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When Seeking Partners, Look for the un-Usual Suspects

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April 1st, 2013
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For many new and growing companies, it’s not enough to have a plan for identifying strategic partners. You also need to successfully implement the plan—and that’s often easier said than done.

Reaching your company goals will no doubt require more capital, perhaps new investors to inject that capital, more third-party involvement, and probably a partner to help with product commercialization. New outside stakeholders add another dimension to your goals; now you’ll need to see how your product/service fits into someone else’s strategy.

How do you find the right fit? The answer actually lies in getting creative in a way that expands the universe of potential partners.

For a company developing a new diagnostic marker, for example, the initial list of possible partners is familiar looking. Those likely to have an interest in the new product would include large diagnostics, pharmaceuticals, and biotech companies developing treatments for whatever your marker could diagnose. But these “usual suspects” are barraged with offers for partnerships and requests for financial assistance just like yours. Adding to this fact is that healthcare product development and technology innovation is risky, requires a long time horizon relative to many other investments, and is more capital-intensive than most other industries. In a perfect world, the usual suspects would always be interested. In reality, that rarely happens.

This is where creativity comes in, where it helps to leverage a mix of diverse perspectives to discover not-so-obvious partnership possibilities. As an example, recently we’ve been developing a business development strategy for a company with a product in the emotional wellness field. Wanting to go beyond the “usual suspects”, we asked, could a very different type of partner be interested? One possible answer: Starbucks. While Starbucks is of course known for coffee, they also spend a good deal of time thinking of the customer experience, which ties into emotional and mental states of mind. In addition, the coffee company probably isn’t getting a lot of partnering requests from medical innovation companies – thus, less competition for our client.

The need to get creative, then, is driven by a necessity to take a lot of shots on goal. And, of course, you’ll still need to validate your creativity, to learn if the company added to your list has the interest, resources, time, and management ability to pursue a relationship with your company.

Our life science and healthcare clients value our guidance, the quality of our ideas, and our ability to articulate a compelling vision. We can help you create new strategies to help get your invention—and company—moving ahead on the commercialization path. To learn more, please subscribe to our newsletter, follow us on Twitter, or send me an email.

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Quantified Self: We Get the Data, But Where’s the Information?

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February 19th, 2013
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Now that a few of the year’s first conferences with a “future of health” or “digital health” focus (e.g., the Consumer Electronics Show (CES) and the JP Morgan Healthcare Conference) have passed, I thought it would be a good time to consider whether consumer-oriented digital health products truly affect outcomes, as often promised.

CES featured an abundance of consumer-oriented devices to measure fitness and track physical activity. There are a growing number of companies – like Jawbone, Fitbit, Nike and Withings – that offer tracking devices, or are introducing new versions. They’re all fairly imprecise by some standards, and measure a variety of parameters, such as number of steps per day, body temperature, heart rate or galvanic skin response, that are then analyzed to measure fitness in a non-specific way.

These devices are primarily aimed at people who have been inactive and are trying to change their behavior and they don’t provide detailed, layered information that serious recreational athletes (e.g., runners) would want. For example, most do not contain a GPS so distance traveled is approximated based on steps and stride length rather than actually measured.

The unanswered question at CES and elsewhere was: How much of the appeal of these devices is just their novelty? Will people keep using these? Clearly, given the relatively nascent state of the industry, we don’t have the answers yet. Of course, the manufacturers know, for example, the number of customers that continue to use the devices after initial activation, but those numbers are typically not disclosed.

Marketing claims aside, it seems reasonable to ask if these devices are likely to make a difference in the health of a majority of consumers who purchase them. Maybe they help people get active, but we’ll need some time to know if they make a difference in helping people stay active. Stated differently, what is the impact of quantification on behavior choice as compared to the impact of general awareness and knowledge (e.g. “exercise is good”)?

