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Saturday, December 29, 2018

This Is The Top Dow Stock Of 2018 — And It’s Not Even Close


Dow Jones stocks have tumbled in late 2018, slipping by as much as 12% for the year before rallying the day after Christmas. However a few star names have managed to outperform, including Merck (MRK), Microsoft (MSFT), Nike (NKE), Pfizer (PFE) and Visa (V). Merck stock is by far the top Dow Jones stock of 2018. All five Dow stocks also helped lift the S&P 500 index this year.

Merck Is The Top Dow Jones Stock

Merck stock has increased a muscular 34% in 2018, nearly twice as strong as the next-best top Dow Jones stock of 2018. Shares rose 1.9% to 75.38 on the stock market today, reclaiming their 50-day line as the Dow Jones led a powerful rebound. Merck stock is just 6% off its Dec. 4 peak of 80.19 and up modestly for the fourth quarter.
The Dow Jones stock has seen its relative strength line soar to a near 4-year high, continuing a powerful uptrend since early March. The RS line compares a stock’s price performance to the S&P 500 index.
https://research.investors.com/ibdchartswp.aspx?cht=pvc&type=daily&symbol=MRK
In October the Dow Jones drug giant projected earnings for the year to come in above analyst estimates. Merck also hiked its quarterly dividend by 15% to 55 cents a share. This month Merck agreed to buy Antelliq, which sells digital animal identification, traceability and monitoring solutions, for $2.4 billion.

Pfizer Stock Stands Tall

Pfizer stock has jumped 18.3% so far this year. Shares got off to a slow start, but picked up steam after clearing a 26-week consolidation in late July, MarketSmith analysis shows. Pfizer stock hit 46.47, the best price since early 2001, after breaking out of a 7-week flat base on Nov. 30. That failed amid the broader sell-off. Pfizer stock is now 7% off its high. Like fellow Dow Jones drug giant Merck stock, Pfizer stock is just below a fast-rising 50-day moving average.
Pfizer issued cautious 2018 guidance back in October despite topping Q3 earnings views after sales lagged.
The company makes top drugs such as Viagra, cholesterol fighter Lipitor, painkiller Lyrica and antibiotic Zithromax. Earlier this month the Dow Jones stock announced a deal with British pharma giant GlaxoSmithKline (GSK) to combine their consumer health divisions.
https://research.investors.com/ibdchartswp.aspx?cht=pvc&type=daily&symbol=PFE

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Self-powered electric bandages could speed up healing


Scientists have known for a long time that electricity can speed up healing for skin wounds, but the necessary power has usually tied patients to electrotherapy machines. In the future, though, it might not be much more complicated than treating a wound the old-fashioned way. Researchers in the US and China recently developed self-powered electric bandages that promise to be as easy to wear as ordinary dressings. The dressings include tiny electrodes powered by nanogenerators wrapped around your torso. All you have to do is breathe — the movement of your ribcage activates the nanogenerators, sending low-intensity pulses to the wound area.
While it’s not fully clear how the pulses help, scientists noted that they increase the viability of fibroblasts (a kind of skin cell) and encourage them to line up, which is key to the healing process. The pulses also produced additional biochemical materials that contribute to tissue growth.
The results were dramatic in lab tests. Wounds on rodents that took almost two weeks to heal the normal way only required three days with the electric bandage. The technology uses comparatively common materials and is simple to make, for that matter, so it shouldn’t cost much more than conventional bandaging. The challenge at this stage is simply bringing it to fruition. The team still wants to test it on pig skin (similar to human skin), and human trials would have to follow after that. If they succeed, you could spend much less time recuperating, not to mention less time in the hospital.
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Exposure to cannabis alters the genetic profile of sperm


