Nephron Research LLC: Recent Episodes
Nephron Research LLC
This year’s Heart Rhythm Society (HRS) meeting was a great opportunity to take the pulse of electrophysiologists on how they’re incorporating Farapulse and Medtronic’s PulseSelect into their practices, whether these catheters are living up to the hype as they transition to broad commercial use, what technologies they’re displacing as adoption ramps, and how the PFA competitive landscape could evolve over the next 12-18 months as new devices enter the field.
To help us put this year’s meeting takeaways in perspective and think through how the PFA revolution is playing out, we’ve enlisted the help of Dr. Sunil Kapur, a leading electrophysiologist at Brigham and Women's Hospital and Assistant Professor of Medicine at Harvard Medical School.
The China market remains dynamic for our Life Science Tools & Diagnostics coverage. On May 17th, Jack Meehan hosted a discussion with Dr. Mao Mao for an updated on-the-ground view as to the factors driving investment trends in the region.
Topics of discussion included:
1) BioSecure Act: Thoughts on impact of US Congressional efforts to target Chinese competitors, and potential for a response from China on the manufacturers in our coverage.
2) VBP + Local Competition: An updated view on government VBP initiatives, the key local manufacturers, and how they compete with multi-nationals.
3) NGS: An update on results from MGI, and the competitive dynamics with Illumina in the region.
4) Diagnostics: A look at public company results in local companies like Mindray, Burning Rock, KingMed and others.
5) Macro: Perspectives on the current macro situation in China, and implications for investment into life science tools and diagnostics.
On Dec. 11th, Jack Meehan hosted a KOL discussion for an updated on-the-ground view as to the factors driving investment trends in Life Science Tools & Diagnostics in the region. Topics of discussion included: 1) Perspectives on the current macro situation in China, 2) Views on investment into life science tools and diagnostics, 3) a discussion on current capacity for various industries our coverage is exposed to, 4) an update on how the Chinese national government, local provinces and cities approach Life Sciences and Diagnostics purchasing; 5) Recent updates around procurement initiatives in the Diagnostics industry; and 6) An overview on the key local manufacturers, and how they compete with multi-nationals.
On Dec. 11th, Jack Meehan hosted a KOL discussion for an updated on-the-ground view as to the factors driving investment trends in Life Science Tools & Diagnostics in the region. Topics of discussion included: 1) Perspectives on the current macro situation in China, 2) Views on investment into life science tools and diagnostics, 3) a discussion on current capacity for various industries our coverage is exposed to, 4) an update on how the Chinese national government, local provinces and cities approach Life Sciences and Diagnostics purchasing; 5) Recent updates around procurement initiatives in the Diagnostics industry; and 6) An overview on the key local manufacturers, and how they compete with multi-nationals.
On Dec. 5th, Jack Meehan hosted a KOL call on the bioprocessing industry. Bioprocessing has historically been one of the fastest growing areas of our coverage, and we think the long-term outlook is bright. However, the industry is facing short-term headwinds from excess inventory and the roll-off of demand for COVID-19.
Topics of discussion on this conference call included an overview on the environment for bioprocessing purchasing, expected growth in gene therapy from Sarepta, stocking trends, views on various suppliers and product categories, and a discussion on quality of CDMO participants. Both of our experts have significant experience as industry consultants in helping customers establish biologics manufacturing and evaluate these big debates.
Our Tools & Dx coverage is facing a macro and micro storm in the China market. Jack Meehan hosted a discussion with Dr. Mao Mao and Dr. John Zhang for an on-the-ground view as to the factors driving investment trends in Life Science Tools & Diagnostics in the region.
Topics of discussion included:
1) Perspectives on the current macro situation in China,
2) Views on investment into life science tools and diagnostics,
3) a discussion on current capacity for various industries our coverage is exposed to,
4) an update on how the Chinese national government, local provinces and cities approach Life Sciencs and Diagnostics purchasing;
5) Recent updates around procurement initiatives in the Diagnostics industry; and 6) An overview on the key local manufacturers, and how they compete with multi-nationals.
