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My friend and Wharton classmate, Rice University Adjunct Professor Lin Giralt, is building a new concept. What if citizens of the “grey market” (Third World) had access to “white market” (First World) healthcare? Legally registered insurers in Mexico, for example, are selling policies in pesos that entitle cancer patients (through their local oncologist) to send DNA samples to the University of Pennsylvania (a charter hospital). • Mexican doctors benefit because they get access to the very latest medical research and technologies, plus networking and advisory service support from a Penn Medicine oncologist. • Mexican patients similarly benefit and get better health care. • Mexican insurers have an additional “buy-up” product available for customers, and may reduce costs by quickly focusing on therapies with a greater chance of success. There is a secure IT platform, foreign currency conversions, translation services, and case managers for one-to-one follow up. See http://medgroup.biz/grey-market-cancer for details. What do you think of the model? Are there similar models to build your business outside in the grey market? ++++++ IMPLICATIONS FOR THE MEDICAL DEVICE INDUSTRY Professor Giralt’s idea decouples the in-person/physical and virtual/intellectual-capital parts of the value chain. Lin wants to address gaps in handling and transmitting paper medical records and EMRs. He seeks more reliable teleconferencing platforms for international physicians, and better software/mobile apps to enable and track the process. He believes if Next Generation Sequencing DNA analysis (now done in the US by an Illumina machine or similar) could be deconstructed and modularized (so parts could be done in lab modules overseas), we could reduce the cost and failure rates of the process. He suggests doing some parts of the DNA-biopsy analysis in the home country. Lin is starting with oncology, but neurology, cardiology, and others are sure to follow. Is he on to something? How would you guide his development? Contact Lin at his LinkedIn profile. ++++++++++ Discussions this week New China GMP Code Published What happens if you don’t pay the Medical Device User Fee? First step to market a bone-conducted hearing aid? Best way for single-line company to approach distributors? Suggested best practices for finding angels? What to do when your molded plastics vendor repeatedly delays? ++++++++++ Make it a great week. Joe Hage P.S. Congratulations to ASCO Numatics’ Michael Dellosso who, with his 27-24 Patriots guess won free admission to 10x! http://MedicalDeviceEvents.com Jonas Moses Diagnosis and/or predicting future development of cancer, on the basis of markers is an unproven and sketchy methodology, and (at best) an inexact science. Until and unless those engaged in delivering such “services” can demonstrate better-than-90% accuracy (at least as good as the chance that a condom will prevent the transmission of disease or pregnancy), those providing these “services” are merely using human beings as unwitting guinea pigs. As far as I know, the Nuremberg Trials expressly condemned this kind of medical experimentation. Lin Giralt Joe Hage Joe, as a consulting cancer biologist (wrote a ground-breaking book on cancer, predicated on my research at […] University) and former clinician (military surgeon), married to a Mexican physician (currently practicing Medicine in Mexico City), I concur with your other private commenter. It is far more likely that Mexican patients might be “snookered” into paying for insurance — which is very expensive in Mexico — thinking they are going to get critical services from US hospitals. In point of fact, the relationship between genetic markers for cancer and the actual development of various cancers is hazy, at BEST. It is my expert opinion, having been in the forefront of tumor modeling and the developmental biology of cancer: Cancer is not a genetic disease, nor are there accurate, direct genetic markers for any cancers. In a classic example, BRCA1, was wholly discredited by a colleague of mine, while at […] University…albeit quite unintentionally. He was planning to build his entire career on the proof-positive and exploration/exploitation of BRCA1 and derivatives. However, after three solid, grinding years of experimentation with this “marker,” he not only shut down his lab and left the University, he actually walked away from a promising career in cancer research. He was a brilliant scientist…who discovered fundamental, catastrophic flaws in the science behind these genetic markers. When he tried to go public with his findings, he was threatened with a lawsuit! At the risk of sounding ominous, there are some very dangerous and dark goings-on in the cancer diagnosis and treatment industries, Joe. Consider that we announced the “war on cancer” under Nixon, in the 1970’s, when I was a small