At-Home Covid Tests Are Getting Better

As many of us rush around trying to find the perfect Thanksgiving turkey and holiday gifts, there’s another thing experts recommend we stock up on: at-home tests for Covid-19.

“At-home testing will be essential over the next few months,” said Leana Wen, an emergency physician and professor of health policy at George Washington University.

The most common form of at-home testing is the rapid antigen test — think BinaxNOW, QuickVue, or Ellume — where you swab your own nostrils and get results back in around 15 minutes. These can be found at your local pharmacy, though supply has been erratic (more on this below). Antigen tests are typically contrasted with molecular tests — think lab-based PCR — which are better at picking up the virus, though you have to get swabbed by a professional and then wait, sometimes several days, until results come back.

Now, however, companies like Cue Health and Detect are selling a new class of tests: molecular tests that can be performed entirely at home. They promise PCR-quality results in under an hour — all without ever having to get up off your couch.

If you can find and afford at-home tests — whether they’re the relatively cheap antigen tests or their more expensive molecular cousins — experts say it will be particularly useful for you to have them on hand this fall and winter, for a few reasons.

For Americans who got their first two doses this spring, immunity may well be waning. Data so far shows the vaccines’ effectiveness against infection tapers off around the six-month mark. And so far, only 18 percent of Americans have gotten a booster shot (though that may well rise now that all adults are eligible). That, together with the fact that infection rates are climbing in the US, means breakthrough cases are likely to rise here, as they’ve already begun to do in Europe. And with the weather getting colder and the holidays coming, we’re all going to be spending more time indoors with others.

To be clear, if you’re fully vaccinated, the data shows you’re still well protected from severe disease or death from Covid-19, and reported infections in the US are so far still mainly among unvaccinated people. But should you get a breakthrough infection, you could infect others who are unvaccinated, have waning immunity, or are elderly and thus more at risk for severe illness even if they are vaccinated. That’s what testing can prevent.

“We need to shift from thinking about at-home testing as just a diagnostic tool to thinking about it as a preventative tool,” said Wen, who recommends taking a test before an indoor social gathering even if you’re not feeling symptoms.

Neil Sehgal, a health policy professor at the University of Maryland School of Public Health, told me he’s about to fly from Washington, DC, to California to spend Thanksgiving with relatives there. Everyone in his family plans to take a rapid test before the holiday meal, he said, to help ensure they don’t pose a risk to others.

“The challenge right now is that even if you are vaccinated, your breakthrough infection is a link in a chain that may end up infecting somebody for whom consequences may be more serious than for you,” Sehgal told me. “We all have to make a decision about whether or not we want to participate in those chains of transmission.”

Likewise, Wen said she’s planning to use rapid tests for holiday get-togethers. She also finds them useful for birthday parties and dinner parties; now that it’s getting too cold for outdoor meals, her family and her invited guests test before gathering in her home.

Both experts noted that there’s an additional reason why it’s useful to keep a few tests in your house in the coming months: Antiviral pills for Covid-19, produced by Merck and Pfizer, will probably soon be available in the US under an emergency use authorization. But these treatments are most effective if you take them soon after you’ve become infected. That means it’s in your interest to catch the virus early on — and having a test close to hand can help you do that.

It shouldn’t be so hard to get at-home tests. Here’s what went wrong.

One issue clouds these expert recommendations: The availability of at-home test kits has been spotty at best.

An American, looking at how easy it is to snag a rapid test across the pond in the UK or Germany, could be forgiven for feeling a pang of envy — and a hefty dose of frustration. More than a year and a half into the pandemic, over-the-counter antigen tests are often sold out at stores like CVS or Walgreens.

Despite the Biden administration’s decision to invest $1 billion in rapid tests, the market remains constrained, in part because of regulatory hurdles. Early on, the US decided to categorize these tests as medical devices, which means they needed to pass a stringent FDA approval process, Sehgal explained. As a result, only a few companies’ tests squeezed through to market in 2021.

“We’ve been slow to adopt and approve them in the US because they’re not as sensitive as PCR tests,” Sehgal said. But even though antigen tests are not foolproof at detecting the virus, “they are sensitive enough to give you a pretty realistic sense of whether you pose a risk to the people you’re gathering with” — that is, of whether you’re actively contagious.

“I do think a more public-health-minded mental model would have led to quicker approval of more rapid antigen testing options,” Sehgal continued. In other words, the US should have conceived of the tests as a harm reduction measure: We know they’re not perfect, but if we deploy them at scale, they’ll reduce harm overall.

“The FDA would still have to approve them under an emergency use authorization to make it to market, but the urgency with which the FDA has acted with vaccines could have been similarly applied to testing. If so, I think we’d have seen earlier approvals for more domestic manufacturers of rapid tests,” he added.

Another reason for the low stock is simply that bigger purchasers snapped up a lot of the tests early on. Companies, sports teams, and school systems placed bulk orders in the spring and ate up a lot of the stock before the general public could get to it. “They made contracts because they knew that to resume in-person activity, this would be a good strategy,” Sehgal said.

