Growing Role of Compound Pharmacies in Precision Medicine with Kurt Lunkwitz ProRx Pharma

Kurt Lunkwitz, Chief Operating Officer at ProRx Pharma, describes the role compound pharmacies play in filling gaps when certain drugs are in short supply and providing personalized medications for patients. Compound pharmacies offer a wide range of customized formulations and delivery methods to meet the specific needs of patients, particularly in the areas of functional and preventative medicines. These pharmacies are enabling a shift towards precision medicine and individualized care, responding to the market demand for alternative and preferred formulations of medications.  Kurt explains, "There's primary clientele and then there's secondary clientele. Our primary clientele includes a host of prescribers, medical clinics, and could be telemedicine-type companies, and med spas. There are tens of thousands of these types of practitioner offices across the country, and it's a wide and booming industry as it relates to functional medicine, alternative medicine, or as we like to refer to it, preventative care. And the secondary customer would be the patient themselves. So the medications that ProRx is compounding would be ordered through these physicians’ offices, these practices, and for their particular patient and customer base." "One of the primary functions in the role of a 503 B outsourcing facility, or a number of them across the country, is to step in and fill this gap. If the primary manufacturer, the pharmaceutical manufacturer, has a disruption in the supply chain, or simply just can't keep up with the demand." "If we want to take a look at one of the largest supply chain gaps that has existed, and it's been a very popular topic of conversation here more recently, this would relate a lot to some of the GLP-1 medications, both semaglutide and tirzepatide. So these were two medications that ProRx participated in and helped to fill the shortage gap. There were a handful of months where ProRx went into production, and we helped to fill tens of thousands of prescriptions for patients of medical necessity who badly needed these medications."  #ProRxPharma #CompoundPharmacy #DrugShortageList  prorxpharma.com Download the transcript here

Amanda Wiggins is CEO of cGP Lab, a New Zealand-based company that is commercializing cycline Glycine Proline, cGP, a dipeptide molecule that helps regulate blood vessel formation. The Lab is pursuing a medical food regulatory pathway to bring its cGP-based products to the market for the dietary management of peripheral neuropathy and other vascular complications of type 2 diabetes and is exploring the potential for Parkinson's disease and other dementias. The Lab sources cGP from a combination of New Zealand blackcurrant and beef bone collagen using a proprietary manufacturing process. Amanda explains, "The cGP Lab is a relatively new company. We were formed in 2020, and our mission is really to commercialize a really interesting dipeptide molecule called cycline Glycine Proline, or cGP for short. Although we're new to commercializing it, there's quite a huge body of evidence that sits behind where we've got today. Our Chief Science Officer, Dr. Jian Guan, has researched cGP for around 30 years. It's her life's work. What makes it really interesting is that cGP exists in all of our bodies. It's an endogenous molecule, but it also exists in some food sources. So we've identified those food sources and we've created a manufacturing process to create a standardized cGP ingredient that we use in our supplement range."   "Like many companies, we were actually founded on somewhat of a serendipitous discovery. So, back in 2016, the founders of the company had done a clinical trial on Parkinson's patients. And in that trial, they'd given the patients capsules containing blackcurrant extract because they were interested in whether blackcurrant extract, which is high in anthocyanins, could address some of the symptoms of Parkinson's disease." "What we've ended up with now is a proprietary manufacturing process that combines New Zealand blackcurrants together with beef bone collagen. And we put those two together through a prolonged heating process. And what happens is that the amino acids, glycine and proline, when subject to heat or, even better, heat and pressure, will cyclise and form the cGP. So it's really that manufacturing process that brings out the cGP. And in that initial Parkinson's study, the level of cGP was actually quite low because that heating process hadn't been done for long enough. So we've come a long way in learning how to make cGP, and it really comes from that combination of New Zealand blackcurrant together with the collagen peptides." "So, where we're seeing it being most useful is right at the start of a peripheral neuropathy diagnosis. So patients often, well, I know in the US anyway, foot checks are generally done annually for people with type 2 diabetes. It's a bit different here in New Zealand. And so that should hopefully pick up the first inklings that someone's starting to develop peripheral neuropathy. And what the path to market that we're seeing for our innovation is called the medical food category, which is a bit different." #cGPLab #cGP #MedicalFood #DiabeticPeripheralNeuropathy cGPmax.com Download the transcript here

