Melinta Therapeutics filed
for Chapter 11 bankruptcy in December 2019, with Deerfield Management
taking control of the company in exchange for the $140 million loan it
had provided the company. Melinta focuses on antibiotics, which despite
an increasing need for new antibiotics to treat drug-resistant bacteria,
is a difficult market space. Last year two other antibiotics companies,
Aradigm and Achaogen, filed for bankruptcy, even after the U.S. Food
and Drug Administration (FDA) approved Achaogen’s antibiotic in June
2018.
Deerfield placed
Melinta’s assets up for auction, but no other companies made competing
bids, leaving Deerfield in control of the company’s assets. The
agreement is expected to be approved by the bankruptcy court on March
13, with the Chapter 11 plan being confirmed on April 2, with the plan
going into effect shortly afterward.
As part of the Chapter 11 agreement, $3.5 million be placed into a
trust to benefit general unsecured creditors. Existing equity interests
in Melinta will be canceled and equity holders will receive nothing.
Since filing Chapter 11 on December 27, 2019, Melinta has continued operations.
Its antibiotic portfolio includes Baxdela (delafloxacin), Vabomere
(meropenem and vaborbactam), Orbactive (oritavancin) and Minocin
(minocycline) for Injection.
Deerfield offered financing related to Melinta’s 2018 acquisition of
the infectious disease business of The Medicines Company, which has
since been acquired by Novartis. That deal included Baxdela, Orbactiv
and Minocin.
Melinta’s
2018 annual report indicates that Deerfield granted up to $240 million
in debt and equity financing spread over six years, with an initial loan
of $147.8 million and an acquisition of $42.2 million in Melinta
shares.
As the stories of Melinta, Achaogen and others suggests, there could be something wrong
with the antibiotics market. Big pharma has largely gotten out of the
antibiotics business, with about 90% of research on new antibiotics
being conducted by small biotech companies with market caps of less than
$100 million, more than half pre-revenue.
It’s not the science. The science is there. It’s the market.
A Wired article,
“The Antibiotics Business Is Broken—But There’s a Fix,” noted that
since it takes 10 to 15 years and at least $1 billion to develop a drug,
companies need to charge a high enough price to sell enough of the drug
to earn back the R&D expenses, reward investors and be profitable.
“That math works for most of the products of the pharmaceutical
industry, from old drugs that people take every day—antidepressants,
beta-blockers, statins—to the newest cancer therapies known as CAR-T,
which can cost almost $500,000 per dose. But antibiotics don’t fit that
equation. Unlike cancer drugs, most antibiotics are inexpensive; the few
with high price tags are reserved for rare hospital use. And unlike
drugs to treat chronic diseases, people take antibiotics for only short
periods of time,” Wired wrote.
There are also reimbursement issues, as the San Francisco Business Times
reports. Government reimbursement programs and private insurers
reimburse hospitals for antibiotics as a bundle rather than separately.
The less a hospital pays for the components of the bundle, the more
likely it is to cover it costs or be profitable.
“They might not ever be reimbursed, so maybe they don’t buy it,”
Heather Shane, a consultant and former biotech corporate lawyer, told
the San Francisco Business Times.
https://www.biospace.com/article/deerfield-wins-melinta-assets-after-chapter-11-bankruptcy/
Saturday, March 7, 2020
Manufacturing India’s restrictions on API exports only temporary, official says
India’s curb on the export of 26 APIs in the face of the
COVID-19 outbreak has reverberated through the drug manufacturing
industry, but the government insists it is a temporary measure as the
government takes heed of its needs.
Speaking at a conference Wednesday, Mansukh Mandaviya, minister of
state for chemicals and fertilizer, said the measure was taken to make
sure there are no shortages of medicine for India, the Times of India reports.
He said the policy should be short-lived while a task force he heads
makes plans for India to reduce its dependence on APIs from China.“It is not a permanent measure and is being reviewed on a daily basis,” Mandaviya said. “It has been done to ensure that there is no shortage of medicines in the country regarding coronavirus.”
India this week stopped exports of the 26 APIs and drugs that range from paracetamol––the ingredient in Tylenol––to antivirals like acyclovir for treating shingles and antibiotic neomycin.
India supplies about 40% of generics to the U.S. The FDA is reviewing the situation. Citing experts, The Globe and Mail reports India’s action is most likely to affect countries in Africa, Southeast Asia and Latin America first.
That hasn’t stopped some in Europe from pushing the panic button, Dinesh Dua, chairman of the Pharmaceuticals Export Promotion Council of India (Pharmexcil), told Reuters. He said some of the restricted APIs and medicines were widely used in the U.S. and Europe.
“I am getting a huge number of calls from Europe because it is very sizeably dependent on Indian formulations and we control almost 26% of the European formulations in the generic space. So they are panicking,” Dua said.
However, Adrian van den Hoven, director general of Medicines for Europe, an association of EU generic and biosimilar drugmakers, told Reuters EU drugmakers have enough supplies to last for several months and that India’s restrictions were unlikely to affect large volumes to Europe.
https://www.fiercepharma.com/manufacturing/india-s-restrictions-api-exports-only-temporary-official-says-report
GSK, Bristol, Roche, Sanofi and more limit travel due to coronavirus
Biopharma companies are hunkering down as the COVID-19 epidemic breaks out worldwide.
