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Sunday, January 13, 2019

Battle for Venice Beach: Homeless Surge Puts Hollywood Progressives to the Test

With swelling transient encampments abutting seven-figure homes, the beachside enclave has emerged as a flashpoint for the inequality shaping Los Angeles — and a real-world test case for the liberal ideology of the area’s showbiz residents.

After the first attack, Randy Osborn figured it was just his turn. Tire slashings in his east Venice Beach neighborhood had become commonplace. But when his vintage Land Rover was hit a sixth time in the course of a few months, Osborn, who runs a small virtual reality company and has lived in Venice for seven years, began to worry he was being singled out.
“It may have been random, but it sure felt targeted and concentrated,” says Osborn, who now protects his tires each night with a jury-rigged plywood-and-chain contraption that has so far deterred the assailants. Every time he takes his family out of town, he worries about his house being robbed. “It’s not a very fun way to live,” he says. A lot of residents within Osborn’s 15-block area just east of Lincoln Boulevard — where actor Viggo Mortensen owns a home and director Jon Favreau is opening a production office — have similar stories. And though they can’t say for sure, Osborn and others suspect the crime is tied to several homeless encampments that have sprung up nearby in the past 15 months.
Los Angeles is grappling with a homeless epidemic. “It’s the worst human catastrophe in America,” says Andy Bales, a pastor who runs the Union Rescue Mission on Skid Row. Faced with a growing crisis, city leaders last year budgeted more than $100 million for affordable housing, addiction treatment, job placement and mental health services. And yet, as L.A.’s real estate prices soar, so does the city’s homeless population. And nowhere have the twin forces of inaccessible housing and inequality created a more explosive mix than in Venice Beach, a hotbed of entertainment executives and talent where the median home price is $1.9 million. Many of these residents are now grappling with a quality-of-life issue that defies their own liberal ideals.
Sleepless in Seattle and Community producer Gary Foster, who moved to the area two years ago from Westwood and works with the homeless advocacy group The People Concern, says he was surprised by the number of residents who expressed exasperation with — if not outright disdain for — the transient population. “They tend to be liberal, they want to do good in the world, but they’re balancing their beliefs with how that might impact the value of their real estate,” says Foster, who began his activism after producing The Soloist, about a journalist who discovers a musical savant living on Skid Row.
Tristan Cassel
The Frank Gehry-designed home of artist John Baldessari.
“There are actually [residents] advocating driving the homeless out of Venice — shipping them off somewhere, which is such a proto-fascist move,” says television writer Evan Dunsky, a 27-year resident of the area. “And then what? Do we have to build a wall around Venice?”
Venice is now home to the largest concentration of homeless anywhere on L.A.’s Westside, with nearly 1,000 non-domiciled people. During the past 18 months, several encampments have swelled in more residential areas where homes can easily sell for eight figures and up. Tents, many of them equipped with mini refrigerators, cupboards, televisions and heaters, vie with pedestrian traffic.
Residents who live near the encampments say mail regularly goes missing. Break-ins have jumped. Hypodermic needles and human waste are appearing on sidewalks and at local playgrounds. Residents have complained to police about harassment and even physical assaults. “This is more of a criminal problem than a homeless problem,” says one resident, who lives next to the so-called Frederick camp adjacent to the Penmar Golf Course.
“There are crime problems in Venice,” concedes Mike Bonin, whose Council District 11 includes Venice Beach. Bonin has come under intense criticism for his handling of the homeless crisis by Venice residents displeased with his support of a measure to introduce a massive, $5 million transitional housing project in their city. At the same time, Bonin says, “I can’t accept the idea that there is an inextricable link between crime and homelessness. It is wrong, it is not backed up by the data, and it leads to bad policy.”