Dan Nardi, the CEO of Reimagine Care, is using a technology-enabled platform to support cancer patients and clinicians to extend care beyond the clinic and address the unique challenges of cancer treatments. The evolving landscape of cancer therapies and rise of oral and subcutaneous methods of delivering drug has increased the need for remote patient support and medication management. The use of AI and digital tools provide significant opportunities to help triage patient questions and reports of side effects to provide necessary, timely support from clinicians. Dan explains, "At Reimagine Care, we focus on helping to support providers as they are providing care for patients going through cancer treatment. We built an on-demand cancer care platform that combines technology and an oncology-trained clinical care team. Then we partner with our providers, our oncologists around the country, to help them extend the really great care that they provide for patients in the clinic. We help them extend that and support those patients 98% of their time when they are outside of the clinic. And so that's what we've built, and we've been at this for a handful of years and are very excited about the continued progress." "The uniqueness really stems from the fact that we call it cancer, but it's a combination of so many different types of that disease, and there's so much uniqueness in each one of the diagnoses and the treatment plan. It's not an easy one-size-fits-all model that some of healthcare has. Knee replacements and hip replacements are fairly straightforward and have been done somewhat the same for decades now. But when it comes to cancer, there's so many different factors that go into it, and as we've had such an increase in more of the personalized medicine and the oral oncolytics and the other treatment plans, it's become a lot for not only the patients, but also the providers and the care team to keep up. And so being able to use technology to help bridge that gap has been really impactful." #ReimagineCare #EmpoweredPatient #DigitalHealth #AIinOncology #PatientCenteredCare #HealthEquity #MedStarHealth #PatientEmpowerment reimaginecare.com Download the transcript here

Dr. Eden Miller is an osteopathic board-certified family practitioner, a type 1 diabetic, and Founder of the nonprofit organization Diabetes Nation. The guidelines for injection technique have not been updated in 10 years, and poor injection can lead to improper medication absorption and other complications. The recently released FITTER Forward Guidelines address established approaches for clinicians and patients to improve injection practices, especially for those using injectable therapies such as insulin or GLP-1 agonists.  This initiative was brought together by embecta, which worked with Dr. Miller and other experts to revise the guidelines. Eden explains, "So the FITTER Forward Guidelines are taking the concept of injection technique and injection instruction, and giving it a fresh new look, a new peering back into something that many of us as clinicians kind of feel that we have nailed down. But what we have found with looking into communicating with patients, how to do injections, and how to maximize their technique, we needed to revisit it. So we convened a consensus of experts across many different disciplines of medicine, as well as engineers. We took a look at the data, took a look at the person who's using injection techniques, especially in the field of diabetes, either with insulin or with non-insulin agents. We gave it a fresh new look to help clinicians empower their patients to achieve the best possible results with injectable therapies." "I think it spans the gamut. We always want to start people out on the right foot. The FITTER Forward Guidelines and resources are going to be a great way for our clinicians to freshen up. So when they do have a new patient who is very naive to injection technique, they may have a lot of barriers or preconceived ideas that really get in the way. They think it's going to hurt. They think it's hard to do. They don't know what to do with clothing. They think they have to go into the bathroom to get it done. So we have opportunities both for new users, but we also have the opportunity to go back to established users. " #FITTERForward #Diabetes #Embecta #InjectionTechnique DiabetesNation.com embecta.com Download the transcript here

Dr. Jay Anders, Chief Medical Officer at Medicomp Systems, discusses the issue of dirty data — inaccurate and inconsistent medical data — and its origins, as well as how technology can be used to maintain correct health records. These kinds of errors can lead to incorrect diagnoses, inappropriate treatment, and negative consequences for patients, providers, and payers. AI and other technologies are being leveraged to help identify and flag inconsistencies, providing stakeholders with the tools to prioritize accuracy over efficiency.  Jay explains, "What we do at Medicomp is a clinical knowledge engine with a knowledge graph that's built in that helps clinicians document, sort data, and clean up data. That engine was developed 46 years ago, and it's been done over again in different iterations for those 46 years. We're now incorporating new technologies inside of it to make it more efficient. But we handle medical data in documentation, presentation, and cleanup."   "Well, dirty data has been around since physicians got a chisel and a hammer and etched it in a rock. Because if you think about the old days of dictation, when physicians didn't follow what they dictated or read it very carefully, things got into that medical record that may or may not be correct.  What I mean by dirty data is, does the documentation of that patient's data actually represent what's going on with the patient?" "The other thing that happens, and it's happening more now with ambient listing technologies and other things, is that a family history of a terminal disease will all of a sudden be applied to the patient that's in front of you. So my father had Alzheimer's, now I have Alzheimer's, and it gets into the medical record that way. Gender changes. I have seen this back in the days of dictation, where he turns to her and back and forth again in the same note, which is obviously not correct. So when I say dirty data, that's the kind of thing I'm talking about. Basically, it's incorrect or misconstrued, and it gets propagated through the medical record, and with interoperability, that medical record tends to follow you everywhere you go now, and getting rid of some of that is a daunting task at best."  #Medicomp #MedAI #MedicalRecords #PatientInformation #EHR medicomp.com Download the transcript here

