You Say Tamiflu, I Say Scamiflu
In 2019, influenza was the go-to example many health tech entrepreneurs used to describe their vision for how healthcare might be successfully disrupted. During a 2019 GeekWire Health Tech podcast interview, one health tech co-founder and CEO said, “We might be able to imagine, in five or eight years from now, the FDA approving an algorithm that is […] built on top of machine learning that is capable of diagnosing the flu and prescribing the right medication in the right circumstances.”
Later on in the conversation, he noted that the flu costs the United States about $10 billion a year. Then, he described how Amazon is well-positioned to help decrease this enormous financial burden. He said, “by virtue of operationalizing the distribution and the testing associated with the flu, and then operationalizing the delivery of the medication associated with the flu, [Amazon] could likely cut out a material percent of that cost. Like people literally would not need to leave their home to be tested for the flu, and then to get their medication for the flu.”
A couple of months later, in a different episode of the GeekWire Health Tech podcast, another health tech CEO drew on the same example. In this case, she shared her own personal experience of coming down with the flu during a conference. She said, “trying to get my prescription for Tamiflu while I was there, like I needed a drone to come and deliver me this the Tamiflu because […] I had to find a drugstore, and I had to go there while I'm infecting everyone else.”
Both of these health tech entrepreneurs were envisioning a similar future — one in which people with a confirmed case of influenza could simply click a button to place an expedited order for Tamiflu. The second CEO added, it’s about “knowing who wants what and where they want it and when they want it.” However, although the model of direct-to-consumer healthcare might succeed in giving people what they want, this is often not the same as actually helping people.
As I listened to these interviews, I was struck by the huge disconnect between the use of influenza as the ideal example of these health tech entrepreneurs’ vision for the future and the disappointing realities of clinical medicine. About five years before these conversations took place, a meta-analysis, published in the BMJ, showed that Tamiflu (oseltamivir) provides very little benefit. Previously, the medication was thought to prevent the transmission of influenza, reduce hospitalizations, and decrease deaths; but the meta-analysis indicates that Tamiflu does no such thing. In fact, all it does is decrease flu symptoms by less than a day, while causing nausea and vomiting. Moreover, the medication also increases the risk of adverse psychiatric effects and renal events.
In light of all of this, Tamiflu was nicknamed “Scamiflu.” Nevertheless, health tech entrepreneurs have continued to use the diagnosis and treatment of influenza as a promising example of how healthcare might be disrupted. Yet ironically, the example demonstrates why shifting healthcare to a direct-to-consumer model could be incredibly detrimental. In this case, it would further perpetuate the use of Tamiflu — an ineffective and sometimes harmful medication.