Search This Blog

Sunday, March 10, 2019

State Pensions Fought Guns and Tobacco. Why Aren’t They Divesting From Opioids?

State pension funds have historically taken stands against controversial industries, like firearms and tobacco, sometimes divesting their investments to push companies to act.
But in the opioid crisis, which has generated hundreds of lawsuits seeking to hold manufacturers and distributors accountable, the funds have mostly stayed on the sideline so far. Some of the biggest ones, including New York and California pension funds, hold investments in Endo International, the largest maker of branded opioids after privately held Purdue Pharma LP. Even in West Virginia, which has been racked by opioid-related deaths, the state pension fund has a $1.8 million equity stake in Endo.
“West Virginia is literally and metaphorically ground zero for both the opioid epidemic and litigation,” said Charles Webb, an attorney at Webb Law Centre, which represents towns that brought suits. While local West Virginia unions have been outspoken about the epidemic, Webb said he hasn’t heard any outcry from the state pension fund. The fund did not respond to requests for comment.
The opioid investments, to be sure, are tiny relative to the funds’ overall assets. And pension fund members may not know they are invested in the opioid industry. Many fund investments are held through indexes, which are passive vehicles, said Keith Brainard, research director for the National Association of State Retirement Administrators. The New York State Teachers’ Retirement System, which manages about $122 billion, holds $3.1 million in Endo stock, about 75 percent through passively held indexes, a spokesperson said.
Funds including California’s and New York’s say they generally oppose divesting from controversial companies because it doesn’t change corporate behavior. Instead, they say they try to engage with management through activist measures. The California State Teachers’ Retirement System, CalSTRS, has been active with a group called Investors for Opioid Accountability, which represents 54 institutions. New York’s fund said it has asked opioid manufacturers to address potential financial, legal and reputational risks.
Still, the opioid epidemic has made for awkward situations. In Florida, former state attorney general Pam Bondi filed a lawsuit in late 2018 against more than a dozen opioid manufacturers and distributors, including Endo. At the time, Bondi sat on the board of the Florida Retirement System Pension Fund. The fund is invested in both Endo and Insys Therapeutics, Inc., another opioid maker that was part of her lawsuit.
The attorney general “does not get involved in the day-to-day operations of the pension fund,” said John Kuczwanski, the fund’s manager of external affairs.
Unlike the firearms industry, which hasn’t yielded notable returns in years, Endo was a profitable investment for nearly a decade, hitting a peak in 2015. It’s since fallen dramatically, tanking 24 percent after OxyContin maker Purdue was reported to be exploring bankruptcy.
Endo has been open to talking to institutional investors and recently held a “constructive engagement” with them, according to a spokesperson. The company no longer markets opioid products and withdrew one pain product, Opana ER, from the market altogether.

US IPO Week Ahead: Plenty of potential launches

This week, instead of pricings, look out for IPO launches. Recent updates from CAR T biotech Poseida Therapeutics (PSTX) and hospital chain Ardent Health (ARDT) make those deals more likely to launch. NASH biotech Genfit (GNFT) is able to start its roadshow later in the week, and close comp Cirius Therapeutics (CSTX) may decide to join the IPO calendar as well.
Five 2018 IPO lock-ups are expiring in the week ahead, including biotech Principia Biopharma (PRNB). Street research is expected for medical device maker Avedro (AVDR; BofA/JPM; -16% from IPO) and biotechs TCR2 Therapeutics (TCRR; Jefferies/Leerink; 4% from IPO) and Stealth Biotherapeutics (MITO; Jefferies/Evercore; +40% form IPO).

Short seller Carson Block targets medical device company Inogen

Prominent short seller Carson Block is saying that medical device company Inogen Inc has inflated the size of its markets and expects the stock price to fall.
Block, whose research firm Muddy Waters is best known for targeting the shares of China-based companies, has written a new report that asserts that Inogen’s management has made overly optimistic growth forecasts.
The company’s stock fell 6.2 percent Friday morning to $131.07. It had climbed steadily to as high as $282.92 in September.
Calls to the company’s media relations and investor relations departments seeking comment were not returned.
Muddy Waters is short Inogen Inc because it question’s Inogen’s statements about total addressable market (TAM) size and potential growth, the report seen by Reuters said.
Inogen has a market capitalization of $3 billion and makes lightweight portable oxygen concentrators that free its users from being tethered to heavy tanks.