Disagreements over the potential causes of the crimes have begun to factionalize Venice’s neighborhoods. “It was six months of terror, absolute terror,” says radiologist Maria Altavilla, who lives in east Venice. She says that the period of increased health and safety concerns coincided with the expansion of the homeless encampments the past year. She recently arrived home with her two children to find a woman shooting up in her yard. Lately, her husband has expressed a desire to move because of his frustration with the encampments. Several residents shared an unconfirmed theory — suggested to them by a local patrolman — that certain assailants were using the social media app NextDoor to monitor which residents are most vocal about their opposition to encampments and then targeting those individuals for retribution.
As the problem worsens, homeowners are banding together to try to reclaim patches of sidewalk in an effort to deter future encampments. At the corner of Millwood Avenue and Lincoln, bulky wood planters now hog much of the sidewalk. Those planters emerged mysteriously two months ago outside a Staples office supply store that was once a popular resting spot for a handful of tent dwellers. The same pattern can be seen on another block, further south on Palms Boulevard, where similar metallic planters have recently appeared.
Courtesy of Randy Osborn
After multiple tire slashings, one resident built a homemade deterrent system.
Tristan Cassel
Others have put up unpermitted planters to eat up sidewalk space on Millwood Avenue
On Venice Boulevard in front of Vice Media’s offices, a chain-link fence was erected to prohibit tents from going up. Residents around Penmar Golf Course have started a GoFundMe page and have hit their goal of raising $80,000 to fill a pedestrian pathway with native plants and landscaping — a project being called the Frederick Avenue Pass-Through but whose real objective is to deter the large encampment that has ballooned there.
“Honestly, I think we are a step and half away from vigilantism,” says a talent manager who has lived in the area for two decades. “I feel like this is heading toward a Guardian Angels type situation that you saw in 1970s New York. Someone is going to go out there with a lead pipe and give someone a serious beatdown. It’s awful to say, but I don’t see what prevents that from happening.”
***
Life in Venice Beach has always come with its own distinct form of urban grittiness. Unlike its bougie neighbors to the north in Pacific Palisades and Malibu, Venice has embraced its counterculture past. It’s the land of head shops and street art that celebrates icons like Jim Morrison, Dennis Hopper and Jerry Garcia. And, to a degree, that grittiness added to the area’s allure, helping turn Venice into one of L.A.’s most desirable neighborhoods. Venice now counts as residents actress Emilia Clarke, screenwriter Mark Boal and Participant Media’s David Linde, among many others in the industry. The area also has become “Silicon Beach,” home to tech giants Snapchat and Google.
Dunsky has witnessed Venice’s transformation from a battleground for gangs to one that boasts several Michelin-starred restaurants. A self-proclaimed progressive, Dunsky says he fears that recent gentrification has altered people’s sympathies. “There is a fever of money in Venice that has nothing to do with its past. Whatever progressive elements were historically here have dwindled, and they’re being replaced by tech money.”
“It’s worse than it’s ever been,” says Tami Pardee, Venice’s top real estate broker, who moved to the area in 1993. “But sometimes it has to get like this for a real movement to start.” Compass’ Mark Kitching says that in the past year, four buyers he worked with opted out of purchasing after unpleasant encounters with homeless residents when touring the area. “The Palisades is looking way more attractive when you are thinking about schools and cleanliness,” he says.
The most common refrain heard when discussing the cause of L.A.’s homeless crisis is soaring housing costs. But there are other forces at play in Venice and throughout the city involving various laws and ballot measures that date back more than a decade. A 2006 ruling by the 9th U.S. Circuit Court of Appeals in Jones v. City of Los Angeles required that law enforcement and city officials no longer enforce the ban on sleeping on sidewalks anywhere in the city until a sufficient amount of permanent supportive housing could be built. Further complicating matters were two state ballot measures that voters overwhelmingly approved in 2016 — Propositions 47 and 57 — which decriminalized certain felonies to misdemeanors in an effort to address the state’s overburdened prison system. Officials, including Bonin, admit that those measures have complicated matters for law enforcement, who make arrests only to see the same perpetrators back on the street days later.
