Jeffrey DelVerne’s Post

🔥Pretty incredible tool for ChatGPT Plus Subscribers to preview the o1 version! 🧘This new model is a reasoning model that takes a bit longer to answer but is a bit more thoughtful. From the OpenAI website they launched earlier: “This next model update performs similarly to PhD students on challenging benchmark tasks in physics, chemistry, and biology. We also found that it excels in math and coding. In a qualifying exam for the International Mathematics Olympiad (IMO), GPT-4o correctly solved only 13% of problems, while the reasoning model scored 83%. Their coding abilities were evaluated in contests and reached the 89th percentile in Codeforces competitions.“ 🤯For complex reasoning tasks this is a milestone for AI capabilities as we move into almost two years since the OG was launched in November of 2022. I have been tinkering with it for the past few hours and it is fun to double click on some of the responses.

😎 Not really a surprise from UNH on Humira biosimilars after the announcement by Cigna last week and CVS in April to move towards Humira biosimilars. 💡 Stelara is next up for biosimilar uptake in 2025 as there are three (3) approved biosimilars today and primarily given outpatient (similar to Humira). According to the 2023 J&J 10-K, sales of Stelara were around 7 billion in the US and 10.8 billion globally. 🔎 Humira sales peaked in the US in 2022 at 18 billion (21.2 billion globally) so it was a larger opportunity to reduce costs for employer groups but has started to accelerate amongst the largest PBMs in 2024. ❓ What is a biosimilar? Biosimilars are officially approved versions of original "innovator" products and are manufactured when the original product's patent expires. Unlike generic drugs, biosimilars are not exact replicas of their biologic counterparts due to the complex nature of biologics. Biologic drugs are made from living organisms, such as bacteria or yeast, and are often complex mixtures of molecules. This complexity makes it impossible to create an exact copy of a biologic drug. The manufacturing process for biologics is intricate and sensitive to changes in the environment, process, and even the materials used. The approval process for biosimilars is different from that of generic drugs. Biosimilars are generally less expensive than the original biologic drugs, but the difference in cost is usually not as significant as the difference between generic and brand-name drugs. ❓ Why is this important? According to IQVIA (report in comments), it is estimated that biologic specialty drugs has accounted for $260 billion of the 350 billion the US spends on specialty drugs each year. The biosimilar drug market is estimated at 30-40 billion today and expected to exceed 100 billion by the end of the decade. As the IQVIA report points out there is significant savings to be harvested as more inpatient settings adopt biosimilars drugs along with PBMs moving them into preferred position for some of these outpatient drugs (Stelara/Humira). The move on Humira is officially underway and we now await Stelara next year! #healthcare #marketaccess https://lnkd.in/gZSCnSph

🏈 Wells Fargo Conference kicked off yesterday in Boston and there was some interesting headlines but the major story yesterday was from Drew Asher of Centene as he reported higher than anticipated medical loss ratio (MLR) for Q3. ➡ Centene is the nations largest provider of managed medicaid with over 13.1 million beneficiaries but the report by Centene sent the stock crashing 9% while also sending Molina (4th largest Medicaid provider) down almost 7% along with a 3% hit to the stock price of Elevance (2nd largest provider). ➡ Centene is maintaining their 2024 guidance but the report alerted investors to a potential problem for the Q3 earnings calls. This is an unforeseen headwind as many of the Medicaid providers just weathered some of the risk acuity challenges that plagued their balance sheet in the early part of this year with mass redeterminations over the past 14 months. ➡ Additionally, Drew said that they would finish the year with only 13 million Medicaid members which is less than the 13.6 million they projected. In June of of 2023, they had 16.1 million members which is a 20% reduction as redeterminations have unwound Medicaid. That was the largest first day headlines that moved equities but some other interesting facts: ➡ Humana is leaving 13 markets with their Medicare Advantage offerings next year which is around 560,000 member headwind for them headed into 2025. This was expected as Wellcare (Centene), Aetna (CVS), and Humana had all mentioned this in the first quarter earnings call as the CMS rate decision did not meet expectations. As margins in Medicare Advantage are shrinking, we are going to see less competition in more markets which is not great for beneficiaries but should create an interesting dynamic for 2026 bids.