Doug Ryan, CEO of Arineta, describes the advancements in cardiac CT imaging technology and how their ultra-fast scanning is revealing more accurate and higher-quality imaging of the heart. Using wide-area coverage and deep learning image reconstruction, the Arineta platform can detect arterial occlusions and coronary plaque buildup, which is a significant risk factor for sudden cardiac events and is often missed when relying solely on calcium scoring. The development of a mobile cardiac CT scanning unit is improving access to this technology, particularly in rural and underserved areas. Doig explains, "What you're trying to do is to stop the most complex organ inside the human body. The human heart translates, rotates, and beats somewhere between 60 and 100 beats per minute. So you really need advanced CT technology that comprises a great many areas, but the most important things are coverage speed and the ability to reconstruct it very quickly." "You're using advanced algorithms like our DLIR, our deep learning image reconstruction, which focuses on high-contrast, high-spatial, low-noise reconstructions that can then be put into what we call a multiplanar format. So you can look at these coronary arteries from all angles and do the diagnostic." "So it's actually a combination of several things. Ultra FAST is, of course, very important because you are literally trying to stop a bird mid-flight and get an accurate picture of it, but it's also the ability to encompass and see the entire heart in a single rotation. So, one of the secrets of the SpotLight and SpotLight Duo is both the ultra-fast rotation and the wide area coverage that we get with our detector system." #Arineta #CTImaging #CardiovascularDiagnostics #Cardiology #DeepLearningImageReconstruction   Arineta.com Download the transcript here    

Kory Daniels, Chief Information Security Officer at Trustwave,  highlights the unique cybersecurity challenges facing the healthcare industry, particularly in this environment of funding constraints and the increasing sophistication of cyberattacks. Healthcare data is highly valuable to cybercriminals, who can use it for ransomware attacks, identity and insurance fraud, and other nefarious purposes. AI can be part of both the attack and the solution, helping to build in more cyber resilience and awareness about vulnerabilities. Kory explains, "Healthcare is a prime target for cyberattacks for a very fundamental reason. When human lives are at risk due to a criminal objective—which is to make money—they view organizations where human lives are at risk as a greater potential and opportunity. Facilitation of ransomware payments: Ransomware is one of the largest tactics that criminals use to achieve financial gain, but it's not the only tactic they use to achieve financial gain. So, they're looking to exploit the fear and uncertainty, putting patient lives at risk and adding complexity to patient care through their nefarious actions. But also, healthcare data is very attractive for cybercriminals, and just criminal activity in general. And why that is, is that criminals are looking at healthcare data even more so—it's more valuable than driver's license data." "Look at the opportunity of what you can do with healthcare records, and what can you do with PII, Personally Identifiable Information. Threat actors are tapping into this data in several different ways to achieve the additional financial gain above and beyond targeting a healthcare organization with a ransomware attack." "But they're also committing fraud, and fraud toward healthcare insurers, and looking at submitting false claims, fraud against the prescription drug industry in terms of soliciting and looking to obtain prescription drugs through nefarious means, but utilizing data and identity data that comes from hospital and healthcare records. There are a variety of different ways that we've just scratched the surface on, which make the healthcare industry such a desirable target for those seeking to achieve financial gain in the criminal industry." #Trustwave #Cybersecurity #CyberAttacks #HealthcareSecurity #HealthcareIT #CISOInsights trustwave.com Download the transcript here