The people living in the encampments say they have been unfairly maligned, even as they admit there is little policing when they do break the law. City rules dictate that tents be taken down between the hours of 6 a.m. and 9 p.m. But police rarely enforce the code, say several members of the Frederick homeless encampment. “We get away with a lot,” says Randy “Dee” Collins, 25, who adds his family has long owned property in Venice and that he has chosen a life on the street against their wishes. The Frederick camp, home to about a dozen tents and twice as many people, is littered with nine weeks’ worth of trash. These homeless people say neighbors are openly hostile to them. Collins says he offered one resident money for water but “she didn’t want to participate in anything that would help us.”
John Maceri, executive director of The People Concern, takes issue with residents who complain about the problem and then go on to criticize every proposed remedy. “The criminal element needs to be dealt with, but statistically, homeless people aren’t committing more crimes than other people, it’s just more visible and they are easier to blame,” he says.
“I understand both sides. No one wants to see a tent city outside their window,” says one woman who lives at the Frederick camp. “There could be a solution if everyone wasn’t so hell-bent on destroying us.” This woman, who declined to provide a name, is a former heroin addict who left her two daughters in Tennessee and moved to Venice several years ago. She claims neighbors have pulled guns on her and says that “the biggest crimes we’re guilty of are digging in the trash and being homeless.” As if to make her point, a well-dressed jogger happened through as she was talking, exclaiming, “Oh, aren’t we lucky to have a new city dump right here!”
Tristan Cassel
Residents have started a GoFundMe page for a landscaping project to deter the Penmar encampment, pictured.
Things reached a boiling point at a packed town hall meeting in October, when residents got a chance to address the city’s plans to open a 154-bed transitional (“bridge”) housing shelter set to be built on a former Metro bus yard at Sunset and Pacific avenues (the plan was approved by the City Council in December). At the four-hour meeting, Bonin and Mayor Eric Garcetti were targets of angry chants and tirades that effectively centered on whether Venice was being asked to unfairly shoulder the burden for the entire Westside’s homeless population. Bonin says he had an obligation to place the bridge housing for his district in Venice because that is “where the problem is most acute” (each council district is required to open a bridge-housing shelter under a City Hall directive). Those opposed to the shelter contend that the site is too close to schools and residences.
“We have a homeless problem that needs to be addressed,” says screenwriter and Venice resident Michael Lerner. “But the solutions being proposed are these pie-in-the-sky ideas that don’t make economic sense. If you’re talking about providing shelter for tens of thousands of homeless people but your solutions are costing $475,000 per unit, you’re not going to shelter a lot of people.”
Even the homeless woman at the Frederick camp says the city’s housing plans aren’t a viable long-term solution. “I’m not going to rub my tummy and jump through hoops just to live inside,” she says, “I shouldn’t have to go through that much of an act just to get housing. People should be allowed to live how they want.”
Bonin alleges that critics of the city’s efforts are resorting to hyperbolic, inflammatory language in an effort to smear the homeless. “One of the anti-bridge-housing organizers posted something online that said, ‘We need to call in Stephen Miller to help us deal with this,’ ” says Bonin. “The similarities in the language used when referring to the homeless and how Trump refers to immigrants is startling.” The councilmember’s critics say his efforts are simply misguided.
“Bonin sent out a survey like 10 months ago asking residents where would be a good place for the shelter,” says software executive Travis Binen, who lives directly across from the Metro bus depot and has emerged as one of the most vocal opponents to the bridge shelter. “Of the 641 surveys returned, only 5 percent pointed to [the Metro bus depot] as a good location. More people pointed to Bonin’s house. He is, like, the most hated man in Venice.” Binen, who spends four hours a day online organizing against the shelter, says his activity has pushed him rightward.
Garcetti has hinted that once enough shelter beds and sup­portive housing have been built to meet the court’s requirements, it would clear the way for the city to start enforcing the former law that banned sleeping on sidewalks. Says Bonin, “We have approved a shit ton of money, and if we are building housing with it, we should be able to go to the courts and say no to [certain] encampments.”
No one expects Venice to resolve its homeless issue soon, if ever. For now it remains a worrisome microcosm for one of L.A.’s most intractable questions: How much burden should homeowners bear for transients? And perhaps more important, where do we expect them to go?