While the company has said the U.S. TAM is roughly 3 million users and is growing at 7 percent to 10 percent a year, Block said the real U.S. TAM is far smaller at about 1.3 million, citing Centers for Medicare & Medicaid Services (CMS) data. He also said CMS data shows that the oxygen therapy market has been shrinking. He wrote that Inogen based its estimates on data from Wintergreen Research.
“The key to INGN’s extreme multiple is its blue sky story,” the report said.
Block sees more room for it to fall, arguing that “INGN will hit peak sales as soon as this year, and likely no later than next.” Block wrote in the report “At our forecast of peak earnings, we value INGN at $46 per share, a 67 percent decrease
from its current price.”
Block ranks among the industry’s most closely followed short-sellers, who seek to make money when a stock price falls. Some occasionally publish research reports detailing what they consider to be wrong with a company.
Dedicated short-sellers like Block, whose fund oversees roughly $210 million, tend to manage small amounts of money and often face uphill battles when the stock market is zooming higher.

Last year when Block published three reports, including one on Chinese tutoring company TAL Education Group, his fund earned 20 percent after fees. The Standard & Poor’s 500 index fell 4.4 percent and the activist investors on average lost 11.25 percent.
Block, who trained as a lawyer but started his career as an equity analyst, distributed his research for free for years and said it took him years to create his hedge fund, which was launched in 2016.

Care.com does not verify credentials of recommended caregivers, WSJ reports

Despite its pledge to “help families make informed hiring decisions” about caregivers, Care.com (CRCM) largely leaves it to families to figure out whether the caregivers it lists are trustworthy, Wall Street Journal reports. The company does what it calls “preliminary screening” of caregivers, which isn’t a full background check, and doesn’t verify credentials, the Journal points out. Further, it does no vetting of day-care centers listed on its site and suggests that customers purchase additional screening packages, which cost $59 to $300, the paper adds. In about nine instances over the past six years, caregivers in the U.S. who had police records were listed on Care.com and later were accused of committing crimes while caring for customers’ children or elderly relatives, the Journal reports, citing its own investigation, which included the review of police records, court records and local media reports. Alleged crimes included theft, child abuse, sexual assault and murder. In addition, the Journal found hundreds of instances in which day-care centers listed on Care.com as state-licensed didn’t appear to be. Shares of Care.com have quadrupled in three years and its largest stockholder is Capital G, a fund backed by Alphabet (GOOG, GOOGL), the paper notes. Shares of Care.com closed Friday up 61c to $23.41

HHS to divert up to $385M from health programs to shelter migrant children

The Department of Health and Human Services (HHS) will take up to $385 million from programs, including those that fund cancer prevention efforts, to house an increasing number of unaccompanied migrant children in its care.
HHS will reallocate millions of dollars from some of its health programs to increase shelter capacity for the “overwhelming number” of migrant children, Secretary Alex Azar told Congressional appropriators in letters this week.
Children who cross the border without parents or family are often referred to HHS for shelter, food and other services until sponsors are found in the U.S. But HHS’s shelters are nearly full, and the agency needs to take funds from other programs to pay for more space, Azar said.
That includes up to $286 million from health programs that fund Head Start, Alzheimer’s care and cancer prevention. Most of the money will come from the Administration for Children and Families, the Centers for Disease Control and Prevention, and the National Institutes of Health.
Up to $99 million from within the Office of Refugee Resettlement will also be reprogrammed, Azar said.
An HHS spokesperson said the funds that will be reallocated are unobligated, meaning they were appropriated by Congress but have not yet been used by the department.
But Rep. Rosa DeLauro (D-Conn.), the chairwoman of the House Appropriations Committee’s health panel, accused HHS of “robbing vital health and human services initiatives in order to pay for their failed policies.”
“We cannot continue to spend taxpayer dollars on the President’s manufactured crisis at the border, which is government-sanctioned child abuse,” DeLauro said in a statement.
HHS also reallocated nearly half a billion dollars in funds late last year to pay for more shelters.
The Obama administration also transferred $167 million to deal with an influx of arrivals at the border.
Such requests are not new — similar transfers of money have been used in times of public health emergencies, such as the Zika virus outbreak in 2016.

Cities, counties unlikely to heed FDA warning on importing foreign drugs

Prices of drugs from overseas pharmacies can be as much as 70% lower than what people pay in the U.S. because the costs are regulated by the foreign governments.


