How is the COVID-19 pandemic affecting cancer treatment plans? Oncologists are weighing switching treatment plans, and they have many questions. That’s where Nanthealth Inc., of El Segundo, Calif., is looking to help.
“We’ve been doing this … for just under 10 years, and this is unprecedented,” Sandeep “Bobby” Reddy, chief medical officer of Nanthealth, told BioWorld. “Our whole … value proposition is around evidence-based medicine and homogenization or standardization of care based on good evidence-based medicine guidelines.” The fundamental question is, in the wake of the pandemic, does that go out the window?
The problem is that no one knows precisely what is going on. To that end, the company has sought to collect data and understand how the marketplace – and doctors in particular – have reacted. It also has sought to provide guidance when appropriate.
Nanthealth, a member of the Nantworks family, is a next-generation, evidence-based, personalized health care company. It offers Eviti, an oncology clinical decision support and treatment validation platform that brings together providers and payers looking to help cancer patients.
With this solution, providers have the evidence that their treatments are effective and covered by payers. Meanwhile, both clinicians and payers have a clear picture of the cost and quality of treatment.
The company’s insights could prove invaluable as the COVID-19 pandemic continues. When the virus started to take hold in the U.S., data was coming in from China and Italy related to cancer patients. Specifically, it showed that cancer patients had significantly higher mortality than the average person – a reality seen with other infectious diseases, including the flu.
Against this backdrop, the company pondered whether this would change how doctors treated cancer, particularly for people with a curative form of the disease. “So, the guidelines that were coming out were basically hey, go ahead and use growth factors as much as possible to minimize the risk of infection. And the truth is that really doesn’t work for COVID, because the growth factors that we have only increase … types of white blood cells that help you fight bacterial infections, not viral infections,” Reddy explained.
There was a lot of talk about providing patients with drug regimens so they would not have to enter a facility, given that would defeat the purpose of social distancing. Data from Spain and Italy had shown that many patients had gotten sick as a result of contact with a health care practitioner.
The question became whether regimens should be given so patients can stay at home, representing a change in practice. Another option is to space out visits, meaning if they came every two weeks, could they instead come every three.
“And what I can tell you – it’s very early – is that, yes, we’re seeing that in the U.S.,” and there is a slight trend among doctors toward more utilization of these type of regimens. The question remains whether the outcomes change.
If there is no real change between the first six months of this year and the same time frame of 2019, that could be significant in terms of treating patients in a less intensive way while maintaining outcomes.
The company has worked with payers and providers to create a feedback loop. So, with the payers, conversations have centered around relaxing some of the rules around preauthorization. “It wasn’t so much we going to payers and saying, ‘Hey guys, we need to do this because there’s an epidemic going on out there,’ they actually had done this on their own.” That permitted doctors to make decisions in the best interest of their patients.
All of this could lead to a different model, such as the one in the U.K., which does not emphasize the speed of treatment, yet has similar patient outcomes compared with the U.S.
Earnings amid COVID
During Nanthealth’s May 7 first-quarter earnings call, COO Ron Louks highlighted that the company saw the sale of its connected care business for $47 million during the quarter. In addition, total revenue was $18.2 million, of which software as a service revenue was $18.1 million, representing a 2% increase over the prior year quarter.
In addition, the quarter saw the publication of a peer-reviewed study in breast cancer research on an artificial intelligence technique in breast cancer. “The study reports on a novel deep-learning system of digital pathology images and omics data used together to more precisely identify mechanisms of therapy resistance,” Louks explained.
Charles Rhyee, an analyst with Cowen, asked how COVID-19 will affect the back half of the year, particularly as physicians’ offices are closed. “So obviously, with Q1, we had no material financial impact due to the virus, and so it's a bit early to tell on the longer term,” Louks explained. “And I think as time progresses, we'll have a better understanding of this. And if we can actually be able to do it without having to be face-to-face with the customer.”