U of Arizona Offers Free Med School Tuition for Primary Care

The University of Arizona (UA) Colleges of Medicine in Tucson and Phoenix will offer free tuition starting in the spring semester for qualifying medical students to boost the primary care workforce in underserved communities in the state.

Students must agree to practice primary care in a federally designated underserved community in Arizona for at least 2 years after their residency.

Arizona currently meets only 40% of its primary care physician (PCP) need, according to the Health Resources and Services Administration. Arizona ranks 42nd among states for total active PCPs at 77.9 per 100,000 (the US average is 91.7) according to the university’s physician workforce report published in October.

“Arizona needs nearly 600 primary care physicians today, and the number is expected to grow to more than 1900 by 2030,” Michael D. Dake, MD, senior vice president for UA Health Sciences, said in a press release.

The two colleges are the only two designated medical schools in the state.

To be considered for free tuition, applicants must be an Arizona resident and current full-time medical student enrolled in one of the UA Colleges of Medicine.

The minimum commitment of 2 years practicing in an underserved Arizona community must be started within 6 years of graduation from medical school and completed within 10 years of graduation.

The money will come from part of the $8 million annual funding approved by the Arizona Legislature in May. According to the press release, nearly 100 students or about 10% of the student body could get free tuition at the two medical schools.

In addition to building up the state’s primary care workforce, the waived tuition is meant to reduce financial barriers to even applying to medical school with the looming promise of student debt.

Nearly half of medical school graduates owe more than $200,000 in medical school loans, according to the latest Medscape Residents Salary and Debt Report.

Medscape Medical News has reported on several other medical schools that are waiving tuition, including New York University, which is offering free tuition to all current and future medical students; the University of Houston’s new College of Medicine, where all 30 medical students in the inaugural class will receive free tuition when the school opens in the fall of 2020; Kaiser Permanente School of Medicine in Pasadena, California, which announced in February that it will waive tuition for all 4 years for the school’s first five classes starting in summer of 2020; and Weill Cornell Medicine in New York City, which is waiving tuition for all students who qualify for financial aid beginning as of the current 2019-2020 academic year.

https://www.medscape.com/viewarticle/922275

12 Biotech Stocks Primed For A Short Squeeze

Biotech investment is risk fraught. Most biotech stocks are at the mercy of binary events, which serve as make-or-break catalysts. These binary events, however, provide an opportunity for making huge profits for those investors placing the right bets.

Even if the outcome is expected to be negative, one can still make money by adopting a strategy called shorting, which is a bet placed on the price of the security falling in the near future.

Pros And Perils Of Shorting

The mechanism of shorting works like this: borrow a stock and sell it at the prevailing market price, hoping to buy it back later at a less price in order to square up the position. Since the short bet is placed on the premise the security will decline in value, one can make a neat profit out of the price differential between the purchase and sale transactions.

Contrary to expectation, if the stock price begins to move up, a short seller would be left staring at a loss. The situation gets worse when several short sellers, in a bid to cut their losses, scramble to buy the stock, pushing the stock price up further. This is known as a short squeeze.

Why Biotech Stocks Are Ideal Candidates For Short Selling

Most binary events have prescheduled deadlines, giving a clear idea on the investment timeframe.

For instance, Lexicon Pharmaceuticals, Inc.’s (NASDAQ: LXRX) sotagliflozin faced a FDA panel review in mid-January, with the reviewers handing out a split verdict. The investigational asset had a PDUFA action date of March 22. With the writing on the wall fairly clear, a short seller could have got away with a bet against the stock.

The stock slumped about 23% post the Adcom decision, and plunged an incremental 29% over two sessions after the FDA refused to approve the diabetes drug candidate.

That said, the inherent volatility and low float characterizing biotech stocks make shorting a risky proposition. One can end up losing money if the bet goes awry. A short seller trying to cover up his short position in the event of a short squeeze may not be able to buy the stock, especially when it is of a low float.

Metrics Associated With Shorting

The short interest is denoted in absolute number of shares shorted. This apart, short interest is expressed as a percentage of float. Another metric called short ratio refers to the number of days it would take to cover the short positions. Mathematically, it is the number of shorted shares divided by the average daily trading volume, expressed in percentage terms.

