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☆ Your tax dollars are getting spent on weight-loss drugs like Ozempic, and the total is adding up
▼ + stars: | 2024-01-11 | by ( Juliana Kaplan | Ayelet Sheffey | ) www.businessinsider.com time to read: +7 min

AdvertisementConnecticut was quick to experience the impact of weight loss drugs on its economy last year. Politico reported in November that the state's employee health plan was set to spend $30 million on drugs like Ozempic and Wegovy. Comptroller Sean Scanlon told BI that that was up from $8 million in 2020. Connecticut began testing out a method to offer those seeking weight loss drugs access to a program with online tools for weight management. In North Carolina, the State Health Plan has put a moratorium on new users of GLP-1 drugs for weight loss.

Persons: Sean Scanlon, Scanlon, it's, Dale Folwell, Folwell, Shelby Livingston, Eli Lilly, that'll, Nik Modi Organizations: Service, Business, Bloomberg, Medicaid, Politico, BI, State, North, State Health, Novo Nordisk, Wall Street, University of Texas System, UT, RBC Capital Markets Locations: Connecticut, Wegovy, . Connecticut, North Carolina, Novo, Netherlands, United States

☆ 25 healthcare startups that are set to take off in 2024, according to top VCs
▼ + stars: | 2023-12-18 | by ( Rebecca Torrence | Blake Dodge | ) www.businessinsider.com time to read: +1 min

AetionAetion's website. AetionPicked by: Lynne Chou O'Keefe, the founder and managing partner of Define VenturesWhat the company does: Aetion provides pharmaceutical companies, payers, and regulators with real-world evidence they can use to inform decisions. Aetion provides the real-world evidence that insurers, pharmaceutical companies, and regulatory agencies need to evaluate the value of drugs and inform those conversations, she said. "The cost of specialty drugs, what's happening in the Inflation Reduction Act — all are bellwethers that we need a more value-based-oriented system around therapeutics going forward," she said. — Shelby Livingston

Persons: Aetion, Lynne Chou O'Keefe, O'Keefe, — Shelby Livingston

☆ Spora Health's founder painted a rosy portrait of his healthcare startup. The reality is more complicated.
▼ + stars: | 2023-10-30 | by ( ) www.businessinsider.com time to read: +14 min

The way Dan Miller told it, his startup Spora Health was crushing it, providing high-quality care to "thousands" of people online. The startup had secured at least one big contract, with Apple, according to three former Spora employees and another source close to Spora. Four of them told Insider they either no longer worked with Spora or hadn't seen Spora patients in a year. Two doctors listed on Spora's website as "featured Spora providers" also told Insider that they no longer worked for the startup. Another former clinician said she only ever treated a handful of Spora patients.

Persons: Dan Miller, Miller, Spora, it's, UnitedHealthcare, Aetna didn't, paychecks, hadn't, he's, It's, —, we've, " Miller, Shelby Livingston, Rob Price, Emmalyse Brownstein, Ryan Pickrell, Gloria Dawson, Stephanie Hallett, Alcynna Lloyd, Hayley Peterson Organizations: Company, TechCrunch, Spora, US Securities and Exchange Commission, Apple, Aetna, Stanford Graduate School of Business, Human Ventures, MaC Venture, SEC Locations: Spora, Level's, slivingston@insider.com

☆ Inside the struggles at Calibrate, a new kind of weight-loss startup that's facing a mountain of patient complaints and refunds
▼ + stars: | 2023-09-05 | by ( Rebecca Torrence | ) www.businessinsider.com time to read: +19 min

Weight-loss startup Calibrate has struggled to get patients access to buzzy drugs like Ozempic. Kenyon's startup Calibrate, which she launched in June 2020, is one of the healthcare companies feeding the frenzy. CalibrateThe company is now running up against several massive challenges: Weight-loss drugs are expensive and in short supply, and health insurers are increasingly reluctant to pay for them. Kenyon said about 20% of Calibrate members do not have coverage for weight-loss medications, and around half of those people request refunds from Calibrate. Want to tell us about your experience with Calibrate or weight-loss drugs?

Persons: lightbulb, Isabelle Kenyon, Kenyon, Jenny Craig, OptumRx, She's, she's, Saxenda, —, weren't, It's, they've, Holly, hadn't, hasn't, Claire Rosenzweig, Rosenzweig, it's, Andrew Kelly, Shelby Livingston, Rebecca Torrence Organizations: New, Tiger Global, Founders Fund, Optum Ventures, FedEx, Food and Drug Administration, Jefferies, Better Business Bureau, BBB, Better Business, Metropolitan New, Better, Apple, Businessolver, Optum, UnitedHealth, Employees, REUTERS, Madryn Asset Management, SM Ventures, Ventures Locations: America, New York, Danish, GLP, Florida, Metropolitan New York, slivingston@insider.com, rtorrence@insider.com

☆ ChenMed just tapped a UnitedHealthcare veteran to take over as the clinic company confronts financial pressures
▼ + stars: | 2023-07-20 | by ( ) www.businessinsider.com time to read: +4 min

The family behind primary-care company ChenMed is stepping back from their leadership roles. He will bring on an almost entirely new leadership team, effective August 1. "The Chen family remains owners of the ChenMed company, and we will no longer be directing company operations," Chris Chen told staff. As a private company, ChenMed does not disclose its financials. During the meeting Thursday, Chris Chen told staff that the family and leadership team have "decided to keep the ChenMed brands together."