The upshot is that when regular individuals walk into their drugstores to try and buy a couple boxes, there’s not much left on the shelf.

Under the Trump administration, officials at times appeared to discourage testing, for fear that it would reveal more positive cases. Instead, the US focused on developing vaccines at warp speed, thinking of them as the silver bullet that would destroy the pandemic.

But this fall, the Biden administration decided to make testing a more integral part of its pandemic strategy. White House coronavirus response coordinator Jeff Zients said in October that the $1 billion investment “puts us on track to quadruple the amount of at-home, rapid tests available for Americans by December. So that means we’ll have available supply of 200 million rapid, at-home tests per month starting in December.”

Many experts hailed it as a welcome, if overdue, commitment.

“What rapid tests do is they allow us to live more peacefully with this virus — to actually be able to not have it be so disruptive to society,” Michael Mina, an epidemiologist who’s been one of the most vocal proponents of rapid tests, told the Washington Post. These tests can make quarantines unnecessary, allowing us “to keep students in school, to keep businesses running and to stop the need for shutdowns, even amid outbreaks.”

The next generation of at-home tests

Up till now, at-home testing has been pretty much synonymous with antigen tests, such as BinaxNOW or QuickVue. Overall, these tests’ sensitivity tends to be in the range of 85 percent, meaning they miss about 15 percent of people who are infected. That said, they’re very good at detecting an infection when people have high viral loads, which is when they’re likeliest to infect others.

Molecular tests are considered the gold standard in Covid-19 testing. They take your sample and amplify the genetic material in it many times over, so if there’s even a tiny shred of virus in it, they will almost certainly detect it. Traditionally, the downside has been that you need a professional to swab you and a lab to process your results.

At-home molecular testing is starting to change that. This month, the health tech company Cue Health began selling directly to consumers a molecular test that can be performed entirely at home. You can buy it online, no prescription needed, and get lab-quality results without leaving home, according to the company. The Cue test shows results in line with lab PCR results 97.8 percent of the time, as verified in an independent study conducted by the Mayo Clinic.

And it’s quick, offering results in 20 minutes, similar to the wait time for antigen tests. There’s a catch, though: It’s not cheap. A three-pack of single-use tests will run you $225, and that’s not counting the reusable reader, which costs $250. At that price point, it’s far from ripe for equitable access. (For comparison, antigen tests are priced from about $10 to $40 per test.)

“We’re not priced like an antigen test, but we don’t perform like an antigen test,” said Clint Sever, Cue’s co-founder and chief product officer, adding that the test is used by the likes of Google, NASA, and the NBA. “It’s a breakthrough technology.”

Detect is another health tech company offering an at-home molecular test (the product will be available soon). This one will also come with a reusable hub and single-use individual tests. With the hub priced at $39 and each test at $49, Detect’s system will be more affordable than Cue’s, though still pricier than an antigen test. The Detect test is 97.3 percent accurate, similar to a PCR lab test, according to Axios. It returns results in one hour.

Both Cue’s and Detect’s tests have earned an emergency use authorization from the FDA, and both companies have their sights set on much more than just Covid-19 testing. With a bit of tweaking, their platforms should be able to test for other health issues, too.

Detect’s plan “is that you’ll be able to get a flu test or a Covid test or whatever you need, at home,” Owen Kaye-Kauderer, the company’s chief business officer, told Axios.

Cue envisions a future where its reader will be able to test you for everything from the flu and strep throat to chlamydia and gonorrhea. “Covid has basically accelerated the transition to virtual care services and connected diagnostics,” Sever told me.

The fundamental innovation here — giving your humble home the diagnostic capabilities of a professional lab — will likely become popular in many areas of health care over the next few years. That helps explain why companies like Cue and Detect are eager to get into the game, even though many experts say that as we approach springtime, Covid-19 will likely be entering the endemic phase: It’ll keep circulating in parts of the population, but its prevalence and impact will come down to relatively manageable levels, so it becomes more like the flu than a world-stopping disease.

“When we get to the point where transmission has slowed and we enter the endemic phase,” Sehgal said, “at-home testing becomes much less important.”

In the meantime, Wen recommends that each family keep a few at-home tests in the house. Don’t fret too much about whether they’re antigen or molecular; get what you can find and afford.

“This is a case of ‘don’t let the perfect be the enemy of the good,’” she said. “These tests can allow us to go from Covid-19 as a threat that feels almost existential to just another risk among all the risks we take into account every day. They can let us get back the normalcy we’re craving.”

Sigal Samuel

Source: At-home Covid tests are getting better. Stock up for winter holidays. – Vox

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More Contents:

How Will the COVID Pills Change the Pandemic?

In March, 2020, researchers at Emory University published a paper about a molecule called NHC/EIDD-2801. At the time, there were no treatments available for the coronavirus. But NHC/EIDD-2801, the researchers wrote, possessed “potency against multiple coronaviruses,” and could become “an effective antiviral against SARS-CoV-2.” A few days later, Emory licensed the molecule to Ridgeback Biotherapeutics, a Miami-based biotechnology company which had previously developed a monoclonal antibody for Ebola.

