Day three of the JP Morgan Healthcare Conference brought us closer to understanding who’s been able to capitalize on the pandemic as a business opportunity – and who, notwithstanding market position, has not.
With two highly efficacious vaccines now available in the U.S. and more on the way, and distribution ramping up after a sluggish start, we are in the early innings of the COVID-19 battle. Still, for some of the key players supporting the country in that fight – from pharmacies and EHR vendors to big med-tech companies – data are rolling in on how it has impacted business.
Among those seizing the opportunity have been pharmacies such Walgreens Boots Alliance. The company has enlisted its 9,000 U.S. retail locations, drive-thrus and large workforce in helping out with viral testing and especially the “last mile” problem of getting shots into arms, said co-COO Alex Gourlay.
“We’re building on our relevance and scale,” he said.
Gourlay said Walgreens, which contracted with the government for the rollout, is on track to have all shots doled out in skilled nursing facilities by Jan. 25 and will reach capacity for 100,000 COVID tests a day by next month. Moreover, by next month, 50,000 of its pharmacists will be trained in vaccination, and Walgreens itself has capacity to vaccinate 25 million people.
How profitable might this be? Gourlay responded that, of the roughly 300 million vaccinations expected to be given this year, retail pharmacies have “about a 30% share” of that market, equating to the potential for about 100 million needles touching skin in the retail setting.
“We’re not just getting meds in the bottle,” he said. Later, he added that while start-up costs have been high, COVID vaccination and testing has been a “good investment.”
CVS Health also spoke about its role in the rollout, with Karen Lynch, EVP for CVS Health and president of Aetna, confirming the retail pharmacy chain’s ability to pull off 20-25 million vaccinations per month in its 10,000 retail locations, or a million a day.
“To put that in context, we’re coming up to a million vaccinations this week through long-term care centers,” she said during a panel.
Like Walgreens Boots, CVS Health has been working closely with the Trump administration’s Operation Warp Speed and the Centers for Disease Control and Prevention on vaccinating in long-term care facilities. More than 40,000 nursing homes selected CVS Health to dole out shots, Lynch noted.
Lynch, the incoming CEO of CVS Health, added that once the federal program is fully in play, it will “open up the aperture for more shots in arms” by enabling individuals to get the shot at a community-based pharmacy.
Healthcare IT firm Cerner has similarly been able to take advantage of “being structurally relevant to the surge response,” said Don Trigg, the company’s president.
The Department of Veterans Affairs, Department of Defense and U.S. Coast Guard are all using its EHR. It has enabled field hospitals and expanded its telemedicine capability so that, against the backdrop of COVID, the value proposition for its healthcare IT gear has increased.
Cerner’s fortunes are tied to hospitals. While the spring surge saw medical centers “dig in” and cancel elective procedures, their outlook “looks solid,” said CEO Brent Shafer.
Hospitals are now unlocking government funding and spending money to improve operations and workforce management, investing in Cerner products like touchless registration and other front-end improvements. That has “made a tremendous difference” for the firm, Shafer added. “You see spending that looks normal.”
Moreover, with the help of Amazon Web Services, Cerner has amassed a 500,000-patient database of COVID-positive patients. Trigg said it is being utilized by 30 academic medical centers to improve treatment and future pandemic response, as well as to target vaccination in underserved communities.
But not everyone has been able to capitalize. Asked to comment on how sales of Siemens Healthineers’ antibody tests – an established market segment for the big med-tech – are going amid the vaccine rollout, CEO Bernhard Montag gave this sanguine assessment: “The irony is that this market didn’t really take off.”
Montag said Siemens is working very closely with governments to see if there is any use for its antibody tests as a companion diagnostic of sorts. “But I would not bet on it,” he cautioned. “I would not make a story out of it.”
The jury is still out in terms of testing’s role in clinical trials, Montag added, noting that “there’s a lot of work ahead” in understanding how the body’s reaction to the shot and immunity work together. But to the point of whether there’s a need to test every person, he said, “I don’t want to be bullish.”
Montag’s comments clearly reflect a business opportunity that has not panned out, at least not to the extent Siemens had hoped. It’s similar to the experience of makers of monoclonal antibody therapies, such as Regeneron, which pushed through an emergency approval for its casirivimab-and-imdevimab cocktail, only to see infectious-disease doctors give the drug a lukewarm reception.
“It’s a problem,” acknowledged Regeneron R&D chief George Yancopoulos, who was asked on Monday by JPM analyst Cory Kasimov why the biotech’s antibody cocktail, which targets the SARS-CoV-2 spike protein and is injected intravenously, isn’t being used more in real-world settings. Yancopoulos attributed this to the cocktail’s rollout in the midst of an emergency.
“We need to work much more closely with the government to figure out much more effective ways to get this to patients,” he explained. “There are hundreds of thousands of people getting infected that fit the profile of the antibody therapies. It could slow down progression of patients into hospitals and more severe states.”
Regeneron stands in contrast to drugmaker Gilead, whose CEO, Daniel O’Day, revealed on Monday that its COVID-19 therapeutic Veklury (remdesivir) was estimated to bring about $2.8 billion in sales for 2020.
It may be too early to crown anyone a pandemic winner or loser, other than the leading vaccine makers. What is apparent, especially after this year’s JP Morgan conference, is that while COVID has been a catalyst for the healthcare industry, its effects have not been felt equally.