In a FiercePharma survey of biopharma
companies late last month, most drugmakers said they were simply
limiting travel to hard-hit countries such as China, South Korea and
Italy. Now, as more cases pop up across the U.S., Europe and Asia, their
tone has shifted.
GlaxoSmithKline has “instructed all employees
to postpone non-critical international business travel until further
notice,” a spokesman said. Bristol Myers Squibb started restricting on
business travel and put the kibosh on workplace and company meetings
until the end of March. And BMS’ limits don’t just apply to employees
and contractors, but to partners, suppliers and vendors, too, a
spokeswoman said.
Boehringer Ingelheim, for its part, is
restricting travel throughout Europe, where the case count has picked up
in the last several days. The German drugmaker has also put China, Hong
Kong, Macau, Taiwan, southeast Asia, South Korea, Japan and Iran
off-limits.
“We expect employees to reschedule
business meetings that require traveling or organize them virtually in
those areas,” a spokesperson said, adding that the restrictions aren’t
entirely new. They’re a more detailed version of a previous policy
limiting travel in affected areas.
Swiss drug giant Roche is asking
employees to “postpone all travel to China, including Hong Kong and
Macau, until further notice,” and “limit business travel to and from
Korea, Japan, Singapore, Iran and Italy to the absolute
business-critical activity only.” Any employee returning from one of
those areas must work from home for at least 14 days upon their return,
Roche says.
Amgen is suspending international business travel until March 21 and strengthening cleaning routines and visitor screening at all of its locations.
Last week, the drugmakers who responded
to FiercePharma’s inquiries mostly said they are monitoring the
situation and restricting travel to and from China. GSK also restricted
travel to Italy and South Korea at the time.
In a new statement, Sanofi said it’s
requesting employees and contractors to avoid travel in China, Hong
Kong, Macau, South Korea, Iran and seven regions in Italy. They’re asked
to “keep all the travels to business essential only,” with some
exceptions, such as to return home. Sanofi has created an “internal
crisis committee” and still prohibits travel to Wuhan and throughout
China’s Hubei province.
Mylan is limiting international travel and prohibiting travel to and from China, Hong Kong, Iran, Italy, Japan and South Korea.
“We are asking that all business travel is minimized and alternatives
to travel and in-person meetings are considered,” a spokeswoman said.
The travel restrictions and limitations
are designed to help contain the novel coronavirus, which has spread to
85 countries, infecting about 100,000 people worldwide. The virus has
caused more than 3,300 deaths.
Among those infected are three Biogen
employees—two from Europe and one from outside of Massachusetts—who
traveled to a management meeting in Boston last week. At the meeting,
several attendees had flu-like symptoms, according to a company
statement. Several tested positive for flu, while three have confirmed
COVID-19 infections.
In response, Biogen has instructed all of the
meeting attendees to work from home for at least two weeks and is
restricting employee travel through the end of March. Aside from those
who attended the meeting, any employee should stay home if they don’t
feel well and contact healthcare providers as necessary, Biogen says.
Biogen isn’t alone. Seattle-area employees for Amazon and Microsoft have tested positive for COVID-19, as has a contractor for Facebook. Tech companies in Seattle are asking employees to work from home, and some have shut down certain offices.
Amid the threat, two prominent cancer
centers—the Dana-Farber Cancer Institute and MD Anderson—are restricting
business travel. And the Healthcare Information and Management Systems
Society canceled its annual conference in Orlando for the first time in
more than 50 years. Prominent medical conferences say they are
monitoring the situation, but haven’t made a decision to cancel.
Infectious Disease Docs in Short Supply Yet ‘Critical’ for COVID-19 Crisis
As the coronavirus outbreak continues to spread, infectious disease
specialists are in short supply and might be overwhelmed by the
emergency, Thomas File Jr, MD, president of the Infectious Disease
Society of America, told Medscape Medical News.
“Depending on the burden on our healthcare systems, we’re going to be at the center of caring for these patients,” said File, who is a practicing infectious disease specialist at Summa Health in Akron, Ohio.
“Also, we have to spend time communicating with the community to dispel some of the myths [related to the novel coronavirus]. So already, we’re seeing an increased workload because of this. And if COVID-19 spreads significantly — and I think we have to be prepared that it will — we’re going to need a larger workforce to deal with this,” he said.
Infectious disease specialists at Summa Health, File added, are overtaxed because of “a very active influenza season,” on top of helping the institution prepare for COVID-19 cases. This involves setting up a command center and creating protocols to diagnose and treat patients as they arrive.
In addition, ID specialists are on the front line of coping with “the public health crisis of antimicrobial resistance,” he points out. “We have to make sure we’re using antibiotics appropriately and promoting the development of new antibiotics so we’ll have them available for the future.”
File emphasized that COVID-19 is not the only emerging pandemic that ID specialists have had to deal with or will have to deal with in the future. He cited the threats that Zika and SARS posed in past years. “COVID-19 illustrates the need for more trained ID specialists, because we know we’re going to be seeing more outbreaks in the future.”
In 2017, there were 9122
infectious-disease specialists in the US, about 1% of the total number
of American physicians, according to the American Association of Medical
Colleges.
