Peter Wehrwein

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Climbing the Career Ladder: 10th in a series of 10 profiles of healthcare executives and their careers.

Growing up in Lake Success on Long Island, New York, Adam Sabloff had pinned his dreams to career in the film industry. He spent summers interning at various production agencies in Los Angeles, and after graduating from Emory University in Atlanta, he worked in the mailroom of an agency. “I loved the creativity and people in the industry,” Sabloff, “but I was quickly disillusioned by the spotlight.I wanted to tell stories and I wanted to create, but I didn’t want the fanfare.”

The real estate industry beckoned as the film industry’s appeal faded and faltered. Sabloff’s first job was in Manhattan with the Newmark Group, a large commercial real estate company. Sabloff says there’s more overlap between real estate and film than one might imagine: “There is a tremendous amount of collaboration that takes place between architects, interior designers, trade unions, marketing firms and brands. When it’s over, you have something that was far greater than the sum of the parts.” But his career veered off in an unexpected direction after one of his clients asked him to check out a waterfront property in New Orleans. Sabloff purchased a 75,000-square foot warehouse next to it “on a whim.” To cover the cost, the warehouse was rented out for events and live music. That business evolved into TwiRoPa, a huge entertainment complex with multiple stages and dance floors.

Then, in August 2005, total disaster. And another curve in the career path.

“We had just been named one of the top 10 venues in the country and were in the process of putting a restaurant on the second floor when Hurricane Katrina hit,” says Sabloff. The fledging entertainment center was irreparably damaged by the category five hurricane and Sabloff’s apartment, condemned. He says he lost everything and wound up living with his grandmother in Fort Lauderdale, Florida, while trying to figure out his next move. 

“At the time," he says, "I thought this was the lowest point of my life."

But Sabloff says he became closer to his grandmother — “one of the smartest and most magnetic people I have ever known" — and got an experiential, hard-knocks lesson about the down-then-up dynamics success. “It’s not about getting knocked down. Everyone gets knocked down,” he says. “It’s about getting back up again.”

At this point in his life, for Sabloff, “getting back up again” meant jumping back into real estate. He joined a New York City-based company called Midtown Equities and while with Midtown, Sabloff worked on a Ritz-Carlton Residences project in Baltimore. That undertaking and others opened up his eyes to the healthcare needs of older people and to “next generation care delivery that would make the home an organic extension of the healthcare continuum.” Then a late-stage cancer diagnosis and loss of a close family member hit hard and revealed to Sabloff the gaping shortcomings of American healthcare: extravagant costs, enormous resources in medical personnel and service, bad outcomes.

“If all of our incentives were aligned, why did we all lose?” says Sabloff. “Early detection and treatment would have saved a life, freed up resources, and saved the insurance company money.I vowed to be a part of the change to make healthcare proactive.”

Sabloff founded VirtualHealth in 2012, which markets Helios, a does-it-all care management platform designed to reduce unnecessary ER visits and avoidable hospitalizations, manage chronic conditions, administer community resources for social determinants of health, and align with care with national quality strategies and standards. The company, which is based in New York City, has about 150 employees. Two years ago, it closed Series B financing, bringing the total amount raised by the company to more than $25 million.

As terrible as the COVID-19 pandemic has been, Sabloff says it has pulled back the curtain on American healthcare and shown that it needs to be more proactive. Now is also time, in his opinion, to build on the advantages of digital health that the pandemic spotlighted. Sabloff unapologetically plugs his company’s platform: “Tools like telehealth, transportation coordination, connected devices, wellness apps and wearables, all of which have been part of Helios from its inception, have become exponentially more important. We are on the dawn of a healthcare revolution that was badly needed and long overdue.”

Sabloff says industry veterans were skeptical about his and VirtualHealth’s ambitions: They thought it was too much change too quickly and that legacy products were the better way to go.

He has kept his father’s watchwords in mind. “He would always remind me that ‘if you don’t quit, you’ll win.’ Nothing is more important than perseverance.” Customer service and happy employees also keys to running a business says the product of Lake Success: “In my opinion, there are really only two things that matter — happy clients and happy employees. If you have both you are guaranteed success.”