On June 27th, Jack Meehan hosted a discussion on the laboratory and diagnostic industries with two thought leaders in the space. Topics of discussion included:
- COVID-19: Demand for COVID-19 testing solutions is winding down following the conclusion of the public health emergency. We plan to discuss implications for the Diagnostics industry repurposing or de-commissioning equipment taken on, and future anticipated demand for respiratory testing solutions
- MDx Innovation: There are a number of new multi-plex Diagnostic launches underway, including BioFire’s SpotFire system and Quidel’s Savanna (available in Europe). We plan to discuss the commercial viability of these systems, and implications for competition with MDx leaders such as Danaher’s Cepheid and Hologic.
- Operating Environment: Offsetting the weaker COVID demand has been a strong recovery in core testing. We plan to discuss how the combination of pent-up demand, a recessionary backdrop and inflationary factors are impacting the laboratory industry.
- Regulation: Finally, there are several moving parts on the regulatory environment related to reimbursement and laboratory developed tests.
On June 6th, Jack Meehan hosted a KOL call on the bioprocessing industry. Topics of discussion on this conference call included an overview on the environment for bioprocessing purchasing, stocking trends, demand dynamics from COVID-19, views on various suppliers and product categories, and a discussion on quality of CDMO participants.
**Following the read-out of Guardant Health’s ECLIPSE study, the big debate is on FDA approvability of the Shield assay in CRC screening. On April 12th, Jack Meehan hosted two former FDA leaders to discuss Shield’s clinical data in ECLIPSE, FDA considerations for approval of the test built on historical experience, and the potential approval pathway for liquid biopsy.
Andrea Chamblee, former FDA Director & senior counsel in the Washington, D.C., office of Wilson Sonsini Goodrich & Rosati.
Dr. Sousan Sheldon, President of Medical Consultants, LLC.**
Following the read-out of Guardant Health’s ECLIPSE study, we hosted a KOL discussion on how the results and potential introduction of liquid biopsy might influence the market for CRC screening. We were joined by one primary care physician (Dr. Gary Cohen, North Shore Physicians Group) and one gastroenterologist (Dr. Jatin Roper, Duke U. School of Medicine) to get two differing opinions on the ECLIPSE results and potential value of a blood test in the screening paradigm. Topics of discussion also included adoption of non-invasive diagnostics for colorectal cancer screening, such as Cologuard and FIT, as well as recent trends around patient care and screening practices.
Joseph Tyler, MS, Consultant at Pharmsupply Inc.
Brian Tham, Biotechnology Consultant at Pelegrine Bio.
On November 22nd, Nephron hosted a KOL call on the bioprocessing industry. Bioprocessing has historically been one of the fastest growing areas of our coverage, and we think the long-term outlook is bright. However, the industry is facing some short-term headwinds from excess inventory and the roll-off of demand for COVID-19. Topics of discussion on this conference call included an overview on the environment for bioprocessing purchasing, stocking trends, demand dynamics from COVID-19, views on various suppliers and product categories, and a discussion on quality of CDMO participants. Both of our experts have significant experience as industry consultants in helping customers establish biologics manufacturing and evaluate these big debates.
On October 5th, we hosted an expert call discussion on how the ECLIPSE results and potential introduction of liquid biopsy might influence the market for CRC screening. Topics of discussion included adoption of non-invasive diagnostics for colorectal cancer screening, such as Cologuard and liquid biopsy.In addition, we will discuss the how emerging entrants in liquid biopsy stack up in the testing paradigm.
On September 8th, we hosted a KOL call with two researchers to discuss their experience with Illumina and considerations when evaluating competitor systems. Dr. Joseph Powell is a current NovaSeq customer, who weighed in on purchasing perspectives through the eyes of a high-throughput customer. Dr. Yuriy Alekseyev is a current NextSeq customer performing RNA Seq research, who discussed the competitive considerations for mid-throughput customers. Topics of discussion included an overview on research spending trends, experience working with Illumina, and perspectives on the credibility of emerging competitive launches.
Myriad published the results of the PRIME Care Study on Tuesday afternoon in JAMA. In the 2K patient study, GeneSight was successful on both of the co-primary endpoints. Despite the rosy headlines, the devil is always in the details! Such was the case with the GUIDED Study published in 2019.