Asked why so few doctors are going into the specialty, File replied, “To put it simply, we’re overworked and underpaid.”
A 2019 Medscape survey shows ID specialists earned an average of $239,000 a year. That’s in the same range as the compensation of primary care physicians. However, File noted, it’s about $100,000 less, on average, than what other non–primary-care specialists earn.
The main reason for this, File said, is that ID specialists perform cognitive tasks rather than procedures and are thus compensated under the lower-paying evaluation and management codes. Yet ID specialists manage very complex cases and know how to administer specialized drugs that other physicians may have no experience using.
“We don’t do procedures, but we take care of very sick patients in the ICU, which may take hours, and we’re not going to be compensated for the value we’re providing,” File said.
Infectious diseases requiring complex care coordination are commonly observed in settings with high poverty, mental illness, addiction, and incarceration, the Merritt Hawkins report pointed out.
File admitted that some young doctors might be hesitant to enter the specialty because of that factor. He noted there has been a steep rise in infectious disease complications stemming from the opioid epidemic, including skin and bloodstream infections.
On the other hand, File said, there are many positive factors that should attract physicians to the infectious-disease specialty. These include the intellectual simulation of research, the opportunity to fight emerging infections in third-world countries, and the ability to cure very sick patients whom other doctors can’t help.
“The nice thing about infectious diseases, as compared to some of the other medical subspecialties, is we actually cure patients,” he said. “When I see a patient with life-threatening meningitis and we’re able to give him the appropriate medicine, he can be cured and leave the hospital perfectly fine. That’s very gratifying, and the patients are very appreciative of that as well.”
Several studies have shown that ID specialists not only improve outcomes for such patients but also reduce the cost of care, according to File. The Centers for Medicare & Medicaid Services (CMS) should recognize that and increase payments to ID specialists, he said.
As for the US response to the COVID-19 emergency, the ISDA president
stated, “It’s important for infectious-disease specialists to be able to
respond to infectious disease outbreaks and help prepare institutions
to respond to them as well. Many of our members are also helping to
develop vaccines and therapies. So our specialty is extremely important
at this critical time to respond to this outbreak.”
https://www.medscape.com/viewarticle/926387#vp_1
“Depending on the burden on our healthcare systems, we’re going to be at the center of caring for these patients,” said File, who is a practicing infectious disease specialist at Summa Health in Akron, Ohio.
“Also, we have to spend time communicating with the community to dispel some of the myths [related to the novel coronavirus]. So already, we’re seeing an increased workload because of this. And if COVID-19 spreads significantly — and I think we have to be prepared that it will — we’re going to need a larger workforce to deal with this,” he said.
Infectious disease specialists at Summa Health, File added, are overtaxed because of “a very active influenza season,” on top of helping the institution prepare for COVID-19 cases. This involves setting up a command center and creating protocols to diagnose and treat patients as they arrive.
In addition, ID specialists are on the front line of coping with “the public health crisis of antimicrobial resistance,” he points out. “We have to make sure we’re using antibiotics appropriately and promoting the development of new antibiotics so we’ll have them available for the future.”
File emphasized that COVID-19 is not the only emerging pandemic that ID specialists have had to deal with or will have to deal with in the future. He cited the threats that Zika and SARS posed in past years. “COVID-19 illustrates the need for more trained ID specialists, because we know we’re going to be seeing more outbreaks in the future.”
“Overworked and Underpaid”
Nevertheless, the number of physicians entering the field has steeply declined in recent years. According to a 2019 Merritt Hawkins report, “Between the 2009-2010 and 2016-2017 fellowship matches, the number of adult ID [infectious disease] programs filling all their positions dropped by 41% and the number of applicants decreased by 31%. In 2015, fewer than half of US ID fellowships filled their incoming classes.”Asked why so few doctors are going into the specialty, File replied, “To put it simply, we’re overworked and underpaid.”
A 2019 Medscape survey shows ID specialists earned an average of $239,000 a year. That’s in the same range as the compensation of primary care physicians. However, File noted, it’s about $100,000 less, on average, than what other non–primary-care specialists earn.
The main reason for this, File said, is that ID specialists perform cognitive tasks rather than procedures and are thus compensated under the lower-paying evaluation and management codes. Yet ID specialists manage very complex cases and know how to administer specialized drugs that other physicians may have no experience using.
“We don’t do procedures, but we take care of very sick patients in the ICU, which may take hours, and we’re not going to be compensated for the value we’re providing,” File said.
Infectious diseases requiring complex care coordination are commonly observed in settings with high poverty, mental illness, addiction, and incarceration, the Merritt Hawkins report pointed out.
File admitted that some young doctors might be hesitant to enter the specialty because of that factor. He noted there has been a steep rise in infectious disease complications stemming from the opioid epidemic, including skin and bloodstream infections.
On the other hand, File said, there are many positive factors that should attract physicians to the infectious-disease specialty. These include the intellectual simulation of research, the opportunity to fight emerging infections in third-world countries, and the ability to cure very sick patients whom other doctors can’t help.