boy. Forty years later, not only are the vast majority of researchers still using mouse models for experimentation (a completely failed approach), physicians are still treating cancers with radiation and chemotherapy (which are both incredibly toxic to the human body), even though it is well-appreciated that cancer IS a disease process of a damaged immune system. Ergo, why further damage the immune system with radiation and chemo, when the correct approach is to repair and enhance it? Lin Giralt Richard Maloney Lin Giralt Karl Schulmeisters Shikharesh Das The challenges are perhaps more serious than privacy, as the cost of long term chronic disease treatment is out of reach for a large population not covered by medical insurance, even in their own country. As top 20% already has access to comparatively better healthcare, the real benefit to the emerging countries would come when the rest 80% gets covered by Lin’s model in not only sending the samples but inclusive of a full follow up treatment if needed, for a better outcome. He is on the right track to engage the public health officials and may want to study some PPP models. There are some good case studies from E&Y here bit.ly/1LKWEc3 Lin Giralt CMC Bruce Dobsch Lin Giralt 2) Dr. Jeff Birkenmeier – not brilliant, the MD’s at MD Anderson told us this was a problem and we simply followed up on ..please lets connect and see if we can do something together 3) Clark Celmayster – we try to see it as win win…not that we are solving all the problems but one link in the chain at a time 4) Leena Pradhan-Nabzdyk – we are encouraging our partner, Foundation Medicine to explore separating and offshoring parts of the process, but it is not technically easy, another issue, privacy and malpractice, we are HIPAA compliant, get patient OK for everything and only act as an MD to MD advisory service, never talk to the patient so do not practice medicine in that respect 5) Gary Rosensteel – Gary, we are firmly in the second group, we do not do any medical or lab work ourselves, we are merely a ‘value added integrator’ or facilitator, bringing all these elements together- insurance, logistics, following up, lab tests and cancer advisory…thanks for your comments, we believe that separating the Intellectual capital transfer from the physical value chain is a big step forward…please stay in touch and lets connect offline or online… 6) Joe Hage, not disagreeing with the anonymous poster, certainly there are many primary issues in third world countries that we are not addressing…we are not God… but this – genomic testing – is a key issue that can be addressed by us and if we can make US level cancer care more accessible everyone is the winner… one step at a time…btw, it is NOT a sell more insurance scheme, were that the idea, we would have gone for many simpler and more commercial initiatives…this has been 2 yrs in development so we are not out for quick bucks! Our initial target is the top 20% of the population with private health insurance, but we are also talking to public health officials in these countries to make versions available to their public health patients…also those in HMO’s will have a program for them as well… we believe that everyone has the right to the best care available with or w/o money….’no person left behind’ …”global care, everywhere” is our motto… Thanks to all, I am overwhelmed by your response and remain grateful, please keep connected and let me know any other comments or ideas you have God bless you all and thanks, JOE! LIN Joe Hage Gary Rosensteel On another note, I believe Lin has to decide which business model he wants to pursue. The first is performing the analyses, while the second, completely different, is providing a platform to facilitate international medical cooperation. I’ll assume the first has a path to profitability, but I strongly believe the second could be (from an investment standpoint) a home run; if not a grand slam! Zaffar Hayat Leena Pradhan-Nabzdyk Clark Celmayster Bottom line, as long as it isn’t an additional burden on our newly socialized medicine here in the states and that it is being paid for by the Grey Market, it would seem to be a win, win. Dr. Jeff Birkenmeier Zaffar Hayat These types of consults also provide a potential source of international patients for the white market regions.i.e. patients that require specific treatments only available in these regions. The grey markets become a referral source. I think what is key in this regard, is the utilization of Tele-medicine/EMRs that will play a major role in making this process seem-less and easy to use by both sides. Patient records and test results can be easily transmitted. Live consults between physicians, utilizing various tele-medicine tools make the process efficient and cost effective. Marked as spam
 Posted by Asked on February 3, 2015 1:18 am
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