To help pick through the results, Nephron hosted a Q&A call with the leading KOL in the category of pharmacogenetics: Dr. Charlie Nemeroff. Topics of discussion included a review of the PRIME Care study, the pros and cons of the data, implications for clinical adoption of the test and payor coverage, and thoughts on the regulatory environment for pharmacogenetic testing. The primary company in focus wasMyriad Genetics (MYGN).
On Friday we were joined for a discussion with two diagnostics experts, Ms. Camille Hu and Terry Robins, who provided an on-the-ground view as to what is happening in the China market for diagnostics testing. Topics of discussion included:
1) Perspectives on investments in the Diagnostics industry in China;
2) An update on COVID-19 trends in the region and implications for the diagnostics industry; 3) An overview on how the Chinese national government, local provinces and cities approach Diagnostics purchasing;
4) Recent updates around procurement initiatives in the Diagnostics industry;
5) Perceptions of Western multi-national companies in the region;
6) An overview on the key local manufacturers, and how they compete with multi-nationals.
On March 29th, Richard Panico and John Diaz joined us for an update on the latest trends in biopharma services. The durability of biopharma investment has been a major area of focus for our CROs and life science tools coverage to start 2022. In this discussion, we debated funding trends, clinical trial demand, the impact of consolidation of the CRO industry, demand for labor, and also discuss the use of data and technology in clinical trials.
Following the ASCO-GI annual meeting, Nephron hosted a discussion with two key opinion leaders to discuss the latest innovation in diagnostics for colorectal cancer (CRC). Topics of discussion included adoption of non-invasive diagnostics for colorectal cancer screening, such as Cologuard and liquid biopsy.In addition, we discussed the latest data updates from Exact Sciences for Cologuard 2.0, and how emerging entrants in liquid biopsy stack up in the testing paradigm. Finally, we discussed the latest updates in minimal residual disease (MRD) testing and recurrence monitoring in clinical practice for treatment of GI cancers.
Heading into 3Q21 earnings, one of the top debates for our coverage is the China region – and changes in policy which may encourage “buy local” initiatives in Diagnostics. Diagnostics experts Dr. Mao Mao and Ms. Camille Hu joined us for a discussion and provided an on-the-ground view as to what is happening in the market. Topics of discussion included:
1) An overview on how the Chinese national government, local provinces and cities approach Diagnostics purchasing
2) Recent updates around procurement initiatives in the Diagnostics industry
3) Perceptions of Western multi-national companies in the region
4) An overview on the key local manufacturers, and how they compete with multi-nationals
5) An update on the sequencing market, and competition for Illumina from BGI
This morning, Nephron hosted Dr. Albert Vilella for a conversation focused on next generation sequencing (NGS) and genomics technologies. Topics of discussion included investment trends in NGS, an overview on the differentiation amongst new platforms under development, a discussion on the relative cost and quality of different systems, and how the competitive landscape could change over the next few years.
On Monday July 12th, Nephron hosted Ross Margulies of Foley Hoag. Topics of discussion included:
- The status of 340B under the Biden administration, including the threat to fine drug makers for curtailing distribution of discounted drugs to contract pharmacies, the role, if any of alternative dispute resolution to resolve the issue, and what might be next from the administration.
- An update on the many lawsuits by drug makers, hospitals and other entities concerning the contract pharmacy issue.
- Forecasting the most likely legal, legislative, and regulatory outcome.
On Friday May 21st at 10:30 AM ET, Jack Meehan, lead analyst Life Science Tools & Diagnostics, and Eric Percher, lead analyst Pharma Supply Chain, Pricing & Policy, hosted a joint 20-min call exploring their recent reports on biopharma end market growth and the outlook for specialty pharmacy growth 2021-2025, respectively.
Topics included:
- Comprehensive update on the biopharma end market through the lens of the supply chain – including the Life Science Tools, CROs and CDMOs, Distributors, Pharmacies and Payors/PBMs.
- Key data points used to monitor biopharma end market trends: Including FDA activity measures, clinical trial trends, the outlook for biopharma funding, and investment in COVID-19 vaccines.