Persons: Steve Nelson, ChenMed, Chen, Nelson, Chris Chen, Steve Nelson ChenMed, Steve, Chris Chen's, Dr, Gordon Chen, James Chen, Mary Chen, Stephanie Chen, Jessica Chen, Shelby Livingston Organizations: Humana Locations: slivingston, insider.com

☆ People probably have to be on Ozempic forever. But no one is ready for the bill.
▼ + stars: | 2023-06-02 | by ( Hilary Brueck | ) www.businessinsider.com time to read: +9 min

But she knows — from experience — that probably won't be possible if she has to stop taking the drug once her manufacturer-issued coupons expire. But the injections don't work once people stop taking them. Li Ran/Xinhua via Getty ImagesMany health insurers and employers have long declined to pay for weight-loss drugs. He has resumed taking weight-loss medication but said he hoped to go down to a lower dose. Want to tell us about your experience with health insurance and weight-loss drugs?

Persons: Tara Rothenhoefer, Rothenhoefer, Eli Lilly's, Insider's Gabby Landsverk, —, Wegovy, Rothenhoefer Novo, we're, Dr, Martin Lange, Novo, Eli Lilly, Li Ran, Sean Duffy, Omada, Duffy, hungrier, Nisha Patel, it's, " Lange, Bill, Gabby Landsverk, Shelby Livingston, Hilary Brueck Organizations: Rothenhoefer Novo Nordisk, Novo Nordisk, Getty, National Library of Medicine Locations: San Francisco, Novo, Xinhua, slivingston

☆ Digital health faces the same hurdle as fintech: Get profitable or get lost.
▼ + stars: | 2023-05-10 | by ( Dan Defrancesco | ) www.businessinsider.com time to read: +6 min

Digital health, once the darling of the healthcare industry, is having a tough go of it. After a pandemic-fueled surge when health services and offerings utilizing tech were prioritized, digital health has come back down to earth. The similarities between digital health and fintech are striking. For both fintechs and digital health, this year has served as a reminder that they're only partly tech companies. Click here for predictions from 16 bankers and dealmakers on the future of digital health.

☆ Medicare is prohibited from covering weight-loss drugs — Ozempic could change that
▼ + stars: | 2023-04-25 | by ( Lydia Ramsey Pflanzer | ) www.businessinsider.com time to read: +5 min

Medicare is prohibited from covering new weight-loss medications. Medicare, the federal program that covers healthcare for people 65 and older, is prohibited by law from covering any weight-loss medications. That includes looking at programs that test out Medicare coverage and proposed limits to coverage, The Journal reports. The future of the $100 billion weight-loss drugs marketExpanding Medicare coverage to new weight-loss medications could drastically change how Americans access the drugs. Meanwhile, other Americans will continue to go to Canada, Mexico, and unregulated online pharmacies to get the weight-loss medications for cheap.

☆ People Can't Get Ozempic, New Weight-Loss Drugs Because of Broken Healthcare System
▼ + stars: | 2023-04-13 | by ( ) www.businessinsider.com time to read: +15 min

Wegovy is just one of a wave of revolutionary weight-loss drugs, which also includes the buzzy Ozempic, that represents a watershed moment for obesity treatment. Demand for weight-loss drugs is surgingDoctors and healthcare professionals searched for a healthy, safe, and effective weight-loss solution for years before the drugs, known collectively as GLP-1 agonists, exploded on the scene. If there is one key that could unlock access to expensive weight-loss drugs for Americans, it's Medicare. Expanding coverage for Ozempic and other weight-loss drugs for just a small segment of the population could cost Medicare up to $26.8 billion a year. Patients lose outYears from now, patients may have an easier time getting their hands on weight-loss drugs.

☆ The founder of Elemy raised more than $200 million to provide better autism therapy for kids. Now he's ditching patient care to chase billions selling healthcare software.
▼ + stars: | 2023-03-09 | by ( Blake Dodge | ) www.businessinsider.com time to read: +12 min

Yakubchyk told Insider that the venture studio is separate from Elemy and that he's only passively involved in it. Now they have to email a help desk, which takes longer and is less helpful, three behavior analysts said. Yakubchyk told Insider, however, that the company is still in the early stages of finding the right model for the long term. In the meeting, Tim Eby, Elemy's president, told analysts that running their own businesses would offer them more "empowerment." At Elemy, clinicians who leave largely aren't being replaced because everyone in clinical recruiting has been laid off.