Ridgeback partnered with the pharmaceutical giant Merck to accelerate its development.The Emory researchers named their drug molnupiravir, after Mjölnir—the hammer of Thor. It turns out that this was not hyperbole. Last month, Merck and Ridgeback announced that molnupiravir could reduce by half the chances that a person infected by the coronavirus would need to be hospitalized. The drug was so overwhelmingly effective that an independent committee asked the researchers to stop their Phase III trial early—it would have been unethical to continue giving participants placebos.

None of the nearly four hundred patients who received molnupiravir in the trial went on to die, and the drug had no major side effects. On November 4th, the U.K. became the first country to approve molnupiravir; many observers expect that an emergency-use authorization will come from the U.S. Food and Drug Administration in December.

Oral antivirals like molnupiravir could transform the treatment of COVID-19, and of the pandemic more generally. Currently, treatments aimed at fighting COVID—mainly monoclonal antibodies and antiviral drugs like remdesivir—are given through infusion or injection, usually in clinics or hospitals. By the time people manage to arrange a visit, they are often too sick to receive much benefit. Molnupiravir, however, is a little orange pill.

A person might wake up, feel unwell, get a rapid COVID test, and head to the pharmacy around the corner to pick up a pack. A full course, which needs to start within five days of the appearance of symptoms, consists of forty pills—four capsules taken twice a day, for five days. Merck is now testing whether molnupiravir can prevent not just hospitalization after infection but also infection after exposure.

If that’s the case, then the drug might be taken prophylactically—you could get a prescription when someone in your household tests positive, even if you haven’t.Molnupiravir is—and is likely to remain—effective against all the major coronavirus variants. In fact, at least in the lab, it works against any number of RNA viruses besides SARS-CoV-2, including Ebola, hepatitis C, R.S.V., and norovirus. Instead of targeting the coronavirus’s spike protein, as vaccine-generated antibodies do, molnupiravir attacks the virus’s basic replication machinery. The spike protein mutates over time, but the replication machinery is mostly set in stone, and compromising that would make it hard for the virus to evolve resistance.

Once it’s inside the body, molnupiravir breaks down into a molecule called NHC. As my colleague Matthew Hutson explained, in a piece about antiviral drugs published last year, NHC is similar to cytosine, one of the four “bases” from which viral RNA is constructed; when the coronavirus’s RNA begins to copy itself, it slips into cytosine’s spot, in a kind of “Freaky Friday” swap. The molecule evades the virus’s genetic proofreading mechanisms and wreaks havoc, pairing with other bases, introducing a bevy of errors, and ultimately crashing the system.

A drug that’s so good at messing with viral RNA has led some to ask whether it messes with human DNA, too. (Merck’s trial excluded pregnant and breast-feeding women, and women of childbearing age had to be on contraceptives.) This is a long-standing concern about antiviral drugs that introduce genomic errors. A recent study suggests that molnupiravir, taken at high doses and for extended periods, can, in fact, introduce mutations into DNA. But, as the biochemist Derek Lowe noted, in a blog post for Science, these findings probably don’t apply directly to the real-world use of molnupiravir in COVID patients. The study was conducted in cells, not live animals or humans.

The cells were exposed to the drug for more than a month; even at the highest doses, it caused fewer mutations than were created by a brief exposure to ultraviolet light. Meanwhile, Merck has run a battery of tests—both in the lab and in animal models—and found no evidence that molnupiravir causes problematic mutations at the dose and duration at which it will be prescribed.With winter approaching, America is entering another precarious moment in the pandemic. Coronavirus cases have spiked in many European countries—including some with higher vaccination rates than the U.S.—and some American hospitals are already starting to buckle under the weight of a new wave. Nearly fifty thousand Americans are currently hospitalized with COVID-19.

It seems like molnupiravir is arriving just when we need it.It isn’t the only antiviral COVID pill, either. A day after the U.K. authorized Merck’s drug, Pfizer announced that its antiviral, Paxlovid, was also staggeringly effective at preventing the progression of COVID-19 in high-risk patients. The drug, when taken within three days of the onset of symptoms, reduced the risk of hospitalization by nearly ninety per cent. Only three of the nearly four hundred people who took Paxlovid were hospitalized, and no one died; in the placebo group, there were twenty-seven hospitalizations and seven deaths. Paxlovid is administered along with another antiviral medication called ritonavir, which slows the rate at which the former drug is broken down by the body.

Like Merck, Pfizer is now examining whether Paxlovid can also be used to prevent infections after an exposure. Results are expected early in 2022. (It’s not yet known how much of a difference the drugs will make for vaccinated individuals suffering from breakthrough infections; Merck’s and Pfizer’s trials included only unvaccinated people with risk factors for severe disease, such as obesity, diabetes, or older age. Vaccinated individuals are already much less likely to be hospitalized or die of COVID-19.)

