A startup that's taking on Big Pharma just raised $500 million

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Today in healthcare news: EQRx has raised another $500 million, at least 50% of COVID-19 cases spread from people without symptoms, and some evidence that Pfizer’s vaccine works against virus mutations


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EQRx, a startup that’s taking on Big Pharma by making drugs cheaper, just raised $500 million

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At least 50% of COVID-19 cases spread from people without symptoms, a new study found

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Early study suggests Pfizer’s vaccine is effective against coronavirus mutations

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Apps and web portals are streamlining vaccine rollout, but the digital strategies could leave vulnerable populations behind, experts warn

Summary List PlacementOlder Americans, who have died from COVID-19 more than any other population, are finally getting broad access to vaccines in the US. 
Some health systems are starting to release plans on how they will get older populations vaccinated. Michigan-based Beaumont Health, for instance, said the only way people 65-years-old or older can make vaccine appointments will be through the hospital’s online portal, via email. The Cleveland Clinic in Florida has encouraged seniors to sign up for appointments online due to “extremely high volume of calls.” Tennessee’s Department of Health will soon require residents to make appointments online to streamline distribution.
CVS Health, which will assist the US in providing 20 to 25 million shots per month to the public, requires scheduling a vaccine appointment online or via the app.
Using technology could be an efficient way for health systems to keep track of appointments, but might limit access among older Americans. 
Read more: The 8 digital health startups to watch that are changing healthcare in 2021
Fewer than half of seniors aged 80 or older report using the internet and only 28% have broadband service, according to Pew Research Center. Just 46% of older adults living in households earning less than $30,000 a year use the internet.
AARP, the nation’s leading interest group for those 50-years-old and older, has found though older Americans are increasingly more tech-savvy, there’s a “large discrepancy” between low-income seniors compared to the general population in terms of owning technology.
The Sarasota Herald-Tribune has already reported older people without smartphones or computers had difficulty making appointments online in Florida.
“There continues to be a digital divide in the senior population as there is for the general population,” said Tricia Neuman, senior vice president at the Kaiser Family Foundation. “People in communities of color, lower income people, and much older people are less comfortable or have less access with technology and wi-fi than others.”
How to ensure older Americans get equitable access to the COVID-19 vaccines
The Food and Drug Administration is now encouraging states to begin inoculating elderly Americans to speed up the distribution process after the slower-than-expected vaccine rollout: 2.8 million Americans received vaccines in 2020, far short of President Donald Trump’s goal of 20 million. 
“There is no reason that states need to complete, say vaccinating all health-care providers, before opening vaccinations to older Americans or other especially vulnerable populations,” Health and Human Services Secretary Alex Azar told reporters on Wednesday. 
People 75 and older are 8 times more likely to be hospitalized with COVID-19 and 220 times more likely to die than 18-28 year olds, according to the Centers for Disease Control and Prevention. The disease has also spread particularly fast among Black Americans and lower-income workers.
Adam Gaffney, a critical care physician and an instructor at Harvard Medical School, argued in USA Today the US should have begun vaccinating the oldest Americans before slowly widening the scope to younger people to decrease deaths and hospitalizations. 
Even as the disease hurts America’s most vulnerable at higher rates, vaccine distribution seems to be favoring privileged groups. Insider’s Shirley Livingston recently reported white people are getting more vaccines than Black people and other groups, according to state data. Wealthy donors and hospital administration staff getting have reportedly gotten vaccines before frontline workers in some cases. Celebrity plastic surgeons have gotten vaccinated as contract nursing home staff still waits in line.
Read more: A group of huge employers like Walmart and Lowe’s are trying to pick up where Haven left off and find ways to lower healthcare costs
Angela K. Shen, visiting research scientist at the Children’s Hospital of Philadelphia who formerly worked at the US Department of Health and Human Services, co-authored a recommendation on how the US should equitably distribute vaccines. In the report, Shen said ensure older adults should get first access to the vaccine without needing to pay.
Shen said relying on online appointments to get vaccines not only disadvantages some older Americans, but also rural communities that lack fast internet access. But Shen said healthcare systems should focus on getting large swaths of the population access to vaccines, which might require using apps and technology. 
“If you can kind of like capture like a large swath of the population, then you can change and have more precise strategies or tweak strategies that weren’t working before to kind of get at those people that you may have missed,” Shen said. 
Shen and Neuman both said the key to getting equal access to older Americans is to use a variety of methods to reach different groups. In Colorado, for instance, drive-through vaccination clinics were able to inoculate seniors from small and disadvantaged areas first, The Colorado Sun reported. The US gave health systems paper cards with reminders on when to get a second dose. 
Systems will also need to work with in-home providers to access the 2 million people over 65 that are permanently homebound, according to STAT News.
If access to vaccines remains unequal among older populations, Shen said high-risk communities should continue to engage in social distancing and mask wearing.
“Just because you’re older and you don’t use a cell phone doesn’t mean that you’re higher risk; it depends on what actions you yourself are doing,” Shen said. “There’s plenty of older adults who use technology, but then there’s plenty of who don’t.”SEE ALSO: I’ve spent the past 9 months talking to healthcare workers as a reporter. ‘Grey’s Anatomy’ gets the pandemic right.
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One of biotech's most valuable startups just filed to go public. Here are 5 crucial takeaways from Sana's 271-page filing.