“The nice thing about infectious diseases, as compared to some of the other medical subspecialties, is we actually cure patients,” he said. “When I see a patient with life-threatening meningitis and we’re able to give him the appropriate medicine, he can be cured and leave the hospital perfectly fine. That’s very gratifying, and the patients are very appreciative of that as well.”
Several studies have shown that ID specialists not only improve outcomes for such patients but also reduce the cost of care, according to File. The Centers for Medicare & Medicaid Services (CMS) should recognize that and increase payments to ID specialists, he said.
https://www.medscape.com/viewarticle/926387#vp_1
How Can You Feel Assured Today That A Restaurant Is Sanitary?
Journalist Quentin Hardy stirred a tempest in a teapot — a storm in a salsa bowl — yesterday on Facebook. In a welcome distraction from Super Tuesday hysteria, he heartily admonished his followers:
Policy
One respondent took the position that Hardy’s hardnose proposal might
adversely impact both small business owners who were barely getting by
(I was sympathetic; I brought up the example of taquerias). Hardy
replied, “the ‘mom and pop’ thing … is also used by enormous fast food
chains, who will tell you they offer good entry-level jobs, that their
franchisees are heavily minority, etc. All true, maybe, but they could
still install these policies, particularly if the public starts thinking
things through.” He wondered whether asking about a restaurant’s
practices might “lead to national health care. We don’t have to act like
we’re inside an eternally deviant system about which we can do
nothing.”
Interesting point. But I think that’s a long-term solution to immediate concerns. National healthcare is nowhere on the near horizon, regardless of who wins the presidency. In the meantime, people are avoiding live conferences (leading to dozens of event cancellations), retailers are bracing for potential losses, and, yes, the restaurant industry is gauging the potential severity of consumer fears of live dining … and cranking the PR machine to protect its interests. According to a restaurant trade publication, the National Restaurant Association says “the nation’s more than 15 million restaurant employees who serve customers across the country were trained in safe food preparation.”
Politeness
I doubt that will satisfy Hardy and other diners. And I can foresee a groundswell of pushy patrons demanding more info from restaurant owners. I wish I were more pushy; in some ways it would make life easier. I confessed to Hardy: “I’m wondering what’s practical. Easy to research, for example, what Chipotle has in terms of sick time, etc. But I would never ask a taqueria owner what he or she does.” He replied, immediately: “I already have. Why not?” I replied: “Well, you are different from me.”
How different? I do not know. But he got me thinking about my limits, and I am thankful for that. In certain situations, I am painfully introverted (I’m an INFJ, according to the Myers-Briggs people, the infamous personality brokers). To ascertain whether a taco dealer in my neighborhood is doing the right thing, I would visit the place, check out the tables (are they clean?), peer into the kitchen. If am bothered, I would leave.
But what about visiting a taqueria that is not local? Not easy bolting out the door, not knowing where else to go (especially if I am with other people). Cities like New York have letter gradings for restaurants based on how they do with health inspections, and owners are required to display the grades “where they can easily be seen by people passing by.” But no such law exists in many cities and suburbs, and, like national healthcare, a national grading system is unlikely to come anytime soon.
For this problem, I’d like to see a digital, crowdsourced solution. An enterprise like Yelp might specifically ask patrons to report what they learn. Yes, the system could be gamed, but the reputation of the patrons might help us arrive at a clearer picture before we set out on foot or car to the destination. And we can rely on the groundswell to do the work of asking any questions they want of the owners. I’ll be depending on them.
https://www.forbes.com/sites/giovannirodriguez/2020/03/05/how-does-one-ask-a-restaurant-if-it-pays-workers-for-sick-time/#300e370311c0
Before you reserve or give business to any restaurant, ask if they have paid sick leave. Only go to the ones that do. You’ll greatly reduce your chances of infection, since cooks and servers who get sick won’t, because of financial necessity, have to come into work (where they may sneeze on your food.) You’ll also be sending a signal that will reverberate, as the restaurants with a worker health policy do better. Double bonus!To me (more about me in a bit) it felt a tad bossy, if not just impractical. A testy conversation ensued. It should have been no surprise. We’ve entered a new age of health anxiety, and it’s straining our ability to think clearly on how protect ourselves in public spaces, and protect owners and workers as well.
Policy
Interesting point. But I think that’s a long-term solution to immediate concerns. National healthcare is nowhere on the near horizon, regardless of who wins the presidency. In the meantime, people are avoiding live conferences (leading to dozens of event cancellations), retailers are bracing for potential losses, and, yes, the restaurant industry is gauging the potential severity of consumer fears of live dining … and cranking the PR machine to protect its interests. According to a restaurant trade publication, the National Restaurant Association says “the nation’s more than 15 million restaurant employees who serve customers across the country were trained in safe food preparation.”
I doubt that will satisfy Hardy and other diners. And I can foresee a groundswell of pushy patrons demanding more info from restaurant owners. I wish I were more pushy; in some ways it would make life easier. I confessed to Hardy: “I’m wondering what’s practical. Easy to research, for example, what Chipotle has in terms of sick time, etc. But I would never ask a taqueria owner what he or she does.” He replied, immediately: “I already have. Why not?” I replied: “Well, you are different from me.”