Living in an Age of ExtinctionPaxlovid interrupts the virus’s replication not by messing with its genetic code but by disrupting the way its proteins are constructed. When a virus gets into our cells, its RNA is translated into proteins, which do the virus’s dirty work. But the proteins are first built as long strings called polypeptides; an enzyme called protease then slices them into the fragments from which proteins are assembled.
If you can’t cut the plywood, you can’t build the table, and Paxlovid blunts the blade. Because they employ separate mechanisms to defeat the virus, Paxlovid and molnupiravir could, in theory, be taken together. Some viruses that lead to chronic infections, including H.I.V. and hepatitis C, are treated with drug cocktails to prevent them from evolving resistance against a single line of attack. This approach is less common with respiratory viruses, which don’t generally persist in the body for long periods.
But combination antiviral therapy against the coronavirus could be a subject of study in the coming months, especially among immunocompromised patients, in whom the virus often lingers, allowing it the time and opportunity to generate mutations.

Merck will be producing a lot of molnupiravir. John McGrath, the company’s senior vice-president of manufacturing, told me that Merck began bolstering its manufacturing capacity long before the Phase III trial confirmed how well the drug worked. Normally, a company assesses demand for a product, then brings plants online slowly. For molnupiravir, Merck has already set up seventeen plants in eight countries across three continents. It now has the capacity to produce ten million courses of treatment by the end of this year, and at least another twenty million next year.

It expects molnupiravir to generate five to seven billion dollars in revenue by the end of 2022.How much will all these pills soften the looming winter surge? As has been true throughout the pandemic, the answer depends on many factors beyond their effectiveness. The F.D.A. could authorize molnupiravir within weeks, and Paxlovid soon afterward. But medications only work if they make their way into the body. Timing is critical. The drugs should be taken immediately after symptoms start—ideally, within three to five days. Whether people can benefit from them depends partly on the public-health infrastructure where they live. In Europe, rapid at-home COVID tests are widely available.

Twenty months into the pandemic, this is not the case in much of the U.S., and many Americans also lack ready access to affordable testing labs that can process PCR results quickly.Consider one likely scenario. On Monday, a man feels tired but thinks little of it. On Tuesday, he wakes up with a headache and, in the afternoon, develops a fever. He schedules a COVID test for the following morning. Two days later, he receives an e-mail informing him that he has tested positive. By now, it’s Friday afternoon. He calls his doctor’s office; someone picks up and asks the on-call physician to write a prescription. The man rushes to the pharmacy to get the drug within the five-day symptom-to-pill window.

Envision how the week might have unfolded for someone who’s uninsured, elderly, isolated, homeless, or food insecure, or who doesn’t speak English. Taking full advantage of the new drugs will require vigilance, energy, and access.Antivirals could be especially valuable in places like Africa, where only six per cent of the population is fully vaccinated. As they did with the vaccines, wealthy countries, including the U.S. and the U.K., have already locked in huge contracts for the pills; still, Merck has taken steps to expand access to the developing world.

It recently granted royalty-free licenses to the Medicines Patent Pool, a U.N.-backed nonprofit, which will allow manufacturers to produce generic versions of the drug for more than a hundred low- and middle-income countries. (Pfizer has reached a similar agreement with the Patent Pool; the company also announced that it will forgo royalties for Paxlovid in low-income countries, both during and after the pandemic.) As a result, a full course of molnupiravir could cost as little as twenty dollars in developing countries, compared with around seven hundred in the U.S. “Our goal was to bring this product to high-, middle-, and low-income countries at fundamentally the same time,” Paul Schaper, Merck’s executive director of global pharmaceutical policy, told me.

More than fifty companies around the world have already contacted the Patent Pool to obtain a sublicense to produce the drug, and the Gates Foundation has pledged a hundred and twenty million dollars to support generic-drug makers. Charles Gore, the Patent Pool’s executive director, recently said that, “for large parts of the world that have not got good vaccine coverage, this is really a godsend.” Of course, the same challenges of testing and distribution will apply everywhere.

Last spring, as a doctor caring for COVID patients, I was often dismayed by how little we had to offer. We tried hydroxychloroquine, blood thinners, and various oxygen-delivery devices and ventilator maneuvers; mostly, we watched as patients got better or got worse on their own. In the evenings, as I walked the city’s deserted streets, I often asked myself what kinds of treatment I wished we had. The best thing, I thought, would be a pill that people could take at home, shortly after infection, to halt the cascade of biological processes that sends them to the hospital, the I.C.U., or worse.

We will soon have not one but two such treatments. Outside of the vaccines, the new antiviral drugs are the most important pharmacologic advance of the pandemic. As the coronavirus becomes endemic, we’ll need additional tools to treat the inevitable infections that will continue to strike both vaccinated and unvaccinated people. These drugs will do that, reducing the damage that the coronavirus can inflict and, possibly, cordoning off avenues through which it can spread. Still, insuring that they are meaningfully and equitably used will require strength in the areas in which the U.S. has struggled: early and accessible testing; communication and coördination across health-care providers; fighting misinformation and building trust in rapid scientific advances. Just as vaccines don’t help without shots in arms, antivirals can’t work without pills in people.