As legal access to marijuana continues expanding across the U.S., more scientists are studying the effects of its active ingredient, tetrahydrocannabinol (THC), in teens, adults and pregnant women.
New research from Duke Health suggests men in their child-bearing years should also consider how THC could impact their sperm and possibly the children they conceive during periods when they’ve been using the drug.
Much like previous research that has shown tobacco smoke, pesticides, flame retardants and even obesity can alter sperm, the Duke research shows THC also affects epigenetics, triggering structural and regulatory changes in the DNA of users’ sperm.
Experiments in rats and a study with 24 men found that THC appears to target genes in two major cellular pathways and alters DNA methylation, a process essential to normal development.
The researchers do not yet know whether DNA changes triggered by THC are passed to users’ children and what effects that could have. Their findings will be published online Dec. 19 in the journal Epigenetics.
“What we have found is that the effects of cannabis use on males and their reproductive health are not completely null, in that there’s something about cannabis use that affects the genetic profile in sperm,” said Scott Kollins, Ph.D., professor in psychiatry and behavioral sciences at Duke and senior author of the study.
“We don’t yet know what that means, but the fact that more and more young males of child-bearing age have legal access to cannabis is something we should be thinking about,” Kollins said.
National research has shown a steady decline in the perceived risk of regular marijuana use. This, combined with the demand and wide availability of marijuana bred specifically to yield higher THC content, make this research especially timely, Kollins said.
The study defined regular users as those who smoked marijuana at least weekly for the previous six months. Their sperm were compared to those who had not used marijuana in the past six months and not more than 10 times in their lifetimes.
The higher the concentration of THC in the men’s urine, the more pronounced the genetic changes to their sperm were, the authors found.
THC appeared to impact hundreds of different genes in rats and humans, but many of the genes did have something in common — they were associated with two of the same major cellular pathways, said lead author Susan K. Murphy, Ph.D., associate professor and chief of the Division of Reproductive Sciences in obstetrics and gynecology at Duke.
One of the pathways is involved in helping bodily organs reach their full size; the other involves a large number of genes that regulate growth during development. Both pathways can become dysregulated in some cancers.
“In terms of what it means for the developing child, we just don’t know,” Murphy said. It’s unknown whether sperm affected by THC could be healthy enough to even fertilize an egg and continue its development into an embryo, she said.
The study was a starting point on the epigenetic effects of THC on sperm and is limited by the relatively small number of men involved in the trial, Murphy said. The findings in men also could be confounded by other factors affecting their health, such as their nutrition, sleep, alcohol use and other lifestyle habits.
The Duke team plans to continue its research with larger groups. They intend to study whether changes in sperm are reversed when men stop using marijuana. They also hope to test the umbilical cord blood of babies born to fathers with THC-altered sperm to determine what, if any epigenetic changes, are carried forward to the child.
“We know that there are effects of cannabis use on the regulatory mechanisms in sperm DNA, but we don’t know whether they can be transmitted to the next generation,” Murphy said.
“In the absence of a larger, definitive study, the best advice would be to assume these changes are going to be there,” Murphy said. “We don’t know whether they are going to be permanent. I would say, as a precaution, stop using cannabis for at least six months before trying to conceive.”
In addition to Kollins and Murphy, study authors include Nilda Itchon-Ramos, Zachary Visco, Zhiqing Huang, Carole Grenier, Rose Schrott, Kelly Acharya, Marie-Helene Boudreau, Thomas M. Price, Douglas J. Raburn, David L. Corcoran, Joseph E. Lucas, John T. Mitchell, F. Joseph McClernon, Marty Cauley, Brandon J. Hall, and Edward D. Levin.
The research was supported by a grant from the John Templeton Foundation.
Story Source:
Materials provided by Duke University Medical Center. Note: Content may be edited for style and length.

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Dealmaking stayed hot in 2018, with a focus on physician practices


Stop me if you’ve heard this one: Consolidation was a trend that dominated healthcare over the past year.
Consolidation is hardly a new phenomenon, but the pace at which it’s happening, the types of buyers and their targets all morphed in interesting ways in 2018.
Hospital consolidation, which continued at high levels, has almost lost its ability to surprise, especially given the sheer size of deals like the merger between Catholic Health Initiatives and Dignity Health, a deal expected before year-end that would create the nation’s largest not-for-profit hospital company by revenue.
But the degree to which profitable physician practices are being gobbled up by a number of different buyers has been quite the spectacle.
This year, buyers hungry for acquisitions paid particular attention to specialty practices in such areas as orthopedics, cardiology, dermatology, gastroenterology and dentistry. Primary care is in strong demand, too.
As far as who is buying practices, it’s a three-way race between the old hats—health systems—plus private equity firms and, a relatively new entrant: payers. UnitedHealth Group’s OptumCare has been particularly aggressive about buying physician practices as part of its strategy to get as close to consumers as possible. But Centene Corp., Humana and Anthem are adopting a similar strategy as they work to control spending.
Private equity investors and payers may have the upper hand. Health systems are known to struggle when it comes to integrating practices into their operations, and often aren’t willing to make the capital investments physicians demand, said Matt Caine, a managing director with Solic Capital. Groups like Optum, by contrast, are more inclined to support physicians’ instincts. “I think their strategy is one that’s quite remarkable relative to what’s going on in the industry today,” Caine said.
Physician practice acquisitions take on a number of forms. Carole Streicher, a partner with KPMG who leads its healthcare and life sciences deal advisory practice, said that sometimes different practice areas with one or two physicians are rolled up into groups with 50 or 100 different physicians.
The difference that Streicher has observed in recent acquisitions is a real focus on value creation. “What we’re seeing is finance folks dive into ‘How can we now create one plus one equals three?’ ” she said. “It’s really the optimization of that business and how that can create better cash flow for the business overall.”

