Principia Biopharma readies IPO

South San Francisco-based Principia Biopharma (PRNB) has filed a preliminary prospectus for an $86M IPO.

The clinical-stage biopharmaceutical firm develops therapies in immunology and oncology based on its Tailored Covalency platform that it says enables its oral treatments to deliver potencies and selectivities on par with injectable biologics.

Lead candidate is PRN1008, a BTK inhibitor Phase 3-ready for pemphigus and in Phase 2 development for immune thrombocytopenic purpura.

In June 2017, it inked a collaboration agreement with AbbVie (NYSE:ABBV) for the research and development of oral immunoproteasome inhibitors.

In November 2017, entered into exclusive license agreement with Sanofi (NYSE:SNY) for the continued development of BTK inhibitor PRN2246.

2018 Financials (6 mo.)($M): Revenue: 24.4 (+999%) (upfront payments from Sanofi and AbbVie); Operating Expenses: 22.0 (+47.7%); Net Income: 2.1 (+111.2%); cash flow ops: (22.3) (-999%).

https://bit.ly/2OPiCAB

Many don’t understand their health insurance plans or medical bills

Have you ever opened a medical bill only to have your jaw drop at the astonishing amount due? Welcome to health insurance USA.

According to a recent Bankrate survey, 41 percent of Americans who sought out medical care were surprised at how expensive their bill turned out to be.

The story is all too familiar: someone heads to the doctor, gets treatment, is slapped with a stunning bill a few weeks later, and they don’t understand why.

While some argue that the billing system is broken, others say there’s more to it; consumers don’t understand their health insurance plans or how the system works, and it creates chaos in a mysterious and inflexible system.

Medical billing, insurance seem designed to confuse

The lifecycle of a medical bill is complex. For example, let’s say you go to the doctor. Your doctor treats you, then sends a list of everything included in that treatment to a third-party medical biller.

That biller then matches the services to specific codes. Those codes get sent to your insurance company.

Your insurance company runs these codes through software and algorithms to determine your eligibility for coverage and prices of the services rendered. Then, it pays your doctor.

At the same time, though, your doctor might have already sent you an initial statement without the insurance payment included.

You open your bill and see a total amount that’s thousands of dollars. You have no idea why the bill is so high and you panic. But, your insurance company’s payment reaches your doctor — and then a final statement shows up in your mailbox weeks later.

So how much do you actually owe? Why are there two bills? What are you supposed to do?

Jeremy Urbas, vice president of Healthcare Solutions at Broadridge, is a former director at Blue Cross Blue Shield. Today, he leads a company working to simplify communications between health care providers and customers.

He acknowledges that the billing process is complex. Much of the confusion, he says, stems from patients not understanding their insurance benefits.

“Even the most well-designed bill can still be confusing because the patient doesn’t understand their insurance,” says Urbas. “Before even seeking care, the patient needs to have an understanding of what their benefit is of their insurance. If they don’t, receiving their bill is going to be even more confusing.”

Before accepting treatment, Urbas urges patients to ask as many questions as possible. Knowing what services are in-network, and which aren’t, can help avoid sticker shock and out-of-pocket expenses down the road.

Understanding bill coding errors, how to dispute them

What if your final bill is still much higher than you expected.

Aside from the difficulty of navigating healthcare jargon and prices, billing errors are common. Some experts estimate that more than 80 percent of medical bills have an error, many of which are due to wrong codes being reported.

Three of the most common errors are:

Bundling errors: With bundling, a provider pools together multiple services and materials used. If the biller sends a bill to the insurance company that includes items that should have been covered in the bundle, the insurance company can reject them and hand that cost to the patient instead.

Upcoding: This is where a more severe diagnosis is reported to the insurance company than what actually occurred. For example, someone with a sprained ankle ends up getting charged for a broken one, or a name-brand medication is billed when the patient received the generic brand.

Downcoding: A care provider sends the wrong diagnosis to the coder, meaning that the billing shows they treated you for a less-severe or different diagnosis than what actually occurred. The insurance company can rule that the treatment was unnecessary and refuse to pay it.