Sablofff's advice to others is to stay focused, believed in your mission and brace yourself for rejection if you’re trying to break new ground: “Many forget how badly panned the iPad was upon release.”

Articles

Adam Sabloff, CEO and founder of VirtualHealth, says his father’s watchwords, “if you don’t quit, you’ll win,” have inspired and motivated him throughout a varied career that has had ups and downs.





Adam Sabloff, VirtualHealth: "If You Don’t Quit, You’ll Win"

Source: Vizient Summer 2021 Pharmacy Market Outlook

Hospitals, health systems and other nonacute providers will spend 3.1% more on drugs next year, with oncology drugs accounting for roughly quarter of the expense, according to a 

Vizient, historically a group purchasing organization for hospitals that now bills itself as healthcare performance improvement company, based the result on analysis of its members’ purchasing pharmaceutical data. The company, which is headquartered in Irving, Texas, also surveyed members about 

The report, titled the Summer 2021 Pharmacy Market Outlook, discusses the effect of the COVID-19 pandemic on drug expenditures and usage. Between April 2020 and March 2021, the hospitals and healthcare providers in Vizient’s drug purchasing database spent more money purchasing remdesivir, the antiviral sold under the brand name drug Veklury, than any other drug besides Humira (adalimumab), the immunosuppressive drug used to treat a variety of autoimmune diseases, and Keytruda (pembrolizumab), the leading drug among the new generation of cancer drugs that work by harnessing the immune system.

Vizient analyst also had access to a clinical database that included 436 hospitals to track the usage of COVID-19 medications. As the report notes, use of 

, a low-cost corticosteroid with anti-inflammatory effects, shot up in July 2020 after the report in June that it was effective in reducing mortality from COVID-19. Vizient’s data shows that by November, about 70% of hospitalized COVID-19 patients were treated with dexamethasone. The Vizient data also show steep climb in the use of remdesivir starting in May, the month that the FDA issued an emergency use authorization for the drug.

The Vizient identifies specialty drug as a major factor hospital and other provider organization spending, with spending expected to increase by 4.68%. FDA approval of increasing number of drugs for rare diseases and Humira price hikes prior to 2023 when biosimilars to Humira are scheduled to come on the market are the main reasons for the upward trend, said the press release about the report.

The report sounded an optimistic note about insulin and biosimilar competition. Early last year, insulins were reclassified in such a way as to open them up to biosimilar competition, Vizient noted. The report also mentions the possibility that 

, a spin-off company from Pfizer, is seeking FDA approval for versions of insulin glargine and insulin aspart that would be 

How ‘White Bagging’ Affects Patients, Physicians and 340B Funding

The Vizient report covers a wide range of topics from overall spending patterns to white bagging to FDA’s accelerated approval pathway and the use of surrogate markers.

Cancer drugs are the big-ticket class (24.3% of the spend) followed by drugs to followed by infectious disease products (12.77%) and the disease-modifying antirheumatic drugs, or DMARDs (11.4%). Vizient says the therapeutic class with the highest estimated price change next year is DMARDs because of anticipated Humira and Enbrel (etanercept) price hikes.

Inpatient volumes at hospitals will rebound but not quite return to prepandemic levels, Vizient predicts. The company says inpatient volume is expected to decrease by 1% over the next decade, partly because of the push to changing the side of care to lower-cost outpatient facilities.

Vizient said “premixed drug formulations” of drugs that used to be combined (“compounded’) in-house is a “notable trend.” The report gave Myxredin, an insulin product, as an example of premixed drug that is far more expensive ($420.20 vs. $14) than the version that could be created in hospitals and other facilities. “While patient safety is paramount and ready-to-use/ready-to-administer formulations may offer a safety advantage (e.g. reduction in compounding errors), it is also paramount for the industry to strike a balance between charging a premium for safety and innovation and taxing providers with a price increase.”

The report applauds biosimilars and generics coming on the market. Vizient mentioned that four generic versions of intravenous acetaminophen have come on the market starting late last year, giving the brand-name version, 

, some competition. But the report also noted the Humira biosimilars won’t be on the market for another two years and that biosimilars to Humira will perhaps be most impactful given the price of the drug and how commonly it is prescribed.

