Early Detection Revolution: How a Simple Scan Could Save Your Life

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This week on Forward.

I don't believe you can underestimate just the power of peace of mind. You know, we have a healthcare system that says, you know what, don't go looking, you're normal until you present with some sort of acute symptoms. And now guess what, you have advanced X, whatever that happens to be. And you know, these exams could be 2, 3, $400 in the not too distant future. And obviously the cheaper they are, the more likely they are to be within someone's budget and the more likely they are to be covered by insurance as well.

It is my pleasure to welcome to the podcast the founder and CEO of the healthcare technology company Prnov. Oh my God, I have to say it right. The founder and CEO of this new healthcare technology company, Prenuvo, Andrew Lacy. Welcome Andrew.

Thanks. It's awesome to be here.

So I first found out about your company as a user and it's awesome. I have to say I'm excited for this convo in part because I think it might save someone's life. But tell my listeners, what the heck is Prenuvo?

So Prenuvo is a whole body screening company. We use advanced research grade MRI machines that we build in Europe and ship over here. We in 45 minutes are able to take clinical diagnostic images of the entire body and screen for cancer at stage one, for aneurysms before they burst and for hundreds of other conditions that if not caught early end up being chronic conditions that can burden our health care system and lead to worse outcomes for patients.

Yeah, so I get. I found this as a customer, and I want to give everyone a backdrop and context. So a couple of months ago, I lost a friend to cancer, and it was quite sudden. He had esophageal cancer, stage four. When it was caught, he went to the ER because he was having trouble eating and keeping down food. He was told by the doctors that he had two to four weeks to live, and he passed away three weeks later. So this was incredibly sad. Dramatic, traumatic, jarring. And my wife and I went to his memorial service, and my wife turned to me and said, we're going to get a whole body scan. And so we then reached out to various companies to figure out, okay, who's doing this right now. Hooked up with Prenuvo. And one thing I do want to say is that Prenuvo was excited to have me use it so I could speak about it. And so I. I did get complimentary screening in a way that is not something that, you know, is obviously customary because ordinarily, you know it, there's a cost attached to it. So my wife and I went to. To Prenuvo screening facility in New York. And you lie down in a machine. There are some noises and words. It was about an hour, as I recall. And you watch Netflix the whole time. Like in my case, you're just lying still and watching Netflix, I have to say, was something of a pleasure. You don't really think of full body screening as something you're going to enjoy, but I did enjoy it. And then a number of days later, I had a consultation with someone telling me about my findings. Well, first the findings were sent to me, and obviously you're a little bit nervous and you click on it. And then an appointment is set up for you to review your findings with professional who then calls and says, okay, this is what we found. This is what we found. This is what we found. This is what we found. I will say, if there's any suspense out there, I got a clean bill of health that they did tell me about a few things that were developing that I should keep an eye on. But I have to say that I came away thinking, wow, that was an extraordinarily positive experience.

Yeah, no, thanks for sharing and letting folks know sort of what the actual experience is like. It is pleasant. We try and make it as comfortable as possible. You know, a consequence of our very reactive healthcare system is that we only ever associate negative health outcomes from ever Setting foot inside a medical facility. And we wanted to create an environment where healthcare wasn't something that was scary, where being diagnosed with disease wasn't something that was necessarily life altering. Because, you know, we are able to see so many things that could affect you so early that it can really make a massive difference in terms of outcomes for patients. And it's a pretty comprehensive scan. There's almost no stone left unturned. I hope one day maybe this would be a one. This is a requirement for running for president, is you get one of these scans and then we could sort of put to bed all of the conversation about whether someone's healthy or not.

Well, you know, I'd be happy to share my results. As it turns out, though, you know, maybe, you know, I wouldn't feel that way if I was one of, one of the candidates. So if you want to give people a sense as to how you got to this point, because developing this offering must have been a lot of work, a lot of resources. What's your background and how did you wind up founding Prenuvo?