Urbas recommends patients always look at their explanation of benefits (EOB) to make sure that the services listed are correct.

“This is where your relationship with your insurer is really important,” says Urbas. “That EOB is the anchor for you to determine if your bills are accurate and if you’re being asked to pay for something you shouldn’t.”

If something is incorrect, you have the right to file a dispute with your provider and insurance company.

How to financially prepare for and settle medical bills

All of that confusion is burning a hole in patients’ wallets. A Consumer Reports survey finds that more than one-third of respondents paid a bill they weren’t sure they owed, and 20 percent of that group paid more than $1,000.

And if patients simply ignore their medical bills? Those unpaid bills get sent to collections, which damages credit scores. According to Experian, medical collections remain part of your credit history for seven years from the original delinquency date.

Some of the newer credit scoring models no longer list paid collection accounts in their score calculations, so the faster you pay them off, the better — just be sure they’re accurate before you start funneling money toward them.

Most Americans don’t have enough money to cover an unexpected $1,000 bill. Building an emergency savings account is one way to take the sting out of an unexpected medical bill.

The first step to building a financial cushion is to open a savings account and slowly add money. After paying off debt, funnel those payments into the savings account, too. Unless you’re facing an emergency, those funds should be off-limits. Better yet, open a money market account or CD to compound that nest egg.

Adria Gross, owner of Medwise Insurance Advocacy, works on behalf of patients to solve their medical bill issues. She helps denied claims get approved, negotiates lower payments and fights for reimbursements.

For those who are facing a high medical bill they can’t cover, Gross offers three tips on what to do next:

Compare the costs to Medicare rates. Double check that the provider isn’t overcharging you for the billed services. Gross recommends comparing them to local Medicare rates. To do this, log onto the Center for Medicare and Medicaid Services’ physician fee schedule page. From there, access the patient fee schedule search and input the corresponding code to compare your rate.

Call the healthcare provider as soon as possible. Gross warns patients not to let their bills get sent to collections; it makes the process of disputing them much harder. As soon as you receive a medical bill you can’t pay, call the related healthcare provider and explain your situation. Always get any negotiated terms in writing.

Seek out an advocate. If you’re unable to have your disputes cleared or bills lowered or dismissed, consider hiring an advocate to help. These professionals charge a fee for their services but will rally on your behalf for a resolution.

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Weight loss: Surprising scale of health benefits for biggest losers

When it comes to shedding pounds, it pays to think big, according to new research by The University of Texas Health Science Center at Houston (UTHealth).

The study, in collaboration with the American Cancer Society, focused on Americans looking to slim down and found those who lost more than a fifth of their body weight more than doubled their likelihood of good metabolic health, compared to those who only lost a relatively small amount.

“If you’re overweight or obese, even losing just a little is better than none. But the rewards appear to be greater for those who manage to lose more. The evidence to date suggests that a 5 to 10 percent weight loss for those with excess weight is beneficial to one’s health. A higher level could potentially lead to lower cardiometabolic risk,” said Greg Knell, Ph.D., the study’s lead author and a postdoctoral research fellow at UTHealth School of Public Health.

Its findings, published today in Mayo Clinic Proceedings, are representative of people in the U.S. who are trying to lose weight, where more than two-thirds of adults are overweight or obese.

Using data of 7,670 adult participants of the National Health and Nutrition Examination Survey, the study examined their weight history and results from physical examinations, including waist size, blood sugar and cholesterol levels to determine metabolic health.

Those who lost between five and 10 percent were 22 percent less likely to have metabolic syndrome, a combination of conditions which increases risk of heart disease, stroke and diabetes — three of the country’s most lethal health problems. By contrast, those who lost more than 20 percent lowered their odds by 53 percent.

But the study, among the first at such a large nationally representative level, also revealed how hard Americans find it to lose any weight at all. Despite trying, nearly two-thirds (62 percent) of participants, with an average age of 44, were unable to lose between 5 and 10 percent — the recommended target for adults with excess weight, according to the American Heart Association. While almost one in five (19 percent) achieved this, only 1 in 20 (5 percent) succeeded in losing greater than or equal to 20 percent.

