2025 predictions: GLP-1s, telehealth, AI, employer health plans

Transcript - 2025 predictions: GLP-1s, telehealth, AI, employer health plans

Kelsey Waddill: Welcome to our 2025 predictions episode where a few of our Xtelligent Healthcare editors discuss top trends to watch in the new year. I'm Kelsey Waddill, multimedia manager and managing editor of Healthcare Payers, and with me remotely, I have a couple of my colleagues. Anuja, can you introduce yourself?

Anuja Vaidya: Of course. Hi, Kelsey. I am Anuja Vaidya. I am a senior editor and special events lead at Xtelligent, and I cover virtual healthcare.

Shania Kennedy: Hi, guys. I'm Shania Kennedy. I'm the assistant editor on Healthtech Analytics.

Veronica Salib: Hi, I'm Veronica Salib, and I'm the associate editor for Pharma Life Sciences.

Waddill: Awesome. Welcome, everybody. All right. Just as a heads-up to our audience, we are recording this in December 2024, so some of the policy topics that we're discussing might be slightly different when this airs on January 6, 2025, but we're going to try to keep it general and relevant. So with that disclaimer behind us, I wanted to kick us off with a bit of a spicy topic: GLP-1s. It has been one of the major hot-button issues in 2024. Glucagun-like peptide 1 drugs…. Am I saying that right, Veronica?

Salib: I think it's glucagon, but yes, close enough.

Waddill: Glucagon. All right. I only ever have to read it. Glucagon-like peptide 1 drugs, which are traditionally a diabetes drug, have proven extremely effective at weight loss. The drug has frankly reshaped certain areas of the industry, and it's wildly popular and shows no signs of retreating from the healthcare conversation in 2025. This trend has touched most of our sites in some way, shape or form. But, Veronica, I really wanted to kick this segment off with you with the Pharma life Sciences perspective, because I know you've been following this closely all throughout 2024. What have you been hearing from industry leaders, what can we expect to see with GLP-1 drugs in 2025 based on the trends that we saw in 2024?

Salib: Yeah. So GLP-1 medications have been by far one of the hottest topics in the pharma and life sciences space. I feel like I've covered them so, so much this year and am continually covering them. And they've gained a lot of attention, not only across the medical community, but in mainstream media, on social media and all these different apps, which is both a blessing and a curse. It's a little bit nice that the public is hearing about these medical innovations, but at the same time, there are challenges that come with them. These 'miracle drugs,' and I use the quotes because they don't work for everybody -- they work for a lot of people, but they don't work for everybody -- but they have been so successful for so many patients over the past couple of years, ranging from diabetes management to weight loss. And then there have also been a lot of experimental uses for different mental health conditions, different rheumatology-related conditions.

This year at the World Medical Innovation Forum in 2024, leaders discussed how these drugs may be beneficial beyond their approved indications. And although those clinical studies are still in the early stages, I expect we're going to learn a lot more about GLP-1s and their roles in diseases besides diabetes and obesity. But I think the bottom line here is that these drugs work, they work for a lot of patients, they've made a significant change in a lot of people's lives, but that has resulted in a lot of challenges, because so much of the U.S. population is eligible for these medications. So much of the U.S. population either has type 2 diabetes or is struggling with overweight and obesity, which are the three primary indications for these drugs.

By the time this podcast [episode] airs, I think it will have been a month or so since our podcast [episode] on GLP-1 compounding has aired and the challenges that arise from compounding. Compounding is used for a lot of drugs that are in shortage, which many of these medications are, and they can also be used as a cheaper alternative to get different medications. So while manufacturers like Novo Nordisk are arguing with the FDA and saying that these drugs shouldn't be compounded because they are so complex, different organizations, like the Alliance for Pharmacy Compounding, maintain that they can be compounded by licensed pharmacies. So there's a bit of a tug-of-war going on right now, and I expect that that's going to continue in the coming years. And it might even blow up into a bigger legal battle, especially as we see more wellness and supplement industries kind of trying to piggyback off of the success of these medications. And that is a very loosely and poorly regulated industry. There's a lot of challenges there on its own.