How different? I do not know. But he got me thinking about my limits, and I am thankful for that. In certain situations, I am painfully introverted (I’m an INFJ, according to the Myers-Briggs people, the infamous personality brokers). To ascertain whether a taco dealer in my neighborhood is doing the right thing, I would visit the place, check out the tables (are they clean?), peer into the kitchen. If am bothered, I would leave.
But what about visiting a taqueria that is not local? Not easy bolting out the door, not knowing where else to go (especially if I am with other people). Cities like New York have letter gradings for restaurants based on how they do with health inspections, and owners are required to display the grades “where they can easily be seen by people passing by.” But no such law exists in many cities and suburbs, and, like national healthcare, a national grading system is unlikely to come anytime soon.
For this problem, I’d like to see a digital, crowdsourced solution. An enterprise like Yelp might specifically ask patrons to report what they learn. Yes, the system could be gamed, but the reputation of the patrons might help us arrive at a clearer picture before we set out on foot or car to the destination. And we can rely on the groundswell to do the work of asking any questions they want of the owners. I’ll be depending on them.
https://www.forbes.com/sites/giovannirodriguez/2020/03/05/how-does-one-ask-a-restaurant-if-it-pays-workers-for-sick-time/#300e370311c0
Two test positive for coronavirus at US conference attended by Pence
Two people have tested positive for the new coronavirus after taking
part in a pro-Israel lobby group’s conference in Washington which Vice
President Mike Pence, Secretary of State Mike Pompeo and dozens of
lawmakers also attended.
The influential American Israel Public Affairs Committee said in an email to attendees, speakers and congressional offices that the infected pair had traveled from New York to go to the March 1-3 event.
“We have confirmed that at least two Policy Conference attendees from New York have tested positive for the Coronavirus,” AIPAC said in the message, posted to its Twitter account.
Officials said on Friday that 22 new cases had been confirmed in New York state, mostly in a Westchester County cluster north of New York City, bringing the total to 44.
“We have continued to remain in constant communication with the Westchester County Health Department and the DC Health Department which is coordinating with the New York Health Department, and national health authorities,” AIPAC added.
AIPAC circulated a statement later Friday it attributed to Washington health authorities saying no immediate risk to attendees had been identified. DC Public Health was unavailable for comment.
The event attracted several high-profile attendees including Pence, Pompeo, Senate Majority Leader Mitch McConnell, and Democratic former White House hopeful Mike Bloomberg.
Pence is leading the US response to the novel coronavirus.
Lawmakers from all political stripes make an annual pilgrimage of sorts to AIPAC to pledge their support for the state of Israel on a grand stage.
About 18,000 people had been expected to travel from across the US to attend the conference, which typically attracts around two-thirds of the members of Congress.
Attendees swamped Capitol Hill in their hundreds during the event.
“If you test positive for Coronavirus, we urge you to inform your local health authorities so they can properly coordinate the response to this situation with the appropriate health authorities,” AIPAC said.
The virus has now killed more than 3,450 people and infected more than 100,000 across 92 nations since the outbreak first emerged in China in December. Over 3,000 of those deaths have been in China.
https://medicalxpress.com/news/2020-03-positive-coronavirus-conference-pence.html
The influential American Israel Public Affairs Committee said in an email to attendees, speakers and congressional offices that the infected pair had traveled from New York to go to the March 1-3 event.
“We have confirmed that at least two Policy Conference attendees from New York have tested positive for the Coronavirus,” AIPAC said in the message, posted to its Twitter account.
Officials said on Friday that 22 new cases had been confirmed in New York state, mostly in a Westchester County cluster north of New York City, bringing the total to 44.
“We have continued to remain in constant communication with the Westchester County Health Department and the DC Health Department which is coordinating with the New York Health Department, and national health authorities,” AIPAC added.
AIPAC circulated a statement later Friday it attributed to Washington health authorities saying no immediate risk to attendees had been identified. DC Public Health was unavailable for comment.
The event attracted several high-profile attendees including Pence, Pompeo, Senate Majority Leader Mitch McConnell, and Democratic former White House hopeful Mike Bloomberg.
Pence is leading the US response to the novel coronavirus.
Lawmakers from all political stripes make an annual pilgrimage of sorts to AIPAC to pledge their support for the state of Israel on a grand stage.
About 18,000 people had been expected to travel from across the US to attend the conference, which typically attracts around two-thirds of the members of Congress.
Attendees swamped Capitol Hill in their hundreds during the event.
“If you test positive for Coronavirus, we urge you to inform your local health authorities so they can properly coordinate the response to this situation with the appropriate health authorities,” AIPAC said.
The virus has now killed more than 3,450 people and infected more than 100,000 across 92 nations since the outbreak first emerged in China in December. Over 3,000 of those deaths have been in China.
https://medicalxpress.com/news/2020-03-positive-coronavirus-conference-pence.html
GoodRx Saves Money on Meds, Shares Data With Google, Facebook, Others
Update: After this article was published, GoodRx posted a statement
saying that it planned to stop sharing personal medical information
with Facebook, had appointed a new vice president of data privacy, and
was providing a way for GoodRx users to delete their data. For more on our findings and instructions for how to protect your health data, see Consumer Reports’ follow-up on the changes. This article was originally published on February 25, 2020.
