A Blueprint to Health

SweetSpot
BluePrint Health

Why 2016 is important: Company seeks at least $3 million in capital to expand network of patients and doctors.

Dan Miller, CEO Blueprint Health

Dan Miller, with a long career in tech startups, including several successful mobile marketing firms, is devoted to personal fitness, from riding his bike to work to grueling CrossFit classes.

Despite analyzing, advising and investing in companies for 30 years, Miller rarely came across a health care business he believed had the right components to become a blockbuster success. That changed after Miller met pharmaceutical sales executive Jake Michel, behind a St. Petersburg startup called BluePrint Health.

Michel and his partners founded BluePrint Health from what they believed was a significant gap in health care: A company that could bring sophisticated technology, processes and logistics to hormone replacement therapy — a segment of health and wellness often misunderstood and occasionally tarnished by some shady players. “There is a stigma around hormone therapy,” says Miller.

But Miller, whom BluePrint initially hired to analyze the business plan and market, was wowed by the what-could-be. Hormone replacement therapy is a $4 billion to $8 billion industry, but few, if any companies, work with both doctors and patients on the process.

BluePrint Health does that through a team of nurses outside the physician’s office, who work with the patients from diagnosis to hormone injections. The company started treating patients in August. Officials project BluePrint will turn a profit next year and, if it reaches its target capital-raise goal, the company could surpass $7 million in sales in 2016.

“We are not creating a new market, but we are approaching it from a more efficient way,” Miller says. “This is such a unique model. There isn’t a direct competitor who does what we do.”

Miller liked BluePrint so much, he became an investor and was later named CEO. Miller’s past ventures range from business incubator Startup Florida to Movo Mobile, a cell phone marketing firm. He relished the chance to lead BluePrint. “The idea that I could become involved in a business that could dramatically improve someone’s life,” says Miller, “was very inspiring to me.”

Hormone replacement therapy treats imbalances in the body caused by a lack of hormones. Symptoms from a lack of hormones include mood swings, weight gain and depression.

BluePrint offers affiliate agreements for physicians, who can sign up and utilize the service without any fees after being trained on the process. An affiliated physician then prescribes BluePrint for a patient, man or woman, in need of hormone replacement therapy.

A patient, meanwhile, can work through his or her doctor or go to BluePrint directly. The process after that follows normal medical procedures: A patient gets a blood workup. Then BluePrint clinicians look at everything from cholesterol levels to liver and kidney health to the thyroid function.

BluePrint, in consultation with a physician, next puts the patient on a 12-week hormone replacement therapy cycle. BluePrint virtual nurses work regularly with patients, on follow-up calls and to monitor progress.

BluePrint earns a fee from charging patients. Payments are cash only, though Miller says the firm is working on possibly adding an insurance program this year. Costs vary, but medical oversight for the specialized lab work is $350 to $400 and medications can range from $150 to $500 a month.

BluePrint’s competitive advantage, Miller says, is technology, including a comprehensive database, which simplifies hormone replacement therapy — both for patient and physician. “We built a very scalable, very robust back-end platform,” Miller says.

Miller and the founders invested about $200,000 to get the business going over the past year. That money, for technology and marketing, led to a fast start in signing up physicians nationwide. Doctors with BluePrint affiliate agreements are in at least seven states, from New York to Oklahoma. Several doctors in the Sarasota and Tampa markets have also signed on with BluePrint.

The looming business challenge at BluePrint is to raise capital so it could graduate from shoestring days, and also invest more in marketing. It seeks at least $3 million, and is working with both angel and startup investors and other potential backers.

Miller, while working with investors, remains motivated by the company’s mission. Says Miller: “We are really helping people feel better and live more fully.”

Combination Estrogen/Continuous Progestin Reduces Postmenopausal Risk of Endometrial Cancer

Adding continuous progestin to estrogen lowers the risk of endometrial cancer in postmenopausal women, according to a study recently published in the JNCI: Journal of the National Cancer Institute(doi:10.1093/jnci/djv350). The addition of progestin to an estrogen regimen is known to lower the risk of endometrial cancers, which are associated with estrogen alone use; but just how much the addition of progestin lowers that risk has remained unclear.

To determine the effects that continuous estrogen plus progestin use has on the risk of endometrial cancer, Rowan T. Chlebowski, MD, PhD, at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, and colleagues reviewed data from a Women's Health Initiative (WHI) randomized clinical trial assessed 16 608 postmenopausal women age 50 to 79 years with intact uteri. All participants had normal findings on endometrial biopsy on entry. In the double-blind placebo-controlled trial, participants were randomly assigned to daily estrogen plus progestin given as one pill or placebo. The participants were followed for 13 years.

Study findings demonstrated a statistically significant reduction in endometrial cancer incidence in the intervention group (33 cases, 0.06% yearly) compared with the placebo group (95 cases, 0.10% yearly) after 5.6 years' median intervention and 13 years' cumulative follow-up.