But beyond those challenges, we are seeing more and more physicians trying to understand why these drugs work better for some people and not for others, why certain formulations of these drugs work better than others in some people. And as we're working towards an era of more robust and comprehensive obesity care and obesity medicine, there's a chance that we're going to see more personalized approaches to GLP-1 prescribing and better attention to how different patients react to different side effects. And Anuja, this is where you could probably talk a little bit more about remote patient monitoring for that specific area.

Vaidya: Absolutely. In remote patient monitoring, the biggest benefit of it is that continual tracking, having those metrics, having that data come in in real time so you can make those adjustments and make sure that the medications are having their intended effect. And with GLP-1s, as we're expanding those indications and making sure that they really work as well as we are hoping or various combinations and compounds of these drugs are working as well as we're hoping, remote patient monitoring can really be that kind of critical tool to keep track of patient metrics and sort of make sure you don't have to just prescribe someone a GLP-1, wave at them and say, Come back in three months, and hopefully you do great. And if you don't … I don't know, call us or go to the ER.' Ideally, we want to avoid that.

And in fact, today, I think I saw something about a company, the name is escaping me, but it's a startup that's going to test, I think, GLP-1s with whether they can be useful in Parkinson's disease care. And I think one of the ways they're going to test it is by using wearables. So still need to look into how exactly they plan to do that, but I think that's super interesting.

Of course, all of this depends on the all-important reimbursement, which is something that's an issue in the RPM world. So yeah, I'd love to hear actually a little bit more on the coverage front. Kelsey, what has that been like? Because I feel like it's been in flux and interesting ongoings in that space.

Waddill: Right, yeah, absolutely. It's been a massive theme for payers and employers in 2024 and will continue to be going into 2025. As you mentioned, one of the big barriers to access to GLP-1s for just your average patient is coverage. These drugs are Ozempic, for example, $944, and Wegovy, just shy of $1300, and that's per month. So that's genuinely more than my rent. And so obviously, people don't want to cover -- and can't usually cover -- these out of pocket. And so a big question has been what are payers and employers going to do about it? Are they going to cover it? And largely the answer has been hinging on what Medicare is going to do. So if Medicare covers these drugs for weight loss indications, then a lot of commercial payers and employers will likely follow suit.

At the time of this recording, Medicare does not cover GLP-1s for weight loss. There has been some regulatory movement on this in recent months. CMS released a proposal recently that would expand Medicare Part D and Medicaid coverage to anti-obesity medications. And there was also a law proposed in the House called the Treat and Reduce Obesity Act, or TROA, that had similar goals. The CMS proposal, however, even if it is finalized, which is still a question, would not go into play until January 2026. So we're still waiting on that, and that's not a certainty for 2025.

On the commercial side, large self-funded employers, who have a lot of resources, large employee populations and a lot of control over their benefits and coverage have a vested interest in covering these drugs for weight loss, and a lot of them want to. 79% of HR decision-makers agree that GLP-1 coverage would improve employees' long-term wellness, and 77% agree that coverage of GLP-1s would improve their employees' satisfaction with their benefits, which are all things that employers want. But coverage expansion has been slow due to, as we mentioned, that high price tag. Also, as Veronica was mentioning, that the high demand for these…. Only 34% of corporate plans as of 2024 covered GLP-1s for weight loss this year, which is up from 26% in 2023, but still not a huge amount, and only 19% of corporate plans were even thinking about covering them in the future. So the amount of employers that are already on board with this coverage for weight loss purposes is still pretty small.

And then for those who do cover these drugs, they typically aren't just handing out coverage for every employee who wants a GLP-1 for weight loss, again due to the price. Instead, they're implementing step therapy and utilization management efforts so that they don't have quite as much uptake. And then other employers, who haven't committed yet, are just waiting until competition drives down the price, or a lot of them are also just waiting to see the long-term value of these drugs. I think you sort of touched on this, Veronica, that we have a lot of data on different maybe potential use cases that's coming out, but this is all still happening right now. We don't have specific data, or at least the quantity that would make employers feel comfortable, in terms of cost savings that these drugs will produce and whether that will ultimately outweigh the upfront price of the drugs.

Salib: I think another challenge that employers are having kind of in the same vein is: that we don't know that patients that are on these drugs, do they have to be on them forever? Can they be weaned off? Is it kind of some people can be weaned off, some people have to stay on them forever, kind of like the way antidepressants work, where some people are just in a situation where they need them versus some people need them long term? And I think that, as we learn more, might really dictate whether or not they're covered and who they're covered for.

