When the Condition You Treat is High Costs

An unmet medical need isn’t always an untreatable disease. Sometimes it’s a glitch in the healthcare system that can be made to work better by the application of just the right molecule.

That was the take-away from a conversation I had the other day with John Babich, a noted radiologist and CEO of the Cambridge, MA-based biotech Molecular Insight Pharmaceuticals, which specializes in targeted radiopharmaceuticals and imaging. The company’s lead product these days is Zemiva, a radio-labeled fatty acid analog for diagnosing cardiac ischemia.

“The heart is a furnace,” Babich explains. “If there has been ischemia, metabolism shuts down.” Zemiva (a new formulation of a Japanese-developed molecule known as I-123-BMIPP) has been on the market for 10 years or so as Cardiodine. Babich’s new twist is to develop the drug to serve as a quick, reliable way to diagnose cardiac disease in the emergency room.

If you want a perfect example of how to waste money in healthcare, you could hardly choose a better example than patients who show up in the ER complaining of chest pain. Something like 4 million are admitted to hospitals each year—most of them completely unnecessarily. The problem is that it’s not easy to tell if a serious cardiac problem has taken place. A patient can show a negative EKG and negative troponins and still be in immediate danger. So a lot of people with nothing much wrong with them get admitted to intensive care units at costs of $10,000 to $20,000.

Zemiva is designed to cut down those unnecessary admissions. How? The imaging agent mimics the fat that the heart feeds on. If the heart is working normally, Zemiva is absorbed and can be seen in a SPECT scan. Molecular Imaging provides not just imaging agent, but a library of scans that a physician can use to diagnose the patient.

Pricing hasn’t been set yet, but if it falls somewhere in the range of $1,500 per patient, it’s easy to imagine that payers will jump at the chance to cut the number of ICU admits by what Babich estimates will be 80 percent or more. Think of it as rationing by accurate diagnosis.

Zemiva goes into Phase III later this year.