Importantly, regardless of the answer, the relatively sudden abundance of these trackers is an element of a larger phenomenon, i.e., the “quantified self” movement. People are taking to measuring various aspects of their lives, something made possible by smartphones and apps, remote sensors, activity trackers and the cloud.

While there is no doubt that the quantified self is adding to the world’s data, I wonder when that data will generate meaningful information. What’s missing is a service that analyzes an individual’s specific data to identify possible correlations to various physiological and emotional states. For example, how does my sleep time and quality correlate to my stress level? Am I at my best when I sleep for the recommended 8 hours or, in my case, might 6 hours be better? Or 10?

As we further understand biology, it should be possible for a personalized trainer (either human or virtual) to provide specific advice on specific diets, workouts, etc., to reach optimum fitness and health levels. Current recommendations for diet and exercise are generalized for a population and as such result in trial and error approaches on the part of individuals. In some ways this is analogous to blockbuster drugs, which often don’t work in a significant number of patients prescribed them. Just as we recognize the potential benefits of personalized (or precision) medicine, there will be a growing awareness that we need more personalized approaches to diet and exercise to achieve optimal health and fitness levels.

At Popper and Company, we think there is a valuable market for innovations that organize and personalize this fitness data – and we’re monitoring the industry closely. We can help you create new ideas (and new inventions) to address true unmet needs, and give your company (and its products) a sustainable market advantage. To learn more, you can subscribe to our newsletter, follow us on Twitter, or send me an email.

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Dealing with the Growing Power of “Medical Googlers”

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November 7th, 2012
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The increased use of the internet by healthcare consumers has led to at least two types of medical conversations ironically illustrated by two different online features sharing a name: the “DocTalk” here, in which Arizona kidney specialists share treatment information on smartphones, and another “DocTalk,” where Ontario physician Stuart Foxman discusses such communications issues as the risks of physician’s giving too much information, and the growing irritation among physicians with patients who research conditions and treatments online.

Like it or not, these two “doc talks” are merging. While physicians and other providers are busily keeping up with changing practice parameters, medical literature and patient management (increasingly by computer, smartphone or tablet), patients are trying to keep up, too. WebMD receives more than 40 million hits a month, and anywhere from half to 80% of all Americans have used the internet to research a medical condition or symptoms. Even larger medical providers like Kaiser Permanente encourage the use of websites for gathering medical information. In addition, consumers increasingly have the ability to research and share opinions on their providers through sites like www.vitals.com.  Interestingly, the ability of consumers to rate and offer opinions on providers is not growing quite as quickly as other industries, due to reasons we’ll cover in a future post.

If you talk to physicians, many are not thrilled with this new “patient empowerment” reality. Some physicians express frustration with patients coming into their offices apparently under the impression – often false – that they are as informed about their medical condition as their doctors. In addition, a new type of patient, the “cyberchondriac,” believes that his or her condition must be the worst one they read about online. This, of course, is not a new problem; even medical students are warned “When you hear hoofbeats, don’t assume they’re zebras.”

What can physicians do, and how can digital healthcare innovation help them? It’s estimated that two thirds of patients now want doctors to recommend reliable websites to them. Doctors should be able to do more than that, and digital technology should help them:

  • Use Google news alerts and other online tools to stay current with the same breaking information that will be read by patients—this will help keep up with consumers but also stay ahead of recent (say, announced that morning) FDA Drug Alerts and other developments.
  • Find and recommend patient groups and discussion communities that benefit patients. There are thousands of such groups online, with tens of thousands of patients. Quick searches will result in better exchange of information and satisfied patients. More of this information can be searched and downloaded via smartphones and other digital technology.
  • Encourage the use of reliable smartphone apps and online news bulletins, clinical research sites and university medical centers. By steering patients/consumers toward the better-designed and monitored sites, both sides benefit from sharing good information.

The internet has made sharing information easier, and caused empowered consumers to demand more from their doctors. This new world isn’t going away, and medical innovators might be well-served to work closely with doctors—no matter the resistance—to encourage the use of information that separates hoofbeats from zebras.

