Plus: This startup built a hospital in India to test its AI software |
| In this week’s edition of InnovationRx, we look at the millions who would lose health insurance under the Republican bill, a startup that built a hospital in India to test its AI software, the impact of the vaccine panel changes, and more. (Did someone forward this to you? To get it in your inbox, subscribe here.)
The Republican domestic policy bill, which cleared the Senate this week and could be voted on in the House as early as today, will have a drastic impact on Americans’ health and that of the country’s healthcare system if it goes into effect.
According to a report from the nonpartisan Congressional Budget Office, released on Saturday night, 11.8 million more Americans would become uninsured by 2034 under the Republican bill. Federal spending on Medicaid would be slashed by more than $1 trillion over that period, and total federal spending on Medicaid, Medicare and Obamacare would drop by more than $1.1 trillion. The scale of the proposed cuts to Medicaid is unprecedented in the program’s 50-year history. They largely come from two key provisions: tight work requirements for those who receive health coverage and new restrictions on a strategy used by some states to finance Medicaid. The cuts could have a devastating impact both on those left without insurance and the hospitals that serve them. Medicaid, jointly funded by the federal government and the states, provides health coverage to more than 71.2 million disabled and low-income Americans. The proposed cuts to Medicaid could be particularly rough for those who are nearing retirement and can’t find work, particularly blue-collar workers who are no longer physically able to perform their former jobs. As AARP executive vice president and chief advocacy and engagement officer Nancy LeaMond wrote in a letter to Senate leaders on Sunday: “This creates a steep coverage cliff for those in their 50s and early 60s – particularly for those nearing retirement or working part-time – who may be left with no affordable coverage option at all.” These cuts would also ripple out through hospitals and other healthcare providers. Particularly in rural areas, hospitals and healthcare providers rely on Medicaid patients to stay financially in the black. Although the pending bill includes $25 billion to support rural health systems, an analysis from the National Rural Health Association found that this covers less than half of the revenue hospitals would lose from Medicaid cuts–a gap that increases significantly once clinics, doctors’ offices and other healthcare services are taken into account. “Medicaid is a substantial source of federal funds in rural communities across the country. The proposed changes to Medicaid will result in significant coverage losses, reduce access to care for rural patients, and threaten the viability of rural facilities,” the group’s CEO Alan Morgan said in a statement. “It’s very clear that Medicaid cuts will result in rural hospital closures resulting in loss of access to care for those living in rural America.” |
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 | | Pi Health founders Geoff Kim (left) and Bobby Reddy maria ponce |
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| As longtime cancer doctors with regulatory experience, Pi Health cofounders Geoff Kim and Bobby Reddy knew that completing clinical trials took far too long. There was the painfully slow process of signing up patients and after that a grueling slog through vast swamps of data to prepare voluminous regulatory filings–something that few hospitals and clinics can handle. The pair knew their startup’s best chance of success meant doing an end run around all that. So they did something audacious and unprecedented: they built their own cancer hospital in India. Clinical trials are an enormous bottleneck in drug development, and Kim and Reddy thought the AI-enabled software they’d been building at Pi Health could help do them faster and cheaper by expanding the pool of potentially eligible patients. But the majority of clinical trials today are done in top-notch academic medical centers, and first they needed to prove that their AI-enabled software could help overseas hospitals and smaller community cancer centers handle the documentation required to get through regulatory approval. So they found a site in Hyderabad, a major technology and pharmaceutical center in southern India, and built a 30-bed, state-of-the-art cancer hospital. Pi Health Cancer Hospital opened in September 2023, and began running clinical trials last year. It’s participated in eight so far, including one that helped lead to a drug for head, neck and lung cancer being approved in India just seven months after the first Indian patient was enrolled in the study. That’s less than half the time such a process would typically take and a major validation point for the software, one that Kim and Reddy believe will help them attract more customers. “We are trying to do everything in our power to make this a much more efficient process,” Kim, the company’s CEO, told Forbes. “There are all these new and exciting ways to attack cancer. If we can do [the clinical trials] faster and cheaper and get therapies out to patients, we want to do it now because there are people waiting right now.” Read more here. |
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| Newark-Calif.-based biotech Protagonist Therapeutics, which develops peptide-based drugs, announced its new obesity treatment candidate, called PN-477, on Monday. The new drug would target GLP-1 receptors, like current obesity drugs, and two other receptors that could both limit potential gastrointestinal issues and induce the body to burn more calories at rest. The mechanism of action is similar to Lilly’s triple-agonist Retatrutide, which is currently in clinical trials, but Protagonist CEO Dinesh Patel told Forbes that his company is working on an oral version. Patel expects to begin clinical trials in 2026. Plus: How the kings of CBD at Charlotte’s Web hope to treat autism, PTSD and depression with pharmaceuticals derived from cannabis and psilocybin. |
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| PUBLIC HEALTH + HOSPITALS |
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| Last week, the CDC’s new Advisory Committee on Immunization Practices met for the first time since HHS Secretary Robert F. Kennedy, Jr. purged the previous 17 members of the panel, replacing them with seven handpicked members, some of whom have spread misinformation about vaccines. The vaccine committee voted 5-2 to recommend Merck’s new prophylactic antibody for infants with RSV. But it also voted 5-1 against recommending the preservative thimerosal, despite there being no evidence of it causing harm. Questions from the panel, especially during presentations on COVID-19, raise questions about future votes. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, told Forbes in a video interview that some of the questions and statements made during the meeting indicated “some of the committee members didn't understand how these studies were done” to demonstrate the safety and effectiveness of vaccines. "I think the ACIP just took a giant step backward,” he said. “And I think for the most part the medical and scientific community is going to do their best to ignore them because I think at this point they can only do harm.” Plus: The Supreme Court upheld the Affordable Care Act’s preventive care mandate, which includes routine immunizations and cancer screenings. |
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| Generic cancer drugs failed quality tests, putting cancer patients in more than 100 countries at risk of ineffective treatments and potentially fatal side effects, according to an investigation by the Bureau of Investigative Journalism. Research on what wildfire smoke does to the human body is in its infancy – but the signs are pretty bad. Many of the more than 1,000 medical devices deemed “breakthrough” by the FDA since 2016 are backed by patchy evidence. Disposable e-cigarettes that may look like travel shampoo bottles and smell like bubble gum are vastly more toxic than older e-cigarettes, according to a recent study from the University of California, Davis. After Texas banned abortion, more women nearly bled to death during miscarriage. The ProPublica data analysis of hospital discharge data from Texas, the largest state to ban abortion, adds to growing evidence that abortion bans have made first-trimester miscarriage far more dangerous. AbbVie agreed to acquire Capstan Therapeutics, which is developing CAR-T therapies for cancer and autoimmune disorders, in a deal worth up to $2.1 billion. Startup Sama Fertility raised $43 million in seed funding led by VC firm SNR to launch a hybrid in-person, virtual IVF program. |
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