China says will reduce foreign investment curbs, 2018 FDI up 3%


China will reduce restrictions on foreign investment and address difficulties facing foreign companies investing in the country, the commerce minister said, according to a transcript of an interview he gave to state media.

Commerce Minister Zhong Shan said China would allow full foreign ownership of companies in more areas of the economy and would reduce the number of industries in which foreign investment was restricted or barred, according to the transcript posted on the Ministry of Commerce’s website on Sunday.
The comments appeared to be largely reiterations of past pledges by Chinese officials for further market opening.
Foreign direct investment (FDI) into China rose by 3 percent year-on-year to $135 billion in 2018, Zhong said.
That would mark a slowdown from growth rates of 7.9 percent in 2017 and 4.1 percent in 2016.
But Zhong said China had maintained stable FDI growth “against a gloomy global climate,” noting that total FDI around the world had slumped by 41 percent in the first half of last year.
China has been pushing to broaden opportunities for private firms and foreign investors to stimulate an economy that is slowing on the back of weakening domestic demand and a trade war with the United States.
Zhong said “properly handling” trade frictions with the United States was a major task for the ministry in 2019.
The ministry would “conscientiously implement” the consensus to work toward a resolution of the trade row reached by Chinese President Xi Jinping and U.S. counterpart Donald Trump in Argentina late last year, he added.
The two sides held three days of trade talks at a vice-ministerial level in Beijing last week.
Zhong said the Commerce Ministry would push for the introduction of a foreign investment law as soon as possible, improve the handling of complaints from foreign firms, and encourage foreign investment in manufacturing and high tech.
The ministry would also encourage foreigners to invest in central and western China, he said.

Post-JPM: Pfizer eyes Amarin, Biogen shops anyone with ‘multiple’ Phase 3s


The J.P. Morgan Healthcare Conference may be over, but that doesn’t mean the dealmaking is. Often, deals that took shape at the meeting materialize later in the year, and some recent buzz puts Pfizer and Biogen at the center of potential takeovers.
Pfizer is reportedly eyeing a buyout of cardiovascular player Amarin, whose fish-oil-derived lipid drug Vascepa recently cut heart risks in a controversial study. And while Amarin’s shares leapt on the news, Pfizer investors were less than stoked, sending shares downward.
If a deal does materialize, the New York pharma giant—which boasts a history of cardiovascular leadership thanks to one-time globe leader Lipitor—could slot Vascepa into a growing portfolio in that area. It’s also looking to bring candidate tafamidis, which treats a rare heart disease, to market.
How realistic is an Amarin buy, though? New CEO Albert Bourla has expressed a desire to step away from Pfizer’s megadeal history, despite the company’s strong balance sheet. But on the other hand, he’s also said the company would be on the hunt for smaller deals. Amarin’s current market cap stands at $5.68 billion.

Meanwhile, Biogen could be another larger player looking to buy, if JPM comments from company executives are any indication. The Big Biotech “would love to get something larger” with “multiple phase 3 assets,” management said, as quoted by Mizuho analyst Salim Syed, who noted that the company has $13 billion worth of financing capacity.
That kind of deal would be a change in business development strategy for Biogen, which has traditionally done early-stage deals. But Syed doesn’t see it happening imminently, and Biogen’s executives noted that such a move was “not essential” but “would be nice to do.”

After a quiet M&A year in 2018, industry watchers are expecting biopharma to pick up the pace this year—especially after big moves from Bristol-Myers Squibb and Eli Lilly set the tone.
2019 should be “a very robust year,” Glenn Hunzinger, PwC’s pharma and life sciences deals leader, predicted, citing “pent-up demand” from companies that wanted to shop last year but were held back by CEO changes, high prices and uncertainty around the regulatory and pricing landscapes.

3 Big Reasons Why AbbVie Isn’t Worried About Humira


AbbVie (NYSE:ABBV) raised some eyebrows — and some concerns — in its Q3 conference calldiscussion of the early days of European biosimilar competition for Humira. CEO Rick Gonzalez said at the time that discounting for Humira biosimilars was steeper than the company expected. The obvious implication is that Humira sales outside of the U.S. could decline more quickly than projected.
The threat to Humira came up during AbbVie’s presentation and question-and-answer session on Wednesday at the J.P. Morgan Healthcare Conference. But Gonzalez and AbbVie President Michael Severino expressed confidence that the big pharma company would continue to grow for years to come despite challenges for its top-selling drug. Here are three big reasons AbbVie isn’t worried about Humira.

1. A strong lineup beyond Humira

Michael Severino addressed the threat to Humira head-on in his presentation at the J.P. Morgan conference. His first response to the impact of biosimilar competition was to point out the strong growth and future prospects for two other AbbVie drugs, Imbruvica and Venclexta.
Severino noted that the two hematology drugs currently represent a $4 billion franchise with double-digit percentage sales growth. He said that AbbVie expects Imbruvica and Venclexta combined will generate over $9 billion of risk-adjusted incremental annual sales by 2025.
In addition, Severino singled out a couple of other current products, Orilissa (elagolix) and Mavyret. Orilissa was approved by the FDA last year for the treatment of endometriosis, an indication for which no new treatment has been introduced in decades. AbbVie plans to file for approval of the drug in treating uterine fibroids later this year. The company thinks that Orilissa will contribute upwards of $2 billion in incremental annual risk-adjusted sales by 2025.
Rick Gonzalez acknowledged that Mavyret won’t be “a big growth vehicle” in the years ahead. However, he said the hepatitis C virus (HCV) drug would nonetheless generate strong cash flow for years to come.