A few weeks ago, a Philadelphia resident named Marie received a
prescription for a new medication, but the drug wasn’t covered by her
insurance. “It was way too expensive for me to get on my own,” she says.
(Like other consumers we spoke to, she asked us to withhold her last
name to preserve her privacy.) “So I reached back out to my doctor. She
directed me to GoodRx, and said I’d be able to afford the medicine with
one of their coupons.”
The doctor was right. “The discount was about $500,” Marie says. “I was excited to go fill the prescription and not have to worry about it anymore.”
The doctor was right. “The discount was about $500,” Marie says. “I was excited to go fill the prescription and not have to worry about it anymore.”
Millions of people like Marie have downloaded the GoodRx app. The
price comparisons and coupons it provides can save money on prescription
drugs that otherwise would be out of reach for many patients. That’s
why Consumer Reports and other organizations have recommended GoodRx in the past.
However, there is a tradeoff involved.
However, there is a tradeoff involved.
While people like Marie are saving money with GoodRx, the company’s
digital products are sending personal details about them to more than 20
other internet-based companies. Google, Facebook, and a marketing
company called Braze all receive the names of medications people are
researching, along with other details that could let them pinpoint whose
phone or laptop is being used.
That worries patients like Marie, along with doctors and healthcare advocates we interviewed.
“It’s becoming a situation where privacy is for the privileged,” says Dena Mendelsohn, a senior policy counsel for Consumer Reports. “People use GoodRx when they’ve been prescribed something to improve their health, which in some cases can be a life-changing drug. But people shouldn’t be in a position where they have to choose which is more important, their health or their privacy.”
That worries patients like Marie, along with doctors and healthcare advocates we interviewed.
“It’s becoming a situation where privacy is for the privileged,” says Dena Mendelsohn, a senior policy counsel for Consumer Reports. “People use GoodRx when they’ve been prescribed something to improve their health, which in some cases can be a life-changing drug. But people shouldn’t be in a position where they have to choose which is more important, their health or their privacy.”
Medication Names Are Shared
To determine how GoodRx shares data, we monitored traffic using a
data packet-capturing tool to observe the company’s Android mobile app
and website as we searched for deals on a number of prescription
medications.
Several of the company’s business partners received the names of the medications, along with ID numbers and other information that can be used to single out individuals. The data can reveal intimate information that many people would keep private from all but their close friends and family.
As a test, we looked for discounts on Lexapro, an antidepressant; PrEP and Edurant, used to prevent and treat HIV, respectively; Cialis, for erectile dysfunction; Clomid, a medication used in fertility treatments; and Seroquel, an antipsychotic often prescribed to control schizophrenia and bipolar disorder.
With the information coming off our test phone and browser, a company could infer highly intimate details about GoodRx users suffering from serious chronic conditions, and make educated guesses about their sexual orientation.
Braze, a marketing firm, received the names of the drugs, the pharmacies where we sought to fill prescriptions, and ID numbers that advertising and analytics companies use to track the behavior of specific consumers across the web.
Like other companies we talked to, Braze assures Consumer Reports that the data collected isn’t shared broadly with data brokers or advertising companies. Braze says the data is only used to help GoodRx target its own users with information.
Similarly, a company called Branch says it only uses the data it collects from GoodRx to make sure that links within the mobile app work correctly. GoodRx executives say the company doesn’t sell or share users’ health data with other companies to support targeted advertising.
“When we believe a user is running out of medication, we use Braze to email or text a reminder,” says Thomas Goetz, chief of research at GoodRx. “We may also notify users when we are able to find a better price for their prescription,” he says. “To reach new customers who might find GoodRx useful, we place advertisements for GoodRx on third-party platforms, including Facebook and Google, and retarget users who have visited GoodRx to encourage them to come back and use the service.”
Both Google and Facebook deny using prescription information for targeting individuals with ads. “We prohibit personalized advertising and advertising profiles based on sensitive information, including a user’s prescriptions,” a Google spokesperson says.
A Facebook spokesperson says, “We don’t want websites sharing people’s personal health information with us—it’s a violation of our policies. After an initial review, we think GoodRx’s use of our business tools requires a deeper investigation, and we’re reaching out to the company.”
Our testing of the GoodRx app and website was led by Bill Fitzgerald, a privacy researcher in CR’s Digital Lab. “We observed sensitive information being passed along,” he says. “If Facebook doesn’t want this information, and GoodRX doesn’t want to send it, it shouldn’t be happening. The app and site don’t need to be designed this way.”
GoodRx users we reached out to say they are surprised such intimate information was being shared for any purpose.
“I just assumed that there had to be some kind of protection laws or something associated with it because, you know, it’s medical data,” says Cam, a GoodRx user who works as a business analyst in New York.
“My instinct was that it was okay, probably because of my past experience with medical information,” Marie of Philadelphia says. “I just assumed, you know, this was my private prescription app.”
“It doesn’t feel right,” she says.
Several of the company’s business partners received the names of the medications, along with ID numbers and other information that can be used to single out individuals. The data can reveal intimate information that many people would keep private from all but their close friends and family.
As a test, we looked for discounts on Lexapro, an antidepressant; PrEP and Edurant, used to prevent and treat HIV, respectively; Cialis, for erectile dysfunction; Clomid, a medication used in fertility treatments; and Seroquel, an antipsychotic often prescribed to control schizophrenia and bipolar disorder.
