In this week’s episode, journalist Christina Farr gives her shortlist of the companies to watch from CNBC’s Disruptor 50, relays riveting first-hand accounts from heroes on the front lines of the pandemic, and weighs in on why the road to effective contract tracing in the United States is proving to be a not-so-simple path.
Jeffrey Freedman: Hello and welcome to the RP HealthCast by RooneyPartners. I am your host, Jeffrey Freedman. As we continue our Novel Coronavirus Series, today we are going to take a look at the pandemic coverage from a different angle. While biopharmaceutical companies continue to work on the front lines to find a cure or vaccine for COVID-19, there is a whole set of medtech and AI companies that are developing technologies to assist in everything from patient care, to access to medicine, to speeding up drug discovery, and to modernize in clinical trials. And to talk about this, I am excited to say we have as our guest this week, Christina Farr.
Jeffrey: Christina is an award-winning technology and healthcare reporter for CNBC, based in San Francisco. Prior to joining CNBC three years ago, she was a senior writer at Fast Company covering biotech and health tech and she was a reporter at Reuters News. Christina, thank you so much for joining us today.
Christina Farr: Thanks for having me.
Jeffrey: Yes, so before- while preparing for our interview, I did my usual homework, but I ran across an interesting fact that I had to ask you about before we talked about your reporting. Now, you are an award-winning health tech and medtech reporter based in Silicon Valley. You are at the heart of high technology, the discovery and all the funding. But the interesting fact was, you are an amateur historian, from what I read. That is kind of ironic, right? A paradox. Can you tell us a little bit about that?
Christina: Yes, absolutely. So I actually, originally, I am from the UK, if you cannot already tell. So I had aspirations to be a historian when I was younger, and I went to University [inaudible] in history and I did a masters in 19th century history. So, that was going to be my career, and then I ended up getting involved with the university magazine and newspaper. Basically, had a change of heart where I decided that I was really passionate about journalism, and so I ended up doing- pursuing that. Somehow ended up in California, just being here exposed me to the tech scene and particularly the Medtech scene which from the beginning, I found most interesting. That kind of led me down that path but I still love history. I read a ton of biographies. It’s definitely my first love. I think it’s good to have kind of a mix of things and to look into the past as well as kind of focusing on the future.
Jeffrey: It’s true because it seems like we come full circle in life. I mean, what’s past is also becoming the future again. Alright, so let’s talk about some of your recent stories. Every year, CNBC issues a list entitled the ‘Disruptor 50’. It’s CNBC’s annual take on the private venture backed companies, the ones that transform our economy and the way we live. Now, you wrote about a company called ‘GoodRX’. It was really interesting, you drew out the following quote from the CEO and I’ll quote, “If America as a country decided to keep all Americans healthy and things were up-front and transparent, there would be no need for GoodRX.” Now to me, that’s really interesting and it’s also really sad that same time. Can you discuss a little more about everything, about the Disruptor 50, why GoodRX qualified and explain how the list is developed.
Christina: Yes, of course. So we do this Disruptor 50 list every year and this year was a bit different because we couldn’t do any in-person events to celebrate some of the folks that made it onto the list, but they saw the opportunity to be on TV and talk about their businesses and also we did kind of some profiles on the reporting side of the companies that we knew [inaudible] and found most interesting. So there’s a lot of things that go into choosing these companies. There’s judging panels and the reporters also get involved and it’s a whole process. It’s something that CNBC takes really seriously and they invest in. I think they’ve definitely picked out some good ones in the past and we’ve seen them go on to become big public companies. So it’s sort of our way to make sure that we know some of the founders before they end up as public companies and that CNBC has those relationships early on.