Declining margins

Hospital margins continued to plummet in 2018, even as balance sheets remain stronger than ever. Martin Arrick, a managing director in S&P Global’s U.S. public finance division, said health systems continued to depend heavily on non-operating income throughout the year, and non-operating margins exceeded that of operating margins.
“Normally it’s the other way around,” he said. “That points to a dependence on non-operating income.”
That proved to be a thorn in the sides of some systems in 2018 when the stock market failed to deliver to the degree it did in 2017, a banner year. Oakland, Calif.-based Kaiser Permanente’s net non-operating income fell 52% in the third quarter of 2018 year-over-year mostly due to the volatile equities market, but an executive told Modern Healthcare the system does not plan to change its investment strategy.
Arrick said S&P isn’t likely to downgrade a system because of poor investment performance if its operating performance remains stable.
Even hospitals that are still seeing strong investment gains kept capital spending modest this year, according to a November report from Fitch ratings. One-quarter of hospitals had AA- ratings at the time of the report, up from 17% at the same time in 2017, mostly because Fitch’s new rating criteria bumped hospitals up. Meanwhile, fewer hospitals were rated BBB+ or below.
Providers placed strong emphasis during the year on bringing in technology to centralize and standardize back-office tasks, said Tracey Coyne, a senior manager in Crowe’s healthcare performance division. With that, teams were able to use those tools to analyze their operations from a broader perspective.
The year also saw providers’ continued—albeit slow—march toward value-based care. There weren’t any huge moves; more like providers gradually positioning themselves to take on risk, whether in the form of insurance contracts or through bundled payments, said Joe Fifer, CEO of the Healthcare Financial Management Association.
“There wasn’t a big aha moment,” he said. “But I’m seeing steady preparation and the actuality of taking on more risk,” he said.
Fifer agreed providers are hesitant about the move toward value-based care given its potential to cut into their revenue. “It’s human nature to be hesitant and quite honestly, it’s human nature to gravitate toward something that’s familiar,” he said. On a broader scale, it’s healthy for providers to look at such arrangements strategically and analytically to understand how they’ll work, Fifer said.
The year also saw a heavy emphasis on data analytics. Providers are investing more and more into being able to harness and analyze data to better understand their finances and operations. It’s also been an important component in the evolution toward value-based care.
In some ways, 2018 saw examples of breaking from the traditional merger and acquisition strategies of the past as a way to rise above the disruption that’s dogging the industry. Case in point: the merger between pharmacy chain CVS Health and health insurer Aetna to create a $70 billion company whose leaders say will reinvent healthcare for Americans. The new company, which promises cheaper, integrated healthcare, could deliver stiff competition for providers.
Another interesting move was not-for-profit health system ProMedica’s purchaseof the nursing home provider HCR ManorCare for $1.4 billion through a complex deal that required the conversion of HCR’s for-profit facilities into not-for-profit assets. The combined entity includes 13 hospitals; health plans; assisted-living and memory-care facilities; skilled-nursing and rehabilitation centers; and hospice and home health services.
“They’ve got this huge initiative to get into the long-term care space and have really fundamentally changed the nature of their organization,” Arrick said.
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Foundation Medicine Cancer CDx Approved in Japan


Foundation Medicine announced today that its FoundationOne CDx genomic profiling assay has received regulatory approval from Japan’s Ministry of Health, Labour and Welfare (MHLW).
The next-generation sequencing-based assay — which was approved by the US Food and Drug Administration in late 2017 — is designed to detect substitutions, insertion and deletion alterations, and copy number alterations in 324 genes, as well as select gene rearrangements, known to drive cancer growth. It also detects genomic signatures including microsatellite instability and tumor mutational burden in DNA isolates.
According to Cambridge, Massachusetts-based Foundation Medicine, the MHLW approved FoundationOne CDx as a comprehensive genomic profiling test for all solid tumors and as a companion diagnostic for advanced cancer patients. The agency is expected to issue a reimbursement coverage decision for the assay in the first half of 2019, the company added.
“Similar to our FDA approval in the United States, the MHLW has approved FoundationOne CDx as a comprehensive genomic profiling tool for all solid tumors and a broad companion diagnostic — a first of its kind comprehensive diagnostic test for individuals living with cancer in Japan,” Foundation Medicine Chief Business Officer Melanie Nallicheri said in a statement. “This is also an important milestone for our biopharma partners who can leverage FoundationOne CDx to accelerate companion diagnostic development and improve access to personalized oncology care in Japan.”
Earlier this year, Foundation Medicine and Chugai Pharmaceutical — both part of Roche — signed an agreement giving Chugai the marketing rights to FoundationOne CDx in Japan.
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Confronting the side effects of a common anti-cancer treatment