Matt Brown, VP of Telehealth at Advisory Services at CHG Healthcare, discusses the current state and future of telehealth, including the rapid adoption during the COVID-19 pandemic, the role of technology and AI in enhancing telehealth experiences, and how telehealth can help address physician and nurse burnout. Improved internet access, mobile device usage, and consumer preferences for convenience have driven the increasing telehealth usage for initial visits, follow-up appointments, and chronic care management.   Matt explains, "We are the nation's largest staffing agency. So, we're actually the founders of what's known as the locum tenens marketplace. CHG has been a pioneer in bringing physician services into remote and rural locations across the United States for the past four years. And over the last 10 years or so, we've continued to innovate on top of that physician-led experience and started to bring technology operations, as well as consulting services and telehealth, into the marketplace. So think of us as providing a broad array of staffing services, but also on top of that, technology and operations, and consulting that help the largest health systems in the country manage their physician workforce."   "It's been widely adopted since the pandemic. If you think about coming out of the pandemic, a lot of our health systems and hospitals were really forced to do a few things. One, they really had to upgrade a lot of their infrastructure and technology. So that meant that they were bringing broadband access into their hospitals. They started to think about how they could deliver care to their patients more remotely. And as they were doing a lot of these technology upgrades, they also started to address patients more like consumers. So I think that there was a big shift that started to take place in consumer services, starting to look like healthcare services."   "About that same time, you had a number of very large retail-focused, consumer-focused companies start to enter into the healthcare marketplace. So these are folks like Amazon, you have CVS and Walgreens, and now you've had a number of companies like Hims and Hers, and all of those are entering into the healthcare ecosystem through telehealth as a channel. So, as we've seen this increased infrastructure, this improvement in infrastructure, as well as consumerization of healthcare, continue to accelerate after the pandemic, and now we have more of this consumer-centric focus coming from a retail perspective."   #CHFGHealthcare #MedAI #DigitalHealth #PatientAccess #Telehealth #PhysicianBurnout #ClinicianBurnout CHGHealthcare.com Download the transcript here

Dr. Chuck Link is the Executive Chairman of Syncromune, a company developing a novel immunotherapy approach for solid tumors by delivering the therapy into the tumor and surrounding lymph nodes to stimulate a systemic immune response. Their complex drug has four different components with varying levels of activity that activate the immune system and counteract immune suppression. This in situ immunotherapy technology, SYNC-T, was tested in a phase 1 trial for metastatic castration-resistant prostate cancer, which showed high response rates and a favorable safety profile with low rates of serious side effects and minimal autoimmune toxicity.   Chuck explains, "So, SYNC-T is a technology in which you put a needle directly into a tumor that can be done by a urologist in the prostate cancer situation, or by an interventional radiologist. That needle then the tip of it freezes, and does a freeze fracture. Think of a Coke bottle rupturing like in the freezer. And what that does is release the antigens from that patient's own specific tumor. So, it's personalized because the tumor proteins and antigens are used to create a vaccine effect that's released directly from the cancer." "The tumor microenvironment is basically within the tumor itself, and there are immune suppressive mechanisms that the tumor has evolved to protect it from the immune system. I like to think of it as a castle, multiple levels of defense where you have the castle itself, and then you have a castle wall, and then you have a moat, and then an army in front of the wall. So the cancer has multiple immune-suppressive mechanisms that are activated to defeat the immune system, even though cancer has a lot of abnormal, mutated proteins that the immune system should attack and destroy. So what SYNC-T accomplishes is it basically hits solutions for all four of those types of defense simultaneously to make it more difficult for the castle, in this case, the tumor, to protect itself." #Syncromune #Immunotherapy #MetastaticSolidTumors #Cancer #ProstateCancer syncromune.com Download the transcript here

David Sontag, CEO and Co-Founder of Layer Health, describes the environment of chart reviews in healthcare and how AI and large language models can be used to analyze a patient's medical record to extract key clinical details. Applying natural language processing to medical records has been challenging due to the complexity of the language and the longitudinal nature of the data. This large language approach from Layer can enhance clinical decision-making, quality measurement, regulatory compliance, and patient outcomes. David explains, "Every patient will have experienced a chart review at some point. Whether it's when they've come home from a medical visit and go to their electronic medical record to look at the notes written by their providers. Or it's been experienced in the patient room, in the doctor’s room, watching a clinician review the past medical records to try to get a better context of what's going on with that patient, so that's from the patient’s perspective." "The same thing happens everywhere else in healthcare. So, chart review is the process of analyzing a patient's medical record to extract key clinical details. You can imagine going through clinical notes, lab results, imaging reports, and medical history, trying to create that complete and accurate picture of the patient's health. And it's used everywhere for measuring quality, for improving the financial performance of health system providers, and for regulatory compliance."   "Some aspects of natural language understanding from patients' medical records have been attempted for well over a decade, and these approaches have been typically very surface-level. So look at a single note, try to answer a relatively simplistic question from that note, but the grand challenge has always been one of how do we mimic the type of reasoning that a physician would do where they would be looking at a patient's longitudinal medical record across many notes trying to piece together data from not just from the unstructured but also the structured data."  #LayerHealth #ClinicalAI #AIinHealthcare #MedicalChartReview #PrecisionMedicine #ClinicalResearch #LLMsinHealthcare layerhealth.com Download the transcript here