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Why consistency can affect health care costs — and what one doctor is doing about it

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Dr. Andrew Pecora, founder of COTA Inc., oncologist at HackensackUMC and member of Regional Cancer Care Associates.
Dr. Andrew Pecora, founder of COTA Inc., oncologist at HackensackUMC and member of Regional Cancer Care Associates. - ()

Finding a use for all the data collected by electronic medical records and billing claims is the wave of the future, but for Andrew Pecora, the future is already here.

Pecora is an oncologist at Hackensack University Medical Center and a member of the Regional Cancer Care Associates who founded a data-driven, cloud-based tool to help improve cancer treatment outcomes last year.

The New York City-based company, COTA Inc., has since grown from three to 85 employees and is looking at further growth in the coming year.

Pecora hopes that, by increasing the influx of data and creating strong filters to identify best treatment methods, eventually the outcomes of treatments will become more consistent around the globe. Horizon stepped up to infuse the needed $7 million in the first round of funding, and a second round is underway — but no details are currently available.

There is growing interest in the market, Pecora said, and the ultimate goal is to place the same tool in the hands of the patients.

NJBIZ: When you founded COTA, did you imagine it would grow to a national or international level? What areas of growth do you envision for the future?

AP: No. I didn't really think about how applicable it could be; that wasn't my issue. I'm a scientist; I don't think about the market. I just thought about, here is the problem and here is a way to solve the problem. Hospitals who want to join simply have to sign up, and they can benchmark themselves against other hospitals. It's being used across the country now. We started with cancer, and we are going to add mental health and cardiovascular disease. We are going to Canada — we were invited by the Canadian government — and we are talking to people in France and I think Germany. Currently, pharma is using it, insurance companies are using it, hospitals are using it and I want patients to start using it.

NJBIZ: What is the goal for next year?

AP: I want to help the nation get rid of variance in certain areas, and put us on the path of the “Goldilocks Formula” — not too much, not too little, but just right. I don't want people not getting therapy they deserve and need because they can't afford it. I don't want people going through things they shouldn't, because it's a waste of money and their time, and maybe even their health.

So if I can put tools in the marketplace, with who I am and the influence I have, starting in cancer but then going through all the medicine, that's my laser-beam focus for next year.

NJBIZ: What about the debate over costs of pharmaceutical products and medical devices?

AP: I think the biggest mistake we are making is we've got the lens on the wrong thing. If you have a drug that costs five times more than the last drug, but if it reduces overall cost of care — because people aren't going to the emergency room — do you really care what you paid for the drug? No. That's the point. We missed the boat on this discussion. In health care, you are buying an episode of care for one year. I'm not supporting drug companies, but I am a doctor and I want my patients to get better.

NJBIZ: So what should the goal be?

AP: If I can give you a medication that costs 10 times more than the last one, but it keeps you out of the hospital, makes your cancer go away, you never have to have radiation, you don't need surgery — at the end of the year, the total amount of money you spend is less than had I not given you that drug, and your outcome is better. So we need to focus on total cost of care. When you start saying you want to lower the cost of care, people hear that you want to ration care. That shouldn't be the drive, to lower the cost of care, it should be to lower the variance (in outcomes) of care.

NJBIZ: Are there many roadblocks created by regulations either at the state or federal level?

AP: All the time. You have to be respectful of the regulatory agencies in the country, but they are people, too, and you can negotiate with them. As long as, in the end, they think you are doing the right thing by patients, and you know you are doing the right thing by patients, you can get around the roadblocks. Regulators are very smart people. They have to follow a statutory approach that was built for a system that wasn't evolving as fast as we are evolving. We clearly have overregulated things, in general, in this country and we will have to pull it back. I call it the great elasticity of the United States. Every time we go too far one way, we pull back.

NJBIZ: What are some other medical developments you are working on or keeping an eye on?

AP: Well, the field is exploding. The application of the human immune system on the treatment of cancer. I'm one of the people helping to develop that. I'm in the stem cell arena, so we using stem cells from people's bone marrows to repair their damaged hearts after heart attacks. I've got eight patents on that. The genomic revolution — the ability to use genomic information to decide the risk for disease, and treatment of diseases — is exploding before our eyes. It's just an amazing time to be in science and medicine.

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Anjalee Khemlani

Anjalee Khemlani

Anjalee Khemlani covers health care. You can contact her at anjaleek@njbiz.com.

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