“Since weight loss is so difficult, a 5 to 10 percent weight loss for those with excess weight should be the target. This should be done gradually through following a healthy lifestyle with guidance from experts, such as your primary care provider,” said Knell.

As the study analyzed data at a specific point in time, further research is required to monitor the same individuals at multiple points to see if these findings still hold true.

“Future research should continue exploring effective strategies to help individuals achieve and maintain a healthy weight which includes individual strategies and social support,” said study co-author Qing Li, M.A., M.Ed., senior analyst at the American Cancer Society.

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Story Source:

Materials provided by University of Texas Health Science Center at Houston. Note: Content may be edited for style and length.

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YouTube ‘source of misinformation on plastic surgery’

In the first study to evaluate YouTube videos on facial plastic surgery procedures, Rutgers University researchers found that most are misleading marketing campaigns posted by non-qualified medical professionals.

The millions of people who turn to YouTube as a source for education on facial plastic surgery receive a false understanding that does not include the risks or alternative options, said lead author Boris Paskhover, an assistant professor at Rutgers New Jersey Medical School’s department of otolaryngology who specializes in facial plastic and reconstructive surgery.

The study appears in JAMA Facial Plastic Surgery.

“Videos on facial plastic surgery may be mainly marketing campaigns and may not fully be intended as educational,” Paskhover said.

Paskhover and a team of students at Rutgers New Jersey Medical School evaluated 240 top-viewed videos with 160 million combined views that resulted from keyword searches for “blepharoplasty,” “eyelid surgery,” “dermal fillers,” “facial fillers,” “otoplasty,” “ear surgery,” “rhytidectomy,” “facelift,” “lip augmentation,” “lip fillers,” “rhinoplasty” and/or “nose job.”

The researchers evaluated the videos using DISCERN criteria, a scale for assessing the quality of medical information presented online or in other media, which takes into account risks, a discussion of non-surgical options and the validity of the information presented. The researchers also evaluated the people who posted the videos, including whether they were health care professionals, patients or third parties. Physicians were rated by their board status on the American Board of Medical Specialties database.

The results revealed that the majority of videos did not include professionals qualified in the procedures portrayed, including 94 videos with no medical professional at all. Seventy-two videos, featuring board-certified physicians, had relatively high DISCERN scores and provided some valuable patient information.

“However, even videos posted by legitimate board-certified surgeons may be marketing tools made to look like educational videos,” said Paskhover.

“Patients and physicians who use YouTube for educational purposes should be aware that these videos can present biased information, be unbalanced when evaluating risks versus benefits and be unclear about the qualifications of the practitioner,” said Paskhover. “YouTube is for marketing. The majority of the people who post these videos are trying to sell you something.”

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Story Source:

Materials provided by Rutgers University. Original written by Patti Verbanas. Note: Content may be edited for style and length.

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Journal Reference:

1. Brittany Ward, Max Ward, Alexis Nicheporuck, Issa Alaeddin, Boris Paskhover. Assessment of YouTube as an Informative Resource on Facial Plastic Surgery Procedures. JAMA Facial Plastic Surgery, 2018 DOI: 10.1001/jamafacial.2018.0822

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Nanoparticle-based approach detects and treats oral plaque without drugs

When the good and bad bacteria in our mouth become imbalanced, the bad bacteria form a biofilm (aka plaque), which can cause cavities, and if left untreated over time, can lead to cardiovascular and other inflammatory diseases like diabetes and bacterial pneumonia.

A team of researchers from the University of Illinois has recently devised a practical nanotechnology-based method for detecting and treating the harmful bacteria that cause plaque and lead to tooth decay and other detrimental conditions.

Bioengineering Associate Professor Dipanjan Pan (seated) and doctoral student Fatemeh Ostadhossein have demonstrated a drug-free, nanotechnology-based method for detecting and destroying the bacteria that causes dental plaque.