- Our forecast for specialty pharmaceutical market growth 2021-2025 across 18therapeutic categories, detailing implications for biopharma and participants in the specialty pharmaceutical supply chain
On May 18th, Nephron Research hosted a discussion on the latest updates in bioprocessing with one of the top thought leaders in the industry, Dr. Howard Levine.Topics of discussion included the backdrop for industry funding, an analysis of supply/demand capacity, as well as a closer look at the technologies and providers playing a leading role in the category. We discussed an updated view on the market opportunity for COVID-19 treatments and vaccines for the industry. Dr. Levine presented an analysis on the industry with investor Q&A.The discussion is most relevant for our Life Science Tools coverage of Agilent (A), Avantor (AVTR), Danaher (DHR) and Thermo Fisher (TMO), and CDMO coverage of Catalent (CTLT).
On Friday March 12th, Nephron hosted one of the top diagnostics payor experts in the field, Dr. Joel Brill for a discussion on reimbursement prospects for early cancer detection testing.Our discussion focused on the health economics of screening for CRC and multi-cancer focused liquid biopsy tests, the potential reimbursement pathways for Medicare, and steps needed to earn coverage. We also discussed broader oncology testing areas such as comprehensive genomic profiling (CGP) and minimal residual disease (MRD) testing.
On Friday, March 5th, Nephron hosted Dr. Niall Lennon (one of the top experts in technology assessment in the field) for an update on the latest genomics technologies following AGBT 2021. Each year, AGBT is the largest annual meeting for genomics and biology for our coverage. Topics of discussion included an update on the NIH’s All of Us Program, where Niall is helping to lead the Broad Institute’s sequencing efforts, as well as an analysis of the latest product updates in genomics, changes in the competitive environment for sequencing, and emerging areas of investment with single cell and spatial research.
On February 23rd, Nephron Research hosted a brief call to discuss our Telehealth initiation of coverage note out on Monday February 22nd. Key topics included:
- Updated Telehealth Utilization Data – we see utilization normalizing in the high single-digits
- Comprehensive Post Pandemic Market Analysis – public players + private pure plays + EMR vendors + telecom software
- Pure Play Telehealth Competitor Funding – who raised what and who will be next to IPO or SPAC
- Government Payor Telehealth Expansion Limitations – what stays and what goes
- Competitive Dynamics in Flux – health systems are poised to appropriate payor telehealth territory
On Friday Feb. 19th, Nephron hosted the CEO of one of the top private solutions providers in the field, Dr. John Wilson for a discussion on the latest innovation in proteomics for mass spectrometry.Topics of discussion included the latest competitive dynamics in mass spectrometry between Bruker’s TOF Pro and Thermo Fisher’s Orbitrap, the potential for single cell proteomics, the potential for mass spectrometry to translate into the clinic, and areas of investment amidst COVID-19. Companies in focus included Bruker (BRKR), Thermo Fisher (TMO), Agilent (A), Danaher (DHR), PerkinElmer (PKI) and Waters (WAT).
The next era of healthcare will be defined by the trend of physician enablement. This morning, the Nephron Research team hosted a conference call to review our thesis and the opportunities where we:
- Introduced and defined the physician enablement sector, a movement that puts the physician at the center with systems, technologies and capabilities to surround those physicians, enabling the capture of value through risk bearing arrangements.
- Explained the factors that are leading to significant growth, including the motivations for payors to push this forward (i.e. working with, not against, physician enablers), as well as the financial incentives for the primary care physician.
- Presented a financial model to value a covered/attributed life, wherein we explained how patients are 5x more valuable to an enabled physician than a Medicare Advantage plan.
- Presented a market model sizing the total addressable market, by segment, where we estimate a total physician enablement market opportunity of $1.9 trillion today, growing at >6% annually to arrive at $3.5 trillion by 2030.
The healthcare system, and perhaps the broader economy, is focused specially on the dissemination of vaccines to get us “back to normal.” It is the number one question on the minds of investors so Nephron Research brought in THE expert. Jarrett Lewis joined us from Public Opinion Strategies where he focuses the healthcare polling efforts, centered exactly at this question. Jarrett’s work is used by municipalities, governments, health systems, corporations and many others to help shape messaging and gather information. After months of work on masking policies, the attention is on vaccines. Jarrett walked through all of the current data and told us what he is looking for to gauge the ultimate adoption rates.