Do you think physician skepticism of online health information is justified? Or is the online power of consumers helping improve and personalize healthcare? How can technology help steer things in the right direction? Is your medical device or digital health company working on a solution? We’d love to hear your thoughts.

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The Physician’s New World of Consumer-Driven Healthcare: A View from Eric Topol

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September 25th, 2012
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We’ve had a lot of discussions about the waves of changes happening in healthcare, thanks to smartphone- and internet-fueled consumer power. In a recent Popper and Company post, Caroline Popper discussed how consumers’ access to information, expectations from the medical profession, focus on wellness (instead of disease) and determination of value are changing the industry.

Dr. Eric Topol, author of The Creative Destruction of Medicine, presented another face of this consumer-driven change; the effects on doctors. In this Medscape video presentation, Dr. Topol suggests that doctors, no longer the sole holder of personal health information, will need to change how they approach their practices as well as their patients.

Consumers are getting health information from many sources. For example, companies like Walgreens are increasing the information content of their consumer interactions. By educating its customers on the data generated by the devices Walgreens sells, patients have more knowledge of their own condition – and a knowledge base that does not start with the physician. Thus, the patient enters the doctor’s office with a more thorough basis of information and more challenging questions. This information base may make physicians uncomfortable, just as direct-to-consumer ads from the pharmaceutical industry have discomforted many. But, as Dr. Topol points out, physicians will continue to have an important role; it’s just going to be a different one.

How will physician roles change in this new world? What does it mean for the device or diagnostic?  Who bears responsibility for patient/consumer education? Watch Dr. Topol’s video here to learn more, and let us know your thoughts.

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A New Healthcare Model Rising from Tradition’s Ashes (and Tim Berners-Lee)

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September 10th, 2012
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Marketing is dead,” proclaims a recent Harvard Business Review blog post, adding that traditional marketing (i.e., advertising, corporate communications, PR, overall branding) doesn’t work anymore. Consumers are finding more personal ways to make buying decisions and increasingly do not value general “push” efforts (other than perhaps to become aware of a product/service).

But what of healthcare? The perspective in the HBR post helps us understand that traditional provider-dominated sharing of healthcare services is also dead. We’re beyond the point of believing what we’re told, particularly if the person doing the telling is a representative of a company and thereby being paid to endorse a particular product or service.

Instead, the model has shifted to one of validation. Consumers conduct research, join online community groups, and listen to trusted influencers. These developments are everywhere now:  discussion groups (e.g. PatientsLikeMe), which connect people by diseases, can often provide more information on an individual’s specific symptom/disease than physicians who, limited by time, tend to be more generally focused.

What started this? The game-changing invention appeared on the scene a long time ago: It was the Internet. Driven by consumer behavior, which correlates with patient and prospective patient (preventative) behavior, the Internet has changed how we address healthcare. Now, learning more about how to identify symptoms and treatment options is no further away than a quick trip to WebMD.

Many physicians are not thrilled with the new reality. Resistance to patients arriving with results of searches and group opinions still threatens the physician-patient relationship, and doctors have a valid point regarding the abundance of inaccurate information available online. But we as consumers have the ability to research our issues, and in many cases can even research our providers.

How can life science and healthcare innovators make this new model work? Most importantly, don’t fight it. Instead try to:

  • Restore community sharing: point patients to groups and sites that facilitate communication in a valuable way (maybe even form your own, or add content and discussion forums to existing site and materials).
  • Identify influencers: they can lead discussions, so make sure they’re informed. Get them involved in rating—or designing—your solutions. This builds their reputation, and yours.
  • Take their advice: let the group promote your valuable contributions, and listen when they don’t promote you. This makes developing product research much easier—now, just be sure to reach out to the right group.

What does this portend?

