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Healthcare Weekly: Oncology, ALGN, and AMZN Care

Alyees Qureshi | September 01, 2022

This past week at Stream by AlphaSense we’ve seen oncology become a trending topic in the transcripts and a few more of my favorite trends circling back to me. This week we’re discussing new developments: Trabecta (new lung cancer drug), Hologic Inc (HOLX), Takeda Pharmaceutical (TAK). We’ll also be circling back to Align Technology (ALGN) and Amazon’s (AMZN) acquisition of One Medical (ONEM).

Keep reading for sneak peaks and a deeper dive of the transcripts below. You’ll have to sign up for a free trial though if you want the full tea though. (“Tea” is short for transcripts now…I’m starting that trend.)

Top Six Transcripts of Last Week

Top transcripts by engagement per user

  1. Novartis Inc (NVS): Oncologist Sees a Limited Role for Tabrecta in Treating Patients With NSCLC
  2. Hologic Inc (HOLX): Former VP Believes the Growth Rate of HOLX’s Diagnostics Business Is Structurally Higher Post-Covid
  3. Thermo Fisher Scientific Inc (TMO): Customer Expects Next Mass Spectrometry Purchase Will Most Likely Be TMO Despite Some Concerns About the Platform
  4. Takeda Pharmaceutical Co Ltd (TAK): Former Business Unit Head Thinks TAK Is Losing Market Share in Plasma-Derived Therapies as Novel Therapies Displace Traditional Ones
  5. Novartis Inc (NVS): Former Customer Believes AAV LNP and Base Editing Are Exciting on the ~3-5 Year Time Horizon

NVS has the highest engagement I’ve ever seen in a transcript and it ranks twice in just the top 5 alone. Apparently Tabrecta has brought forth bearish sentiments among NVS experts.

Looks like Tabrecta is a compelling treatment option for lung cancer…if the patient has enough time for the drug to take effect.

“I think it is a compelling treatment option for one particular reason…If the patient had the insurance to cover it and I thought that their disease was small enough that I had that two to three months in order for it to have some efficacy, in other words, a small amount of disease, maybe in many different places rather than one large tumor. Then the answer is yes. If I’m dealing with bulky disease, then the answer would be no. Just like I wouldn’t use hormones in a bulky disease, I use chemotherapy first in an attempt to shrink it and then to use this agent on top of it.”

Medical Oncologist and Cancer Epidemiologist, Private Practice

Although this oncologist isn’t off the walls excited about it, but they’re not really excited about anything. (Neither am I to be honest…expert if you’re reading this let’s be friends.)

No. I’m not excited about it at all. I’m not excited about anything. If you can’t cure a patient or at least give them a long survival with normal function, to me, this is, ‘Okay. Move on.’ We do a wonderful job. We really have done a great job compared to my 30 years in practice, 35 years actually starting in academics, in the adjuvant setting in early-stage disease. We’re still doing a lousy job with the exception of breast and solid tumors advanced disease because we’re not curing anybody. We’re not putting them into long-term remission.

Medical Oncologist and Cancer Epidemiologist, Private Practice

Another expert brings up a similar sentiment regarding cancer treatment in the second NVS transcript ranking in the top 5. This gene therapy researcher is unimpressed by cancer drug innovations because they often don’t work for humans. Unfortunately for pharmaceuticals, we evolved from mice and monkeys eons ago.

“The ideas which will work in mice and monkeys will be successful, but in humans, the entire complexity is entirely different level, so there, the idea doesn’t work. It means that it’s a big loss.

Until it works in humans, we cannot say that this technology will create a revolution in the pharmaceutical industry. All the ideas, if you could talk to any professors or any industry startup company, they say that this idea is going to change in that pharmaceutical industry. They have been saying this for ages. They say this for cancer drugs.

Whenever they invent or discover something new, they always say that it is going to change the pharmaceutical industry, but as of now, nothing has changed. Still, they are doing the same thing. In humans, the complexity is much higher. That’s where the bottleneck is and they can’t achieve what they think they might be achieving based on basic research.

The best example would be cancer drugs. They figure out, read, I don’t know, how many millions of publications of small molecules which could eradicate cancer, but still now in the clinic, we don’t have any small molecule drug to eradicate cancer. I learned that all the small molecules, all those publications, everything worked in small mice, monkeys but didn’t work in humans.

Senior Research Investigator of Lead Gene Therapy, University of Pennsylvania (Prior)

Important to note, the former Vice President of Operations at HOLX VP believes that the pandemic had some positive impacts on the growth rate of HOLX’s diagnostics business. HOLX is gearing up to be the women’s healthcare company and is on an acquisition conquest.

Hologic is positioning themselves as the women’s healthcare company…Their passion is to basically help the woman, their purpose is to make the woman’s health healthier…

The third biggest thing is, of course, they have created a lot of cash as part of the COVID product. The margins were 80%, 75% [revenue] margins. They’ve really, really created a lot of cash. Because of that, they’re also in the acquisition [spring] mode. They acquired about three companies, primarily in women’s health care in the last, I would say a year or 15 months… They also acquired a company called Biotheranostics, which is basically a more cancer diagnostics specialty. The strategy is women’s health plus diagnostics.”

Vice President of Operations, Hologic (Prior)

The former Head of Immunology at TAK believes that it won’t have any major blockbusters in oncology. (Is being a blockbuster still a good thing, considering a BlockBuster isn’t really a blockbuster anymore?)