 

Source: https://www.newyorker.com/

More on the Coronavirus

JP Morgan Chase Launches Its Own Health Business Unit Three Months After Haven Implodes

https://g.foolcdn.com/image/?url=https%3A%2F%2Fg.foolcdn.com%2Feditorial%2Fimages%2F616249%2Fjpmorgan-branch-courtesy.jpg&w=1200&h=630&op=resize

JPMorgan Chase is staking out its own healthcare venture, after its joint project with Berkshire Hathaway and Amazon failed earlier this year. On Thursday, the financial firm announced the launch of Morgan Health, a business unit focused on improving employer-sponsored healthcare, to be led by Dan Mendelson, founder and former CEO of the Washington, D.C.-based healthcare consultancy Avalere Health.

The move comes a little over three months since the joint venture Haven Health, which also aimed to lower employee healthcare costs and boost quality services, said it would be winding down.

Morgan Health will invest up to $250 million in “promising healthcare solutions” and will also enter into strategic partnerships, the company said. The new division, which will be headquartered in Washington, D.C., will also focus on health equity issues.

“JPMorgan Chase has been focused on improving healthcare for its employees for many years,” Morgan Health CEO Mendelson said in a statement. “We are going to take what we’ve learned and accelerate healthcare innovation in the employer-sponsored healthcare market, partnering with and investing in companies that share our goals, and measuring key health outcomes to show what works.”

Mendelson has a background in both health policy and finance. He was an operating partner at healthtech PE firm Welsh Carson for the past two years and served as the associate director for health in the Office of Management and Budget in the Clinton White House prior to founding Avalere. With 165,000 employees in the United States, JPMorgan Chase provides health insurance to around 285,000 people, including dependents.

Haven was announced with much fanfare in 2018, with billionaire Warren Buffet calling rising employee healthcare costs “a hungry tapeworm on the American economy.” Around half of Americans receive healthcare benefits through their employers, according to the Kaiser Family Foundation. The federal government estimates total national healthcare spending reached $3.8 trillion, or $11,582 per person, in 2019. And health spending continues to outpace inflation, growing 4.6% in 2019.

The implosion of Haven three years later demonstrated how even well-capitalized corporate juggernauts could be thwarted by the complexity of the U.S. healthcare system. “We were fighting a tapeworm in the American economy, and the tapeworm won,” Buffet said at Berkshire’s annual shareholder meeting earlier this month, according to Yahoo Finance.

“Haven was supposed to show how creativity, ingenuity and private sector, entrepreneurship could beat the healthcare sector. And it failed,” David Blumenthal, a physician and president of the healthcare think-tank The Commonwealth Fund, told Forbes in an interview earlier this year.

He said the speculation as to one of the big challenges Haven faced was that each company wanted to make its own choices for its employees, which has been the downfall of many similar coalitions. Amazon has also been making its own big push into the healthcare sector recently with a virtual primary care service called Amazon Care, the launch of its wearable Amazon Halo and its purchase of online pharmacy PillPack for $750 million.

The radical change needed to control healthcare costs requires buy-in on many levels, including some that employees might not be happy about, says Blumenthal. It could mean narrower networks of physicians to choose from or requiring travel for certain surgeries so they take place at top-ranked facilities, as opposed to the comfort of a local community hospital.

But the biggest impediments are structural—the lack of purchasing power for employers and consolidation among health systems, he said. “In the end, controlling costs in almost every other Western country is a responsibility that government assumes,” Blumenthal said. “It’s for precisely this reason that the alternatives are not effective.”

Despite what may be an uphill battle ahead, JPMorgan leadership is giving it another go. “Covid has shed light on both the greatness of our healthcare system and its challenges,” Peter Scher, vice chairman of the company who will be overseeing Morgan Health, said in a statement. “The firm has been investing in developing solutions to address social and economic challenges over the past 10 years. We plan to take what we’ve learned there and apply it to healthcare.”

Follow me on Twitter or LinkedIn. Send me a secure tip.

I am a staff writer at Forbes covering healthcare, with a focus on digital health and new technologies. I was previously a healthcare reporter for POLITICO covering the European Union from Brussels and the New Jersey Statehouse from Trenton. I have also written for the Los Angeles Times and Business Insider. I was a 2019-2020 Knight-Bagehot Fellow in business and economics reporting at Columbia University. Email me at kjennings@forbes.com or find me on Twitter @katiedjennings.

Source: JP Morgan Chase Launches Its Own Health Business Unit Three Months After Haven Implodes

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References

 

“The History of JPMorgan Chase & Co.: 200 Years of Leadership in Banking, company-published booklet, 2008, p. 5. Predecessor to J.P. Morgan & Co. was Drexel, Morgan & Co., est. 1871. Retrieved July 15, 2010. Other predecessors include Dabney, Morgan & Co. and J.S. Morgan & Co” (PDF).

