Preempting severe genetic disease
Around 2% of births come with a genetic disease, often with devastating impact. While some appear de novo (either from germplasm dominant mutations or from chromosoma…
Summary: Over the coming decades, Alzheimer’s disease threatens to become a huge drag on national well-being. To put things in perspective, by 2040, the US may be allocating more resources to the care…
“media attention [is] on lead identification, probably because it sells headlines” – Greg Meyers, Chief Digital and Technology Officer, BMS[1]
The biopharma industry is known for its high risk and po…
The new Humira?
It’s not that often that you see industry-sponsored head-to-head studies of one biologic vs. another, but Abbvie took the plunge comparing risankizumab (Skyrizi) to ustekinumab (Stela…
About the author: Phiona Nabagereka is currently a high school senior attending the Noble and Greenough School. She spent the summer of 2024 with Recon Strategy as a paid intern assigned a project to …
We refresh a prior analysis of two cohorts of oncology development programs: one with first-in-human (FIH) in 2012, and the other with FIH in 2017H2. We use a Kaplan-Meier approach to track whether pr…
The quest for solid tumor CAR-T
For all their success in hematological cancers, the track record of CAR-Ts against solid tumors has been disappointing (though see here for an exception). One key obsta…
What lessons can be drawn from Walmart’s precipitous shut down of its attempt to launch primary care, dental and behavioral health services? The Walmart Health management team (after some mid-stream …
A PDF version can be downloaded here.
One of the major aims of the proposed BIOSECURE ACT[1] is to reduce supply-chain risks for pharmaceuticals, by penalizing firms that contract with China-based “bi…
Hitting reset for the immune system
Every time I get into a new issue of the NEJM, I have a sense of anticipation as in “will this one have an article that blows my mind?” It doesn’t happen very often…
Summary
After challenging conditions in 2022, deal-driven biotech spending appears to have picked up in 2023. To quantify this trend we have systematically reviewed deals announced during this period …
A Chinese study uncovers a new use for an old drug
Bleeding in the small intestine is often due to vascular malformations and is difficult to diagnose and manage because 1) the area is hard to reach w…
PDF here
Summary
The idea of a single blood-test to detect many cancers is attractive, but is it practical? Can an MCED enhance, or even replace, current screening tests?
This paper delves into these …
How the US taxpayer saved 25M+ people
A short piece celebrating the 20th anniversary of PEPFAR, a program that few outside of the field of Global Health are aware of. The world is not always nasty and…
Preparing for the next pandemic: don’t waste the value of waste
During the Covid-19 pandemic, I got in the habit of checking weekly the Boston sewage report, as a reliable, unbiased way of monitoring …
What does Socrates have to do with AI? And what's the Spooky Mountain and why we need to conquer it to get to an AI enabled future?
https://www.youtube.com/watch?v=5V10R6lcIl4…
PDF: Trends and strategy in oncology development
Summary
We review a sample of oncology programs from the past decade and arrive at the following key findings:
The use of expansion cohorts in first-i…
Hypertension?!
Antihypertensive drugs are so 80s and 90s (well, except for pulmonary hypertension) to the point that I cannot recall when I last read research in the NEJM about a new blood pressure dr…
View the PDF here.
The supply chain of pharmaceuticals consumed in the US has become reliant on foreign sources of drug products and intermediates over the last two decades. Growth of generics and bio…
Download a PDF of this article here.
Hematologic cancers account for ~10% of annual new cancer diagnoses and continue to have some of the poorest overall outcomes, particularly for older adults.[1] Ho…
An unusual article on road safety
Motor vehicle accidents are a major share of morbidity and mortality in the young, and as such prevention has long been considered a medically adjacent area (e.g. wit…
A psychedelic for refractory depression
While major depression is awful, treatment-resistant depression (as defined not responding to at least two different courses of therapy) is worse with sufferers…
Back in 2018, I offered a speculation about what Amazon might do in healthcare as part of its now defunct joint venture with JPMorgan and Berkshire Hathaway. The focus was on doing what Amazon is re…
Is Parkinson’s α-synuclein going to be as elusive a target as β-amyloid has been for Alzheimer’s?
Alpha-synuclein aggregates are characteristic of Parkinson’s disease and genetic variants of this prot…
PDF: Trends in oncolytic virus therapeutics: then and now
The idea of using pathogens to treat disease is not new; ranging from phage therapy to malariotherapy (resulting in the only Nobel in medicine…
PDF: Are some of Kaiser’s regional ambitions starting to pay off?