Well, for me, it started with asking a question that a lot of people start asking in their 40s, particularly those of us that work hard and are perhaps not looking after ourselves because we're investing in a better future. And I remember waking up one day and looking in the mirror and saying, just asking myself this very honest question, you know, how do I know I'm going to be around for that future? And I, I. That sent me on my own personal journey to learn more about my health. And, and, and in that journey, I ran into a gentleman who was doing these screenings up in Vancouver, Canada, of all places. So I got on a plane, I did a scan, and I just learned more about my health, you know, in that hour than the health system had told me in my entire life. And, and for me, it became my mission from that moment to find a way to bring this to us, many people as possible. The technology itself is kind of new, but not new. It's not new in the sense that if you're one of a very small number of people that have a genetic cancer predisposition to syndrome, where you will get cancer multiple times in your life. And it's just a question of where and when these screenings are done. In hospitals, they cost 50 to $100,000 and they take three to four hours. And so they. The real innovation here is the hardware that we use enables us to take those same screenings in about now 45 minutes. And no one wants to sit in an MRI for three hours, no matter how much Netflix they have to watch. But 45 minutes is very tolerable and it really sort of enabled this market for generalized screening for people that may have normal risk and just want to get on top of health conditions before it's too late.

So when was your Vancouver experience? What year was that?

That was 2018. So I've been at it now for five or six years.

So you come away from that screening saying, wow, I learned so much about my health. How can I bring this to more people? And then you found a way to try and make the offering more cost efficient, more cost effective, less time consuming. When were the first real customers for Prenuvo? What year was that?

We started screening people in 2018. So we were. We've been at this for some time and the founding radiologist had been doing these scans for 10 years before. So our first screening was 2009. So we've been at it for a long time. We expanded into the US during COVID We're now in 11 locations. We have just thousands of people that credit us with saving their lives. And yet obviously we still face a skeptical healthcare system. And, you know, we're working really hard to change, you know, hearts and minds so that doctors and eventually the insurance system and the healthcare system will embrace these types of screenings because our experience has been they save lives.

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Yeah, I mean, it's a great question and a great observation. I, unfortunately, I'm attracted to very difficult challenges, and I think this is definitely one of those. The cost of the screening for cancer is $999. And for the entire body, where we screen for hundreds of other diseases as well, is 2499. So it's perhaps less expensive than people think. We think it's great value for what you get. We're screening every region of interest in your body for maybe 20 or $30. So we screen for pancreatic cancer for $20. We screen for lung cancer for $20. But of course, the cost is still expensive enough that it's out of reach for a lot of folks. And there are a lot of folks that can afford it that don't necessarily want to know what's going on with their health. So this is a difficult challenge because there's human psychology involved. We don't always want to know, Even though we wish we would knew if we got caught with something late, we would wish that we knew earlier. And on the institutional side, I think there's a lot of questions about, well, this is expensive. You know, can we afford to do this for everyone at the population level? And they're really. The challenge is we think about this as only incremental technology. We believe that if we had a world where we were diagnosing everything early, everything downstream, all of the Clinical care pathways would look totally different and we would have a leaner and meaner healthcare system, maybe twice the size of, you know, and it would be focused on keeping people healthy rather than, you know, spending an awful amount of money trying to keep very sick people alive a little bit longer. And, and in the context of the U.S. economy, I mean, you can't fix the economy without fixing healthcare in the long run just because of so many people, so many baby boomers retiring and ad demands on healthcare just going up year on year.

Yeah, the healthcare system is getting more and more costly every year. I believe it's about up to about 17% of the economy now. Our outcomes are not getting any better. There are people who hear $2,500 for the full body scan and think, wow, that's a lot. And then there are some other people who hear $2,500 and say, huh, like that's not as much as I thought it was going to be. Like, well, what is the long range target? Like could it become less expensive over time if you are quote unquote like at scale or that there, there are some efficiencies.

Yeah, there's really three things that bring the cost down and we're working on all three. The first is to shorten the time it takes to acquire these images. When we first started it took almost two hours and now it takes 45 minutes. And the long term goal is this is a 15 minute exam and these machines are expensive and so time in the machine becomes an important component. The second is just old fashioned scale. Some of the facilities we operate have more MRIs than any other facility in North America. So this is not a space that is sort of operating at scale yet and scale will bring down cost. And then the third piece is really AI and here we're working on AI models that can help our radiologists be more productive. And maybe in the future we may not need radiologists for some parts of the exam. And we think the combination of these three mean that, you know, these exams could be 2, 3, $400 in the not too distant future. And obviously the cheaper they are, the more likely they are to be within someone's budget and the more likely they are to be covered by insurance as well.

If you could get it down to 500 in 20 minutes, let's say, oh my gosh, at that point it would become very, very customary I think. And there, there are many situations where even at the current price point it makes a world of sense. Foreign. It's Toyota truck month time for A.