2. Blockbuster pipeline candidates

Another key reason behind AbbVie’s confidence is its pipeline, especially in the area of immunology. Severino stated that AbbVie will “evolve from a single product to a portfolio of therapies” in immunology over the next few years.
The first immunology product likely to join Humira is risankizumab. An FDA approval decision for the drug as a treatment for psoriasis is expected by late April 2019. Risankizumab could soon be followed by upadacitinib. AbbVie expects an FDA decision on the drug as a treatment for rheumatoid arthritis in the second half of the year.
AbbVie is also pursuing additional indications for both drugs. The company thinks that risankizumab and upadacitinib will be best-in-class therapies that together generate $10 billion or more in incremental annual sales by 2025.
In addition, Severino said that the company’s neuroscience pipeline candidates should begin contributing to growth by the middle of the next decade. AbbVie’s pipeline includes a late-stage candidate targeting Parkinson’s disease as well as experimental Alzheimer’s disease and multiple sclerosis drugs in earlier-stage clinical studies.

3. Time is on its side

It’s also important to remember that Humira isn’t going away anytime soon. Severino stated that AbbVie expects the drug to remain at the top of the immunology market through 2022. That’s in line with the thinking from market research company EvaluatePharma, which projects that Humira will remain the top-selling drug in the world through 2024.
Although Humira is being challenged by biosimilars in Europe, AbbVie continues to state that there probably won’t be direct biosimilar competition in the U.S. until 2023. That gives the company plenty of time for its other drugs and pipeline candidates to ramp up.
Gonzalez also said that Humira’s sales should continue to grow in the U.S., although he acknowledged that the growth rates have moderated and will continue to do so. He stated that Humira has been “a phenomenal story” and will “continue to be an important growth story” for AbbVie.

The magic number

There’s one number that investors will want to pay special attention to: $35 billion. That’s the minimum level of risk-adjusted sales that AbbVie projects it will generate from drugs other than Humira by 2025. By comparison, AbbVie’s total revenue in 2017 including Humira was $28.2 billion.
Some might question whether AbbVie can achieve that goal. Skepticism certainly is higher now than in the past after cancer drug Rova-T flopped in clinical studies.
But the prospects for AbbVie’s other drugs and pipeline candidates discussed by Gonzalez and Severino don’t seem to be just pie in the sky. AbbVie should be able to continue doing what it’s been doing since being spun off in 2013: deliver revenue growth, deliver earnings growth, and deliver a steadily increasing dividend.