Waddill: Yeah, and especially in an environment where employees stay for two or three years, and then a lot of times, they move on. And employers, if there's a long-term commitment to these drugs that has to happen to see results, a lot of times the employer who covers it at the beginning isn't going to see those results in the end. So the incentive there -- apart from just doing the right thing to cover these drugs, which is a good incentive for a lot of employers, but -- is a little lopsided at the moment.

And so long story short, I think in terms of if anyone is waiting for big coverage expansion to happen in 2025 for GLP-1s for weight loss, they're going to be disappointed. It's going to be a long road.

And just to pivot us a little bit, this does feed into a significant theme for payers that I wanted to highlight with a big trend in 2025 being, unfortunately, not new: The costs are going up. Healthcare prices are escalating. And drugs like GLP-1s and also new central nervous system drugs and other expensive drugs like that are big drivers behind the 8% year-on-year medical costs trend for group market and the 7.5% trend for [the] individual market in 2025.

Other factors behind that exist, obviously. There's the health insurance consolidation, workforce shortages that we're going to talk about probably a little later, certain policies, and of course, inflation is just touching all of us right now.

As these costs climb, employers are going to have a hard time keeping up with it. So a lot of employers are going the route of utilization management, as I mentioned. A lot of them are going to be focusing on primary care and also reevaluating all of these point solutions that they've accumulated over the years, especially for chronic diseases, just to see which ones are actually worth the dollars that we're putting into them. So a lot of damage control from employers for this coming year.

But I mentioned … the financial pressure of workforce shortages, and Shania, I kind of wanted to get your input on this one because I know a lot of healthcare leaders have been looking at how technology might be able to alleviate providers' burdens and fill that gap. We're seeing so much provider burnout, and it's affecting us in many more ways outside of the financial aspect. So I'd love to hear, I know there's been a bit of a movement toward AI to see if that could help us out with this issue of workforce shortage in the provider space. You've been tracking AI development for the last year and just very extensively. What kind of trends are you looking at for 2025 in the AI space?

Shania Kennedy: So I think it's really important to start out by saying AI in healthcare is not new, but it is in a hype cycle, and I'll explain. So we all sort of remember when ChatGPT came on the scene in 2022, and now AI is kind of in the popular lexicon, and now the average person is talking about it and is more exposed to it than ever. So healthcare is sort of riding that hype train, I would say, and this past year, 2024, we've seen a lot of orgs [that] are dealing with pilot fatigue. There's pressure to adopt these tools and these technologies, but a lot of health systems are struggling to identify that return on investment or that path to value for that technology. A lot of organizations have made meaningful progress in this area by adopting AI for billing, rev cycle management, clinical documentation improvement, those administrative tasks that can be easily automated.

But right now, a lot of organizations are also looking at the clinical side and saying, 'Okay, here's the potential for this technology on the admin side, but clinically, what are sort of the potential really valuable ways we can use it?' And a lot of life sciences and healthcare stakeholders are pursuing breakthroughs in AI-driven research to that end, particularly in the realm of precision medicine, drug discovery, genomics, those things that require that mountain of data, that's where AI is really driving that value, processing that information that health systems are generating. And of course, generative AI is generating a lot of excitement, and a lot of orgs are looking toward how those GenAI tools can be used for clinical documentation, like they already have been. And also to things like patient-facing virtual assistants or chatbots that help them with care navigation or claims processing.

But like you said, cost is a big hurdle here alongside lack of resources, workforce considerations. Those things are really top of mind right now alongside the cybersecurity risks, which as we know, data breaches are becoming more and more common, and they're impacting a lot of patients. And of course, as with any tool, health equity, bias, those are huge issues that we're still trying to navigate and figure out how to address.

But some health systems are sort of preemptively working on that. Recently, I actually chatted with Melissa Knuth, who is the vice president of planning at OSF HealthCare, because they have adopted an approach that is working toward GenAI-ready healthcare workforce. Roll the clip. [laughs]

Melissa Knuth: We were given six weeks to develop education for 24,000 employees, our mission partners. The reason behind that was that these tools were proliferating, they were becoming more and more publicly available. And so we wanted to make sure not to stifle the use of those tools, because we want everyone to really understand how it can augment their role, but to help give some guidelines and guardrails for how they would use those tools internally.