The report includes criticism of white bagging — the provision of a medication directly from a pharmacy to a patient. Specialty pharmacies and payers say white bagging is safe and saves money because it eliminates the “buy and bill” markup providers charge when they take possession of the medication and administer it. But Vizient says white-bagging as disrupts patient care and winds up adding cost, not saving money. Today’s report includes results from a survey Vizient conducted from March 24, 2021, to April 16, 2021, that had 268 respondents. According to the report, 83% of the respondents said they had an experienced a white-bagged drug not arriving in time for administration and 68%, a white-bagged medication that was the wrong drug or the wrong dose.

Wide ranging report covers a lot of ground. It sounds an optimistic note about biosimilars but is critical of white bagging.

Vizient’s Outlook Report Is a Mixed Bag: Projected 2022 Drug Spend, White Bagging, Insulin Competition and COVID-19 Treatment. It’s All in There.

Climbing the Career Ladder: Eighth of 10 profiles of healthcare executives and their careers.

His passion was for music, specifically for the French horn, the curlicue brass instrument that is notoriously difficult to play. Being a pharmacist was strictly for paying the bills. While pursuing a master’s at Carnegie Mellon University in Pittsburgh, Michael Zeglinski squeezed in two days a week as a pharmacist. His master’s thesis was on the French horn parts in Gustav Mahler’s symphonies, and he studied with the principal horn player for the Pittsburgh Symphony Orchestra. There was an audition for the orchestra and gigs playing in the orchestra for the Pittsburgh Opera.

“But if you’re going to be a symphony-level musician and have that as your career, you need to have that je ne sais quoi, or that talent, that pushes you over the edge,” says Zeglinski. “I was kissing the pinnacle but never quite felt I was going to be able to stay there for 20 to 30 years.”

Zeglinski has reached a different sort of pinnacle — and stayed there — as a pharmacist and healthcare executive. The senior vice president and CEO of specialty and infusion pharmacy at OptumRx oversees a part of the business that accounts for roughly 10% of UnitedHealth Group’s revenues, and Zeglinski sits atop an organizational chart with roughly 6,000 employees.

His stab at a musical career has served him well, he says: “Being in an orchestra has its own dynamics — the conductor, being part of a team and doing your best to contribute to the whole. All of that applies to business.” Playing an instrument also instilled confidence, especially when it comes to public speaking. “There’s nothing scarier than being a soloist in an orchestra in front of 2,000 people. Everybody is listening to just you. Talking in front of people, that is a cake walk,” Zeglinski says with a laugh.

Zeglinski grew up outside of Pittsburgh in Beaver County, Pennsylvania, which is better known for producing football players (Joe Namath, Tony Dorsett) than musicians or healthcare executives. His father lost his job when the Pittsburgh steel mills closed, which may explain Zeglinski’s practical side and hedging a bet on a musical career. Armed with a pharmacy degree from Duquesne University in Pittsburgh that he earned before enrolling at Carnegie Mellon, Zeglinski says he tried nearly every aspect of pharmacy on before deciding on home infusion: “It was so complex. It wasn’t just pharmacy. It was business. It was nursing. It was dealing with payers and contracts.”

In one of his budding-career jobs at a small home infusion pharmacy business in western Pennsylvania, Zeglinski did all the hands-on work: compounding medications under a laminar flow hood, putting labels on IV bags, and medications into boxes. He says he was promoted into management partially because he was a serial volunteer: “If there was an opportunity to do something new, I’d volunteer. ‘Hey, we need somebody to work on this site project.’ Sure, I’ll do it. ‘Hey, we need somebody to travel over here and train these new pharmacies that we’re opening up.’ Sure, I’ll do it. Those types of things. I always just seized the opportunities as they came up.”

Zeglinski’s first full step into the executive career track was with Gentiva Health Services, a specialty pharmacy in Warrendale, Pennsylvania, outside of Pittsburgh. As with many people in healthcare, Zeglinski’s career path has been rerouted, then rerouted again, by acquisitions in a Russian nesting doll pattern. Gentiva’s pharmacy business was sold to Accredo, which was bought by Medco, which now part of Express Scripts, which was acquired by Cigna. He is at OptumRx because the company that hired him became Catamaran, which was acquired by Optum. In between, he had a stint of about 10 years with CVS Caremark, CVS Health’s PBM.

