AI is having its moment in all industries, including healthcare. In this episode, hear how AI-driven tools can help oncologists treat patients. , CEO of , talks about the role of AI in care and how it helps doctors do their jobs. And Terry and...
AI is having its moment in all industries, including healthcare. In this episode, hear how AI-driven tools can help oncologists treat patients. Navid Alipour, CEO of CureMatch, talks about the role of AI in care and how it helps doctors do their jobs.
And Terry and Bob dive into the latest healthcare headlines, including Mark Cuban’s Cost Plus Drugs’ expansion into brand name medications, how a MedPAC decision could threaten patient access to Part B accelerated approval drugs, and ProPublica’s report on insurance claims being denied without being read.
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Artificial intelligence is a tool. It's a very powerful tool, but it's not going to replace the doctor. You need the human intelligence married with artificial intelligence. What does artificial intelligence mean for healthcare? Today's conversation explains how AI tools can help doctors but can't replace them. What that means for the future of your healthcare is up next.
Welcome to the Patients Rising podcast. I'm your host, Terry Wilcox. CEO of Patients Rising. I'm here with my co-host, who's practicing his swing for next year's Master's tournament by hitting matzo balls off a tee. He's Dr. Bob Goldberg, co-founder of the Center for Medicine in the Public Interest. Bob, how did that go? Use your imagination, Terry. The way I cook matzo balls, actually, my drive was pretty good. I almost had a hole in one. But in any event, I'm taking time off from practicing my swing to be on the show because here on the Patients Rising podcast, we cover the healthcare policy news that impacts you. That means the patients and the caregivers in the chronic disease community. And on deck for today's show, Terry, we chat with Navid Alapur about how AI is being used to improve and personalize cancer treatment. Now, he's the CEO of CureMatch. It is a company that does leverage AI to help oncologists match therapies to patients to achieve that goal. So I thought with all the talk about the chatbot and GPT-4 and AI, he explains how it's being used as a tool for providers and doctors today and in the future.
We'll have that conversation up shortly, but on a side note, how many of you have had an insurance claim denied? I'm sure I can't hear all of you, but I'm sure it's many. I can speak for everybody, yes. We have. A new ProPublica investigation shows that Cigna, one of the largest health insurers in the country, has denied patient claims without even reading them. We'll get into that story along with recent news on how Mark Cuban's Cost Plus Drugs has expanded its prescription drug offerings beyond generics. Now patients can access certain brand-name drugs without going through insurance.
But first, let's kick off our episode with AI. So, Terry, you know, lots of companies have been developing ways to use artificial intelligence to deliver better care. And let me just give everybody a sort of a working definition of what AI is. AI is the result of the machine learning of large datasets. And machine learning basically is going to find patterns in the data that can be used to either detect, treat, diagnose patients. It's also being used to generate notes from your conversation with a doctor so that you have a transcript and then you can ask questions on the transcript. So AI is being used in some cases behind the scenes.
But here is a company, Curematch. The CEO is Navid Alipour. And just for everybody's reference, we had the founder of Curematch, Razel Kurzak, on, I think, last year. And Navid talks about how AI is being used in health care to improve outcomes to the patient. You know, artificial intelligence is a tool. It's a very powerful tool, but it's not going to replace the doctor. You need the human intelligence married with artificial intelligence. And so once they see the power of it, that they can use it to deliver better care, they're the one that's practicing medicine. And it's their profession. They're just using Curematch for this augmentative intelligence, so to speak. Just like in the imaging diagnostic space, there's now more and more powerful tools to detect cancer from images earlier and better. I mean, we have our sister company, Curemetrix, where just like Curematch was the first in history to get the CPT code from the AMA, Curemetrix had the very first FDA clearance in the breast cancer diagnostic space for computer-assisted detection in late 2019. That's not going to replace a radiologist. In fact, we have a shortage of doctors, but they use it to process more mammograms faster and get to the patients that have cancer earlier. So what they've done at Curematch is they've used this artificial intelligence and machine learning of all the different types of treatments, matching it with the tumor profile to help doctors pinpoint the best therapy options for patients. So molecularly, no two lung cancers, breast cancer, brain cancer, et cetera, will ever, ever look the same. So that's where to truly deliver real precision medicine and that augmentative intelligence as the American Medical Association has created this new category, which we're the first company in history to get the CPT code on, that's where we augment that doctor's intelligence to sift through all that data for a three-drug combination, two-drug or three-drug. There's millions of possibilities. That's beyond human cognition.
So that's where we come in and say, based on patient-specific next-generation sequencing panel, and we're agnostic, is it Tempest, is it Guardant, is it Foundation, is it Keras, is it Invitae, is it the community hospitals, own NGS lab, as a lot of them are building up their own labs, as you know, to maintain that revenue stream themselves instead of using one of these other parties. But based on that specific next-gen sequencing panel, the drugs available, on-label, off-label clinical trials, here's the recommended three-drug, two-drug, one-drug for this specific patient. This technology finds the best data by analyzing a vast amount of cancer research and data about the tumor as well. We base it on, again, this curated database and this engine we've built, this proprietary college database that we're always shining the apple on, we're always curating. So we're not stopping. If anything, we're curating faster and faster and faster. And it includes open source information.