Kennedy: And that conversation kind of speaks directly to a challenge that a lot of organizations are facing right now, which is balancing the need and desire for innovation in AI deployment with those concerns about workforce, burnout, those kinds of people-related issues, because you can't take the humanity out of healthcare.

But this speaks to that issue that a lot of people across industries are asking themselves: Is AI going to replace me? What role is it going to have in my day-to-day job? And so by prioritizing workforce augmentation rather than trying to replace people, I think that's one way that health systems can really address issues like burnout and sort of that clinician burden that we hear about so often, especially with EHRs. Automating some of that workflow is going to be really valuable for providers.

But then you run into the issue of resources. Rural and smaller healthcare systems face barriers to adopting these tools, and that creates this risk of innovation inequity. That's going to be an ongoing challenge as we head into next year and probably beyond, if I'm being honest, because these innovations don't always trickle down from the well-resourced organizations to the smaller ones. But there are other approaches that can help healthcare organizations who are looking to tackle their care access barriers or address their workforce challenges, including telehealth, which I know, Anuja, you have insight on.

Vaidya: Yeah, telehealth is definitely one of the approaches that health systems are employing to try to alleviate some of that burden. But similarly to AI, we're at an interesting point where I feel like that hype cycle that you were talking about with AI, we saw that with telehealth in 2020, and now we're on the other side of it where people are no longer sort of saying virtual care, digital health is the answer to everything, but now are looking to see really where it's going to be valuable.

I had an interesting conversation with Dr. Sanjula Jain, chief research officer at Trilliant Health, earlier this year, and we talked about the changing contours of the telehealth market, especially because we are now in a place where telehealth is not as necessary as it had become for a brief period in 2020 and 2021. And so, we are not sort of treating telehealth as a must-have anymore for everything. But at the same time, it is useful. We've seen the benefits, we've seen it really improve patient care delivery, patient satisfaction, so it's not going away either. So it's really searching for that foothold.

Sanjula Jain: To your question of what's contributing to the decline, it's really this recognition that when you take away the force of action, what actually makes sense clinically and financially? How much can you really do clinically? And I think you're starting to see this recognition from providers in particular, who are saying it's not the same level of quality of care.

Vaidya: Yeah, exactly to Sanjula's point there, it's not the same level of care. What we can get out of telehealth in terms of clinical quality for a mental health appointment is not the same as in surgery, and we see data reflect that all the time, where Trilliant Health data itself shows that telehealth volumes for behavioral healthcare skyrocketed from 42% in the first quarter of 2020 to [67%] in the fourth quarter of 2023. But at the same time, telehealth use in other specialties really dwindled, and we see a difference in how primary care physicians or medical specialty physicians, how they feel about telehealth versus, say, surgeons who really continue to say that it's not 'as useful for us.'

So telehealth is just not a one-size-fits-all, and the market is definitely moving to a place where defining the value of your virtual care tool, of your telehealth tool is going to be far more important than just saying, 'Hey, we have a telehealth tool.' So we're really seeing those nuances being defined and a greater focus on the clinical efficacy piece. We even saw some reports coming out assessing that clinical efficacy piece. A big one from this year was the Peterson Health Technology Institute report that showed that digital diabetes tools often don't result in clinically meaningful improvements in patient outcomes. So with that kind of focus, I think the digital healthcare market just has to become much more laser-focused on those outcomes than sort of on the idea.

Waddill: Great points, Anuja, and I think it's just been really interesting to watch the pendulum swing on telehealth as we emerge from the pandemic, as the coronavirus becomes more manageable on a population health level. Yeah, it's been interesting to see the change, the shift in how people approach that tool, which we were once so completely dependent upon, almost.

I'm going to switch us over here to a little bit of policy because y'all, what about this ambiguous policy landscape this year? I think there's a lot that we could say, and we have no idea how it's going to go really on a lot of levels. So we're going to keep this part general, but I do think it's good to just address some of the things that we're looking at, because we're always trying to keep a tab on that aspect. It has such a big influence on the healthcare space, obviously. So as of early December 2024, what are we watching for the new year?