With the information coming off our test phone and browser, a company could infer highly intimate details about GoodRx users suffering from serious chronic conditions, and make educated guesses about their sexual orientation.
Braze, a marketing firm, received the names of the drugs, the pharmacies where we sought to fill prescriptions, and ID numbers that advertising and analytics companies use to track the behavior of specific consumers across the web.
Like other companies we talked to, Braze assures Consumer Reports that the data collected isn’t shared broadly with data brokers or advertising companies. Braze says the data is only used to help GoodRx target its own users with information.
Similarly, a company called Branch says it only uses the data it collects from GoodRx to make sure that links within the mobile app work correctly. GoodRx executives say the company doesn’t sell or share users’ health data with other companies to support targeted advertising.
“When we believe a user is running out of medication, we use Braze to email or text a reminder,” says Thomas Goetz, chief of research at GoodRx. “We may also notify users when we are able to find a better price for their prescription,” he says. “To reach new customers who might find GoodRx useful, we place advertisements for GoodRx on third-party platforms, including Facebook and Google, and retarget users who have visited GoodRx to encourage them to come back and use the service.”
Both Google and Facebook deny using prescription information for targeting individuals with ads. “We prohibit personalized advertising and advertising profiles based on sensitive information, including a user’s prescriptions,” a Google spokesperson says.
A Facebook spokesperson says, “We don’t want websites sharing people’s personal health information with us—it’s a violation of our policies. After an initial review, we think GoodRx’s use of our business tools requires a deeper investigation, and we’re reaching out to the company.”
Our testing of the GoodRx app and website was led by Bill Fitzgerald, a privacy researcher in CR’s Digital Lab. “We observed sensitive information being passed along,” he says. “If Facebook doesn’t want this information, and GoodRX doesn’t want to send it, it shouldn’t be happening. The app and site don’t need to be designed this way.”
GoodRx users we reached out to say they are surprised such intimate information was being shared for any purpose.
“I just assumed that there had to be some kind of protection laws or something associated with it because, you know, it’s medical data,” says Cam, a GoodRx user who works as a business analyst in New York.
“My instinct was that it was okay, probably because of my past experience with medical information,” Marie of Philadelphia says. “I just assumed, you know, this was my private prescription app.”
“It doesn’t feel right,” she says.
No, HIPAA Doesn’t Apply
Doctors we interviewed say they worry on a daily basis about how
patients can pay for the drugs they need to treat serious medical
conditions. All of them say they recommend GoodRx as a solution, many
without realizing that private information could be revealed.
Erin T. Bird, M.D., a urologist in Temple, Texas, frequently brings up GoodRx to his patients. “It’s a conversation that occurs with pretty much every prescription,” Bird says, especially when he’s dealing with erectile dysfunction, urinary incontinence, and cancer—conditions that call for medications that are expensive under many insurance plans, and potentially embarrassing for patients.
Bird says he is surprised that the GoodRx app and website share patients’ prescription information.
“I think that most physicians would think that within the space of healthcare, there are some consumer protections. I would have assumed that,” Bird says.
Bird and other medical professionals are required to keep medical information private and secure under HIPAA, or the Health Insurance Portability and Accountability Act. You’ve probably dealt with HIPAA before—it’s described in the documents you sign when you visit a new doctor’s office.
“If people think that HIPAA protects health data, then they probably believe that any health data in any context is going to be protected. That’s just not the case,” says Deven McGraw, chief regulatory officer at consumer health tech company Ciitizen and former deputy director of health information privacy at the U.S. Department of Health & Human Services’ Office of Civil Rights.
However, HIPAA doesn’t apply to GoodRx or many other “direct-to-consumer” websites and apps that provide health and pharmaceutical information. It doesn’t apply to heart-rate data generated by a sports watch or Fitbit, information you enter into period-tracking apps, or running data held by running and cycling apps such as Strava. As far as the law is concerned, such information has no more protection than your Instagram likes.
Major companies are keenly interested in consumer health data. Last year, the data broker and credit monitoring agency Experian announced it had assigned every person in the United States, an estimated 328 million Americans, a unique “Universal Patient Identifier.” Google and Amazon are publicly investing in efforts to collect consumer health data and acquire or partner with healthcare companies.
HIPAA may actually make medical data more valuable to internet companies. “I can buy a targeted list of people that have opened a new business or bought a BMW,” says Jeff Greenfield, co-founder of the advertising attribution firm C3 Metrics, but it’s much harder to locate people with diabetes or high cholesterol because of HIPAA. “There’s money that’s on the table, hundreds of millions, billions of dollars a year in aggregate, in potential advertising dollars.”
Erin T. Bird, M.D., a urologist in Temple, Texas, frequently brings up GoodRx to his patients. “It’s a conversation that occurs with pretty much every prescription,” Bird says, especially when he’s dealing with erectile dysfunction, urinary incontinence, and cancer—conditions that call for medications that are expensive under many insurance plans, and potentially embarrassing for patients.
Bird says he is surprised that the GoodRx app and website share patients’ prescription information.
“I think that most physicians would think that within the space of healthcare, there are some consumer protections. I would have assumed that,” Bird says.