KEY TAKEAWAYS

The FDA claims CanaRx has sent “unapproved” and “misbranded” drugs to U.S. consumers, jeopardizing their safety.
However, the FDA acknowledged that there were no reports of anyone harmed by drugs received through CanaRx.
Critics say the FDA is more interested in protecting the profits of the U.S. drug industry than acting as a consumer advocate.

Cities and local governments in several states said they will continue to use a Canadian company to offer employees prescription drugs at a highly reduced price, even though federal officials raised safety concerns about the practice last week.
The municipalities use CanaRx, which connects their employees with brick-and-mortar pharmacies in Canada, Great Britain and Australia to fill prescriptions.
In a letter Thursday to CanaRx, the Food and Drug Administration said the company has sent “unapproved” and “misbranded” drugs to U.S. consumers, jeopardizing their safety.
The FDA urged consumers not to use any medicines from CanaRx, which works with about 500 cities, counties, school districts and private employers to arrange drug purchases. Some of these employers have used the service as far back as 2004.
Prices of drugs from overseas pharmacies can be as much as 70% lower than what people pay in the U.S. because the costs are regulated by the foreign governments.
FDA officials would not explain why they waited more than a decade to act. They acknowledged the agency had no reports of anyone harmed by drugs received through CanaRx.
The FDA made its warning as Congress and the Trump administration look into ways to lower drug prices. Last month, Florida Republican Gov. Ron DeSantis said he has President Donald Trump’s backing to start a program to begin importing drugs from Canada for state residents.
After DeSantis’ comments, White House officials stressed that any such plan must get state and federal approvals.
The FDA said that in most cases importing drugs for personal use is illegal, although it very rarely has tried to stop Americans from bringing drugs across the Canadian border. It has not stopped retail stores in Florida that help consumers buy drugs from Canada since 2003. Nine storefronts were raided by FDA officials in 2017, although the FDA has allowed them to continue operating.
Schenectady County in New York, which has worked with CanaRx since 2004, defended its relationship and had no immediate plans to end it, according to Chris Gardner, the county attorney. “We will wait to see how this plays out, but right now it’s status quo,” Gardner said.
He said CanaRx, which is headquartered in Windsor, Ontario, helped the county save $500,000 on drug costs in 2018. About 25% of the county’s 1,200 workers use the program and get their drugs with no out-of-pocket costs. If they use American pharmacies, they generally have a copayment.
“This is a good program, and on the merits it looks lawful, and they are not doing the terrible things that the FDA is suggesting,” Gardner said.
CanaRx officials denied they were breaking any laws or putting Americans’ health at risk. They say they are not an online pharmacy but a broker between brick-and-mortar pharmacies in Canada, Australia and Great Britain and U.S. employees. People can buy drugs via CanaRx only with a prescription from their doctor.
The company said it has no plans to stop distributing drugs.
“The FDA’s characterizations of the CanaRx business model and operating protocols are completely wrong,” said Joseph Morris, a Chicago-based lawyer for the company. “It is not possible to place an order via any CanaRx website; the websites are informational only.”
Morris said the FDA notice prompted calls from many municipalities but all so far say they plan to stick with the company.
Columbia County, N.Y., has been using CanaRx for about a decade and the savings allows it to offer employees drugs with no out-of-pocket costs instead of paying up to a $40 copay in local pharmacies.
“This is bull,” Stephen Acciani, an insurance broker who works with the county, said of the FDA crackdown. “They are not selling unsafe medications.” His recommendation would be for the county, which has more than 600 employees on its health plan, to continue using CanaRx.
He noted that employees receive drugs through the mail in their original packaging from manufacturers.
Kate Sharry, a benefits consultant to the city of Fall River, Mass., and more than 100 other municipalities in Massachusetts, said, “It will give some clients pause. How can you not pay attention to this from the FDA?” But she expects the local governments to stay with CanaRx.
Federal health officials under both Republican and Democratic administrations have blocked efforts to legalize importing drugs, saying it’s too risky.
“Sometimes a bargain is too expensive,” said Peter Pitts, a former FDA associate commissioner and president of the Center for Medicine in the Public Interest, a New York-based nonprofit that receives some of its funding from drugmakers.
Pitts, who applauded the FDA action, said it’s difficult for consumers to know when their pills from foreign pharmacies don’t have the correct potency or ingredients. He said doctors may also not realize a patient’s problem stems from issues with the medicine. Instead, the physicians may just change the medication’s dosages. He said it is not safe for Americans to buy drugs that are imported through foreign pharmacies.
Gabriel Levitt, president of PharmacyChecker.com, a website for U.S. consumers that verifies international pharmaciesoffering drugs online, said CanaRx is one of the safest ways for Americans to get drugs from legitimate pharmacies in Canada and other industrialized counties.
He said the FDA is trying to intimidate CanaRx and its local government clients. “My biggest fear is they will scare consumers and they won’t take their very safe and effective medications because they hear about this bogus warning.”
“The FDA’s action, which appears to try and make those programs look unsafe and sinister, seem to have a political and public relations purpose, one that is perfectly allied with the lobbying agenda of drug companies,” he said.
He pointed to testimony by FDA Commissioner Scott Gottlieb last week — just a day before the CanaRx warning. When asked about importing Canadian drugs, Gottlieb did not mention CanaRx, but he said that people going to a “brick and mortar” pharmacy in Canada “are getting a safe and effective drug. I have confidence in the Canadian drug regulatory system.” He added that his concerns are with online pharmacies.
The Pharmaceutical Research and Manufacturers of America, the industry trade and lobbying group, cheered the FDA action but denied it had any role in it, said spokeswoman Nicole Longo.
“PhRMA supports the FDA’s efforts to crack down on organizations that are circumventing its robust safety and efficacy requirements,” she said. “Drug importation schemes expose Americans to potentially unsafe, counterfeit or adulterated medicines.”