This morning, Eric Percher and Joshua Raskin hosted the Nephron Research 2021 Healthcare Services Outlook, a comprehensive overview of the healthcare services market as we look toward 2021. We included our views on the most important industry trends as well as updates on our covered companies including targets and estimates.
This morning, we hosted a special discussion with Gene Cassis. Topics of discussion included thoughts on the value proposition of analytical instrument categories, views on where the Life Science Tools industry is heading, perspectives on how COVID-19 changes the industry’s investment priorities, and thoughts around approach to managing a business & financial reporting.
This morning, we hosted a 20-minute conference call to discuss the factors that led us to downgrade shares of Walgreens Boots and CVS Health as well as the analysis of the 340B Drug Discount Program profit contributions that catalyzed our more negative outlooks for WBA and CVS shares.
On December 7th, we chatted with Dr. Robert Boorstein focusing on updated implications from COVID-19 testing for the clinical laboratory testing and the diagnostics industries. Topics of discussion included an update on COVID-19 detection and serology testing, as well as the laboratory operating environment. Companies in focus from our coverage include Bio-Rad (BIO), Danaher (DHR), Hologic (HOLX), LabCorp (LH), PerkinElmer (PKI), Quest Diagnostics (DGX), Quidel (QDEL), Thermo Fisher (TMO).
Dr. Boorstein is currently Medical Director for Lenco Diagnostic Laboratory, a rapidly growing commercial laboratory in Brooklyn, NY. He is also Medical Director at Vela Diagnostics, a manufacturer of novel NGS tests for infectious diseases and oncology. He was previously the founding Medical Director at Clinical Genomics, a privately funded laboratory developing novel colon cancer liquid biopsy diagnostics. Earlier, he was Medical Director at Enzo Clinical Laboratories, a full-service clinical reference laboratory serving the New York City medical community. Prior to working in the commercial sector, Dr. Boorstein was Associate Professor in the Department of Pathology at New York University School of Medicine, Director of Pathology at Bellevue Hospital, and Medical Director for Pathology and Laboratory Medicine of the South Manhattan Healthcare Network and Northern Manhattan & Generations plus Health Network of the New York Center Health and Hospitals.
On November 30th, we hosted a discussion with Dr. Bruce Quinn on reimbursement prospects for early cancer detection testing. Bruce is the go-to expert on all things reimbursement for the Diagnostics industry. He specializes in Medicare policy, and helps both large and small companies understand and overcome hurdles to commercialization. Bruce is the Principal at Bruce Quinn Associates, and previously served as a Policy & Strategy Expert at Foley Hoag. Prior to that, he served as the Medical Director for California’s Medicare Program
Our discussion focused on diagnostics for early cancer detection. There are a number of liquid biopsy entrants developing new tools for early detection. Our discussion focused on potential reimbursement pathways for Medicare, and steps needed to potentially earn coverage. Companies in focus from our coverage include Illumina (ILMN), Myriad Genetics (MYGN), and non-covered Exact Sciences (EXAS), Guardant Health (GH), and private companies Freenome and Thrive.
On November 24th, Nephron hosted Dr. Mark Pandori, the director of the Nevada’s State Public Health Laboratory.
Topics of discussion included public health testing strategies for COVID-19, trends in infection rates, preferred testing platforms, the value of antigen testing for screening, the relative value of emerging platforms (such as NGS), and the path forward for COVID-19 testing.
In light of today’s announcement from Amazon, we hosted a very brief call for investors to review the implications for the broad supply chain including Digital Pharmacies, Retail Pharmacies, PBMs and Health plans.
On Nov 13th, we were joined by Mike Waterbury, Chairman of rebate aggregator RemedyOne and the recently launched Famulus Health, ‘payor integrated’ generic drug discount card, for a discussion of the changing brand rebate marketplace (think PBM GPOs such as CI/Ascent and CVS/Zinc) and generic discount card marketplace (think GoodRx)
On November 11th, Nephron hosted two of the leaders of the largest Spine center in Nebraska, with 25%+ market share on all spine surgeries in the state. We were excited to meet with Dr. McClellan and Mr. Leatherman because of NS+PC’s positioning in the evolving world of outpatient surgeries as well as their affiliations with UnitedHealth Group’s OptumCare Segment (part of Surgical Care Affiliates).