Billionaire Eric Lefkofsky’s Tempus Raises $200 Million To Bring Personalized Medicine To New Diseases

On the surface, Eric Lefkofsky’s Tempus sounds much like every other AI-powered personalized medicine company. “We try to infuse as much data and technology as we can into the diagnosis itself,” Lefkofsky says, which could be said by the founder of any number of new healthcare companies.. But what makes Tempus different is that it is quickly branching out, moving from a focus on cancer to additional programs including mental health, infectious diseases, cardiology and soon diabetes. “We’re focused on those disease areas that are the most deadly,” Lefkofsky says. 

Now, the billionaire founder has an additional $200 million to reach that goal. The Chicago-based company announced the series G-2 round on Thursday, which includes a massive valuation of $8.1 billion. Lefkofsky, the founder of multiple companies including Groupon, also saw his net worth rise from the financing, from an estimated $3.2 billion to an estimated $4.2 billion.

Tempus is “trying to disrupt a very large industry that is very complex,” Lefkofsky says, “we’ve known it was going to cost a lot of money to see our business model to fruition.” 

In addition to investors Baillie Gifford, Franklin Templeton, Novo Holdings, and funds managed by T. Rowe Price, Lefkofsky, who has invested about $100 million of his own money into the company since inception, also contributed an undisclosed amount to the round. Google also participated as an investor, and Tempus says it will now store its deidentified patient data on Google Cloud. 

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“We are particularly attracted to companies that aim to solve fundamental and complex challenges within life sciences,” says Robert Ghenchev, a senior partner at Novo Holdings. “Tempus is, in many respects, the poster child for the kind of companies we like to support.” 

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Tempus, founded by Lefkofsky in 2015, is one of a new breed of personalized cancer diagnostic companies like Foundation Medicine and Guardant Health. The company’s main source of revenue comes from sequencing the genome of cancer patients’ tumors in order to help doctors decide which treatments would be most effective. “We generate a lot of molecular data about you as a patient,” Lefkofsky says. He estimates that Tempus has the data of about 1 in 3 cancer patients in the United States. 

But billing insurance companies for sequencing isn’t the only way the company makes money. Tempus also offers a service that matches eligible patients to clinical trials, and it licenses  de-identified patient data to other players in the oncology industry. That patient data, which includes images and clinical information, is “super important and valuable,” says Lefkofsky, who adds that such data sharing only occurs if patients consent. 

At first glance, precision oncology seems like a crowded market, but analysts say there is still plenty of room for companies to grow. “We’re just getting started in this market,” says Puneet Souda, a senior research analyst at SVB Leerink, “[and] what comes next is even larger.” Souda estimates that as the personalized oncology market expands from diagnostics to screening, another $30 billion or more will be available for companies to snatch up. And Tempus is already thinking ahead by moving into new therapeutic areas. 

While it’s not leaving cancer behind, Tempus has branched into other areas of precision medicine over the last year, including cardiology and mental health. The company now offers a service for psychiatrists to use a patient’s genetic information to determine the best treatments for major depressive disorder. 

In May, Lefkofsky also pushed the company to use its expertise to fight the coronavirus pandemic. The company now offers PCR tests for Covid-19, and has run over 1 million so far. The company also sequences other respiratory pathogens, such as the flu and soon pneumonia. As with cancer, Tempus will continue to make patient data accessible for others in the field— for a price. “Because we have one of the largest repositories of data in the world,” says Lefkofsky, “[it is imperative] that we make it available to anyone.” 

Lefkofsky plans to use capital from the latest funding round to continue Tempus’ expansion and grow its team. The company has hired about 700 since the start of the pandemic, he says, and currently has about 1,800 employees. He wouldn’t comment on exact figures, but while the company is not yet profitable he says Tempus has reached “significant scale in terms of revenue.” 

And why is he so sure that his company’s massive valuation isn’t over-inflated? “We benefit from two really exciting financial sector trends,” he says: complex genomic profiling and AI-driven health data. Right now, Lefkofsky estimates, about one-third of cancer patients have their tumors sequenced in three years. Soon, he says, that number will increase to two-thirds of patients getting their tumors sequenced multiple times a year. “The space itself is very exciting,” he says, “we think it will grow dramatically.” Follow me on Twitter. Send me a secure tip

Leah Rosenbaum

Leah Rosenbaum

I am the assistant editor of healthcare and science at Forbes. I graduated from UC Berkeley with a Master’s of Journalism and a Master’s of Public Health, with a specialty in infectious disease. Before that, I was at Johns Hopkins University where I double-majored in writing and public health. I’ve written articles for STAT, Vice, Science News, HealthNewsReview and other publications. At Forbes, I cover all aspects of health, from disease outbreaks to biotech startups.