Oral plaque is invisible to the eye so dentists currently visualize it with disclosing agents, which they administer to patients in the form of a dissolvable tablet or brush-on swab. While useful in helping patients see the extent of their plaque, these methods are unable to identify the difference between good and bad bacteria.

“Presently in the clinic, detection of dental plaque is highly subjective and only depends on the dentist’s visual evaluation,” said Bioengineering Associate Professor Dipanjan Pan, head of the research team. “We have demonstrated for the first time that early detection of dental plaque in the clinic is possible using the regular intraoral X-ray machine which can seek out harmful bacteria populations.”

In order to accomplish this, Fatemeh Ostadhossein, a Bioengineering graduate student in Pan’s group, developed a plaque detection probe that works in conjunction with common X-ray technology and which is capable of finding specific harmful bacteria known as Streptococcus mutans (S. mutans) in a complex biofilm network. Additionally, they also demonstrated that by tweaking the chemical composition of the probe, it can be used to target and destroy the S. mutans bacteria.

The probe is made up of nanoparticles made of hafnium oxide (HfO₂), a non-toxic metal that is currently under clinical trial for internal use in humans. In their study, the team demonstrated the efficacy of the probe to identify biochemical markers present at the surface of the bacterial biofilm and simultaneously destroy S. mutans. They conducted their study on Sprague Dawley rats.

In practice, Pan envisions a dentist applying the probe on the patient’s teeth and using the X-ray machine to accurately visualize the extent of the biofilm plaque. If the plaque is deemed severe, then the dentist would follow up with the administering of the therapeutic HfO₂ nanoparticles in the form of a dental paste.

In their study, the team compared the therapeutic ability of their nanoparticles with Chlorhexidine, a chemical currently used by dentists to eradicate biofilm. “Our HfO₂ nanoparticles are far more efficient at killing the bacteria and reducing the biofilm burden both in cell cultures of bacteria and in [infected] rats,” said Ostadhossein, noting that their new technology is also much safer than conventional treatment.

The nanoparticles’ therapeutic effect is due, said Pan, to their unique surface chemistry, which provides a latch and kill mechanism. “This mechanism sets our work apart from previously pursued nanoparticle-based approaches where the medicinal effect comes from anti-biotics encapsulated in the particles,” said Pan, also a faculty member of the Carle Illinois College of Medicine and the Beckman Institute for Advanced Science and Technology. “This is good because our approach avoids anti-biotic resistance issues and it’s safe and highly scalable, making it well-suited for eventual clinical translation.”

In addition to Pan and Ostadhossein, other members of the research team include bioengineering post-doctoral researcher Santosh Misra, visiting scholar Indu Tripathi, undergraduate Valeriya Kravchuk, visiting scholar Gururaja Vulugundam; and Veterinary Medicine clinical assistant professor Denae LoBato and adjunct assistant professor Laura Selmic.

Their work is described in the paper, “Dual purpose hafnium oxide nanoparticles offer imaging Streptococcus mutans dental biofilm and fight it In vivo via a drug free approach,” published online on July 30, 2018, in the journal Biomaterials. The research was funded by the University of Illinois at Urbana-Champaign Children’s Discovery Institute and the American Heart Association.

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Story Source:

Materials provided by University of Illinois College of Engineering. Original written by Laura Schmitt. Note: Content may be edited for style and length.

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Journal Reference:

1. Fatemeh Ostadhossein, Santosh K. Misra, Indu Tripathi, Valeriya Kravchuk, Gururaja Vulugundam, Denae LoBato, Laura E. Selmic, Dipanjan Pan. Dual purpose hafnium oxide nanoparticles offer imaging Streptococcus mutans dental biofilm and fight it In vivo via a drug free approach. Biomaterials, 2018; 181: 252 DOI: 10.1016/j.biomaterials.2018.07.053

https://bit.ly/2nOYS4z

Lawmakers want British vaping rules relaxed to help smokers quit

Vaping rules should be relaxed to allow the promotion of e-cigarettes as tools to help tobacco smokers quit, British lawmakers said on Friday.