Exciting news in the world of diabetes!

So it begins…..Some interesting stats after Q2 earnings that play into the Cigna presser below 👉🏻Eric Palmer (EVP Enterprise Strategy) from Cigna mentioned about 20% of the book had been switched to the Humira biosimilar since they began shipping at the end of June. 💊Quallent Pharmaceuticals (wholly owned subsidiary of Cigna) has partnered with several Humira biosimilar manufacturers to drive better pricing for employer groups 🤯In her opening remarks, Karen Lynch (CEO) mentioned that CVS has dispensed over 100,000 biosimilar scripts, resulting in over $400 million in net saving as they made the move to add the Humira biosimilar to formulary in April. ❓Why it matters? Humira is the best-selling drug of all time, launched by Abbvie in 2002. In 2022, Humira generated $58 billion in sales, with $22.2 billion coming from the U.S., making the transition to lower-cost biosimilars a significant opportunity for employer groups to save. PBMs have been scrutinized for not driving uptake of the Humira biosimilars sooner over the past couple years but 2024 has seen large movement. 🧐Today, this has become a significant discussion point in many earnings calls, as the biosimilar market is expected to reach $30 billion by the end of 2025 and up to $100 billion by the end of the decade. Stelara is set to be the next drug to face biosimilar competition next year and I expect uptake to be much more efficient with many of these stakeholders prepared. This market is about to really heat up so get your popcorn 🍿! #marketaccess https://lnkd.in/gHDWEaXk.

I will never forget the story he references in point one when we played at Syracuse in 1999! “Put the team first, always, even when facing personal adversity” He literally got up in front of the entire team and sang the victors like he had put together the game winning drive. I remember coming out of the locker room and saying to my parents “Tom Brady is an incredible leader and just sang the victors after being benched” It was one of those moments that changes you. Great article by Harvard Business Review ! #leadership

Always looking for great people!

🌯 As the dust settles from the Q2 earnings calls of the “Big Six Payors” (UNH, Elevance, Centene, Cigna, CVS, and Humana), I’ve taken a deep dive into the biggest trends and what they mean for the payor landscape. From the growing role of AI in healthcare to the evolving dynamics of Part D plans, and the rapid rise of the biosimilars market, there’s a lot to unpack. Here’s a quick snapshot of what I cover: 🤖AI in Healthcare: How major payors are leveraging their vast data to drive efficiency and revenue. 💊Part D Plans: The potential long-term impacts of CMS subsidies to offset the IRA premiums and the future of Medicare Advantage. 💉Biosimilars Market: The strategic moves by payors to capture savings and revenue in the biosimilar space as they shift Humira and prepare for Stelara. 🤷 Predictions for 2024 and Beyond: From potential AI acquisitions to the challenges faced by hospitals, my thoughts on what’s coming next. Healthcare has been pretty dynamic over the past 12 months and what we should be thinking about in the next 12 months. #healthcare 📝Read the full article

🍼This is what Shannon DelVerne and I looked like when we first met back in 1996 before cancer changed our life! 🏃♂️On September 7, 2024, we’ll be hosting the ColtStrong 5K in Sylvania, Ohio, to benefit the ChadTough Defeat DIPG Foundation. This cause is incredibly personal to our family. Our beloved son, Colt, was a brave warrior who battled DIPG before he passed away in 2018. We’re committed to honoring his memory by raising funds to help find a cure for this devastating disease. Why Join Us? Every step you take, every dollar you donate, brings us closer to defeating DIPG and supporting families who are currently facing this battle. The funds raised will directly contribute to cutting-edge research and initiatives aimed at finding effective treatments and, ultimately, a cure. How You Can Help? 🏃 Sign Up: Lace up your shoes and run with us on 9/7. Whether you're a seasoned runner or just want to walk in memory of those we've lost, your participation makes a difference. 🤝 Become a Sponsor: We’re seeking sponsors to help us reach our fundraising goals. This is an opportunity to show your support for the community and contribute to a cause that matters. Let’s Make a Difference Together so Colt’s spirit lives on through this event, and with your help, we can turn our grief into action and bring hope to countless families. 🔗 https://coltstrong.org

Congrats to the Beta Bionics team! https://lnkd.in/gBzkRYud