Mallinckrodt CEO Mark Trudeau Presentation at J.P. Morgan Conference


Mallinckrodt PLC (NYSE:MNK) 37th Annual J.P. Morgan Healthcare Conference Call January 7, 2019 10:30 AM ET
Company Participants
Mark Trudeau – President & CEO
Mark Trudeau
Good morning, everyone. I’d like to start by thanking JPMorgan for hosting here. I’m happy to have them talk about Mallinckrodt story. I think we want to start it out with just recognition of our Safe Harbor statement, recognize that I’m likely to be making some forward-looking statements. And of course, we’re under no obligation to correct or update those statements, and actual results could differ materially from what we’re presenting today. And I would just refer you to our website for the forward-looking statements and our Safe Harbor statement.
So to start off, I’d like to reflect a little bit on 2018 before we get into 2019, and how we see the company evolving. Mallinckrodt has been on a transformational journey to develop a company that is focused on driving innovation and focused on underserved patients with severe and critical conditions. And over the last five years since we’ve spun out, we have made significant strides towards that long-term objective.
Longer term we expect to be a company that can drive growth on an organic basis in the mid-single-digit level. We think we’ve taken some significant strides certainly in 2018 towards that goal. I’d like to highlight just a couple of those things for you.
At the beginning of the year we spoke about a number of things that we wanted to focus on in 2018. We spoke about focusing on driving our in line portfolio, developing our products and our pipeline, focusing on cost management and capital allocation. And we think we’ve had a very strong operational year in 2018. Just to reflect back, we gave guidance in the early part of the year and throughout the course of 2018 we beat-and-raise that guidance twice.
We certainly have had a strong momentum in our overall business and our operational business, commercial business. We’ve seen good recovery of Acthar. We’re pleased with the trajectory that we see for Acthar going forward. We’ve also started to report on some clinical data and we’re quite excited about the prospects for clinical data generation and reporting for Acthar that started really in the third and fourth quarter of 2018, which will continue over the next 12 to 24 months. We have seven clinical trials running for Acthar and those seven trials we will be reporting out over the next several quarters.
Our hospital business continues to operate in a very strong fashion. The business grew collectively in the high-single-digits through the first three quarters of 2018 and we continue to have good strong momentum behind that business across the portfolio, which really comprises three separate products: INOmax, OFIRMEV and Therakos. The business is over $1 billion, again going in the high-single-digit range and has a significant number of pipeline assets behind that business as well and we see our hospital business being a true strength and driver of Mallinckrodt going forward.
We also focus quite a bit on cost management. We stated that our longer term objective for SG&A expenses was to take $100 million out of our 2017 base and we made a significant progress against that already in 2018.
As we look forward in 2019 and in the years to follow that, our SG&A is going to be a little bit lumpy, because we’re looking forward to launching as many as a half a dozen new products or new product presentations over the next couple of years. But long-term, we expect our SG&A to be at $100 million or more below our 2017 run rate. And from a capital allocation standpoint, we’re focused significantly on debt reduction. And through the first three quarters of 2018, we’ve reduced debt approximately $700 million. That’s due to strong operating cash flow and we would expect that trend to continue in the future. …

Saturday, January 12, 2019

When Parkinson’s meets AI: Models for disease progression expected


The Michael J. Fox Foundation partners with IBM to analyze “treasure trove” of data.

There’s a new weapon in the arsenal to fight Parkinson’s Disease: artificial intelligence (AI) and machine learning. If the showdown between technology and the debilitating neurological condition goes well, researchers will better understand disease progression, and perhaps create a blueprint for more effective treatments that traditional forms of medical research would take much more time to unveil. Such outcomes would also likely reduce associated healthcare costs and the impact on health systems.
This week IBM Research Healthcare and Life Sciencesannounced a partnership with the Michael J. Fox Foundation, which includes a grant for an undisclosed amount from the New York City-based foundation, as well as access to data the Foundation has collected for years. The key to progress lies in analyzing this data, known as the Parkinson’s Progression Marker Initiative (PPMI). That capability dovetails with work IBM has been doing in the area of neurodegenerative diseases.
“We have published quite extensively in this area—not just in Parkinson’s disease—but also in Alzheimer’s, as well as Huntington’s,” says Jianying Hu, PhD, global science leader, AI for healthcare at IBM Research. Representatives from the two organizations began exploring whether similar methodologies could be applied to the PPMI data. “That’s how this collaboration came about,” says Hu.

A COSTLY DISEASE

According to the Parkinson’s Foundation, nearly one million will be living with Parkinson’s Disease in the U.S. by 2020, and approximately 60,000 Americans are diagnosed with it each year. It also has a huge impact on the healthcare system.

  • study published by Movement Disorders in 2013, indicates the national economic burden of Parkinson’s Disease exceeded $14.4 billion or approximately $22,800 per patient in 2010.
  • The prevalence of the disease is expected to more than double by 2040, according to an article about the research cited above, published by the Michael J. Fox Foundation.
  • In a separate study, also published by Movement Disordersin 2013, “a treatment that could slow Parkinson’s progression by 50% would yield a 35% reduction in excess costs, representing a dramatic reduction in cost of care spread over a longer expected survival,” the Michael J. Fox Foundation reported.

AI AND MACHINE LEARNING ENHANCE DATA ANALYSIS

“We’ve made huge leaps in the last two decades to better understand Parkinson’s disease, but more research is needed to illuminate pathways to better treatments and ultimately, a cure,” said Mark Frasier, PhD, senior vice president of research programs for the Michael J. Fox Foundation, via email to HealthLeaders. Parkinson’s is a highly heterogeneous disease, he explained, with varied clinical presentations and associated pathology involving numerous genetic mutations.
“The Michael J. Fox Foundation has invested heavily in the collection of comprehensive, standardized data from patients and healthy volunteers,” said Frasier. This PPMI data includes imaging scans, biosample analysis, and patient-reported outcomes.
“Today our challenge is to analyze this treasure-trove of complex imaging, clinical, and molecular data using traditional statistical approaches,” said Frasier. “AI and machine learning technologies can help scientists identify trends and models across Parkinson’s data. These frameworks can help researchers design more efficient and accurate clinical studies and drug trials, speeding discovery and bringing new personalized treatments to patient hands faster.”