In GoodRX, which you mentioned, I definitely think it’s going to be an IPO contender on the very near future. It’s a company that’s been profitable for a long time actually since 2013 in the drug supply chain, essentially just offering kind of drug discount cards and coupons that people can use at the pharmacy. I love that quote that you brought up because that actually is true of a lot of healthcare technology. It exists because the US healthcare system is so messed up. Many of these companies wouldn’t exist in other countries. You couldn’t take the GoodRX model and bring it to the UK because we have the NHS and we have a single-payer health care system. So everything is a lot more transparent and accessible and you just go to the pharmacy and pick up your free medication. So that obviously, that wouldn’t work there. So I like that they acknowledge that and I like that they said, “Frankly, if the system does get better and there isn’t a need for GoodRX, we’ll move on. We’ll go do the next company.” I appreciate that kind of– that frankness and that kind of honesty from founders. It’s not what you usually hear but I think it’s extremely true.
Jeffrey: It is refreshing, but it’s interesting that their business model whereas, they make a good percentage of its revenue from PBMs, pharmacy benefit managers, right? And these PBMs, they’re kind of the middlemen in the pharmacy to pharmaceutical world. Some people say they’re one of the main reasons pharmaceutical prices are so high. So, isn’t it a bit ironic though that GoodRX’ business model is based on getting patients lower-cost prescriptions, but they’re making their money from the people that are raising the prices? They’re the reason why the prices are high. So wouldn’t they be like contributing to part of the problem rather than the solution or am I looking at it incorrectly?
Christina: Yes. This is a really interesting point. I actually did– I talked to someone who’s a drug supply chain expert, who completely agreed that the PBMs are a huge part of the problem of why drug prices are so high and it’s not just them I think, every entity within the system has a vested interest in drug prices going up every single year, except for obviously the consumer. So, there is a little bit of an irony there. Unfortunately, I mean, without GoodRX, if you go to a pharmacy and you do not have health insurance or you have a super high deductible plan, you could end up paying the sort of UNC price which is kind of that highly inflated price that you get quoted if you show up and say you do not have insurance. Most people can’t–what if people can’t afford that? They’ll simply turn around and walk out. So that’s the GoodRX value problem.
The pharmacy side is they essentially tell pharmacies, “We’ll make the drugs affordable enough that at least you can start to even have a transaction…” rather than having the patient simply walk out. On the PBM side, they’re happy to work with companies like GoodRX for the most part although some are starting competing services because it means that people that are outside of the insurance system can still flow through the PBM and they can take a cut of that transaction, and the cuts are obviously very big. In some cases, pharmacies will even lose money when a patient uses a discount card. So, it’s all just very convoluted and complex. I think that’s why they freely recognize that if things weren’t that way, then there wouldn’t be a need for them to exist.
Jeffrey: But they’re helping out the consumer at the end of the day. So I think that’s great. What other Health Tech or Medtech companies that are also on the Disruptor 50 list that stood out to you?
Christina: Yes, great question. I did a few more profiles of different companies that I– for me, it’s just great because I have an excuse to kind of dig into some of these businesses when the rest of the year there’s news. So Ginkgo Bioworks is another one, really interesting company in the synthetic biology world, which I have covered kind of on and off. This a company that sees themselves as doing a lot, I think during this COVID-19 pandemic and they’ve really kind of shifted their focus to that. So, I talked to them about how they’re going to use their technology that previously was primarily for things like Agriculture and Cosmetics to now, is there a way in which they could ramp up to developing half a million COVID-19 test per day? And I think that it’s very possible they achieve that. They’ve got a lot of money behind it and they’re absolutely correct in thinking that we do need a lot more COVID-19 tests, a lot and lot more. I think we’re at something like half a million a day now. We need way more than that, especially as the country starts to reopen.
So that was another business and then I also looked at Healthy.io, which does at home urine analysis tests and things like that which people kind of bucket into this whole idea of remote patient monitoring. I think is going to explode during this pandemic because any way that you can keep people at home and getting the diagnostic tests and doing the monitoring is much better than having them come in unnecessarily and risk exposure. So we definitely look to add a lot of those sorts of companies as well to the list.