Kennedy: Well, I'll say in the AI space, very, very uncertain future about the regulatory environment. Of course, in general, regulations tend to lag behind innovation, and that's especially true in the healthcare AI space just because there are so many moving pieces to these technologies. They are just developing at such a rapid pace, but also HIPAA, cybersecurity risks, all of those things are also becoming more salient in these conversations, and I think that that's been the case for some time. But potential regulatory relaxation could create additional risks as health systems continue to adopt AI.

And as with any presidential election year, there's going to be some policy shifts that impact the most tightly regulated industries, including healthcare. But there are a lot of unknowns about how the Trump administration will approach healthcare AI regulation. Like I said earlier, healthcare AI is not new, but the hype around it is. The previous Trump administration did not necessarily focus heavily on AI regulation, but that is likely to change just because the focus has shifted.

The Biden administration has already sort of laid the groundwork for some policy development in these areas. In October 2022, the administration released its Blueprint for an AI Bill of Rights, and then a year later, President Biden signed the executive order on Safe, Secure and Trustworthy AI. And these frameworks established guardrails focused on promoting safety and protecting American's privacy within AI applications across industries, not just in healthcare. But both of these were nonbinding, and some healthcare stakeholders have criticized these efforts as being insufficient. And that's kind of contributed to this gray area that we find ourselves in.

And the slow pace of regulatory efforts has led some healthcare organizations to prioritize their own in-house governance and infrastructure, with many of them creating new roles like the chief analytics officer or the chief AI officer, to ensure that their analytics and AI deployment is effective and safe. And some of them have even opted to join collaborative entities like the Coalition for Health AI, which sort of aims to bring together public and private partners to advance responsible AI use in the industry.

But some of CHAI's work, which has recently sort of focused on establishing a network of nationwide health AI assurance labs, which would help evaluate and vet these tools, has come under scrutiny recently from Republican lawmakers who are concerned about conflicts of interest, because CHAI was founded by health systems like Mayo Clinic and Stanford Medicine, but also companies like Google and Microsoft. So this is all kind of shifting and changing, but these efforts to sort of regulate these tools are also having to contend with the rise of generative AI, which for all intents and purposes, mature governance frameworks don't necessarily exist for those tools. At this point, that could change. I know that some people are doing that work, and a lot of researchers are trying, but we'll see how that evolves.

It'll be interesting in a year. Maybe we'll circle back and we'll see what happens, but either way, this is likely to be a pretty thorny issue as potential use cases for GenAI sort of expand and other digital health markets are shifting.

Vaidya: I couldn't agree more about sort of the gray area that we're in. We're certainly seeing that on the telehealth side too. The industry has been waiting for a decision from Congress about telehealth flexibilities that were enacted during the pandemic. Still no word on that, although there are a few more weeks left, and we saw this in 2022. It was literally sometime in the last two weeks of December that they pushed through some of the extension of the flexibilities in a year-end package. So it could happen by the time this goes to air, we could have an extension. But as of right now, the flexibilities are set to expire December 31st, which would cut off very critical access that many people have come to depend on very suddenly. [Update: on December 21, 2024, Congress extended the telehealth flexibilities for 90 days and are set to expire March 31, 2025.]

And even in another legislative battle that's ongoing is with the DEA and virtual prescribing of controlled substances. We did see an extension come through on that, but even there, it was just for a year. So the DEA really hasn't given itself much time to finally figure out this issue, which many in the industry are really, really pushing for. Again, people have gotten used to having that access. Many prescribers and healthcare professionals really doubled down on the value of being able to virtually prescribe some of these medications, particularly for mental health conditions for OUD [opioid use disorder]. So we'll see where this lands, but I just expect a lot more urging from the telehealth proponents side to the government to give us a more permanent policy when it comes to virtual prescribing of controlled substances. So that'll be something I'm definitely watching for.

Waddill: Yeah, I echo both of you. I think seeing a lot of ambiguity in the health payer space, too. And actually, the way it's shaping up in the payer space is a little different. I think we saw a lot of regulations go into play, and there's a lot of long-standing regulations that have been in play that we are looking to see implementation of in 2025 or is looking to see the effects of implementation in 2025. So a little different, but there's still some uncertainty there about what that'll look like. So for example, in Medicaid and Medicare, there [were] some key regulations and legislation that went through, especially changes to the Medicare Advantage star ratings, the final rules under the Mental Health Parity and Addiction Equity Act, as well as even just the continuing impact of the Inflation Reduction Act, which has been around for a while now, but we're still looking to see how that continues to shape the industry. So this new year, I think a lot of payers will be watching the impact of those.