Results of a new study by neuroscientists at the University of Massachusetts Amherst and the University of Toronto suggest that a new treatment approach is needed — and how this may be possible — to address adverse effects of aromatase inhibitors, drugs commonly prescribed to both men and women to prevent recurrence of estrogen-positive breast cancer.
The current drug therapy is linked to such complaints as hot flashes, memory lapses, anxiety and depression, side effects so bothersome that some patients discontinue the life-saving treatment, the researchers point out. Their study found that aromatase inhibitors do indeed suppress estrogen synthesis in body tissues, but their unexpected findings in the brain could explain some of the negative effects and provide insight into more effective, less disruptive future therapies.
Neuroscientists Agnès Lacreuse, Luke Remage-Healey and their graduate students at UMass Amherst, collaborator Jessica Mong at the University of Maryland and first author Nicole Gervais worked together on this research. Gervais, who conducted the experiments as a postdoctoral researcher at UMass Amherst, is now at the University of Toronto. The authors studied a small group of aged male and female marmosets, non-human primates whose brains are much like humans’ and which exhibit “complex behavior,” senior author Lacreuse explains.
She adds, “This drug is given to prevent recurrent breast cancer in humans and it does save lives, but a lot of times, patients are not compliant because of unpleasant side effects that affect quality of life.” Their study, showing changes in the animals consistent with some of the human complaints, allowed the researchers to assess cognitive behavior, thermal regulation and neuronal changes in drug-treated vs. control groups. Their findings appear this week in the Journal of Neuroscience.
As Gervais explains, studies in humans are hampered by confounders. “The patients have had cancer, so it’s hard to disentangle the stress of their disease and treatment from the drug effects.” She adds, “We wanted to know if the symptoms while using the aromatase inhibitors can be reproduced in an animal model, and further explore the mechanisms to understand how they work and find alternative treatments.”
In this work supported by the NIH’s National Institute on Aging and National Institute of Neurological Disorders and Stroke, the researchers administered the estrogen-inhibiting drug orally “the way it’s given to humans and at a similar dose,” Gervais explains, for one month, and observed that it did indeed suppress estrogen production in the body. They then compared changes in behavior, memory, electrophysiology, and thermoregulation in the treated and control groups
Gervais says, “Sure enough, we found deficits in some aspects of memory and we also saw the most striking results in thermal regulation, a deficit in the ability to regulate body temperature when the ambient temperature increases, but only in females. It doesn’t match hot flashes exactly but it’s consistent with what we know about the regulation of hot flashes by estrogens in women. Females on the drug could not regulate their temperature as well as control females.”
It was in the investigation of neurons that the researchers saw something quite surprising, says Remage-Healey. “In the hippocampus, which is thought to be critical for learning and memory functions, instead of reduced estrogen levels we found that the drug caused a paradoxical increase in estrogen levels.”
Gervais adds, “We believe that the hippocampus may have synthesized its own estrogens to compensate for low levels it senses in peripheral tissues. According to our results, the mechanism for an adverse effect on memory may be due to an increase of estrogen synthesis in the hippocampus. Perhaps, future treatments could find a way to block this increased synthesis, and maybe prevent some of the negative side effects.”
Remage-Healey points out that “We were also able to follow the excitability of hippocampal neurons, which was compromised in the treatment but not control group. This is consistent with the occasional memory problems reported by patients. It seems the hippocampus is particularly sensitive to estrogens and their blockade. But we have a lot of work to do to understand the precise mechanism underlying these effects.”
The authors state, “These findings suggest adverse effects of aromatase inhibitors on the primate brain and call for new therapies that effectively prevent breast cancer recurrence while minimizing side effects that further compromise quality of life.”
Story Source:
Materials provided by University of Massachusetts at Amherst. Note: Content may be edited for style and length.
Journal Reference:
  1. Nicole J. Gervais, Luke Remage-Healey, Joseph R. Starrett, Daniel J. Pollak, Jessica A. Mong, Agnès Lacreuse. Adverse effects of aromatase inhibition on the brain and behavior in a non-human primate. The Journal of Neuroscience, 2018; 0353-18 DOI: 10.1523/JNEUROSCI.0353-18.2018
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New study raises concerns about use of stents


A December 17 report in the Journal of the American Medical Association-Internal Medicine finds suggestive evidence that doctors misdiagnose patients to justify useless, but lucrative, procedures, that can enrich doctors, hospitals, and stent manufacturers-an industry that includes Abbott Laboratories (ABT), Boston Scientific (BSX), and Medtronic (MDT), Bill Alpert writes in this week’s edition of Barron’s. If there is mischief afoot, it is really the doctors misdiagnosing patients who are to blame, but curbing inappropriate stent use would trim revenue from everyone in the interventional cardiology industry, the report adds.
https://thefly.com/landingPageNews.php?id=2841985
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