Here are the some of the heavily shorted stocks in the biotech stocks (based on data from shortsqueeze.com):

• Intrexon Corp (NASDAQ: XON): short interest 52.79%, short ratio 34.9
• AMAG Pharmaceuticals, Inc. (NASDAQ: AMAG) short interest 48.46%, short ratio 16.4
• Ligand Pharmaceuticals Inc. (NASDAQ: LGND) short interest 44.95%, short ratio 19.5
• Polarityte Inc (NASDAQ: PTE) short interest 38.02%, short ratio 17.4
• Paratek Pharmaceuticals Inc (NASDAQ: PRTK) short interest 37.60%, short ratio 17.2
• Eidos Therapeutics Inc (NASDAQ: EIDX) short interest 36.47%, short ratio 15.5
• Axsome Therapeutics Inc (NASDAQ: AXSM) short interest 36.25%, short ratio 11.5
• Heron Therapeutics Inc (NASDAQ: HRTX) short interest 34.02%, short ratio 18.2
• ZIOPHARM Oncology Inc. (NASDAQ: ZIOP) short interest 33%, short ratio 35.7
• Cronos Group Inc (NASDAQ: CRON) short interest 30.23%, short ratio 8
• Akcea Therapeutics Inc (NASDAQ: AKCA) short interest 30.19%, short ratio 16.5
• Viking Therapeutics Inc (NASDAQ: VKTX) short interest 29.57%, short ratio 13.6

https://www.benzinga.com/general/biotech/19/12/14931993/12-biotech-stocks-primed-for-a-short-squeeze

Sell-Side Remains Optimistic On Sage Despite Depression Drug Disappointment

Sage Therapeutics Inc (NASDAQ: SAGE) shares were savagely sold off Thursday following a negative readout for its lead asset in major depressive disorder.

The Analysts

Morgan Stanley analyst Matthew Harrison maintained an Overweight rating for Sage shares but lowered the price target from $217 to $125. (See his track record here)

H.C. Wainwright analyst Douglas Tsao reiterated a Neutral rating and reduced the price target from $160 to $87. (See his track record here)

Raymond James analyst Dane Leone maintained a Market Perform rating. (See his track record here)

SAGE-217 Remains an Active Drug With a Path to Market

Despite the MOUNTAIN study miss, SAGE-217 remains an active drug with a path to market, Harrison said in a note. The analyst said various factors such as compliance, severity of patients being enrolled etc. influenced the results.

The management continues to communicate with the FDA and plans to compile all data to determine potential changes to studies or potentially additional studies to ensure success, the analyst noted.

“We are encouraged by the manageable tolerability profile and mgt.’s commentary around a higher dose option being attractive in the commercial setting,” Harrison wrote in the note.

Morgan Stanley is confident of the company delivering positive results in the upcoming studies due in 2020.

As such, the firm sees Sage shares significantly higher by year end 2020.

Visibility on Launch Now Less Clear

SAGE-217 can ultimately make it to the market, although visibility on the timing has become less clear, Tsao said.

The analyst sees the need for another confirmatory trial since the magnitude of the effect wasn’t impressive, irrespective of the difference to placebo.

“The ongoing REDWOOD study (fixed, repeat treatment) could fill the need for a second study, but another efficacy study of similar design to MOUNTAIN may ultimately be needed,” the analyst wrote in the note.

The importance of the planned REDWOOD and SHORELINE studies has now heightened to restore shaken investor confidence, Harrison said.

H.C. Wainwright said the MOUNTAIN study results have increased the importance of the sales of Sage’s commercial drug Zulresso, as it now represented a greater proportion of the company’s overall valuation.

The firm noted that Sage has a deeper pipeline apart from its GABAA PAMs, especially its portfolio of NMDA modulators, which have the potential to create significant value over the long term.

Approval In Other Indications Likely

The MOUNTAIN study results have been reflected by the stock movement, Leone said. The analyst expects ongoing clinical development of SAGE-217 to generate substantial debate within the investor and clinical community.

As such, the analyst awaits a clearer outline of clinical catalysts for 2020.

Leone took down his estimates for SAGE-217 in MDD to zero. The analyst said he now expects the management to fully pivot to Treatment-Resistant Depression program during 2020 and not pursue an MDD regulatory approval.