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Eric Lefkofsky

To impact the nearly 1.7 million Americans who will be newly diagnosed with cancer this year, Eric Lefkofsky, co-founder and CEO of Tempus, discusses with Matter CEO Steven Collens how he is applying his disruptive-technology expertise to create an operating system to battle cancer. (November 29, 2016)

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Expert Pharmacist GEMMA FROMAGE Reveals How To Save £200-a-Year On Everyday Essentials

For every condition, there is often a branded over-the-counter remedy we instinctively reach for. And yet there will be a cheaper version with identical contents that could save you a small fortune. Pharmacist GEMMA FROMAGE reveals the definitive guide to the best buys to fill your medicine cabinet.

Painkillers 

Best buys: Aspar Paracetamol 500mg, 16 caplets, 25p, sainsburys.co.uk; Bell’s Ibuprofen 200mg, 16 tablets, 45p, lloydspharmacy.comAnnual saving: £55.20* (Based on the average person buying eight packs of paracetamol a year, and for women, 12 packs of ibuprofen — one for each menstrual period.)

Some branded versions have special coatings, or are contained in soft capsules, and may dissolve more quickly in the body — however, the difference in speed of pain relief will be minimal

Some branded versions have special coatings, or are contained in soft capsules, and may dissolve more quickly in the body — however, the difference in speed of pain relief will be minimal

Expert says: The price of painkillers can vary hugely, yet the own-brand or cheaper versions will contain the same active ingredient in the exact same doses. As a result, they will do the exact same job as any expensive, branded options despite being up to ten times cheaper in some cases.

Some branded versions have special coatings, or are contained in soft capsules, and may dissolve more quickly in the body — however, the difference in speed of pain relief will be minimal.

Also, despite some products claiming to be designed for a specific type of pain, such as migraine or back pain, oral painkillers do not target one type alone, they work throughout the body so it won’t be targeted relief (but gels may offer this, see below).

Paracetamol and ibuprofen work differently: paracetamol can reduce a fever and ease cold and flu symptoms, whereas ibuprofen (which may also ease some of these problems) is an anti-inflammatory and so is beneficial for muscle aches and period pain. 

Antibacterial mouthwash 

Wisdom Chlorhexidine Antibacterial Mouthwash fresh mint

Best buy: Wisdom Chlorhexidine Antibacterial Mouthwash fresh mint, 300ml, £1.49, groceries.asda.com Annual saving: £35.10 (Based on going through ten bottles a year.)

Expert says: Studies have shown that chlorhexidine is the most effective mouthwash ingredient for killing bacteria that cause plaque and lead to gum disease (specifically gingivitis).

Despite the difference of more than £3.50 for the same size bottle of the branded version, the cheapest product contains the same active ingredient and will be just as effective in easing inflammation, swelling and bleeding associated with gum disease.

As with all mouthwash, use at a different time from brushing, as slooshing straight after will wash away most of the protective fluoride in toothpaste.

Allergy tablets

Best buys: Galpharm Cetirizine Hayfever And Allergy Relief, 30 tablets, £1.45, cooppharmacy.coop

Annual saving: £34.20 (Based on getting through four boxes over a year.)

Expert says: With an astounding £8.55 difference in price compared to the leading brand, it is hard to believe that the products contain the exact same 30 tablets of cetirizine at the same dose.

This medicine blocks the effects of histamine in your body, which immune cells release during an allergic response to a perceived irritant, such as pollen, which in turn causes symptoms such as sneezing and a runny nose. Take one a day.

Rehydration sachets  

Best buy: Asda Rehydration Treatment blackcurrant flavour, six sachets, £2.25, asda.com Annual saving: £6.16 (Based on buying a box four times a year.)

Asda Rehydration Treatment blackcurrant flavour

Asda Rehydration Treatment blackcurrant flavour

Expert says: Rehydration sachets — which you dissolve in a glass of water — contain electrolytes, vital salts such as sodium citrate and potassium chloride which keep the muscles and nervous system functioning properly (as well as sugar for energy). The body loses these as a result of diarrhoea, through dehydration, causing symptoms such as dizziness, headaches and tiredness.

Rehydration salts restore the natural balance of salts and fluid in the body, and help eliminate symptoms of dehydration.

There may be slight differences in the salts themselves, from one more expensive product to the next (and prices can be more than double this Asda option), but the overall effect will be the same.

Adults should mix one sachet with water and drink immediately after a loose bowel motion. (Do not give to children under two unless told to do so by a doctor.) If symptoms persist for more than 48 hours, seek medical advice.

LloydsPharmacy Chloramphenicol Eye Ointment

LloydsPharmacy Chloramphenicol Eye Ointment

Eye ointment

Best buy: LloydsPharmacy Chloramphenicol Eye Ointment, 4g, £4.99, lloydspharmacy.com

Annual saving: £5.22 (Based on buying two tubes a year.)

Expert says: Eye infections such as bacterial conjunctivitis are common, and the ointment used to treat them contains the active ingredient chloramphenicol, an antibiotic which stops the bug from growing and spreading.

There are many versions on pharmacy shelves, but the ointment always contains 1 per cent chloramphenicol (the drops always contain 0.5 per cent).

You apply a small amount to the infected eye three to four times a day for five days. A tube has to be binned 28 days after opening.