Topics of discussion included:
- The impact of COVID on surgery trends
- How outpatient surgery trends are developing and share shifts from inpatient to ASCs
- What hospitals are doing to combat the trend of movement of procedures to outpatient settings
- How physicians are thinking about the future, including changes in ownership structures
- How to best partner with hospital systems to improve efficiencies and outcomes
- How bundled payment initiatives, and other value based reimbursement systems are evolving
- What Optum brings to the table in these partnerships and how they are trying to grow
- The latest trends in spine and pain care
This morning, we were joined by leadership from CPA, one of the largest independent pharmacy co-ops in the country and a key AmerisourceBergen customer. Key topics included include independent pharmacy economics, generic sourcing, pharmacy reimbursement, drug discount cards and 340B.
Leadership included Jay Blackburn, CEO, Jim Ross, COO and Tom Marten, CFO.
There are few topics getting more attention that value based care, and yesterday we hosted a full panel of experts for the topic. We were joined by 2nd Mountain Leaders:
- Terry Bayer: Former COO Molina Healthcare, FHP, Maxicare, Matria
- Dr. Greg Buchert: Former CEO Blue Shield of Califoria, CMO of Health Net, HMA and COO of CalOptima
- Dr. Mario Molina: Former CEO of Molina Healthcare, Former CEO of Golden Shore Medical Group
- Juan Jose Orellana: Blue Harbor Consulting Group, Former CMO Golden Short Medical Group, Molina Healthcare
On October 2nd, Nephron had a virtual visit with the Broad Institute, hosted by two leading genomics researchers - Dr. Stacey Gabriel and Dr. Niall Lennon.
We hosted a conference call yesterday at 10:30AM ET highlighting key findings from yesterday morning's market positioning update for Life Science Tools & Diagnostics.
On September 29th, Nephron hosted one of the top thought leaders in the industry, Dr. Howard Levine, for a discussion on implications of COVID-19 drug development on bioprocessing. Topics of discussion included sizing the market opportunity for COVID-19 treatments and vaccines for the industry, as well as a closer look at the technologies and providers who will be supporting the scale-up of vaccines and therapeutics related to the disease.
We hosted a conference call yesterday 9/29 at 11AM ET highlighting key findings from yesterday morning's comprehensive update on COVID-19 detection testing.
On Monday September 21st, the entire Nephron Research team hosted a meeting with senior leadership at Northwell to understand the current environment and how healthcare delivery is changing today. We discussed how Northwell has become a leading innovator of health delivery (with assets including hospitals, clinical labs, pharmacies, dialysis centers, urgent care, physician offices and others).
On Thursday Sept. 9th, we were joined by Drs. Jeffrey Rosenfeld and Brewster Kingham for a discussion on genomics research. Topics of discussion included updates on academic research amidst the COVID-19 pandemic, investment themes for genomics, and implications for life science tools suppliers.
On July 17th, we were joined by Jim Tsipakis and Allen Dunehew to discuss the state of the pharmacy and generic sourcing market with industry leaders representing 400 pharmacies and $3bn+ of generic sourcing.
- Generic Market Focus: Rx Sourcing Strategies recently completed a full rebid of its 100+ supplier book, positioning the company to speak to the current state of the generic sourcing marketplace.
- Pharmacy Operations Focus: Giant Eagle will address recentscript trends,pharmacy reimbursement pressure, 30 to 90-day shift, commercial to cash/Medicaid coverage shift, and retail to mail shift.
- Distributor Focus: After more than a decade with McKesson, Giant Eagle shifted to Cardinal and later moved generic sourcing from TBC to RxSS
On Tuesday July 14th, we were joined by Dr. Charles Nemeroff for a conversation focused on recent updates in the field of pharmacogenetic testing. Topics of discussion included the clinical value of PGx, the focus on regulation of the category, as well as implications from Medicare’s recent final coverage decision on pharmacogenetics. The primary company in focus was Myriad Genetics (MYGN), with testing implications as well for LabCorp (LH) and Quest Diagnostics (DGX).