Summary List PlacementAfter raising more than $700 million since its 2018 launch, one of the biotech industry’s most valuable private companies is planning to go public.
Seattle-based Sana Biotechnology filed paperwork on Wednesday for an initial public offering. Following a red-hot year for biotech IPOs in 2020, Sana is hoping to take advantage of investor enthusiasm to fuel its ambitious cell and gene therapy programs.
The company was founded in July 2018 and is led by former executives of Juno Therapeutics, a cell therapy startup that was acquired in 2018 by Celgene for $9 billion. Sana came out of stealth mode in early 2019 and closed a Series B round in June 2020 in which it raised $435.6 million.
The size of its latest funding round places Sana among the top 10 biotech or life sciences companies in the US, according to data going back to 2002 from PitchBook. Some of the other companies on that shortlist include coronavirus-vaccine-maker Moderna, low-cost drugs startup EQRx, cancer-detection company Grail, and disgraced lab-testing firm Theranos.
Read more: The 26 billion-dollar startups to watch that are revolutionizing healthcare in 2021
Sana commanded a $2.77 billion valuation after the 2020 raise, the second-highest valuation among all private biotechs, according to Silicon Valley Bank’s annual industry report. Sana hasn’t set yet set the pricing terms for its IPO.
The company plans to trade on the Nasdaq under the ticker symbol SANA. Morgan Stanley, Goldman Sachs, JPMorgan, and Bank of America are leading the offering.
We read through Sana’s 271-page filing to learn more about the secretive biotech’s business and strategy. Here are five crucial takeaways from Sana’s latest disclosure. 
Sana’s pipeline is sprawling, but it’s at least a year away from starting human testing
Sana’s filing provides the first detailed look at the treatments it’s working on, and it’s sprawling in terms of both its scientific ambitions and the range of disease areas it’s targeting. 
The biotech’s lead program is focused on a rare genetic blood disorder called ornithine transcarbamylase (OTC) deficiency. Beyond that, the company has early-stage treatment candidates in development for heart failure, Type 1 diabetes, multiple sclerosis, Huntington’s disease, several types of cancer, sickle cell disease, and beta-thalassemia.
Sana’s platform is primarily focused on engineering and manipulating cells. But it’s also researching gene delivery, gene modifications, and pluripotent stem cells.
All this work is still in the earliest stages of development. None of its potential treatments are being tested in people, and Sana doesn’t expect that to happen until 2022 at the earliest.
Biotech companies deciding to go public before any of their treatments are tested in people has been a trend in the last few years, as investor appetite for early scientific bets has grown. By that count, Sana is shaping up to be a mammoth wager. 
The startup has set up an independent research arm and is digging into COVID-19
Sana’s S-1 also gives details on the company’s research arm SanaX, led by Harvard Medical School genetics professor Richard Mulligan. The group is currently investigating new tools for Sana’s cell and gene therapies, including developing new viral vectors, expanding the capacity of existing vectors and manipulating the body’s immune response. 
On top of that, SanaX is exploring how to best delivery specific antibodies to treat the novel coronavirus. That could put the startup in competition with industry giant Regeneron, which has teamed up with gene therapy pioneer Jim Wilson to find new ways of delivering antibodies to fight the virus. 
New tools that come out of SanaX could be folded into Sana’s internal drug portfolio or be used in an external partnership. The company has yet to announce any drug industry collaborations.
“Our goal is to lead both the present and future of cell engineering and we are committed to making significant investments in research and other activities that will ensure a leadership position throughout the next decade,” the S-1 said. 
ARCH and Flagship own nearly half of Sana’s shares
ARCH Venture Partners and Flagship Pioneering are the main venture capital firms backing Sana. 
ARCH owns 27.5% of Sana’s stock going into the offering, and Flagship owns 21.4%. The next largest institutional investor is Canada Pension Plan’s investment fund, which owns 5.8% of the biotech.
How much those shares will ultimately be worth is an open question, as Sana has yet to specify its target pricing range. Most biotech IPOs offered shares somewhere around $15 to $20, which would effectively value Sana at somewhere around $9 billion to $12 billion, Stat News’s Kate Sheridan reported.
Judging by its $705.5 million in previous funding, Sana isn’t a typical biotech. If Sana prices at $20 per share, ARCH’s and Flagship’s stakes would respectively be worth $3.5 billion and $2.7 billion. 
The biotech hasn’t built its own manufacturing presence, instead relying on third parties
The drugs Sana aspires to make are very complex. The filing reveals that Sana hasn’t spent its copious funding on building its own manufacturing capacity. 
“We do not yet own or operate any cGMP manufacturing facilities,” the filing states, referencing current good manufacturing practices, the universal standards enforced by drug regulators. 
Instead, like many pre-commercial biotechs, Sana is relying on third-party contractors to produce its experimental treatments.
While the company doesn’t have a manufacturing footprint, it has built up a nationwide research presence with about 170,000 square-feet in office and lab space across Seattle, South San Francisco, and Cambridge, Massachusetts. 
Sana has been hungry for growth, executing three acquisitions worth a combined $1.5 billion
Sana has made several acquisitions in its first two years of operations, which combined are worth more than the funding it has raised to date. The company has mainly used its own stock to fund the deals.
Its largest was the February 2019 acquisition of Cobalt Biomedicine, which was also incubated at Flagship Pioneering but was still in stealth mode when it was acquired. Sana paid $136 million in stock in the deal, which included the possibility of $500 million in milestone payments and a $500 million “success payment” tied to its valuation.
The acquisition gave Sana access to the in-vivo gene therapy approach used in its lead drug candidate. It also helped Sana grow its workforce, which has ballooned from 37 employees at its launch to more than 200 employees currently. 
Sana has further built out its broad pipeline through the acquisition of two Seattle-based startups. It bought  Cytocardia Inc. in November 2019 for upwards of $148 million and acquired Oscine Corp. in September 2020 for upwards of $234.3 million. Join the conversation about this story » NOW WATCH: Sarah McBride made history becoming the first openly trans person elected to a state Senate seat. In 2018, she explained why the Trump administration wouldn’t discourage her work.