Bird and other medical professionals are required to keep medical information private and secure under HIPAA, or the Health Insurance Portability and Accountability Act. You’ve probably dealt with HIPAA before—it’s described in the documents you sign when you visit a new doctor’s office.
“If people think that HIPAA protects health data, then they probably believe that any health data in any context is going to be protected. That’s just not the case,” says Deven McGraw, chief regulatory officer at consumer health tech company Ciitizen and former deputy director of health information privacy at the U.S. Department of Health & Human Services’ Office of Civil Rights.
However, HIPAA doesn’t apply to GoodRx or many other “direct-to-consumer” websites and apps that provide health and pharmaceutical information. It doesn’t apply to heart-rate data generated by a sports watch or Fitbit, information you enter into period-tracking apps, or running data held by running and cycling apps such as Strava. As far as the law is concerned, such information has no more protection than your Instagram likes.
Major companies are keenly interested in consumer health data. Last year, the data broker and credit monitoring agency Experian announced it had assigned every person in the United States, an estimated 328 million Americans, a unique “Universal Patient Identifier.” Google and Amazon are publicly investing in efforts to collect consumer health data and acquire or partner with healthcare companies.
HIPAA may actually make medical data more valuable to internet companies. “I can buy a targeted list of people that have opened a new business or bought a BMW,” says Jeff Greenfield, co-founder of the advertising attribution firm C3 Metrics, but it’s much harder to locate people with diabetes or high cholesterol because of HIPAA. “There’s money that’s on the table, hundreds of millions, billions of dollars a year in aggregate, in potential advertising dollars.”
A ‘Necessary’ Tradeoff
Prescription coupon services aren’t the only apps sharing sensitive information with third parties.
A recent study by the Norwegian Consumer Council, an advocacy group, looked at 10 apps, including Grindr, OkCupid, Tinder, and the period-tracking apps Clue and MyDays, and found they were collectively feeding personal information, which for some apps may include details about users’ gender, sexuality, political views, and drug use, to scores of companies.
In January, a Gizmodo investigation found that a panic-button app partnering with Tinder shared data with many of the same companies we spotted when we looked at GoodRx. Last week, a report from Jezebel found similar data sharing in the world of online therapy services, such as BetterHelp.
GoodRx says it is careful with consumer data, and that it makes most of its revenue through referral fees collected when consumers fill prescriptions using a GoodRx coupon, rather than through advertising.
However, when you use an app, whether it’s a calculator, GoodRx, or a meditation app, you may be entering into a relationship with dozens of other companies. Even if you had time to go over privacy policies with a fine-toothed comb, you might never learn where your data ends up, or what it will be used for.
GoodRx users CR spoke with found that troubling.
“Machines can break, a human can make a mistake, and then it’s all out there. It’s happened before,” says Hanna, a GoodRx user who lives in New York, and does marketing work in the cosmetics industry. Hanna uses the app to check the prices for her birth control, as well as Lexapro, Trazodone, and Wellbutrin, drugs she takes every day for anxiety and depression.
But that won’t stop her, or other consumers we spoke with, from using GoodRx or similar apps. “The service they’re giving, with the state of our health insurance in this country is, like, necessary,” Hanna says. “My $300 medication is about $28 with GoodRx. I’ll take that. You know what I mean?”
A recent study by the Norwegian Consumer Council, an advocacy group, looked at 10 apps, including Grindr, OkCupid, Tinder, and the period-tracking apps Clue and MyDays, and found they were collectively feeding personal information, which for some apps may include details about users’ gender, sexuality, political views, and drug use, to scores of companies.
In January, a Gizmodo investigation found that a panic-button app partnering with Tinder shared data with many of the same companies we spotted when we looked at GoodRx. Last week, a report from Jezebel found similar data sharing in the world of online therapy services, such as BetterHelp.
GoodRx says it is careful with consumer data, and that it makes most of its revenue through referral fees collected when consumers fill prescriptions using a GoodRx coupon, rather than through advertising.
However, when you use an app, whether it’s a calculator, GoodRx, or a meditation app, you may be entering into a relationship with dozens of other companies. Even if you had time to go over privacy policies with a fine-toothed comb, you might never learn where your data ends up, or what it will be used for.
GoodRx users CR spoke with found that troubling.
“Machines can break, a human can make a mistake, and then it’s all out there. It’s happened before,” says Hanna, a GoodRx user who lives in New York, and does marketing work in the cosmetics industry. Hanna uses the app to check the prices for her birth control, as well as Lexapro, Trazodone, and Wellbutrin, drugs she takes every day for anxiety and depression.
But that won’t stop her, or other consumers we spoke with, from using GoodRx or similar apps. “The service they’re giving, with the state of our health insurance in this country is, like, necessary,” Hanna says. “My $300 medication is about $28 with GoodRx. I’ll take that. You know what I mean?”
Editor’s Note: This article has been updated to clarify the findings of a study by the Norwegian Consumer Council. A number of apps were found to share personal data, but they didn’t all share the same kinds of data, or with the same outside companies. The article was originally published on February 25, 2020.
https://www.consumerreports.org/health-privacy/goodrx-shares-users-health-data-with-google-facebook-others/
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