“If you look at the plasma-derived therapies, there is really strong dominance of Takeda because they are pretty much just four big players on the market with plasma-derived therapies. There is no one new can enter the market because no one new is having access to plasma or the market.

They have quite big dominance over there, but they are losing the market shares because for many of the drugs which in the past could have been treated just by plasma-derived therapies, they might be treated now with some novel therapies like immunotherapies or monoclonal antibodies. They are losing market share in this space.

On the other hand, the company is lacking the pipeline, so they will be losing in the future. For the rest of the portfolio, the company might be, for example, growing in oncology. The company is having some new drugs even in the pipeline. On the other hand, these are not the big oncology products. These are not for the big oncology indication. They will not be blockbusters. If you look at Takeda, you don’t see any blockbuster in the next five years, according to the FDA and according to what the analytics are expecting.

Business Unit Head of Immunology, Takeda (Prior)

Top transcripts by unique users

  1. Align Technology Inc (ALGN): Emerging Market Orthodontist Expects Aligner Penetration Will Grow Meaningfully but Thinks Some Markets Are Very Price Sensitive
  2. Cigna Corporation (CI): Former VP Thinks There Is a Huge Opportunity Combining the Consumer Experience With Strong Clinical Outcomes
  3. Johnson & Johnson (JNJ): Former Sr. Director Sees a Lot of Potential in the Carve out of JNJ’s Consumer Business  but Questions Whether That Potential Will Ever Be Fully Maximized
  4. Dexcom Inc (DXCM): Former Director Is Bullish on G7 and Long-Term Growth for Continuous Glucose Monitoring
  5. Thermo Fisher Scientific Inc (TMO): Customer Expects Next Mass Spectrometry Purchase Will Most Likely Be TMO Despite Some Concerns About the Platform

ALGN landing itself in the top spot this week is another eureka moment for me because ALGN is another trend that I’ve been following in the Stream transcripts for a while. There was so much to discuss that I’ve already split it up into two posts for you: Impact of Economic Downturn on Clear Aligners and The Binding Effect of ALGN’s iTero Scanners on Orthodontists. Check them out!

But first let’s see what our newest ALGN expert has to say about it.

I obviously feel that Invisalign because they’ve been in the industry for the longest time, for any kind of challenging cases, complex cases, I would definitely promote Invisalign because that’s a little more safer grounds even as a clinician to go ahead with. You end up getting better and predictable results with Invisalign, whereas if it’s a very basic, simple case of mild amount of crowding or mild amount of spacing, then it really depends on the patient as to how willing they are.

When I was working in Kuwait, that time it was a lot better. The money was not the issue. It was not a very price-sensitive market. They were a very brand-conscious market. There, yes, patients would come seeking only Invisalign. They would come and not say aligners, they would say Invisalign, then you have to consider accordingly. Still for complex cases, cases that I know that the teeth movement that I want is complex, the amount of torque I want is very sensitive in glass, these two cases, you really need to go for something that you’re very sure about. That would be Invisalign.

[Invisalign] can do 100% of the cases. Any case that you as a clinician are confident that an aligner would be able to do, either stand alone as an aligner or as a hybrid case with fix braces for some time and then aligners, all of them, 110%, Invisalign can do. I don’t think there is any case that Invisalign cannot do as long as a clinician, you are convinced about it, because at the end of the day, you go on the Invisalign site and you make the teeth movements.

Orthodontist, Smiles.ai (Prior)

And that pretty much adds up to what most experts have said in the past in regards to Invisalign. While the product is expensive, it’s incredibly reliable and the industry standard for a reason. Most orthodontists don’t see themselves moving away from Invisalign because of its track record of success in complicated cases. ALGN needs to sponsor Stream at this point considering how much I’ve written about them.

Moving on to another recurring topic here at Stream is the ONEM acquisition by AMZN. The former Vice President of National Sales at Cigna thinks ONEM’S high touch model won’t be affordable for everyone.

“For the most part, you get an Amazon package on your porch and you get a happy feeling. You’re never mad when you get an Amazon package because you’re like, “Oh great, it’s exactly what I ordered. It’s here in two days.” I think that a lot of employers evaluated it because they wanted to evoke the same emotion from Amazon Care. If I have an Amazon in-person care show up at my front door, I feel good about my employer. They’re coming here to help me and now I’m happy that my employer provided benefits…

One Medical has the reputation of this really high touch, like I said, concierge primary care. I’ll go back to what I said earlier about Cigna. We prefer innovative clients that are not afraid to grow and learn with us. Where I think that One Medical combined with Amazon Care or Amazon, whatever, there’s a number of health initiatives going on, it’s going to be this concierge high touch and it won’t be for everybody. There are really great organizations out there that are looking to really have the most robust benefits portfolio. There’s other groups out there that quite frankly won’t be able to afford the high touch One Medical model.

-Vice President of National Sales, Cigna (Prior)

I mean I love getting AMZN packages at my doorstep but I don’t know if I’ll ever feel the same about seeing my AMZN doctor. Either way, I’ve touched more on Amazon’s Fearsome Takeover of Telehealth and Austin previously begged the question “What Does ONEM Bring to AMZN?” on the blog.

I’ll be honest, there’s plenty of more good stuff in these top transcripts but you’ll just have to sign up and read them to find out. Because reading is what? FUNDAMENTAL. (Okay only a handful of you will get that reference but high five if you did!)

Stay tuned for Healthcare Weekly here at Stream by AlphaSense!

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