SAN ANTONIO — The telehealth industry is at an inflection point.

Executives at the American Telemedicine Association conference this week were both convinced that virtual care is destined to grow but also concerned that current growth prospects are dimming.

Short-term pessimism: The executives are concerned about the impact of a Drug Enforcement Administration proposal that, if finalized, would curtail virtual care starting later this year.

The proposed rule would mandate that some patients have in-person visits before starting to use some drugs, such as Adderall for ADHD or OxyContin for pain relief. And it would require patients using other drugs, including buprenorphine for opioid use disorder, testosterone for gender-affirming care and ketamine for depression, to visit a doctor’s office for a refill after an initial 30-day supply.

The rules will take effect at a tough time, amid rising interest rates and a downturn in investment in digital health.

Tunde Akinniranye, associate at the Chicago investment firm 7WireVentures, said that there will be reticence among investors to fund companies that can’t show they can work within the DEA’s rules.

The industry is facing a difficult 12 to 18 months, he predicted, urging companies to prepare for flat or declining investment.

Longterm optimism: Congress in December extended eased rules permitting Medicare patients and those on high-deductible health plans to more easily access virtual care.

Even the DEA’s plans, as disappointing as they are to the telehealth industry, provide certainty about the rules going forward, added Jenny Poth, vice president at investment bank Ziegler.

At least companies know what they’re dealing with, she said: “Uncertainty is way more expensive.”

Kate Merton, executive director at venture collaborative Chicago ARC, said the coming months will reveal the strongest companies.

Merton said the survivors will have solid partnerships and integrate telehealth with other services.

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People who had high trust in public health agencies during the pandemic didn’t have it because they thought agencies did well in controlling the virus’ spread, but because they had “clear, science-based recommendations” and offered resources like vaccines and tests, a new Harvard study found.

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Today on our Pulse Check podcast, host Megan Messerly speaks with Alice Miranda Ollstein about what influenced Walgreens' decision not to sell abortion pills in 20 states — including several states that have no abortion restrictions — after threats of legal action.

Moderna CEO Stéphane Bancel sees major improvements in cancer care on a very short horizon.

Moderna announced in December that an individualized mRNA injection it developed with Merck reduced the recurrence of melanoma by 44 percent when combined with Merck cancer drug Keytruda.

“Are we going to get to curing and zero? That would be foolish with today’s state of science to say so,” Bancel said at a POLITICO roundtable. “Do I think cancer could become a disease like diabetes, that, for most people, we have the tools to find it early and to keep most of the people alive? I think so.”

What’s the timeline? 

Bancel said he expects “incredible improvement” in the next five to seven years with doctors using liquid biopsy to test blood for cancer, followed by treating cancer with customized vaccines that train the body’s T-cells — which usually fight malignancies as a matter of course — to attack cancer cells they’d previously missed.

Europe is behind when it comes to examining psychedelics’ potential to treat mental health disorders — and it’s time for the EU regulator, the European Medicines Agency, to step it up, reports POLITICO’s Sarah-Taïssir Bencharif.

A multi-party group of EU lawmakers wrote recently to Emer Cooke, executive director of the agency, to say that the failure to approve new psychedelic therapies “is creating a disadvantage for millions of Europeans affected by mental health conditions and substance use disorders.”

The lawmakers included members of the EU’s socialist bloc and its center-right Christian Democrats, among others.

They noted Australia’s decision to allow psychiatrists to prescribe MDMA, or ecstasy, and psilocybin, or magic mushrooms, for the treatment of PTSD and treatment-resistant depression, respectively, and also said the U.S. Food and Drug Administration was ahead of EU regulators.

In a separate letter to Alexis Goosdeel, director of the EU agency that advises regulators on drug policy, the European Monitoring Centre for Drugs and Drug Addiction, the lawmakers called for a rethinking: "We believe that the international drug-scheduling system needs to be reformed to ensure that psychedelics with strong medicinal potential are more accessible to scientists and patients.”