☆ 7 top dealmakers share their biggest 2023 healthcare predictions, from new ways to use AI to a surge of new health insurance startups
▼ + stars: | 2022-12-26 | by ( Rebecca Torrence | ) www.businessinsider.com time to read: +2 min

The market downturn will create opportunities for more M&A, Devin Carty, the CEO of Martin Ventures, saysDevin Carty. Martin VenturesIf 2021 was the year of big venture checks and wildly oversize valuations among healthcare startups, 2022 was when it all came crashing back to earth. But the down economy will be an opportunity for venture-capital and private-equity firms, said Carty. His Nashville, Tennessee, venture-capital firm invests in and launches healthcare startups, including companies transforming primary care, such as Wellvana, or kidney care, such as Evergreen Nephrology. So far in 2022, the firm invested in six new companies and nine startups already in its portfolio.

☆ 7 top bankers and investors share their boldest 2023 healthcare predictions, from a big bet on AI to more funding for startups selling directly to patients
▼ + stars: | 2022-12-21 | by ( Rebecca Torrence | ) www.businessinsider.com time to read: +2 min

Funding raised: $27 millionNumber of employees: 20Why it's set to take off next year: Provider burnout is getting worse, and it's exacerbating healthcare's staffing crisis. Nof said he expected Abridge's technology to be in demand next year as hospitals worked to reduce the administrative burdens on doctors. "They've reached a tipping point where people are desperate to gain efficiencies in their workday with all the physician burnout," he said. Abridge's technology takes the audio from doctor-patient interactions and automatically turns it into documentation for billing purposes or a summary of the visit for the patient. That means doctors are relieved of the "hours of pajama time in the evening that they previously spent doing clinical documentation," Cheatham said.

☆ The DEA is alleging Truepill, Cerebral's former pharmacy partner, broke the law in filling prescriptions for highly regulated drugs
▼ + stars: | 2022-12-16 | by ( Blake Dodge | Rebecca Torrence | ) www.businessinsider.com time to read: +5 min

The agency alleges that the pharmacy startup unlawfully dispensed stimulants used to treat ADHD. Truepill partnered with the mental-health startup Cerebral to send prescriptions to its patients. The Order to Show Cause requires that Truepill show evidence to justify its prescribing practices for controlled substances, which are highly regulated drugs. If the evidence isn't convincing, the pharmacy startup could have its DEA license revoked, which would leave the company unable to fill prescriptions for controlled substances. In "numerous instances," the startup dispensed prescriptions that weren't issued for a legitimate medical purpose, the DEA alleges.

☆ SoftBank-backed Cerebral is cutting 20% of its employees as demand for its services slows
▼ + stars: | 2022-10-24 | by ( Blake Dodge | ) www.businessinsider.com time to read: +7 min

Cerebral, the SoftBank-backed mental-health startup, is making changes and cuts that will affect about 20% of its employees, Cerebral CEO Dr. David Mou said in an email to employees, reviewed by Insider. In the October 24 email, Mou said the company was adjusting the size of clinician teams to better match patient demand. Employees will be notified of changes throughout the week, Mou said. "We are deeply appreciative of our employees' commitment to our mission and service to Cerebral," the spokesperson said in the statement. These changes will be spread across all divisions - HQ Operations, HQ Support, Clinical Care - affecting approximately 20% of our employees.

☆ Insiders say Elemy often couldn't deliver on its promise to provide quick access to autism care
▼ + stars: | 2022-10-16 | by ( Jordan Parker Erb | Spriha Srivastava | ) www.businessinsider.com time to read: +4 min

On the agenda today:But first: Senior healthcare reporter Shelby Livingston is giving us a behind-the-scenes look at her reporting on Elemy, a startup that insiders say often failed to provide the quick access to autism care that it had promised. This week, I reported how SoftBank-backed Elemy aimed to transform autism care — but insiders say the $1.15 billion startup overpromised on its capacity to treat kids. More than 20 former and current employees spoke with me for this story. After an initial assessment, Elemy told them they'd be in therapy in no more than eight weeks. Here's what Compass insiders told us.

☆ SoftBank-backed Elemy aimed to transform autism care. But current and former employees say the $1.15 billion startup overpromised on its capacity to treat kids.
▼ + stars: | 2022-10-11 | by ( ) www.businessinsider.com time to read: +18 min

Elemy, a $1.15 billion startup, promised families and healthcare providers quick access to autism care for kids. The current and former Elemy employees who spoke to Insider for this story requested anonymity because they feared retaliation from the company. ABA therapy, while somewhat controversial, is the most widely used treatment to teach kids with autism new skills and discourage challenging behaviors. At the direction of leadership, Elemy employees on the business-development team told those organizations to send their kids with autism, according to four former employees directly involved in forming referral relationships. Each ABA company performs its own expensive, time-consuming behavior assessments, and some insurers pay for only one assessment every six months, he said.

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