At Optum, Zeglinski’s career has gone back to his roots. “I worked in specialty pharmacy before it was even a word,” he says. “So as specialty developed, I moved out of infusion into specialty, and now I am back to where I am managing infusion, although there’s now an overlap. Before they were bifurcated.”

Zeglinksi wants to bring more self-service and digital tools to specialty and infusion pharmacy. “In specialty pharmacy we always said, ‘Oh we are high-touch specialty pharmacy, etc.,’ which means I know more than you, the patient. I’m here as the doctor, the pharmacist, and I’m going to tell you what you need to do,” he says. Self-service and digital services can help patients take care of themselves. “Why do they have to talk to me every month to get their prescription?” he asks. “If I were a patient, I would only want to get on the phone and talk to us when I wanted to, not the other way around. So how do we get there?” says Zeglinski.

Michael Zeglinski, senior vice president and CEO of specialty and infusion pharmacy at OptumRx, has applied the experiences he had playing the French horn in orchestras to his increasingly important roles in healthcare: “Being in an orchestra has its own dynamics — the conductor, being part of a team and doing your best to contribute to the whole. All of that applies to business.”

Michael Zeglinski, OptumRx: Hitting the Right Notes

Say a treatment drug for nonsmall cell lung cancer (NSCLC) increased overall survival by 21.6 months and progression-free survival by the same amount among patients who smoke. That would be a pretty remarkable drug, especially because so many NSCLC patients are smokers. Roughly 80% of NSCLC patients have a smoking history and between 40% and 50% are smokers when they are diagnosed. 

But it isn’t a drug that is associated with such large survival gains. It is smokers giving up the smoking habit that very likely resulted in their lung cancer

show that the adjusted median overall survival time of NSCLC patients who were current smokers when they were diagnosed but then quit was 6.6 years compared with 4.8 years among those who continued to smokers. The median progression-free survival of the NSCLC patients who smoked but quit was 5.7 years compared with 3.9 years for the patients who didn’t quit.

Other comparisons between the quitters and those who continued to smoke showed the same pattern of a strong, statistically valid association between smoking and better outcomes.

The people who volunteered to be in this study were patients at two hospitals in Moscow, N.N. Blokhin National Medical Research Center of Oncology and City Clinical Oncological Hospital No. 1. The researchers compared 297 NSCLC patients who continued smoking to 220 who quit. Patients were identified as current smokers if they smoked one cigarette day for more than a year before they were diagnosed. Of the quitters, 157 (71.3%) quit soon after they were diagnosed and before their first treatment and 33 (15%) quit after treatment started but within a year of when they were diagnosed.

This isn’t the first study to show that smoking cessation has benefits even for those who have been diagnosed with NSCLC. But it is more definitive because it is a large study with a fairly long follow-up period.

Researchers have come up with a variety of explanations for why patients who continue to smoke don’t fare as well as those who quit. For example, the cancer-causing carcinogens in tobacco smoke may promote tumor growth. That’s an exposure that those who quit smoking don’t experience.

In the discussion section of their paper, lead author 

, M.D., Ph.D., of the International Agency for Research on Cancer, which is part of the World Health Organization, and his colleagues write that NSCLC patients who smoke “may feel fatalistic and not recognize the beneficial effects of quitting smoking postdiagnosis.

They go on to say that their results “strongly suggest” that patients with lung cancer who smoke should be encouraged to stop at any time and at each visit after they are diagnosed with NSCLC.

Study shows that nonsmall cell lung cancer patients who smoke but quit after their diagnosis have better overall survival, progression-free survival than patients who continue to smoke.

Peter Wehrwein

Articles

Adam Sabloff, VirtualHealth: "If You Don’t Quit, You’ll Win"

Vizient’s Outlook Report Is a Mixed Bag: Projected 2022 Drug Spend, White Bagging, Insulin Competition and COVID-19 Treatment. It’s All in There.

Michael Zeglinski, OptumRx: Hitting the Right Notes

Never Too Late To Quit: Smoking Cessation Pays Off for NSCLC Patients