When it comes to cancer, it’s not just innovative technologies that move the needle on patient care and treatment options. Earlier this week, Michael Marquardt, the Chief Executive Officer of Epi One and former board member of the American Cancer Society (ACS), Christian Eusemann, the Vice President of Research and Innovation at Siemens Healthineers, and Robert H. Vonderheide MD, Director of Abramson Cancer Center at University of Pennsylvania sat down to discuss redefining cancer care in a conversation moderated by Tiffany Wilson, President & CEO of the Science Center. Through their work, these three healthcare leaders directly impact cancer care for millions of patients – allowing the conversation to dive deep into cutting edge research, innovation, and access to care.
In the audience were stakeholders across the healthcare ecosystem – health systems, payers, strategics, investors, and startups – including the 10 startups selected for the 9th cohort of the Capital Readiness Program, as well as the 4th cohort of Founders Fellows, Their presence ensures that these founders in the early and growth stages of developing their companies heard firsthand from the healthcare stakeholders they may hope to partner with one day. The panel discussed what is and isn’t working, including pain points they believe entrepreneurs would be wise to focus on.
One key takeaway: the future of cancer care depends just as much on strengthening the connection between patients and health systems as it does on advancing technology itself. Here’s what they covered.
Redefining Cancer Care: Shifting Focus from Prevention to Access
Eat this, not that – mammogram every year, colonoscopy every 10 years – there are plenty of preventative tips and tests for cancer that vary depending on who you are and what your risk factors are. One thing that doesn’t vary, though, is that millions of people are consistently missing out on prevention – because they lack access to begin with.
“What we’ve seen in Philly is plenty of people in their 80s who live within a 10-minute commute of Penn and have never had a breast cancer screening in their life,” explained Eusemann. He noted that to meet patients where they were, Siemens teamed up with Penn to host 30 public mobile mammogram events– with the screening unit showing up to churches, community organizations, and more. Since this July, nearly 400 screenings have been completed and multiple cancers detected, with treatment plans underway.
According to Eusemann, over half of the people who came to the mobile event didn’t have health insurance. Many cancers can now be detected earlier than ever before – but if someone doesn’t have the insurance for preventative checkups, the means to pay for treatment, or lacks the ability to get to treatment centers – then the technological leaps forward in detection and treatment aren’t going to necessarily benefit them.
Marquardt underscored this. “What I find most frustrating is that getting the most advanced care isn’t the issue. It’s getting the standard of care in the most even way. Someone might get into a clinical cancer trial somewhere, but it might be unaffordable for them to be there for 6 weeks,” he explained. To help address that disparity, ACS runs 34 lodges around the country for patients to stay at, and volunteer drivers working for cancer patients – for free.
While organizations like the ACS can help fill the gap on transportation and lodging, it speaks to a widespread issue in healthcare: these barriers to access ultimately are barriers to better care.
Marquardt summarized aptly: “If it’s accurate and affordable it’s probably cancer detection, but not early. If it’s early and accurate, it’s probably not affordable. There are many solutions for two of the three, but very rarely is cancer detection accurate, affordable, and early.”
“If it’s accurate and affordable it’s probably cancer detection, but not early. If it’s early and accurate, it’s probably not affordable. There are many solutions for two of the three, but very rarely is cancer detection accurate, affordable, and early.”
Innovation Only Matters if Patients Can Afford It
When it comes to innovation, cost can’t be ignored. “We can cure cancer for $2-3 million – but how is that sustainable?” Wilson asked the group.
Vonderheide says it’s a matter of providing greater value, and sees hope in big breakthroughs rather than incremental improvements.
“Our [country’s] healthcare system is wobbling. This question of, ‘how we can afford the next Car T cells’ is a good one. From the point of view of the innovator, what matters is the value of what’s produced,” he explained. “The days of incrementalism are over. “If you have another targeted therapy that (has modest clinical activity), it’s not going to go anywhere. But something that cures 80% of breast cancer, we’ll find a way to pay for it. Let’s think beyond incremental.”
The two German-born panelists, Marquardt and Eusemann, both felt that the American healthcare system could benefit from examining how other countries have problem-solved healthcare issues, noting that American exceptionalism often prevents the U.S. from exploring these learnings.
“One of my greatest disappointments since I’ve been in the U.S. for thirty-five years is that we are so focused on what we do here and we don’t take a look on what the rest of the world does,” said Marquardt. Of note: The U.S. spends twice as much on cancer care than average for high-income countries, but mortality rates are only slightly better than average for these countries, according to a study published in Jama Health Forum.
“After screening, survival rates double. Screening is an important thing,” explained Eusemann, referencing the outcomes of a national lung cancer trial. “So many people who don’t get screened, they only come into the system when it’s too late: when it’s really expensive. In Europe, screening is a much bigger topic. Here, it’s like whack-a-mole.”
Vonderheide saw potential in re-thinking where diagnostics have to take place, especially as strides made in virtual care make it easier than ever for doctors to communicate with patients where they are at.
“Is there another place to meet the patient besides the hospital room? Can we give home therapy? We try at all costs to avoid the emergency department,” he explained. At-home visits help bridge the gap between clinical care and the patient’s lived reality and can sometimes be a more cost-conscious choice. “We try to treat at home. Sites of care are really changing so if you think about the next innovation to screen, treat, and detect, it may not be the hospital where it happens.”
Innovation vs. the Healthcare System: What Startups Need to Understand
“Currently there are over 1,000 AI-based technologies that are FDA cleared – and roughly 10 are reimbursed,” noted Marquardt. “So we work with folks on the hill, and there’s a bipartisan effort to force CMS to reimburse if something is cleared by the FDA.”
Without insurance reimbursement, important innovations languish in a no man’s land – putting additional pressure on the startups behind the innovations as well, as they might have a limited amount of runway before their funding dries up. “A lot of thought has gone into what it means to the startups,” he added.
Vonderheide advised startups to get in front of health systems and have conversations about usage early on. “We love to meet innovators who have a new idea who are thinking fresh about some problem were having, as long as It’s bidirectional,” he said. “We love to hear your ideas early, and possibly make a suggestion or two about how it could make a bigger impact or have a bigger chance of success.”
Eusemann directed founders to move away from the generalist mindset and get specific. “We develop something and we think, ‘it solves the problem for 80 departments’ – but no department is willing to spend money for another department. If you want to raise funding, there has to be a clear target in mind,” he noted.
For strategics like Siemens, it helps to have introductions to startups from proven partners who have validated them technically and clinically, ensured they’re aligned with regulatory and reimbursement pathways, and ready to integrate or co-develop for scale. “For Siemens, it means more to have a startup put forth by the Science Center or Penn Medicine."
He also advised that founders need to think of the process from end-to-end and not get too caught up in just the present pain points. “Too often I see founders in this field who are myopic,” said Eusemann. “It’s very easy to focus on the lab or funding, but it’s really important to step out and say, how does this fit into the patient and payor experience?”
A 365° view of the process is key. “Founders should put just as much time into interacting with payers as they do with funders,” advised Marquardt.
The Future of Healthcare: Meeting Patients Where They’re At
The translation of innovations into deployment and adoption often breaks down at one of healthcare’s key junctures – patient access.
For many in healthcare, the largest roadblock in cancer care hasn’t been the science, which is proven effective – it’s been bridging healthcare and the patients who need it.
Founders who want to ensure their innovations make the transition from idea to patient care need to keep access at the forefront of their considerations – and they should be open to connecting to patients in spaces beyond the hospital and the doctor’s office, meeting them where they are at.
If you would like to be a volunteer driver for ACS’s Road to Recovery program for cancer patients, start your journey here.