This could include prescribing medically licensed e-cigarettes to assist smoking cessation efforts.

Vaping, or using e-cigarettes, is estimated to be 95 percent less harmful than smoking conventional ones, according to the British parliament’s science and technology committee, which sees big health benefits if smokers can be encouraged to switch.

There is still fierce global debate as to whether e-cigarettes represent a health risk or a benefit, since their long-term effects are unclear.

A study here this week, for example, found that e-cigarette vapor may cause adverse changes in lung cells.

But the British lawmakers concluded that the balance clearly favored vaping over tobacco smoking and it urged greater regulatory leniency to allow advertising of the relative benefits of e-cigarettes.

It also called for incentives to promote them as a less harmful option, in the form of lower levels of taxation, a relaxation of curbs on their use in public places and a review of approval systems for prescribing them as quit-smoking products.

“Concerns that e-cigarettes could be a gateway to conventional smoking, including for young non-smokers, have not materialized,” said committee chairman Norman Lamb. “If used correctly, e-cigarettes could be a key weapon in the NHS’s (National Health Service) stop smoking arsenal.”

The charity Action on Smoking and Health welcomed the committee’s findings and said allowing e-cigarettes to be prescribed by doctors could be particularly important to people on low incomes and those with high levels of addiction.

The report comes a month after Silicon Valley e-cigarette maker Juul launched its flash drive-sized vaping device in Britain, following huge success in the United States. Juul said it chose Britain as its third market – after the U.S. and Israel – partly because of the country’s supportive approach to vaping.

https://reut.rs/2nNtfbH

Wilderness expert’s keys to safety in the great outdoors

Some simple steps can reduce danger when you venture into the great outdoors, an expert says.

“Knowing your limits, not trying to do too much, knowing where you’re going and what you might encounter there and being aware of the environment you’re in are the best ways to avoid problems outdoors,” said Dr. Henderson McGinnis, an expert in wilderness medicine in Winston-Salem, N.C.

“Doing a little preparation before you go and being sensible while you’re out there can make all the difference,” he added in a news release.

McGinnis is an associate professor of emergency medicine at Wake Forest Baptist Medical Center, where he is also medical director of the AirCare emergency transport service.

Here are his top wilderness safety tips:

• Don’t count on your cell phone. “You might not have cell service out in the woods, even in places close to populated areas,” he warned.
• Avoid drinking out of streams and rivers. The water may look clean, but it could contain animal waste or other pollutants. “Have your own source of water or a way to purify water,” he said.
• Proper attire and gear are a must. “You should at a minimum wear some sort of supportive shoe, whether it’s a trail running shoe or a hiking boot. You definitely don’t want to be wearing flip-flops or something that provides no traction or support,” McGinnis said. Choose comfortable clothes that will protect you from sun, rain and insects.

How much you carry depends on what you’re doing and where you’re going. Always carry water and a snack, even on short outings. But if you’re going out for a half-day or less, you can apply sunscreen and insect repellent at home and leave the containers behind, McGinnis said.

“If I’m going out for more than a couple of hours I’ll take a small backpack or waist pack and maybe a soft shell jacket or another layer of clothing, and definitely a hat and sunglasses this time of year,” he said. “Plus enough food and water for however long I’m going to be out.”

When it comes to first aid equipment, McGinnis often carries a “boo-boo bag.” It’s a quart-size plastic storage bag with bandages, some tape, a tube of antibiotic ointment and a couple of steri-strips to close small wounds.

“On a longer trip I’ll throw in tweezers or a multi-tool, baby wipes, a little bar of hotel soap, hand sanitizer gel and a SAM splint, which is a thin piece of aluminum with foam coating that you can do a million things with,” McGinnis said.

Overall, the key is “having a little foresight to plan for what you might encounter,” he said.

 Explore further: Pack the right shoe for your summer vacation

More information: SOURCE: Wake Forest Baptist Medical Center, news release, July 2018

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