Chartis Top Reads – Week of May 2 - May 8, 2021

Our research team breaks down this week’s top healthcare news.


Top Reads Overview

In an age of unprecedented change, staying current has never been more important. Our team at Chartis is curating news most relevant to the healthcare industry and tracking the topics that are trending on seven key issues: high reliability care, digital and advanced technology, financial sustainability, health disparities, the health ecosystem of the future, partnerships, and the provider enterprise. Each week, we break down what’s happening and why it matters.

The State of COVID-19

The Buzz This Week

While there is reason to be optimistic in the United States right now with more than half of the adult population having received at least one dose of a highly effective vaccine, there is also concern about how — or more likely whether — we will reach herd immunity and the continued evolution of new variants. Variants now make up the majority of the new cases in the U.S., and though new studies indicate current vaccines are still effective against at least some of those strains, including the highly contagious B.1.1.7 strain (currently the predominant strain for new U.S. cases), vaccination rates are now slowing.

Worldwide, there have been more COVID-19 cases in the last two weeks than the first six months of the pandemic, with India and Brazil making up more than half of those cases. We are still not able to accurately model outbreak size or where the next surge might occur because it still is unclear what makes someone a super-spreader. What is clear from the models is that vaccines and acquired immunity drive down the spread significantly.

Why It Matters

With vaccination rates falling, it is becoming less likely that we will reach herd immunity. Experts previously thought the number for herd immunity to be 60-70 percent of a population, but with contagious variants emerging, it has been revised to be closer to 80 percent. The number of those reluctant to be vaccinated has decreased in the last few months but still remains at 30 percent. A large portion of the vaccine hesitant would still need to be persuaded to hit revised herd immunity numbers. If herd immunity is not reached and COVID stretches on, the goal will be to manage the virus to significantly minimize the impact — to turn it into an infectious disease similar to the cold or flu without the significant disruption and strain on our healthcare system. Vaccination is still the key, and if the endgame can no longer be eliminating COVID but reducing the impact, then continued vaccination will be a required part of the solution. Boosters or annual vaccinations like the flu shot could become standard, and eventually children will likely need to be included in the rollout. Early next week an Emergency Use Authorization is expected to be issued for Pfizer to allow children 12-15 to get the vaccine, and Pfizer is on track to seek approval for children 2-11 by September.

It is also vital that our global community is protected, both for moral reasons and for the practical reason that the connectedness of our world means an outbreak in one location can lead to issues everywhere. Variants arising in other locations have made it to the U.S. multiple times already. India is seeing double and triple mutation variant strains. Letting outbreaks continue could lead to a mutation that is not protected by the current vaccines. The latest epicenter in India raises additional concerns. Ninety-two countries rely on India’s production for their own vaccine supply, which India has said it will not meet on time. The U.S. has seen glimmers of a return to pre-pandemic life through mass vaccination efforts, but each day of record-breaking cases is a reminder that the pandemic is not yet in the rearview mirror.

Digital and Advanced Technologies

The Buzz This Week

Digital health venture funding broke another record in the first quarter of 2021 with the highest funding to date, at $6.7 billion in Q1 2021. For context, there was a total of $14 billion in digital health venture funding in all of 2020, and only $7.4 billion in 2019, as reported by Rock Health. The start-ups with the highest funding are in on-demand healthcare services, fitness solutions, and mental health apps. Some consolidation in the crowded and fragmented market is taking place, such as the announced merger between Grand Rounds and Doctor on Demand, both virtual care platforms.

This booming market for digital health is being supported by advances in technology, investor belief that digital health solutions play a large role in the future of healthcare, a greater ability to quickly test the efficacy or impact of the solutions in order to bring them to market, and greater consumer and clinician adoption and acceptance, driven in part by the widespread use of telehealth during COVID-19.

Still the sheer volume of these start-ups are causing some consumers to feel overwhelmed or wary to move too quickly to adoption. As a corporate benefits executive stated in a recent Wall Street Journal article, “We are inundated … We already have these very big portfolios of vendors. And with all this new stuff coming into the market, there’s no way to assess, literally thousands” of digital health services available. A recent survey published in NEJM Catalyst found that one-third of healthcare professionals would not adopt new technologies without “sufficient” evidence of the benefits, and another quarter of respondents admitted they were simply slow to adopt. Bob Kocher, a partner at venture capital firm Venrock, commented on the results: “[This shows] that health care professionals are not early adopters and are not risk-tolerant, which is not good news if you are an entrepreneur trying to innovate and sell a product to this industry.”

Why It Matters

Historical investment boom (or even bubble) market patterns would suggest that the current trend in digital health venture funding cannot continue unabated, and that some (if not many) of these digital health ventures will fail. But success of a digital health solution should not be based solely on venture investment and market acceptance and adoption, but its safety and efficacy should be rigorously tested and held to a set of standards as all other therapeutics and pharmaceuticals are.

Though the Federal Drug Administration (FDA) is still developing and finalizing regulations for digital health, the agency released the Technology Modernization Action Plan in 2019, as described in a recent STAT+ article. The goal of the plan is to “‘accelerate the path to better therapeutic and diagnostic options for patients and clinical care providers’ and to better digital tools to enhance and promote public health.”

The FDA’s plan is not simply for regulatory approval — it will also impact research and development. The National Institutes for Health, which provides more than $40 billion in research funding, is adopting the FDA’s plan, which could funnel a much higher proportion of dollars toward research on digital health tools. This would enable more advanced solutions and therapeutics to be developed, tested, and launched. It also will help shape the future reality of digitally supported, digitally enabled health and healthcare. It also supports partnerships between digital health start-ups and medical research institutions, appropriately applying the rigorous scientific process involved in federally funded research to an increasing number of emerging technologies.


Contributors

Roger A. Ray. MD
Chief Physician Executive
[email protected]

Alexandra Schumm
Principal, Vice President of Research
[email protected]

Abigail Arnold
Senior Research Manager
[email protected]


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Chartis Top Reads - Week of May 2 - May 8, 2021 - The Chartis Group