And then employers, on the employer end, are really interested in the impact of price transparency regulation this year. I spoke with Shawn Gremminger, who is the president and CEO of National Alliance of Healthcare Purchaser Coalitions, who said that he is really hoping to see pharmacy benefit managers [PBMs] price transparency rules go into effect. They've had many delays, so he's hoping for that, but he's not optimistic that it'll occur in 2025. Employers are really hoping to get the receipts on employee medical expenses, because without that data, they really can't implement cost controls effectively or even check for clerical errors in those medical expenses. So that is part of a much larger conversation about patient data and who owns it, which we can't get into here. But I think if you asked a large employer what regulatory gift they could have on their wish list for 2025, it would probably be related to PBM and health plan price transparency and trying to get some of that data.

Veronica, I know that there was a fairly historic kind of policy decision of sorts. It was more of a courtroom reinterpretation of constitutional limits of healthcare policy that occurred in 2022 and is still having effects to this day on reproductive health. So I'd love to hear from you a little bit about the state of reproductive rights since the Supreme Court overturned Roe v. Wade in the Dobbs v. Jackson Women's Health Organization case. What are things looking like?

Salib: Talk about a gray area. We've been talking a lot about that. It's definitely still a big gray area, a big gaping hole, but reproductive health has gained so much additional attention since that decision, since before that decision when it was being discussed. And I think before we can even discuss the state of reproductive healthcare right now, it's important to acknowledge that most major healthcare organizations and trailblazers in the reproductive health space, including the American College of Obstetricians and Gynecologists, including ACOG, have included abortion access into their scope of what is reproductive healthcare. And we could sit here for days and discuss the different facets of comprehensive reproductive healthcare, which we won't do because we don't have the time for it. But obviously, abortion access has been really polarizing.

Although it's a little bit less polarizing, contraception access has also been a big question. It's been an increasingly important reproductive health tool as the tides turn and abortion access continues to kind of be up in the air and evolve nationwide. Access to contraception is so critical for preventing unplanned pregnancies. Most sources estimate that about 50% of all pregnancies in the US are unplanned. I think the most recent statistics I remember from the CDC was in 2019: It was 41.6% of all pregnancies in the U.S. were unplanned, which no matter what side of the aisle you fall on, I'm sure we can agree that's a really significant portion of pregnancies that are unplanned. Over the past year, we've seen a lot of progress with birth control, including the availability of Opill, which is an over-the-counter birth control pill, which has blinded access.

However, it's really exciting to see that women are no longer the only people bearing the burden of contraception and pregnancy prevention. After Roe v. Wade was overturned, there was a significant rise in the number of men who were looking at vasectomy as a form of birth control. I think in an article by the University of Florida Health said that in June 2020, the number of vasectomies increased by 50%. The problem is that there is a real caveat with vasectomies. I think there was this rhetoric on social media or maybe in the mainstream media that vasectomies are reversible, and it's important to note that the reversals are not always successful. Planned Parenthood said that vasectomy reversal can be very tricky. There can be a lot of side effects, such as scrotal bleeding, infection, chronic pain. It's very expensive. It costs about $15,000 to get a vasectomy reversed without medical necessity. And then obviously, there's a whole question of whether insurance will cover that or not. And they're only successful about 85% of the time. So there's still a pretty significant portion of people, who if they wanted to get a vasectomy and get it reversed, could not do so.

However, what's really exciting about that is that it obviously points to a need for more male contraceptive options. We're in luck, because there have been a lot of researchers that have been focusing on male birth control, and many people anticipate continued growth in the year to come. Earlier this year, I spoke to Dr. Stephanie Page from the University of Washington, who focuses on male birth control.

Stephanie Page: We in the male contraceptive development community are firm believers, and there's a lot of data about this, that if we gave men more options, there would be more uptake. And so that's really the goal of the field.

Salib: So just like she emphasized: options, options, options. That's a very important part of this. And with her focus on male birth control development, she gave me a lot of information on what's supposed to be coming down the pipeline. Among hormonal options, she did mention that there's an oral birth control pill for men that is being researched. However, that's a little bit farther behind. There's a little bit of slow progress with that.