Jeffrey: Yes, I think the more that we get used to doing stuff at home like Telemedicine as well, I think vast majority of this stuff is going to stick and people are acknowledging and enjoying the aspect of the freedom of doing it that way. So I think those are great. Yes. All right. So let’s switch over to some of your Coronavirus coverage right now. You recently wrote a very moving piece about a handful of San Francisco doctors from the University of California, San Francisco Hospital System who flew here to New York during the peak of our COVID-19 outbreak. You reported though that they mentioned this was some of the most horrifying and challenging experiences that they ever had. Can you talk about some of the stories they shared with you and what they learned from this experience?
Christina: Oh yes, I mean just talking to them, at one point I kind of broke down into tears, honestly. Just hearing some of their stories, it was so harrowing. The fact that they would choose to get on a plane and go over there in the height of a pandemic, when we know that doctors and nurses and other hospital personnel are dying. I mean, that’s just incredible. It’s heroic frankly. I think that’s another reason why I wrote this because they’re out there risking their lives and this at a time when a lot of people just refuse to do the simplest things that they’re being advised to do by public health. When you contrast that to some of these doctors, it’s scary. So their stories was just very sad.
The thing that stood out to me in all of it was, some of the patients that they saw we’re just to learn for a lot of this process because at that time especially in New York, there was a shortage of PPE. So, doctors were having to reuse it and so nobody would be able to visit a COVID patient and just sit with them and keep them company because that would require using PPE. Their family members couldn’t see them either. So one of the doctors told me that they had one iPad on the floor that was just being passed around and all the doctors would just do their best to call up the patients’ families and give them updates by this one iPad and sometimes they’d have to share that the patient had died. Oftentimes, the families hadn’t even seen them in weeks.
So yes, I mean it was, it’s just awful and most of us have no idea what would COVID really looks like because we’ve never had to see it. But for these physicians, many of which– they were trained, they’re pulmonary and critical care docs. So they’re trained to see people in a really terrible, very sick, like extreme stuff, they’ve seen it all. But having to treat people in a pandemic situation where the virus is so new that we’re still learning what treatment protocols can even work. I mean, they felt helpless a lot of the time which is different than most of the experiences that they have. This I think was harder for them than almost anything else.
Jeffrey: Yes. I mean when I spoke to some of the other hospital workers and– it was so appreciative to people that were coming from out of town, out of state. And yes, you did use the right word in heroic and that they were. Did they think, did they express to you that the experiences that they had in New York were kind of a harbinger of what they thought was coming to other parts of the country? Or was New York more of an unusual Battle Zone, offering them a chance to a whole new skills before they return back to California?
Christina: Yes, so I asked all of them that question and they stressed to me that they’re not public health professionals, they’re doctors. So, they couldn’t tell you by looking in the data what were likely to see but they all expressed concerns about in New York happening again. As I was interviewing them, we were starting to see in certain States, just spikes and more cases being reported in record numbers. I mean, there’s definitely States now that a very worrying including Florida and Texas and a few others.
So there was a massive concern that something like New York could happen again. The thing about New York that was so terrible is just that these health systems were completely overwhelmed. There’s only so much capacity. There’s only so many beds, and there’s limited space within the ICU. So this is something that I think we’re all tracking now is, is there enough capacity within the hospitals for these patients in some of the States where you are seeing an uptick in cases? And then, what does this look like come the fall and winter? Is there a second wave? And no one can really know yet, but the predictions that were seeing do not look great and we’re going to be asking these doctors to go out and risk their lives again, and they all said that they are all very willing.
Jeffrey: That’s incredible. Yes, I mean, were three months in and all we know is that we do not know enough and it’s scary, it is crazy. All right, last topic. Switching around a little bit. In April, you wrote a very in-depth piece reporting that Apple and Google were joining forces to create a partnership designed to bring contact tracing to our smartphones. I think you said Apple called it ‘project bubble’. Okay.