"Continuous combined estrogen plus progestin use for 5.6 years in postmenopausal women with normal endometrial biopsy at therapy initiation resulted in a statistically significant reduction in endometrial cancer incidence, with the difference becoming statistically significant during longer-term post intervention follow-up," the authors reported, adding that, "In postmenopausal women, continuous combined estrogen plus progestin use reduces endometrial cancer incidence by 35%."

Original Article

For Women - Hormone therapy: Is it right for you?

Hormone therapy was once routinely used to treat menopausal symptoms and protect long-term health. Then large clinical trials showed health risks. What does this mean to you? By Mayo Clinic Staff

Hormone replacement therapy — medications containing female hormones to replace the ones the body no longer makes after menopause — used to be a standard treatment for women with hot flashes and other menopause symptoms. Hormone therapy (as it's now called) was also thought to have the long-term benefits of preventing heart disease and possibly dementia.

Use of hormone therapy changed abruptly when a large clinical trial found that the treatment actually posed more health risks than benefits for one type of hormone therapy, particularly when given to older postmenopausal women. As the concern about health hazards attributed to hormone therapy grew, doctors became less likely to prescribe it.

Hormone therapy is no longer recommended for disease prevention, such as heart disease or memory loss. However, further review of clinical trials and new evidence show that hormone therapy may be a good choice for certain women, depending on their risk factors. What are the benefits of hormone therapy?

The benefits of hormone therapy depend, in part, on whether you take systemic hormone therapy or low-dose vaginal preparations of estrogen.

Systemic hormone therapy. Systemic estrogen — which comes in pill, skin patch, gel, cream or spray form — remains the most effective treatment for relief of troublesome menopausal hot flashes and night sweats. Estrogen can also ease vaginal symptoms of menopause, such as dryness, itching, burning and discomfort with intercourse.

Although the Food and Drug Administration (FDA) still approves estrogen for the prevention of the bone-thinning disease called osteoporosis, doctors usually recommend medications called bisphosphonates to treat osteoporosis. Low-dose vaginal products. Low-dose vaginal preparations of estrogen — which come in cream, tablet or ring form — can effectively treat vaginal symptoms and some urinary symptoms, while minimizing absorption into the body. Low-dose vaginal preparations do not help with hot flashes, night sweats or protection against osteoporosis. Long-term systemic hormone therapy for the prevention of postmenopausal conditions is no longer routinely recommended. But some data suggest that estrogen can decrease the risk of heart disease when taken early in postmenopausal years.

A recent, randomized, controlled clinical trial — the Kronos Early Estrogen Prevention Study (KEEPS) — explored estrogen use and heart disease in younger postmenopausal women. The study found no significant association between hormone therapy and heart disease.

For women who haven't had their uterus removed, estrogen is typically prescribed along with progesterone or progestin (progesterone-like medication). This is because estrogen alone, when not balanced by progesterone, can stimulate growth of the lining of the uterus, increasing the risk of uterine cancer. Women who have had their uterus removed (hysterectomy) don't need to take progestin. What are the risks of hormone therapy?

In the largest clinical trial to date, a combination estrogen-progestin pill (Prempro) increased the risk of certain serious conditions, including:

• Heart disease
• Stroke
• Blood clots
• Breast cancer

A related clinical trial evaluating estrogen alone (Premarin) in women who previously had a hysterectomy found no increased risk of breast cancer or heart disease. The risks of stroke and blood clots were similar to the combination therapy.

Hormone therapy, particularly estrogen combined with a progestin, can make your breasts look more dense on mammograms, making breast cancer more difficult to detect. Also, especially when taken for more than a few years, hormone therapy increases the risk of breast cancer, a finding confirmed in multiple studies of different hormone therapy combinations, not just limited to a combination estrogen-progestin pill (Prempro).

The risks of hormone therapy may vary depending on whether estrogen is given alone or with a progestin, and depending on your current age and age at menopause, the dose and type of estrogen, and other health risks such as your risks of heart and blood vessel (cardiovascular) disease, cancer risks and family medical history.

All of these risks should be considered in deciding whether hormone therapy might be an option for you. Who should consider hormone therapy?

Despite the health risks, systemic estrogen is still the most effective treatment for menopausal symptoms. The benefits of hormone therapy may outweigh the risks if you're healthy and:

Experience moderate to severe hot flashes or other menopausal symptoms Have lost bone mass and either can't tolerate or aren't benefitting from other treatments Stopped having periods before age 40 (premature menopause) or lost normal function of your ovaries before age 40 (premature ovarian insufficiency) Women who experience an early menopause, particularly those who had their ovaries removed and don't take estrogen therapy until at least age 45, have a higher risk of:

• Osteoporosis
• Coronary heart disease
• Earlier death
• Parkinsonism (Parkinson's-like symptoms)
• Anxiety or depression

Early menopause typically lowers the risk of most types of breast cancer. For women who reach menopause prematurely, the protective benefits of hormone therapy usually outweigh the risks.

Your age, type of menopause and time since menopause play a significant role in the risks associated with hormone therapy. Talk with your Blueprint Patient Care Coordinator about it.