One of the most promising options that she told me about was the NES/T Gel, which has a little slash in between, and we'll have it in the show notes and everything, and it's probably the farthest along in terms of male birth control. It's a gel that combines testosterone with progestin, specifically Nesterone, and men can absorb these hormones through their skin when the gel is applied to their shoulders and upper arms and helps stop testosterone production and sperm maturation. So it's a pretty easy tool to use. They can put it on a few hours before they're planning to have intercourse, and that will help be a form of pregnancy prevention, which is really exciting.

Aside from that, researchers are also looking for a reversible alternative to vasectomies. Something a little bit similar: a nonhormonal reversible alternative to vasectomies that has been researched is called Vasalgel. And it's a long-acting nonhormonal reversible contraceptive hydrogel, which is in the form of a biocompatible polymer that's injected into the vas deferens, which blocks sperm but allows ejaculation.

So, these are all things that men can still use to maintain a healthy sex life, but we can prevent unplanned pregnancies, which in turn will prevent a lot of other issues that can happen with an unplanned pregnancy, such as maternal mortality and so on and so forth. So, while the field is very broad and there's a lot of different things we can discuss, I think one of the most exciting and one of the most promising things that we'll be seeing in this next year is a pretty significant advancement in male birth control options.

Obviously, we don't know how the next administration will impact that, and there has been a lot of questions about how it'll impact research, because policy does inform research, unfortunately, or it does guide research, but I am cautiously optimistic about what's to come, and based on the people I've talked to, I'm seeing the same across the field.

Waddill: Well, that's great news. It's nice to have a bright spot here. Even if there's some uncertainty there, we will take it.

Salib: Yes.

Waddill: A win is a win.

Salib: A win is a win.

Waddill: Before we wrap up here, I just want to give us a chance if there's any other trends that we just haven't touched on yet that you'd like to mention, throw them out there. What else are we thinking about for 2025?

Salib: I will say the one thing I will add that is a little bit concerning is potential dilutions in the infectious disease space. It's a little bit of a bleak outlook. Over the past few years, we've seen a rise in anti-vax rhetoric and misinformation. And while that's not the only factor that's driving infectious disease rates up, it's certainly playing a significant role because less people are getting vaccinated, less people are vaccinating their kids. We've seen a rise in new infectious diseases, like the COVIDs of the world or that kind of realm of things, but we've also seen a reemergence of conditions that developed nations thought we were rid of a long time ago, like measles. We saw an outbreak of polio in 2023. So these factors are a little bit concerning, but again, cautiously optimistic that we've learned a little bit from the COVID pandemic and how we can get messaging out to people about vaccinations.

I spoke to someone earlier this year, who discussed vaccine hesitancy and how we can address vaccine hesitancy, and I think the question that will remain on the forefront of our minds and public health experts minds is: How do we get people vaccinated, how do we make sure that they're getting the right information, and how do we get these vaccines into the hands of all the potential communities that need it, including marginalized communities? So there will be challenges. As we've seen with every single topic that we've talked about today, there [are] going to be challenges, but I'm hoping that with what we've learned throughout the COVID pandemic and with many public health experts advocating for vaccination that we'll see a little bit of a shift in that area as well.

Waddill: Well, hopefully. And I know that you have covered that extensively on your side of Pharma Life Sciences, and anyone who has interest in diving deeper into any of these topics, you're welcome to visit our sites, Pharma Life Sciences, Virtual Healthcare, Healthtech Analytics and Healthcare Payers, as well as the rest of the Xtelligent sites to learn more.

We're going to have to end things there today, but thank you to Veronica, Shania, and Anuja for chatting with me about these projections. And thank you to our listeners, who have been with us through 2024. We are excited to step with you into 2025 and to bring you more interesting and actionable stories from across the healthcare industry.

Vaidya: Also, if you enjoyed today's conversation, please do let us know.

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Salib: And please consider rating and reviewing us on Apple Podcasts, Spotify, or wherever you're listening.

Waddill: And as always, we love to hear from you about any questions or stories you think that we should cover. So you can reach out to me at [email protected], that's [email protected], and we look forward to hearing from you. Happy New Year, everyone!

Salib: Happy New Year.

Waddill: Music by Vice President of Editorial Kyle Murphy, and production by me, Kelsey Waddill.

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