  • Perhaps this trend (patient empowerment via information) will help drive efficiency through the system, as treatments and diagnoses are more tailored to individuals.
  • More “knowledgeable” patients (or at least armed with more information than before) may allow physicians to focus more on how to treat and less on information collection and simple diagnosis.
  • Difficult cases will still require diagnostic tests, imaging, and in-depth, on-site conversations with practitioners.

Is this a viable new model? How could you incorporate consumer groups and sites into your life science business? Can patients and practitioners reach a common, consumer healthcare ground? Let us know what you think.

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Can “Portfolio Theory” Be Applied to NIH Funding Decisions?

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May 17th, 2012
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The National Institutes of Health has faced some critical fire lately: for funding studies that don’t turn into treatments, for not paying enough heed to the “valley of death” (the stage between bench science and clinical trials), and for not funding enough basic research because of budgetary constraints. But few have asked: how could the agency better select prospective projects?

Researchers at MIT and Brigham and Woman’s Hospital in Boston published an intriguing theory: base NIH funding similarly to how investment companies handle portfolios, complete with return on investment calculations. But what would a rate of return be in biomedical research? Years of life saved per dollar spent, say Andrew Lo and his colleagues in their paper published in PLoS One.

But as the authors and others admit, “years of life saved” is probably an overly simplistic measure. Perhaps the authors were trying to make a point in the most extreme way possible.

The paper does illustrate that NIH’s current criteria for funding should be questioned. The agency currently rates projects according to public needs, scientific quality of the proposal, likelihood of scientific progress, need for diversified research, and the need to support people, equipment and facilities. All but the first criteria are not really related directly to improving healthcare, at least not on the individual patient level.

The “portfolio theory” article succeeded in prompting me not only to think about the shortcomings of the current funding formula but also to question the wisdom of the authors’ proposed alternative:

  • Many disease states—rare diseases, and chronic but painful forms of cancer, for example–would suffer after changing to a “portfolio theory” for allocation of funding, either due to the relatively low number of affected patients or as a result of isolating years of life saved to the exclusion of important benefits like pain reduction.
  • Finance theory tries to maximize one thing; profit, free cash flow, or return on investment (ROI), for example. You can choose which metric to maximize, but you do choose just one.
  • To comprehend other outcomes than years of life saved would require a weighted formula, looking at reduced pain and suffering, quality of life, as well as years of life saved. The determination of these weights would require value judgments that would to some extent reduce the benefit of the new quantitative approach to allocating funds.

Nonetheless, the “portfolio theory” discussion is important, and hopefully can lead to an improvement over the status quo of NIH funding.

Does application of the portfolio theory at NIH work for you? Are there other metrics beyond years of life saved? If you wanted to create a weighted formula for matching funding to healthcare outcomes, how would you do it? We’d love to hear your ideas.

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Optimizing Digital Health’s Future Calls for New Regulatory Vision: A Discussion with a U.S. Congressional Aide

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May 11th, 2012
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Washington, DC, is an impressive city. But too many times, one leaves our nation’s capital scratching one’s head. Understanding how large, complex agencies deal with equally large, complex issues is puzzling enough, but issues that change on an almost-daily basis—such as optimizing the potential of advances in digital health—call for much faster solutions than our bureaucratic system is designed to address.

To discuss ways to resolve the puzzles inherent in regulating digital health opportunities, Paul Sonnier and I met with Keith Studdard, the Legislative Director to U.S. Representative Marsha Blackburn (R-Tenn), who has been advocating a clearer, more streamlined regulatory approach to new developments in digital health.  What was our reaction coming home? Instead of scratching our heads, we were pleasantly surprised by the level of engagement and dedication we found.

Our meeting included an acknowledgement that the Republicans in the U.S. House needed to address digital health regulations in a way that involved Democrats. Despite persistent accusations of partisan gridlock in Congress, I came away sensing a high degree of sincerity, at least judging from the candid remarks coming from Blackburn’s office. One of the biggest problems to legislators and regulators in digital health is uncertainty within the industry, a point Studdard reinforced by citing the old maxim that, while “no” is often an answer that people don’t want to hear, “maybe” is worse, particularly in terms of its impact on business planning. And at the moment, digital health’s regulatory future is replete with “maybes.”