Nasal spray

Wilko Decongestant Nasal Spray

Wilko Decongestant Nasal Spray

Best buy: Wilko Decongestant Nasal Spray, 15ml, £1.75, wilko.com

Annual saving: £10.56 (Based on using four a year.)

Expert says: As part of the immune response during a cold, blood vessels swell, membranes become congested, and as a result the nose feels blocked.

Decongestant nasal sprays contain oxymetazoline hydrochloride which can help relieve symptoms by narrowing the small blood vessels in the nose. This brings down the swelling and helps open up the nasal passages to make breathing easier.

All sprays should work within minutes and the effects last for up to 12 hours. Identical sprays can cost up to four times as much.

Cold sore cream

Best buy: Bell’s Lipsore, 2g, £1, wilko.com Annual saving: £20.80 (Based on needing four a year.)

Expert says: At some point an estimated seven in ten of us will be infected with the virus HSV-1 (also known as herpes simplex virus type 1), which causes cold sores.

And once you have the virus, it is always in your body, where it lies dormant and is reactivated by triggers such as sunlight, stress and cold weather.

Treatments can speed up healing or try to halt outbreaks.

One of the most effective over-the-counter remedies is acyclovir, which stops the virus from reproducing, and in turn reduces the duration and severity of blisters.

Some products cost more than six times as much as this cut-price option, for the same size bottle with the same active dose.

Simply apply to the affected area with a cotton bud five times a day. 

Bell’s Lipsore

For cystitis 

Galpharm Cystocalm cystitis relief

Galpharm Cystocalm cystitis relief

Best buy: Galpharm Cystocalm cystitis relief, pack of six, £1.20, wilko.com

Annual saving: £7.40 (Based on using two packets a year.)

Expert says: Cystitis is an inflammation of the bladder, usually caused by a bladder infection, which causes acidic urine, irritation and an unpleasant burning sensation when passing water.

An effective remedy like this contains sodium citrate, which will make the urine less acidic, thus providing relief of the symptoms in a few hours — but some remedies can cost four times as much.

Mix with water and drink three times a day.

If you have no improvement in symptoms in three days, suffer regularly, or have blood in your urine, then see your GP. 

Ibuprofen gel 

Best buy: Tesco Ibuprofen Gel, 35g, £1.85, tesco.com

Annual saving: £12.42 (Based on buying three a year.)

Expert says: This anti-inflammatory gel contains 5 per cent ibuprofen — but identical versions can cost from £1.85 to £6 for the same size tube.

The gels are beneficial for massaging into muscular aches and pains.

Unlike oral painkillers, which get into the bloodstream and travel around the body, the ibuprofen in the gel is locally absorbed into the skin where it is applied.

This means that pain relief can be accurately targeted.

Massage the gel into the skin until fully absorbed, up to a maximum of three times a day.

Expert says: This anti-inflammatory gel contains 5 per cent ibuprofen — but identical versions can cost from £1.85 to £6 for the same size tube

Expert says: This anti-inflammatory gel contains 5 per cent ibuprofen — but identical versions can cost from £1.85 to £6 for the same size tube

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Tesco Health Chesty Cough Relief

Tesco Health Chesty Cough Relief

Cough syrup

Best buy: Tesco Health Chesty Cough Relief, 300ml, £2.25, tesco.com

Annual saving: £11.48 (Based on using two bottles a year.)

Expert says: A common ingredient in cough syrups is guaifenesin, which reduces chest congestion caused by colds or infections. It does this by loosening phlegm and making it easier to cough out.

Differences in these cough mixtures tends to be due to ingredients that make it taste better. However, this has no effect on how the product works, yet can cost four times more. 

Cold and flu remedy 

Asda Max Strength Cold & Flu Relief sachets blackcurrant

Asda Max Strength Cold & Flu Relief sachets blackcurrant

Best buy: Asda Max Strength Cold & Flu Relief sachets blackcurrant, pack of ten, £1.59, asda.com

Annual saving: £10.40 (Based on using four boxes a year.)

Expert says: There are several cold and flu sachets on the market and the most effective — such as this Asda option — will contain the painkiller paracetamol and decongestant phenylephrine, which reduces inflammation of the nasal tissue to open the airway. 

Yet some can cost up to four times as much for the same effect. Mix with boiling water and drink every six hours. Don’t use with other medicines containing paracetamol.

Arjun Olive Oil Ear Drops

Arjun Olive Oil Ear Drops

Ear drops

Best buy: Arjun Olive Oil Ear Drops, 10ml, £1.99, weldricks.co.uk

Annual saving: £7.08 (Based on needing three bottles a year.)

Expert says: Ear drops can contain medical-grade olive oil (which, unlike that in your kitchen, is licensed for use in the body) to soften hardened ear wax gently and make it easier to remove via syringing. 

Despite containing just this basic ingredient, some cost up to four times as much.

✱ Annual savings based on a comparison with the most expensive branded products at time of writing. Advertisement Read more:

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