TWO PHASES OF RESEARCH

Initially, researchers will examine the data to produce a  disease progression model to better assess stages of the disease “not just based on symptoms [patients] have today, but based on the longitudinal progression that we have absorbed over time,” says Hu.
“From that, our model will also be able to help predict what kind of progression pathway this patient is likely going to take in the next phase of the disease,” she says. This work has the potential to enable better assessments plus the ability to track disease progression to better manage patients. The team expects that phase of research to be completed by the end of the year.
The second phase will involve enriching the model and looking at potential clinical and therapeutic use cases and applications.
“The goal is to create models that can identify distinct stages of Parkinson’s and provide predictions for future disease progression,” said Frasier.

RESEARCH MAY LEAD TO IDENTIFICATION OF SUB-GROUPS, BIOMARKERS, AND MORE

In a blog on this topic, published by Soumya Ghosh, PhD, a research scientist at IBM Research, provides further insights:
  • “Because the models provide a quantitative description of progression, they may allow us to discover sub-groups of [Parkinson’s Disease] patient profiles that share a common progression pathway through the disease, and may also help us in the identification of biomarkers that are predictive of progression.”
  • “More broadly, insights arising from an improved understanding of [Parkinson’s Disease] progression may have the potential to transform the care of Parkinsonian patients. For instance, accurate staging can aid in the recruitment of subjects to clinical trials for new drugs, while the discovery of [Parkinson’s Disease] sub-groups can help inform more personalized treatments, and may hopefully improve quality of life and outcomes.”

No way to enforce hospital price transparency rule, CMS says


  • CMS administrator Seema Verma said Thursday the agency has no means of enforcing its new price transparency rule, which mandates hospitals post standard charges online in a machine-readable format.
  • Seema told reporters said that while “there are no penalties at this time,” CMS is asking in a request for information what the enforcement mechanism for the rule should be. There is no timeline for penalty implementation, she said.
  • CMS also does not know — or would not make it known — how many hospitals are currently complying with the rule. Rather, Verma said, “it is the expectation that all of them will comply.”

The new rule, which went into effect on the first day of the year, was considered by many to be in an inadequate first step toward price transparency. It doesn’t require posting any more information than hospitals already provide the public by law. Essentially, it mandates hospitals post that information online in spreadsheets.
Some have criticized hospitals for burying the pricing information on their websites. Ascension, one of the nation’s largest hospital operators, has a one-stop shop pricing website, which lists cost information for each of their hospitals across the country — but it’s hard to find.
The company said it supports price transparency and is in compliance with the regulation. However, it noted the pricing can be confusing for patients. “Pricing does not reflect our financial assistance and charity care policy, and could vary by individual patient and by facility,” Ascension said in a statement to Healthcare Dive. “We encourage those who are seeking or scheduling care to contact us for the pricing that is right for you.”
Other critics have said the price listing can be misleading for patients, and chargemaster information isn’t particularly helpful because hospitals rarely get paid on the sticker price.
Still, Verma was adamant that the rule is an “important first step” toward lowering costs by getting patients the information they need to compare prices. If patients can’t compare costs, she said, competition is stifled. Consumers have been “shut out” of healthcare when they should be the “driving change.”
Studies have shown, however, that Americans aren’t wild about shopping for healthcare. A Health Affairs report found just 13% of respondents responsible for cost-sharing in their last healthcare encounter sought cost information before receiving care. Only 3% compared prices of different providers.
That’s not likely to change any time soon. According to a recent JAMA Internal Medicine report, hospitals are not improving when it comes to providing price estimates for procedures. The study’s authors also said there is “sobering evidence” that the level of price transparency is actually getting worse. The percentage of hospitals that were unable to provide price information jumped from 14% to 44% between 2012 and 2016.
“We are just getting started as we work to increase pricing transparency,” Verma said Thursday. The solution, she added, isn’t as simple as revealing prices.