something small happens to help desperate patients, and wonder how we ended up in a political system that apparently disregards what 85% of the public wants.
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Follow me on Twitter @boltyboy and THCB at @thcbstaff for more similar insights/nonsense (and even the occasional sensible idea)! Enjoy! – Matthew Holt
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One Drop is reimagining chronic condition care. Learn more at
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#Healthin2Point00, Episode 241: Papa, Sword, Trevueta, Trusted Health, Ieso, and Talkspace
THCB Spotlights: Maya Said, CEO, Outcomes4Me
THCB Spotlights: Lindsay Jurist-Rosner, Wellthy
THCB Spotlights: Chris Gervais, CTO of Kyruus
Rumor Check with Vida Health's CEO: Buyer Sentiment on Virtual Care, At-Risk Models, Mental Health
Hope you enjoyed the newsletter. As ever let me know if you have any comments or want to sponsor/advertise–this newsletter doesn’t write itself but about 17,000 people get it and 80-100K visit the blog every month!
Matthew Holt
Matthew Holt
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