The founder of a healthcare venture fund that just raised $200 million shares why she wants to back founders that are building businesses for their communities

Summary List PlacementOne of digital health’s only early-stage venture firms just raised a fresh tranche of funding to help the youngest startups get off the ground during a pivotal year for the industry.
Define Ventures raised $200 million for its latest fund, the second since it was founded by ex-Kleiner Perkins investor Lynne Chou O’Keefe in 2018.
The early-stage firm will continue making new investments in companies in the incubation stage all the way up to Series B, Chou O’Keefe told Business Insider.
The new fund’s timing, coming after a record-setting year of private investment in healthcare startups, was purely coincidental and on track with the typical two-year fundraising cycle at most firms, she said.
“We’ve had well-timed investment cycles,” Chou O’Keefe said “But the activity has increased, overall, post-COVID.”
Read more: A former Kleiner Perkins investor is staking out the future of digital health. Here’s why she just made an early bet on an in-home care startup founded by a former Uber exec.
Define wants to back early startups rebuilding the healthcare system with patients at its center
Chou O’Keefe said she anticipated keeping up the pace in 2021, writing more checks to companies she believes are reimagining what it’s like to be a healthcare patient in the United States. In Define’s first $87 million fund, she backed a wide range of digital health startups, including LGBTQIA+ primary care startup Folx and in-home care provider MedArrive.
She said to expect more of the same coming from Fund II, with consumer-focused healthcare startups taking center stage over other companies that want to sell services to hospitals or insurance companies. The firm’s thesis formed around backing companies that use technology to reimagine the patient’s experience of healthcare was successful enough in Fund I to earn a vote of confidence in Fund II, Chou O’Keefe said.
“We haven’t seen our strategy shifted, it’s more that the time to market has really shortened,” Chou O’Keefe said. 
In practice, the consumerization of healthcare Chou O’Keefe wants to back varies widely. It can look like Dawnlight, a startup that makes remote monitoring products that track fall risks, among other specialties. It can also look like Lightship, a startup that runs decentralized clinical trials that are easy for participants and researchers to use. All these startups, however, share the unique challenge of marketing to regular patients instead of working directly with hospitals, doctors, or insurance companies.
“The make-or-break of digital health is the commercial side of the business,” Chou O’Keefe said. “That’s something that is so critical, and when I started Define the lack of sector-focused early-stage players was a window of opportunity for us because these entrepreneurs need help to build. It takes a village to change healthcare for all of us.”
Chou O’Keefe is betting that founders want to build for their own communities
Chou O’Keefe will write checks from $1 million all the way up to $15 million, depending on the company’s needs. As a former Livongo board member and current Hims board member, she said Define can lead funding rounds that require the active board support, but ultimately leaves that decision to the entrepreneur. 
“Entrepreneurs recognize the oil from water here,” Chou O’Keefe said. “There are people that can partner with you and build these companies with you, but the lessons learned from tech don’t apply in the healthcare space.”
Her investment strategy is in part a bet on authentic founders, she said.
She is particularly interested in supporting the entrepreneurs that are building solutions for their own communities because that perspective can be a differentiating factor that contributes to a company’s success.
Of Define’s 12 portfolio companies, four are founded and led by women, one of the many communities Chou O’Keefe feels has been left out of high-level healthcare business decisions in the past.
“It’s important we have women founders and CEOs in this space because we make the decisions, and it’s really the right business decision as well,” Chou O’Keefe said.SEE ALSO: The 26 billion-dollar startups to watch that are revolutionizing healthcare in 2021
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Fertility benefits company Progyny lost 85% of its business at the start of the pandemic. Here's how its CEO is ramping up an aggressive growth strategy fueled by acquisitions.