Blackburn has been involved in regulating digital health for at least two years, when a Memorandum of Understanding (MOU) was signed between the Food and Drug Administration (FDA) and the Federal Communications Commission (FCC) to help eliminate the “maybes” and coordinate regulations of mobile health apps, devices and other innovations in digital health. The FDA and FCC agreed that wireless and digital health is a brave new world and admitted they were not equipped to deal with this fast-moving area. The agencies admitted that no policies that existed in 2010 could be written in such a way that comprehends what the mobile health space would mean for consumers or patients. The MOU promised to focus on this.

Blackburn was one of six members of Congress who recently crafted a letter asking for a progress report from the FDA and FCC on this MOU. What should be regulated? How should they determine what gets regulated? What regulations would apply? What’s happened since the signing of the MOU in 2010?

Certainly, patient safety, medical record security, and consumer protection are very important areas to consider from a regulatory perspective. But how much regulation is necessary? And how can these regulations provide safeguards without slowing innovation? What types of regulations do you think are necessary in this area? And how would they keep up with the ever-changing digital health world? Let us know, and we commit to continue engaging with those – like Mr. Studdard – who can help make a difference!

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Eric Topol’s 9 Steps Toward Better Health Care—We Add a 10th

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March 8th, 2012
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There appear to be a growing number of revolutions in health care and the life sciences industry. Whether you’re considering the genomics revolution, the information revolution, or the empowered patient revolution, a strong need to “fix” our health care system – to address the various inefficiencies that cause costs to increase and that put quality of care at risk – seems to be at the root of these movements.

Dr. Eric Topol, a cardiologist and scientist at the Scripps Research Institute, recently published a short article on “How to Change Medicine.” The article, which is excerpted from Dr. Topol’s book, The Creative Destruction of Medicine, provides nine key steps to changing health care delivery: from changing focus from populations to individual patients, to using genomic data to help “fit” treatments for each patient, to redesigning the way doctors are reimbursed.

We agree with all of Dr. Topol’s suggestions, but suggest that there should be a 10th step. Controlling the spiraling costs of drug development is essential to realizing the other changes to the U.S. health care system. Today, it costs more than $1 billion for the discovery and development of new treatments. Since “blockbuster” drugs are so called because they generate $1 billion or more in revenue, even an immensely successful drug may no longer be profitable (and blockbuster drugs are becoming increasingly rare). Some of Dr. Topol’s steps do hint at ways to address these costs:

  • By changing health care’s focus from the population to the individual, tailored drug development could produce more effective drugs that work for smaller groups of patients, reducing clinical trial sizes, and cutting costs.
  • Using genomic data to determine whether a drug benefits a certain patient should underlie the creation of companion diagnostics as well as tailored therapies; this pharmacogenomic approach would speed development (less time to market theoretically means sooner time to profit).
  • “Step 7,” which advocates the rewarding of providers for frugal innovation (e.g., using treatments that improve outcomes and cut costs) can be applied to drug development that considers cost-effectiveness as well as efficacy when creating a new therapy.

Addressing health care costs without emphasizing the need to reduce R&D costs strikes us as akin to worrying about your grocery bill when your mortgage eats up the majority of your budget. Future posts on this blog will address drug development innovations that could help tame this billion-dollar monster, including “low-hanging” fruit (like smaller trials and targeted therapies) that could easily reduce costs in a short period of time.

Do you agree with Dr. Topol’s nine steps? Do you think that reducing drug development costs is a key factor in revolutionizing health care? Could there be enough “low-hanging” solutions to make a difference now? Please share your thoughts with us.