On Monday, July 13th, Nephron hosted Brian Evanko, the President for Cigna’s Government Business which includes MA, Med Supp, PDP, Medicaid, the Exchanges, Dental and others as well as leading the company’s efforts on integrated and value based care arrangements.
On Monday, June 13th we were joined by Mara G. Aspinall for a presentation and Q&A on the role of diagnostics in a COVID-19 world. Topics of discussion included recent views on the role and value proposition of diagnostic testing, as well as future implications of the pandemic on testing providers and manufacturers. Companies in focus from our coverage included Bio-Rad (BIO), Danaher (DHR), Hologic (HOLX), Illumina (ILMN), LabCorp (LH), PerkinElmer (PKI), Quest Diagnostics (DGX), Quidel (QDEL), Thermo Fisher (TMO).
On July 9th, Dr. Robert Boorstein joined us for for a discussion focused on the investment implications from COVID-19 testing for the national labs and diagnostics manufacturers. Topics of discussion included detection and serology testing, as well as the laboratory operating environment. Companies in focus from our coverage included Bio-Rad (BIO), Danaher (DHR), Hologic (HOLX), LabCorp (LH), PerkinElmer (PKI), Quest Diagnostics (DGX), Quidel (QDEL), Thermo Fisher (TMO).
On July 1st, Nephron launched coverage of Life Science Tools & Diagnostics. Topics of discussion included views on the long-lasting implications of COVID-19 on the industry, the top factors which will dictate the shape of the recovery, as well as our top stock recommendations.
On June 23rd, we were joined by Joon S Lee, MD and Chronis Manolis, RPh to discuss the impact of COVID-19 and outlook for reopening with UPMC, one of the country's most sophisticated integrated health systems (40 hospitals, 8,000 beds, 700 outpatient sites, 3.7mn life health plan). Key topics covered included:
- Integrated Systems: The accelerated advantages of an integrated system through the pandemic, and how providers will have to rely more on payors in the future
- Pharma & Pharmacy: Impact of COVID-19 on Acute Vs. Chronic, Brand Vs. Generic, Retail Vs. Mail, 30 vs 90 and Commercial Vs. Public Pay
- PBM: Formulary strategy emerging from COVID-19, including initial PBM responses for 1/1/2021
- Diagnostics: UPMC’sefforts to match testing capacity to testing demand and outlook for reopening
On Wednesday, June 3rd, Nephron hosted Andy Slavitt for another chapter of the Nephron Research Expert Series. Slavitt brought the most up to date perspectives on the COVID pandemic, insights into how the government is reacting (and should re-act), as well as views on how health plans and health systems are being impacted.
On 5/21/20, Nephron hosted the CEO of ReviveHealth, Brandon Edwards.
This virtual meeting gave the most current view of the re-opening of the healthcare economy from the source. If you are trying to figure out the impact on hospitals and health plans, this is a must-listen event. Lately, the clear focus has been on helping their systems “re-open” and ReviveHealth serves as a strategic partner for that process. We got several real-time anecdotes on actions being taken around resumptions of services.
On Friday Feb. 28th, we hosted a conference call on the potential impact of COVID-19 on the Drug & Med Supply Chains with Premier Inc's President Michael Alkire, leader of Premier's efforts to address drug shortages, and David Hargraves, SVP Supply Chain.
With $61bn of annual GPO purchasing volume across 2,500+ hospitals and substantial contract manufacturing operations, Premier is unique positioned to help us take a closer look at the potential impact of shortages on Med Tech, Diagnostics, Consumables and Pharmaceuticals.
This call is relevant for investors in:
- Hospitals and Alt. Site Facility Operators
- Med Devices Manufacturers
- Diagnostics and Consumables Manufacturers
- Brand and Generic Drug Manufacturers
- Drug Distributors and Pharmacies
On 12/19/19, we published a comprehensive overview of the healthcare services market as we look toward 2020. We included our views on the most important industry trends as well as updates on our covered companies including targets and estimates. On 12/20/19, we pared down the slides and held a conference call to walk through our thoughts for the year ahead. The following is a replay of that call.