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I mean, oftentimes when people ask me my sort of founder story, they expect that there's going to be, you know, this technology found cancer. And now this is why this is my mission. But to be honest, I just really, I don't believe you can underestimate just the power of peace of mind. And, you know, we have a healthcare system that says, you know what? Don't go looking. You're normal until you present with some sort of acute symptoms. And now guess what? You have advanced X, whatever that happens to be. And meanwhile, as individuals, we feel aches and pains from time to time. You know, you may have found a metal pain in your shoulder or some pain in the abdomen, and there's always that little voice saying, well, what if that, you know, what if that was the same thing that someone else had? Or, you know, what if this is something life threatening and my doctors not paying attention to it? So these scans are sort of a great equalizer because we will catalog everything, regardless of whether you feel any symptoms, regardless of whether you feel like it's normal or not, regardless of whether your doctor is willing to listen to you and do further investigations. And ultimately we, we provide a catalog of whatever we see and then empower the patient to do, you know, to basically take their health into their own hands. And I believe that's the future, because no one cares about Your health more than yourself. And consumers are smart today. They do a lot of research. And I'm sure when you got your report, the first thing you did was you went to Google or ChatGPT and went to work to see what you could learn about yourself.

Yes, that I'm healthy as a horse. That's what the clinical report said. No, I'm kidding.

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You talk about this being covered, and there are a lot of people watching or listening to this right now who are thinking, oh, I actually should try and get a scan either for myself or for a loved one, but then feel very daunted by the cost. What does that world look like in terms of trying to get it covered? And what I'm thinking is that, you know, there might be certain systems that say, okay, when you're a certain age, if you're like showing certain symptoms and like, maybe this makes sense. And I want to preface this by saying that the American health care system is a pain point for so many people. It's overly bureaucratic. It doesn't prioritize prevention. You know, like someone said that it's not a healthcare system, it's a sick care system and it's designed to try and maximize revenue. So what does getting this covered even look like?

Well, in the medium term, you know, every patient that comes in is a data point for us in the evidence that we need to collect to show that these scans are clinically accurate and can, you know, provide benefit at population level. So we follow up with patients, usually a year after the scan. We ask them, how did it go? Those things we saw, did you do any? Did you do the checkups? Resuggested, what was the result? And we do this. I mean, it's kind of cool. No one expects their doctor to call them up a year later and actually just proactively ask them how they're doing. That's a pretty rare thing these days. But at the same time it really helps us understand where are we doing well, where can we do better? How can we adjust the way that we read these scans so that we can be more and more accurate every time and collect evidence that these scans are equivalent to or maybe even better in terms of accuracy than some of the scans that are covered as standard of care screening. And really that's the goal. And I believe we're not six months away from that, but we're not five years away from that as well. We've collected already a good body evidence that gives us a lot of faith that we'll be able to meet that evidentiary burden and then hopefully work with politicians, which sort of, at the end of the day this involves to hopefully have these screenings covered by Medicare and other programs as soon as possible for folks out there. There is a hack that I sort of would, that is worth mentioning, particularly for younger folks, which is we've had a lot of people that were on comprehensive health plans, sort of your typical gold health plan, and they've said, you know what, I'm going to do a, I'm going to pay for a prenuvo scan every year. And on the assumption that I'm healthy, I'm going to now be on a high deductible. So I'm going to save money by actually taking out a different type of insurance and those high deductible plans, the HSAFSA plans, you can pay for the scans through the contributions to those plans. So that is one way that we see a lot of people these days incorporating these screenings as part of their annual health checkups.

Wow, that is a good hack. And I think there's even a tax break involved with that. So you get more data, you demonstrate that, look guys, we're catching stuff. And actually so I have the healthy version, but can you talk about some of the things that have happened where people have caught things earlier? Because that must be a very good feeling.

Yeah, we're pretty mission driven company and so we like to share obviously in a way that respects the anonymity and privacy of our patients. But we, whenever we get like a story of saving someone's life, we share that with the entire company. I want everyone to understand that the impact that they're having in their job, they may just be, you know, one small part of like a quite complex operation. But you know, Collectively, we are making this possible for people to get early diagnosis and save lives. So a lot of patients are excited to tell us about it. You see on social media, a lot of folks are sharing their stories where we've made a life saving diagnosis and that in turn is helping to raise awareness of these exams. That's really the biggest challenge. The technology is incredible. It's getting better every day. And our biggest challenge is just there's still too many people out there that don't even know that this option exists.