Summary List PlacementLike many Americans, fertility benefits provider Progyny is dusting off its 2020 goals, many of which were sidelined at the onset of the coronavirus pandemic, heading into the new year.
The company, which went public in September 2019, saw an 85% decrease in its business in the early months of the pandemic, CEO David Schlanger told Business Insider. Across the country, fertility clinics closed to comply with regional stay-at-home orders in an effort to stretch meager supplies of personal protective equipment, and many treatments were considered non-essential by state and local governments wary of potential hospital surges.
Progyny works directly with companies to offer fertility benefits to employees. Companies pay Progyny for access to fertility treatment and pharmacy benefits based on how many employees choose to use those benefits. If fewer employees opted into treatment, either because clinics were closed or they simply delayed treatment during widespread uncertainty, the company would pay Progyny less than it had before.
“The period of time through COVID was stressful for us, especially when our revenues dropped by 85%,” Schlanger said.
Within four to six weeks, however, clinics started reopening and procedures picked back up, Schlanger said. He attributed that to the time-sensitive nature of fertility treatments that have improved odds of success the earlier in a person’s life they begin.
“Fertility treatments are not emergency treatments, but there is an urgency factor to it,” Schlanger said.
Read more: The 26 billion-dollar startups to watch that are revolutionizing healthcare in 2021
Progyny is looking for acquisitions to expand Progyny’s reach
In the final quarter of 2020, Progyny’s revenue surpassed $98 million, exceeding expectations and growing nearly 62% year-over-year. The company lost most of its revenue in the second quarter of 2020, reporting just $64.61 million in revenue for the three-month period, a drop from the previous quarter’s roughly $81 million in revenue. 
The V-shaped recovery has placed Progyny in a good position to start reevaluating growth plans the team had abandoned in March.
Instead of focusing on keeping the business alive, Schlanger is able to set his sights on acquiring other businesses that could expand Progyny’s reach in the murky world of fertility healthcare. 
“The nice thing about being public is we can do strategic transactions with third parties to make ourselves better,” Schlanger said. 
Although Schlanger declined to specify which areas or companies he has an eye on, he said Progyny’s proximity to women’s health presents enough of an opportunity to expand into different kinds of benefits it can then sell to employers. 
“There are a lot of things we can pursue, but like anything else we have to prioritize them,” Schlanger said.
Schlanger said he doesn’t foresee the reverse happening, in which a large healthcare company purchases Progyny, now that it’s recovered from last year’s decline. He is focused mainly on transactions that “move the needle” for the company in a material way and building up a base of paying companies that has remained fairly resilient to layoffs and cost-cutting to date.
Since the pandemic began, he said Progyny has added 45 new clients and covered an additional 400,000 people.
“We really didn’t miss a beat,” Schlanger said of the company’s sales targets. “We really flourished. We got through it much better than other companies.”SEE ALSO: One of digital health’s only dedicated early-stage venture firms just raised $200 million for its second fund. Here’s how founder Lynne Chou O’Keefe plans to spend it.
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