The analyst still models SAGE-217 approval for patients with post-partum depression and also depressed patients presenting with insomnia.

https://www.benzinga.com/analyst-ratings/analyst-color/19/12/14946247/sell-side-remains-optimistic-on-sage-therapeutics-despite-depression-drug-disappoin

Novo Nordisk takes neighborhood approach to preventing diabetes in Philly

Philadelphia ranks fourth among large cities in prevalence of Type 2 diabetes. That’s one of the reasons Novo Nordisk chose the home of the Liberty Bell as the second U.S. city in its localized initiative to prevent Type 2 diabetes.

Called “Cities Changing Diabetes,” the effort has now spread to 25 cities around the world. Novo Nordisk studies each city for about a year in advance to figure out the unique challenges each one faces, said Dr. Todd Hobbs, chief medical officer for Novo Nordisk in North America. The goal is to partner with 50 cities by the end of 2023.

In the case of Philadelphia, that meant sponsoring research conducted by public health organizations, which found that the characteristics of the city’s neighborhoods may make people more or less prone to diabetes. The research identified three types of neighborhoods where developing diabetes is more likely. Those are areas that are “socially cohesive” with strong community structures in place, “polarized by change” in areas where disruptive change affects trust and civic engagement, and “less anchored” places where there is less of a sense of community.

“At the kickoff, we pulled together public and private stakeholders who want to be engaged, but maybe don’t have the overall resources and coordination needed to make these things successful,” Hobbs said, noting that the next step will be an advisory council meeting and deciding what will be the major effects moving forward.

“What we don’t do is come in and just drop a bunch of money or resources and hope that something sticks or helps,” he added.

Philadelphia represents an ongoing thematic expansion as well. As Hobbs said, “It’s not just diabetes. In Philadelphia we’re also talking about obesity which is a driver of much of the diabetes epidemic. Over the five or six years we’ve been involved in the cities program globally, now we’re really speaking to both of them. Because diabetes is not just about glucose and sugar, it’s about obesity and all the other associated co-morbidities.”

While the effort is a social health initiative, Novo Nordisk markets treatments thta It’s also a disease it’s targeting with semaglutide, a compound already approved in two forms as Ozempic and Rybelsus.

Houston was one of the original Cities Changing Diabetes launched five years ago. Today, it has six initiatives that reach 75,000 people in the city on diabetes prevention and resource management. The approach in Houston focused on individual behavioral characteristics of people, versus the neighborhood approach in Philadelphia to find those who are more vulnerable to developing diabetes.

“It’s a problem in cities because that’s where people with diabetes live. Two-thirds of the growing number of people with diabetes are living in cities. But every city’s challenges to address this major problem are very unique and very different,” Hobbs said.

https://www.fiercepharma.com/marketing/novo-nordisk-adds-philadelphia-to-its-roster-cities-involved-its-diabetes-prevention

Biogen stacks the deck but the path forward is no clearer in Alzheimer’s

The presentation of Biogen’s hugely complex aducanumab pivotal programme confirms that the US regulator is destined to make another polarising decision.

After scrapping and then resuscitating its Alzheimer’s project aducanumab, Biogen needed to make a very strong case for pushing on. That attempt came yesterday at a medical conference, CTAD, and it seems that the hugely complex presentation failed to substantially shift opinions in either the medical or financial communities, many of which were firmly entrenched either way.

Biogen has insisted that it will file for approval next year, setting the FDA up to make a decision that, inevitably, many will disagree with. And yesterday’s presentation will not have made life easier for the regulator. By allowing a company employee to present the data – highly irregular for a medical conference – and having no real dissenting voices among the reviewers, Biogen has remained in control of the message.

That message is clear: aducanumab is an effective drug, dosed high enough and for long enough, and represents a real step forward for Alzheimer’s disease. This almost puts a moral obligation on the FDA to grant approval. It will also make running any sort of confirmatory trial incredibly hard, because if physicians and patients believe this interpretation, enrolling a trial in which subjects might receive a placebo becomes almost impossible.

Biogen has said it is preparing to re-dose patients who were originally enrolled in the Engage and Emerge studies. The company presumably hopes that this endeavour will be sufficient to clear up any remaining questions that regulators may have.

But this would be a deeply imperfect way of rigorously examining aducanumab, and there are a lot of unanswered questions here, as well as unseen data. Even if one stands by the way that Biogen has re-analysed the results, the clinical relevance of the efficacy signal teased out remains a subject of debate. And this is before safety is considered – something that must not be easily dismissed with an agent that will be dosed chronically.