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Well, hopefully this conversation will help a little bit with that. I am a believer and I will say that the word is getting out because even when I spoke to some friends about it briefly, they just said oh pernuvo now where I, I think your target market is actually associating your company with this entire category of scans. And I think you're just going to keep on growing because my experience was awesome. I think peace of mind is a good thing. I think knowledge is good. You know, don't like if, if someone has the either the concern or maybe someone's concerned about them. You know, it's an hour of your life. It is expensive for a lot of people. I will say that there is some part of me that feels like your company will thrive because our healthcare system is so jacked. I don't know if that's something that, that you and yours sense that. I feel like you're part of this new wave of companies that's going to run around trying to solve a problem and then belatedly our system will end up incorporating you. And like right now you're doing things the hard way, but in some ways, like the pure way, which is you just getting the word out to real life human beings who decide that this is of value and then figure you can build from there.

Well, I think, you know, a big part of why this is important for us, to be perfectly honest, is we have a great health care system. Actually, when you're diagnosed with something, there's probably no country in the world I would rather be in if I had serious illness, you know, because the quality of care in general is pretty good. Where we lack and where most countries, in fact everywhere lack, is in diagnosing things early. And I fundamentally believe that, you know, these need to be covered because this is a great equalizer, because typically folks with more financial means have better preventive health. And if they have better preventive health, they catch things early, they get better outcomes, they live longer, they have, you know, they have a better health span. And so if we can, you know, I fundamentally believe that there is no better way to level the playing field than to make preventative screening more widely available. And, you know, we're working on a big pilot project right now in Boston where we're making it available to some folks that meet a social equity criteria so that we can really start to understand what the impact would be if we did. If this was made available through insurance or through government programs for folks that may not otherwise be able to afford these exams, you know, how does their health look today, and how would this really benefit them? I'm really excited for the results of that study.

Well, I mean, it's clear to me that it's going to save money on the back end to know what the heck is going on inside of us. Because what happens if you just let something fester and linger? You wind up showing up at the er, and then there is a lot of belated countermeasures that people pursue. But if you wind up spending a day in the hospital, incredibly expensive. You know, if you find. Find yourself, like, in really dire straits, incredibly expensive. I mean, if you can catch this early, especially the way our system works, I mean, you're gonna end up spending tens, hundreds of thousands of dollars as soon as someone winds up in that hospital. So if you can keep someone out of the hospital, it would be that you. You can assign very, very significant numbers. And as a society, we will end up saving money just about every time when we don't.

And we don't even speak about the, you know, what's the cost of a human life? And, you know, if we're. If through these technologies and other technologies, we could all live.

Yeah. Loved ones not being able to spend time.

Totally. We could all live like three or, you know, three, four, five, six years longer. I don't speak about living to 200 like other folks in the space do. I mean that, you know, what does that mean for time we can spend with families, for productivity, for the economy, for, you know, delaying drawdown of retirement savings? I mean, I think it's an incredible goal and you know, we're already behind the rest of the world when it comes to longevity. So maybe these technologies could be part.

Of the answer, the great equalizer indeed. Know what's going on inside of people, catch things, live longer, enjoy lives, you know, spend time with our loved ones again. You know, I'm, I'm an admirer and a believer in what you all are doing. If people want to find out more about Pernuvo and, and maybe find a location that's somewhere near them, how can they best do so?

So if they go to prenuva.com, they'll see all the locations that are both open and are opening soon. We have 11 open locations in sort of the major metropolitan areas in the US and then there's another 20 or so that we're opening in the next 18 months. There's also a team of people there manning our chat. We are old fashioned. We have a phone number on the screen if someone would like to call and talk to a real person and understand whether the scan's right for them. We just want to be as helpful a resource as possible and hopefully people avail themselves of the technology, you know.

And if someone wants a discount to Prenuvo, you can use the discount code forward. It's prenuvo.com forward for a $300 discount. Get it down to 2200. Look at that. Just trying to make it accessible and help we can, you know, it's, it's obviously still a significant investment, but, you know, so is your health, so is your life. Penuvo.com forward for a $300 discount. Well, keep on building, man. You're saving lives and I'm a happy customer. You know, I'll see you guys in two years, but, but by then you'll be everywhere because, because it' clearer that the demand is there and that people can see the benefits. Congratulations, really, Andrew.

Thank you. Thanks for having me here. And I look forward in two years to seeing that liver without the fragran there.

Yeah, I'll help it up between now and then.

Awesome, thanks for having me. I appreciate it.

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