Jeffrey: Now, it was pretty big news at that time and in fact our podcast here, we talked about it back then. But that was two months ago and I haven’t really heard anything further about this technology. At that time, two months ago, we were led to believe that contact tracing was necessary and it was the only way we might be able to quickly get back to a normal lifestyle without a vaccine. Now, what is contact tracing as a technology? Where does that stand? Is anyone using it?
Christina: Yes, I mean, I think the reason that you haven’t heard that much about it is because you are in America. So, in other countries, contact tracing, especially using smartphones is really full steam ahead. Especially in Europe and in parts of Asia, you are seeing literally millions of contact tracing apps. I just saw a story from two days ago that when Germany introduced its contact tracing app, it was downloaded six point five million times within the space of several days. I believe even the first twenty-four hours since the launch.
In America, things are just not moving particularly quickly and only a few states have even started to build contact tracing apps. For those who do not know what that is, it’s basically a method of trying to understand who’s been exposed to COVID-19 by– if you have someone diagnosed positive, who have they been in close enough contact with that they may have given them the virus and then trying to sort of ask those people to get tested and potentially to also quarantine themselves.
So it’s a method that has been around for a very long time. In the HIV/Aids era it was used–that we use a term more of a partner notification, which is a bit softer sounding but it was essentially the same idea, who’s potentially been exposed? Now we have this way of sort of upgrading it by using smartphones to see who’s been in close proximity using kinds of technologies like Bluetooth to see who’s been within– who’s not been social distancing. We do not know yet whether these electronic methods are going to be more successful, if they’re going to work better than just traditional contact tracing which is just boots-on-the-ground epidemiology. I think it holds a lot of promise and it’s unfortunate that in the US, almost no States have really made significant progress. Whereas in other parts of the world, they’re full steam ahead and people are kind of eagerly downloading these apps just to do their part.
Jeffrey: Yes. I mean you are talking about in our country, unfortunately, we have people that won’t wear face masks on airplanes, people that are not happy to come on board for the social good of others– certain people, certainly the very small minority. But do you think Americans’ views in general on privacy rights are so different than the rest of the world and that’s the reason for lack of adoption?
Christina: [Inaudible] piece of it, there’s also been some challenges along the way just with science communication. The whole issue of wearing masks has been fairly confusing to people because they got some of the guidelines have shifted. There hasn’t been like a great amount of education on just the fact that it’s actually okay for scientists to change their minds. I mean, this sort of part of the scientific method. You are allowed to say, “Based on new evidence, I am shifting. I am shifting my point of view and I am now recommending this when I wasn’t previously.” So that’s kind of been part of the issue as well. People just think it’s inconsistent, it’s unreliable. They do not know who to trust.
We also haven’t seen from the federal government here in the US, kind of as much of a sort of clear, like I said, communication as you would expect. In prior pandemics and epidemics, you definitely saw the CDC take a really active role. Daily briefings, constant updates with the press. In this pandemic, we went about three months without hearing really anything from the CDC. Most people in this country couldn’t even tell you who the director of the CDC is because they’ve been so quiet. So I think that’s been a problem that we sort of left it up to the States and each State will have their different sort of political views and each State will have their own challenges. What we really need is something very science-driven and centralized like you’ve seen in other countries in order to have kind of a strategy that will work across the country, because we can’t just do state-by-state, people are moving around and going from one state to another. So I think we need both.
Jeffrey: It is such a confusing topic for people but there’s some simple answers or simple things that we could do that hopefully everybody will undertake. It’s just common sense a lot of it, but Christina, thank you so much for your time today. This is really interesting, and it was great to have you here.
Christina: Thank you so much for having me.
Jeffrey: We hope you enjoyed this week’s podcast. If you have any questions, comments or a future story suggestions, please reach out to us on social media. Thank you, and we hope you enjoyed the RP HealthCast.