The advisory committee hearing that will inevitably be convened next year will provide the FDA’s first thoughts on all this, and will be a hugely pivotal moment for the biopharma sector. A green light will be interpreted as Sarepta 2.0, and a further demise in standards of evidenced-based medicine. Roadblocks will be criticised for delaying patients’ access to potentially life-changing therapies.

History suggests that Biogen will prevail here. Either way, Alzheimer’s is now set to be one of the big stories of 2020.

https://www.evaluate.com/vantage/articles/news/trial-results/biogen-stacks-deck-path-forward-no-clearer-alzheimers

Bariatric Surgery May Raise Risk for Colon Cancer Years Later

Individuals who undergo bariatric surgery may be at increased risk for developing colon cancer years later, according to a study published online Dec. 4 in the International Journal of Cancer.

Wenjing Tao, from the Karolinska University Hospital in Solna, Sweden, and colleagues compared the incidence of colorectal cancer for adults with obesity in Denmark, Finland, Iceland, Norway, or Sweden in 1980 to 2015 who had and had not undergone bariatric surgery.

The researchers found that 9.9 percent of the 502,772 cohort participants with an obesity diagnosis underwent bariatric surgery. After bariatric surgery, there was an increase in the overall standardized incidence ratio (SIR) of colon cancer (SIR, 1.56; 95 percent confidence interval [CI], 1.28 to 1.88), with SIRs higher ≥10 years after surgery. In surgical versus nonsurgical participants, the overall hazard ratio (HR) of colon cancer was 1.13 (95 percent CI, 0.92 to 1.39) and the HR was 1.55 (95 percent CI, 1.04 to 2.31) 10 to 14 years after bariatric surgery. The risk for rectal cancer was not significantly increased with bariatric surgery (SIR, 1.14; 95 percent CI, 0.83 to 1.52; HR, 1.08; 95 percent CI, 0.79 to 1.49); with longer follow-up periods, there was an increase in risk estimates.

“An increased risk of colorectal cancer following bariatric surgery might merit surveillance of patients undergoing such surgery,” the authors write.

Abstract/Full Text (subscription or payment may be required)

https://www.physiciansbriefing.com/hematology-oncology-12/weight-loss-surgery-bariatric-1005/bariatric-surgery-may-raise-risk-for-colon-cancer-years-later-752723.html

How Well Are You Aging? A Blood Test Might Tell

Imagine a blood test that could spot whether you are aging too quickly.

New research suggests it’s not the stuff of science fiction anymore.

The scientists analyzed plasma — the cell-free, fluid part of blood — from more than 4,200 people between the ages of 18 and 95, and found a link between 373 proteins and aging.

“We’ve known for a long time that measuring certain proteins in the blood can give you information about a person’s health status — lipoproteins for cardiovascular health, for example,” said study senior author Tony Wyss-Coray. He’s co-director of the Alzheimer’s Disease Research Center at Stanford University in California.

“But it hasn’t been appreciated that so many different proteins’ levels — roughly a third of all the ones we looked at — change markedly with advancing age,” he added in a university news release.

The study was published Dec. 5 in the journal Nature Medicine.

“Proteins are the workhorses of the body’s constituent cells, and when their relative levels undergo substantial changes, it means you’ve changed, too,” Wyss-Coray explained. “Looking at thousands of them in plasma gives you a snapshot of what’s going on throughout the body.”

The findings suggest that physical aging doesn’t occur at a steady pace, but is uneven and has three distinct surges — ages 34, 60 and 78.

At those ages, there are spikes in levels of specific proteins in the blood with noticeable changes, according to the researchers.

Eventually, a blood test for these proteins might be able to identify people who are aging more rapidly than normal and at increased risk for age-related conditions such as Alzheimer’s disease or heart disease.

Such a test might also help identify drugs or other factors that slow or speed aging, the study authors said.

However, any clinical use of such a blood test is at least five to 10 years away, the researchers noted.

“Ideally, you’d want to know how virtually anything you took or did affects your physiological age,” Wyss-Coray said.

More information

Healthfinder.gov offers tips on protecting your health as you age.

SOURCE: Stanford University, news release, Dec. 5, 2019

https://consumer.healthday.com/senior-citizen-information-31/misc-aging-news-10/how-well-are-you-aging-a-blood-test-might-tell-752705.html