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Introducing Strategic Advisor Paul Sonnier: Digital Health Expert

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January 11th, 2012
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Strategic advisors play an important role at Popper and Co. While our core team provides diversity and expertise to resolve problems and create strategies for companies in the life sciences arena, the unique advice and perspectives that come from our advisors is invaluable and often not available anywhere else.

Paul Sonnier, our third strategic advisor, already has given us—and you, our clients–invaluable advice on the brave new world of digital health. His perspective is vital to understanding the innovations that are opening doors to new paradigms in consumer health and influencing healthcare across the board.

Paul most recently served as vice president of partner development at the Wireless-Life Sciences Alliance (WLSA), a global trade organization that is dedicated to creating value and improving health globally, through the convergence of communications technologies, consumers, caregivers and all sectors of life sciences and technology.

If you are on LinkedIn, and particularly if you are a user of the Groups feature, you may recognize him as the founder of the 8,000+-member Wireless Health group. This group serves as an ethical, curated forum for advancing professional knowledge and relationships among individuals interested in the super-convergence taking place between the digital world and the “medical cocoon,” as dubbed by Dr. Eric Topol. This includes the four domains of what comprises digital medicine (genomics, wireless sensors and devices, imaging and health information systems) along with technological forces ranging from the Internet to mobile connectivity. Since its inception in 2009, the group has increased in scope to include the full digital transformation of consumer health, healthcare delivery, and medicine.

Jumping in with both feet, Paul is attending the Digital Health Summit in Las Vegas this week and will have takeaways to share in future blog posts. Notes Paul, “For some analysts, the feeling is that ‘mHealth’ is stuck in neutral. But digital technology is everywhere and mobile connectivity—enabled by wireless—is one of the driving trends in health, healthcare, as well as the broader consumer markets…” We hope you’ll stay tuned for more insights from Paul.

Via this blog, our Twitter stream at @Popperandco, and through “real-life” interactions, we look forward to continuing to provide you with front-row seats to life science innovations – now with extra depth in digital. And, we’re glad Paul will be helping us by adding his unique expertise and perspective.

Questions for Paul? Thoughts on the potential affects of digital in healthcare? Please share your comments with us.

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A Strategic Lesson in a Tale of Two Drugstores

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November 29th, 2011
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Have you noticed the very different strategic paths taken here of late by Walgreens and CVS, the national drugstore chains? What’s happened so far is a lesson in strategy and the importance of considering unintended consequences and long-term implications. For me, this drugstore case study evokes the old adage, “Be careful what you wish for.”

A recent article in Forbes magazine compares the stock performance of CVS and Walgreens, in an attempt to measure how each chain’s strategic decision around its pharmacy benefit managers (PBMs) program affected both how well each could negotiate terms and prices with insurers as well as its overall pharmacy sales. PBMs are designed to help a drugstore chain win a price advantage over competing chains.

While CVS kept its PBM, Walgreens sold its PBM in March, which meant Walgreens negotiated contracts on its own, or had to rely on other company’s PBMs. The author of the Forbes article questions Walgreens’ strategy, citing declining pharmacy sales and earnings as well as its decreased stock price. CVS, meanwhile, enjoyed increasing sales and earnings, reflected in a stock price increase.

Short-term fluctuations in stock price don’t always correlate with strategic decisions (or sales volume). But the case couldn’t be more black and white here; two similar companies, both faced with similar decisions. One chose one path, and one chose the other.

Which chain made the right decision? It’s too soon to say. Our team at Popper and Company has extensive multidisciplinary experience, but we don’t have a crystal ball. We do spend a lot of time with our life science clients, drawing on the right sets of experience and capabilities to help formulate recommendations about our clients’ strategic alternatives. We pride ourselves in taking the time to think through what all the consequences might be – particularly the unintended type – and to create various scenarios that ultimately lead to our recommended strategy.

Share your thoughts with us. How has your business been helped or harmed by unforeseen consequences of a business decision? Is the PBM story over on CVS and Walgreens? Can your organization create its best of times, even in the worst of times? We look forward to hearing from you.

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