Ron Kuerbitz, CEO, Agilon Health
Manmeet Kaur, CEO, City Health Works
Dr. Richard Park, CEO, CityMD
Praveen Thadani, SVP Strategy, Trend, Innovation, Humana
Richard Rakowski, CEO, MedicallyHome
Bill McIvor, EVP & Chief Development Officer, Seniorlink
Eric Kinariwala, CEO, Capsule
Michael Dlugos, VP Pharmacy Strategy, GoodRx
Ed Kilroy, CEO, MedAvail
Following our recent upgrade of CERN shares, we bring you a unique perspective from the thought leaders at Chilmark Research, a global research and health system advisory firm focused solely on the market for HCIT solutions.
Our recent series with employers and benefits managers continues with Kathy Donneson, CEO of CalPERS Health Plan and PBM. As the individual responsible for CalPERS move from CVS to OptumRx and bundled payment strategy with Anthem, Kathy brings a unique perspective on health plan and PBM contracting.
Robert Popovian, Pharm D., MS., VP US Government Relations, Pfizer
Chester ‘Chip’ Davis Jr., President & CEO, Association for Accessible Medicines
Diane Digangi Trench, VP Market Access & Patient Services, Sandoz
Peter Bach, M.D., MAAP, Dir. Center for Policy & Outcomes, Memorial Sloan Kettering
Josh Golden, Area SVP, Solid Benefit Guidance, a Division of Gallagher Benefit Svcs.
Tiffany L. McCaslin, Sr Policy Analyst, Public Policy, National Business Group on Health
Bernie Good, MD, MPH, Sr. Medical Director, Ctr. for Value Based Purchasing - UPMC
Chronis Manolis, RPh, SVP Pharmacy & Chief Pharmacy Office, UPMC Health
Erik Sossa, VP Global Benefits & Wellness at PepsiCo, Co-Chair of NDPC Board
David Schlett, Principal Consultant, Cambridge Advisory Group
Jenny Bryant, SVP Policy & Research, PhRMA
Dan Durham, EVP for Health Policy, Biotech Innovation Organization
Keith Fontenot, EVP Policy & Strategy, America's Health Insurance Plans
After several weeks of exploration and analysis, we have concluded that the new PBM contract design announced by Express Scripts and the National Drug Purchasing Coalition on October 23rd represents a significant evolution of the PBM model that could point to the future of pharmacy benefit management in a world without rebates.
Key Topics:
-
Where does the money go?
- We quantify the factors that account for the $153bn gap between brand gross and net and segment PBM profit pools
-
Total Performance Management model mechanics
- Who is NDPC and what makes the model developed by Express and NDPC different from previous acquisition cost-plus models?
-
Implications of a transparent model
- We consider the potential impact on PBMs, Pharma, payors/employers and benefit managers with an eye on the JPM, Amazon, Berkshire partnership
Marc-David Munk MD, Chief Medical Officer MinuteClinic and Assoc. Medical Officer at CVS Health
Stephen Rosenthal, SVP Pop Health Management, Montefiore Health System and Allen Miller, CEO COPE Health Solutions.
Dr. Rob Fields, SVP, Chief Medical Officer Pop Health and Lauren Lisher, VP Commercial Product.
Kaiser Permanente (Walt Meyers, Exec. Director Strategic Market Planning), Humana/Conviva (Eric Jenkins, VP of Care Delivery Operations, Conviva), Collective Medical (Ben Zaniello MD MPH, Chief Medical Officer), Premier Inc. (Blair Childs, SVP Public Affairs)
Clover Health (Dr. Mark Spektor, Chief Medical Officer) Agilon Health (Ron Kuerbitz, CEO)
This call is a companion to our Sept. 7th note which updates our August 16th report, incorporating a broad range of pharma supply chain participant feedback into our analyses of 1) the factors that account for the gap between gross and net, 2) the profit pools retained by pharma supply chain participants and 3) the financial implications of rebate safe harbor repeal and reform.
A SLIDE DECK IS AVAILABLE IN NEPHRON'S RESEARCH LIBRARY (9/7/18)