So if a new drug is FDA cleared tomorrow, we could add that tomorrow, and it'll be included in every single CureMatch report that goes out. So that's open source information. And so as there's new drugs cleared, as there's, let's say, a new research publication done, we're always looking to then add that. So, Bob, when this curates, it's curating everything. I just heard him say, a new research publication, a new approval at the FDA. Is it also curating what has worked for some patients in the past and not? I mean, what all is it curating? Can you sort of give our audience... Yeah, so what they do is they look in the literature for research that shows that certain mutations are responding to certain cancers. And that information is then matched to the analysis of the tumor that people undergo. So someone gets a tumor profile, they'll get the results back, they'll send them to CureMatch. The CureMatch will run it through their AI matching system and come up with not just one treatment, but different combinations of treatments based upon the different mutations that are involved in cancer. The one drug, one mutation approach, you know, has been found based upon the AI and the research that Rizal has done to be fairly limited relative to the saying, well, if I can find three mutations and I can find three drugs to attack those three mutations, I'll probably have a better outcome.
So what happens is it has more information about outcomes is generated in the literature is generated. But you're sort of raising another important question, Terry, that is, you know, when do we start integrating, you know, the real-world data from patients? And that's really something that CureMatch wants to do, but it's really a function of bandwidth and, you know, raising the capital to do so.
So everyone will have a link to this story and more in the show notes.
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Lately, we've seen the emergence of new ways to access prescription medications without going through insurance and middlemen, a big plus from where we're sitting. One of the most popular innovators is probably Mark Cuban's Cost Plus Drugs for a variety of reasons. That's Mark Cuban. They started off with generic drugs, but have since announced several name-brand drugs for type 2 diabetes, showing that this pharmacy model is taking off. I mean, they are every... I mean, Mark Cuban is Mark Cuban, so he's already been in the news. He's a celebrity. And to give credit to other companies that are doing this, there are other companies doing this as well, but Mark Cuban is obviously getting the most bandwidth as far as the most publicity, and I am grateful for that because it's allowing the public to get more engaged in what's happening, right? Yeah. Yeah, he sort of makes it accessible to everybody. And I'm glad... I mean, look, the Cost Plus Drugs is doing great, doing a lot better than the Mavs are since they got Kyrie Irving. But, you know, you can't bet a thousand every time, Terry. What can I tell you? This is really good news. Eliminating anything that eliminates middlemen is good news. Well, just as an aside, I think it may be related. Now, Amazon Pharmacy announced that they will be using copay coupons. They'll apply them directly to the patients for them. So they'll go out and do the searching and link you. So if you have to pay out of pocket for a drug and you're lucky enough not to have one of these thieves called the copay accumulator, Amazon will eliminate the muss and fuss of paying for it. And I think what Mark is doing is doing it from another angle, which is saying, listen, here's the price and we're going to make it affordable for people to take on a regular basis, which is great. Now, I know that this was a great topic, talking about eliminating the middlemen, you know, making things more accessible for patients. I know you have a topic you want to talk about today that's not necessarily going to be doing that. Yeah.
So the Medicare Payment Advisory Commission, which advises Congress on making any legislative changes to the operation and the structure of the program. There's a sister organization called the MACPAC, which is Medicaid. But the troglodytes who have been trying to choke off access to innovation to patients, you know, have been peddling this idea of, well, accelerated approval isn't really full approval. Therefore, you know, we should pay the companies less or charge more in rebates until that approval is granted. We have made it clear on this show, it's very clear, accelerated approval is approval. I mean, it is approval. Yeah. I mean, we have the former commissioner of the FDA who said, this is not consolation approval. This is real approval. It's approval that's accelerated because the evidence of the mechanism of the drug working on the disease is so overwhelming that it would be criminal not to make it available sooner. The whole accelerated approval program came out of HIV. And we use there a surrogate marker. Surrogate marker is instead of measuring the change in disease, you measure a blood level or a virus level that shows that you're getting healthier. That's reliable. We do it all the time. And, you know, if you have a strep throat, you do a swab and that swab tells you if you have a virus or not. That's what accelerated approval is, a faster way using better technologies to get better medicines to people that need them the most faster than before.
So last up on the docket for today, and an important read for any patient who has had to file an insurance claim, ProPublica published a piece that revealed Cigna, one of the largest insurers in the country, has denied millions of claims without even reading them. This piece, literally, in many ways, it broke my heart just because people are so… Callous. Yeah. I mean… How could you work in a job… You know what? Your job is not to read claims and we'll pay you not to read claims. And what that does is it gets your work done faster, but obviously you're defrauding people of their rightful reimbursement of medical procedures. Yeah, I mean, just for it to be that callous and cold… I mean, and Wendell Potter talks about this, which is why, for those of you who don't know Wendell Potter, we'll link to him, because Wendell Potter was a whistleblower in insurance. And he is now totally on the other side because of it. You know, he just couldn't do it anymore. He couldn't stomach it, right? And there's a lot more to his story than that, which we'll share with you if any of you are interested. But this is bringing that home. I mean, it's really showing us, you know, this is what it is. And I've always said this. It's all a numbers game. It's terrible for patient access and it's why we do what we do every day, right? This is very revealing of what our current state of insurance looks like and why we need things like the patient helpline and, you know, why there's all kinds of copay assistance available. It has to be there because insurers have a way of operating. They have a business model and they are really, I'll be quite honest, unwilling from where I sit to really change it.
Now, as always, we have links to all of the stories mentioned in the show notes.
Thanks for listening and be sure to share the episode with fellow patient advocates. This helps us grow our audience. Yes. And click the follow button so you stay up to date on our latest episodes. And join us again next week for another episode of the Patients Rising podcast. Until then, for Bob and everyone at Patients Rising, I'm Terri Wilcox. Stay healthy.