We have produced a new study evaluating developments in Kaiser's regions (outside of California). The report provides an explanation f…
About the author: Alyssa Idusuyi is currently a high school senior attending Miss Porter's School (Connecticut). She spent the summer of 2022 with Recon Strategy as a paid intern assigned a project to…
Download a PDF of this article here.
Ex vivo gene-therapies have been a game-changer for aggressive hematologic cancers. These products can effectively cure patients who otherwise had very low chance …
After the $9.7B acquisition of The Medicines Company two and a half years ago, Novartis is eager to demonstrate value with a successful launch of the primary target of the deal, Leqvio. This launch is…
Tirzepatide in pole position
As previously described in this blog, GLP-1 agonists initially designed to treat glycemia in Type-2 diabetes are emerging as powerful weight loss agents in obesity indepen…
There isn’t a bricks-and-mortar primary care acquisition out there that is beyond Amazon’s financial reach. While the announcement regarding One Medical has provoked fresh rounds of speculation about…
Download Here: Troubleshooting GT_Recon Strategy 2022
In the last decade, gene therapies have been a major area of development and interest. What kicked off with the approval of Spark Therapeutics’ Lu…
A cell therapy success against a solid tumor
In CAR-T therapies, T-cells are transformed to express an antibody on their surface that allows them to home in on cancer cells and effect killing. This ap…
A step forward for kidney xenotransplantation
A report on the recent, well-publicized, temporary transplantation of kidneys from genetically modified pigs in two deceased individuals at NYU. The kidne…
The role of artificial intelligence (AI) and machine learning (ML) in healthcare spans a vast range of potential applications. A view of AI development on clinicaltrials.gov helps to focus this landsc…
The opioid crisis and patient abandonment
A perspective from a February issue that I originally missed highlighting the plight of patients who have been on a long-term opioid regimen for chronic pain.…
There’s a major disruption looming in how the site-of-care for infusions is managed which will have repercussions for plan competition, delivery system economics, PE hunting for healthcare opportunity…
Modern drug discovery is largely based on the identification and validation of a biochemical target, and then screening and optimizing molecules that engage that target. Over time, this has given rise…
Gene therapy in beta-thalassemia and sickle cell anemia
Beta-thalassemia and sickle cell anemia are common genetic diseases of hemoglobin (Hb) which manifest themselves in the former through transfusi…
In search of a diagnosis: deploying genomics at scale
A substantial number of children have a disease identified as “rare” without having any kind of causative diagnosis (autism is not a causative dia…
New molecular diagnostics, especially tests based on next-generation sequencing and gene-panels, could revolutionize how diseases are evaluated. But experience shows that insurers won’t cover these te…
Closed vs. open
Hospitals can compete for patient referrals either by exclusively affiliating with a subset of physicians (“closed model”) or by collaborating with as many qualified physicians as poss…
What is revenue cycle management?
Revenue cycle management (RCM) is the process of converting care delivery into cash. At its most comprehensive, services include:
patient intake (scheduling/registra…
UPMC’s decoupling from Highmark exposed a critical vulnerability: economic dependence on its Allegheny County hospitals. In FY11-12,[1] these hospitals provided 70% of UPMC’s overall operating margin,…
What makes an indication especially tough? The combination of a lack of understanding about the mechanism of disease and a lack of clarity on what endpoints would be sufficient for approval of a thera…
The weird world of synthetic biology
In biology 101, one learns about the alphabet that translates DNA/RNA code into amino acids sequences ultimately resulting in proteins. Given that there are 64 pos…
Cancer and mutational complexity
Probably the biggest news in cancer treatment this year is the approval of sotorasib (Lumkras, Amgen) which received accelerated approval in lung cancer with mutated K…
Iora Health was one of the original primary care transformers offering a clinically capable, engagement-focused, and accountability-grounded care model. After an initial foray into commercial, Iora p…
We identify four different business strategy rationales for hospital@home depending on each hospital’s specific market situation and each with clear predictive implications for local markets. These a…
Last week, WMT acquired MeMD, a virtual provider in Arizona. Per the press release, MeMD will “allow Walmart Health to provide access to virtual care across the nation including urgent, behavioral and…
Healthcare is by nature conservative; despite a huge level of interest for artificial intelligence (AI) and machine learning (ML) techniques, significant penetration in standard workflows of care will…