Behind TrovaGene’s volatile ride

It’s déjà vu for biotech investors, who witnessed a wild rally in Bio-Path Holdings Inc BPTH 45.96% this week.
Shares of another thinly traded, nano-cap biotech are clocking double-digit gains for the second consecutive session. TrovaGene Inc TROV 16.22%, which develops therapies targeting cell division to treat leukemia, lymphomas and solid tumors, gained more than 30 percent Thursday and was up about 70 percent midday Friday.
The advance came in reaction to the company’s fourth-quarter results, released after the market close Wednesday. The company reported a wider-than-expected loss for the quarter.

The Catalyst

What appealed to investors is the clinical pipeline update provided by the company in its earnings release, especially on its lead candidate onvansertib, which is being evaluated as a combination regimen for a variety of cancers.
Onvansertib is being evaluated in a Phase 1b/2 trial in combination with low-dose cytarabine or decitabine (chemotherapy) for acute myeloid leukemia, or AML.
“Our AML trial continues to advance and data shows that the combination of onvansertib and standard-of-care chemotherapy is demonstrating both a favorable safety profile and showing activity in greater than 88 percent of evaluable patients treated to date, which is very encouraging,” TrovaGene CEO Thomas Adams said in a statement.
In another Phase 2 study, the pipeline asset is being tested along with Zytiga for metastatic castration-resistant prostate cancer, or mCRPC.
Following the go-ahead nod from the FDA in January, the company is on track to begin enrollment in the trial by midyear. A data readout from the midstage study is expected in 2019, the company said.
TrovaGene said it is planning to present safety and preliminary clinical data from the Phase 1b/2 trial in AML and Phase 2 trial in mCRPC at the American Association for Cancer Research annual conference scheduled for March 29-April 3.

Rumor Mill Goes Into Overdrive

The euphoria continued into Friday’s session, with the stock almost doubling as traders circulated word of a “positive” FDA abstract for TrovaGene’s prostate cancer treatment.
Although nothing has emerged in that direction, the buying is continuing unabated on roughly 90 times the stock’s average volume.
TrovaGene had not responded to a request for comment from Benzinga at the time of publication.
Out of the 4.2 million outstanding shares of TrovaGene, 3.8 million are available as float, which is the actual number of shares available for trading after excluding closely held shares.
The strong upward move is atypical of low-float, low-volume shares, which tend to move sharply and quickly in the wake of a positive catalyst.
Yet one should be of wary of trading the volatility of low-float shares, as they could come crashing down at the same pace at which they went up when bad news hits.
Maxim Group reiterated an $8 price target for TrovaGene shares, citing the positive onvansertib data readouts as imminent catalysts for the stock.
Noble Financial’s Ahu Demir reiterated an Outperform rating on TrovaGene and lowered the price target from $27 to $20, incorporating the recent reverse stock split and data readouts.
TrovaGene shares were trading 68.28 percent higher at $6.95 at the time of publication Friday.