Baxter Expects Restatement to Cut Income From Continuing Operations

Baxter International Inc. will restate certain results for 2016 through the first half of 2019, reducing income from continuing operations, to correct accounting for foreign exchange gains and losses.
The maker of medical devices and drugs said in October that it would review certain intracompany transactions “undertaken for the purpose of generating foreign exchange gains or losses,” and said it might need to restate at least five years of results.
A Thursday securities filing detailed preliminary changes for 2016, 2017, 2018 and the first half of 2019. The largest change was for 2017; the company expects to revise income from continuing operations before income taxes to $1.1 billion from $1.22 billion.
Baxter “believes that its internal investigation, as it pertains to the evaluation of related financial statement impacts, is now substantially complete.”

https://www.marketscreener.com/BAXTER-INTERNATIONAL-INC-11763/news/Baxter-International-Expects-Restatement-to-Cut-Income-From-Continuing-Operations-29996384/

Medtronic to Acquire Digital Surgery

Medtronic PLC on Thursday said it agreed to buy Digital Surgery, a privately held provider of surgical artificial intelligence, data and analytics, and digital education and training, for an undisclosed amount.
Medtronic said the acquisition will strengthen its robotic-assisted surgery platform and has applicability for its broader portfolio.
The Dublin-based medical-technology company said Digital Surgery will join its surgical-robotics business as part of its minimally invasive therapies group.

https://www.marketscreener.com/MEDTRONIC-PLC-20661655/news/Medtronic-to-Acquire-Digital-Surgery-for-Undisclosed-Amount-29992570/

3 Analysts Dissect Teva’s Q4 Results

Teva Pharmaceutical Industries Ltd TEVA 6.58% reported fourth-quarter sales and revenues that slightly exceeded estimates but issued a guarded outlook for 2020.

The Teva Analysts

BofA Securities analyst Jason Gerberry eiterated an Underperform rating on Teva and raised the price target from $8 to $11.
Raymond James analyst Elliot Wilbur reiterated an Outperform rating and $15 price target.
Oppenheimer analyst Esther Rajavelu reiterated an Outperform rating and increased the price target from $12 to $16.

Austedo Opportunity And Long-Term Targets Less Probable

Gerberry said upside is attributable to Teva suggesting an imminent Phase 3 data readout for Austedo in Tourette’s syndrome, a large add-on indication not reflected in estimates, and updated 2023 financial targets, which suggest EBITDA about 11% above consensus.
However, the analyst remains bearish on the stock, given insufficiency of data to assign credit to Austedo in TS, a lack of sufficient growth drivers to support long-term targets and the opioid risk. The New York Attorney General case scheduled for March 20 is likely to be a key binary event.

Upside Scenario In Teva Likely Over Next 12-18 Months

Teva continues to move the chains on its long-term turnaround drive, Wilbur said, citing the better-than-expected results and the initial 2020 outlook. Armed with $974 million in free cash flow and expectation of FCF hitting $1.8 billion to $2.2 billion, the company is slowly regaining credibility.
Wilbur expects the company to return to at least modest growth in 2020 and beyond, given the turnaround seen in U.S. generics.
“While the company has been the victim of excessive likelihood assigned to opioid headline litigation events, with more opioid litigation settlement clarity emerging towards a positive outcome and its key brand assets – Austedo and Ajovy – continue to fill Copaxone void, we continue to see upside scenarios in Teva shares over the next 12-18 months given bottom in U.S. generics,” Wilbur wrote in the note.
He attributed the bullish stance to favorable reward-to-risk, with a demonstrated stabilization and recovery in adjusted EBITDA levels.

Well Positioned To Manage Opioid Litigation-Related Payments

Oppenheimer is now more bullish on improving bottom line, helped by factors within management’s control. However, Rajavelu remains cautious on top-line growth drivers, especially ahead of continued execution on new generic/biosimilar launches and pipeline maturity.
The stock is in for near-term volatility related to opioid litigation, according to the analyst. The adjusted price target reflects $4.4 billion in litigation-related cash flows over 10 years, including $400 million in 2020, and a 5% incremental litigation risk premium to its discount rate.
“We remain comfortable that TEVA is well positioned to manage these payments while continuing to delever,” the analyst said.
https://www.benzinga.com/analyst-ratings/analyst-color/20/02/15324596/3-analysts-dissect-tevas-q4-results

Marketing To 100-Year-Olds: Longevity Will Transform Finance, Healthcare

Right now, Stanford University is addressing a pressing and fascinating question:

What happens to society when everyone starts living to 100? How will we stay physically fit, financially stable and mentally sharp, especially in that back half?
Exploring these questions is the goal of the Stanford Longevity Project. To answer them, they’ve partnered with major brands like Wells Fargo, Instructure, and Principal to help research key elements like financial security, lifelong learning, and healthcare.
Despite America’s average life expectancy declining the past couple years due to more overdoses, suicides and alcohol-related illnesses, people are going to be able to live longer. Strong advancements have been made in cancer. This month, the U.S. saw its sharpest one year decline in cancer death rate. That will save millions of lives alone.
But this isn’t just a health and wellness conversation. What this presents are multiple opportunities in multiple verticals for marketers.
One of the biggest trends at CES this month was a new generation of healthcare wearables. There were earbuds designed to detect blood pressure for those with hypertension, temporary tattoos that tell you when to get out of the sun, smart glasses that assist people with dyslexia and watches that detect sleep apnea. These technologies are all discreet, easy to use, and built in to everyday things we already use.

We are heading toward a near future in which every human body will have a functioning check engine light. You can imagine how much better healthcare will be when a sensor will tell you something needs attention, rather than panicked scrolling through WebMD.
We will have the ability to know when something is wrong and immediately trigger tests, medication and treatment. Imagine if that sensor, using the IoT, could immediately send and fill a prescription for you.

This is all coming down the pipeline, and it’s going to help us live longer. It’s also going to change the way marketers do their jobs and open up countless new opportunities to reach new audiences.
Here’s what some of those opportunities will look like.

Opportunities in Healthcare

Cincinnati has one of the best healthcare startup scenes in the country. Cincinnati Children’s Hospital is ranked #3 nationally. CincyTech has raised nearly a billion in healthcare follow-on investment over the past ten years.
The common thread these organizations share is they are tackling high-use issues in different ways. That includes everything from small, wearable, injectable devices (Enable Injections) that can be used for a multitude of conditions, to analyzing people’s sweat to ensure proper medication dosing (Eccrine Systems).
One of the most interesting might be Sense Diagnostics because their simple device addresses a huge need: stroke detection. Right now there isn’t a good way to tell which kind of stroke (transient ischemic, ischemic, or hemorrhagic) someone is having in the field. An ambulance with this non-invasive device will be able to quickly diagnose which stroke is occuring, allowing them to begin the best possible treatment immediately.

Opportunities in Finance

Living longer changes a person’s entire financial strategy.
“Most standard retirement principles assume that retirement will last a maximum of 30 years. The commonly-used “4% rule” of retirement is an example of this. However, if you live to 100 or beyond, your retirement could last 35 years, 40 years, or longer,” said Nathan Hamilton, director and industry analyst at The Ascent from The Motley Fool.
“A deferred annuity could be worth a look. Essentially, you put some money into an annuity when you first retire (or earlier), but that won’t start paying out until a certain age—say, 80 or 85. The idea is that even if your retirement nest egg is getting low as you get older, this move guarantees you a predictable income stream for life.”
How we invest may also change as we look to create steady income streams that kick in throughout retirement rather than just upfront. This also may inevitably cause people to work later and longer especially as our workforce trends farther away from physical labor to more mental and creative labor.
The biggest takeaway here isn’t that living longer will impact one thing. It will impact everything.
As humans, we need to think about that for ourselves and our future generations. And as marketers and entrepreneurs, we can start thinking about ways we can make that reality better, more productive, and more secure for people.
https://www.forbes.com/sites/shamahyder/2020/02/13/marketing-to-100-year-olds-how-longevity-will-transform-finance-healthcare-and-education/#11ab59b51911

Per-Person Health Care Spend Up 18% from 2014 to 2018, Driven Mostly by Price

Average employer-sponsored insurance (ESI) spending rose to $5,892 per person in 2018, according to the Health Care Cost Institute’s annual Health Care Cost and Utilization Report, which analyzes 2.5 billion medical claims to inform the public about trends affecting approximately 160 million U.S. individuals with employer-sponsored insurance. This spending growth outpaced 2017’s growth due to continued price growth combined with an uptick in utilization.
“Prices, spending, and out-of-pocket costs continue to rise for the 160 million Americans with employer-sponsored health insurance,” said Niall Brennan, president and CEO of HCCI. “Higher prices for medical services continue to drive most spending increases, but in 2018 we also saw an uptick in utilization for the first time in several years. If these price and utilization trends continue, we expect spending growth to stay on an upward trajectory in the coming years.”
Despite recent increases in utilization, rising prices were the primary driver of spending growth over the 5-year study period. After adjusting for inflation, spending rose by $610 per person between 2014 and 2018. “Higher prices for medical services were responsible for about three-quarters of overall spending increases between 2014 and 2018, after inflation,” said Jean Fuglesten Biniek, report co- author and senior researcher at HCCI.
While utilization changes accounted for a smaller share of spending growth after inflation, about one- fifth, most of the increase in use occurred over just one year. The increase in utilization in 2018 had a greater effect on costs than a similar increase would have had earlier in the period because of price growth between 2014 and 2017.
The report examines four groups of health care services and dozens of sub-categories. Of the four major categories, outpatient visits and procedures saw the highest 2018 spending increase (5.5%).
Other notable trends include:

• Inpatient services.
  • Per-person spending on inpatient admissions rose 11.4% between 2014 and 2018.
  • Within each sub-category of inpatient admissions, average prices grew steadily between 2014 and 2018 while utilization trends varied. However, the 2.0% price increase in 2018 was lower than the near 4% annual increases from 2014 to 2017.

• Outpatient services.
  • Increases in prices and use led to a 16% increase in spending from 2014 to 2018.
  • Over that period, ER visit spending increased 32% and spending on observation stays went up 29%.

• Professional services.
  • Spending increased 16% and growth accelerated over the 5-year period, driven by office visits and administered drugs.
  • Psychiatry also saw strikingly high spending growth of 43% from 2014 to 2018, which was driven mostly by increased use.

• Prescription drugs.
  • Generic drugs accounted for 88% of all prescriptions.
  • Out-of-pocket payments for prescriptions for generic drugs was less than one-fifth of out-of-pocket payments on brand drugs.

Out-of-pocket spending grew in each year of the 5-year period. “People with job-based insurance saw their out-of-pocket costs rise 14.5%, or $114, between 2014 and 2018,” said John Hargraves, senior researcher and co-author of the report. Study authors stressed that the analysis covers out-of-pocket costs paid for services, such as copays, coinsurance, or deductible payments, but does not include other payments related to health care like insurance premiums.
Methodology. Since 2011, HCCI has tracked, independently analyzed, and reported health care spending, utilization, and prices each year in its Health Care Cost and Utilization Report, using de- identified claims data of people up to age 65 with employer-sponsored health insurance. Data come from four of the largest health insurance providers in the U.S. — Aetna, Humana, Kaiser Permanente and UnitedHealthcare — representing about 26 percent of the employer-sponsored insured population. For this year’s report utilization and price measures for three of the four service categories (the exception being prescription drugs) were adjusted to account for changes in the mix of services provided in each category, and therefore, facilitate comparisons across years. Further, measures of drug spending reflect discounts negotiated from the wholesale price of drugs but do not include manufacturer rebates that are provided through separate transactions. Thus, drug prices reflect the point-of-sale prices.
The Health Care Cost Institute’s mission is to get to the heart of the key issues impacting the U.S. health care system — by using the best data to get the best answers. HCCI stands for truth and consensus around the most important trends in health care, particularly those economic issues that are critical to a sustainable, high-performing health system. Launched in 2011, HCCI currently holds one of the largest databases for the commercially insured population, and in 2014 became the first national Qualified Entity (QE) entitled to hold Medicare data. For more information, visit healthcostinstitute.org or follow us on Twitter @healthcostinst.
https://www.eurekalert.org/pub_releases/2020-02/hcci-phc021320.php

Acid reflux drug is a surprising candidate to curb preterm birth

Lansoprazole, an over-the-counter acid reflux drug that is often taken by pregnant women, may be a promising therapy to reduce preterm birth, according to a computational drug repurposing study that also tested several of the drugs in mice.
The study also identified 12 other FDA-approved drugs that are deemed safe in pregnancy. While the drugs encompass a variety of modalities, the scientists said they all appear to act on biological pathways that affect the immune response, which is implicated in preterm birth.
“Inflammation clearly plays a role in initiating labor and preterm birth,” said Marina Sirota, PhD, assistant professor of pediatrics, a member of the Bakar Computational Health Sciences Institute at UCSF, and the senior author of the study, published Feb. 13, 2020, in JCI Insight. “Immune pathways are very significantly dysregulated in women who end up delivering preterm, and they’re also dysregulated in babies who are born early. However, we have seen from our previous work that there is an interaction between the maternal and fetal immune systems and a breakdown in maternal-fetal tolerance.”
To identify candidate drugs that might be effective in preventing preterm birth, the scientists first looked at which genes were up- or down-regulated in the blood cells of women who experienced spontaneous preterm birth to identify a gene expression “signature.” Then they looked for the opposite signature in cells that had been exposed to 1,309 different drugs, reasoning that if a drug could correct the effects that preterm birth had on the women’s blood cells, the drugs might also prevent preterm birth itself.
The scientists identified 83 drug candidates, but when they excluded those found to have pregnancy risks in animal or human studies, they wound up with 13 drugs, ranked according to their “reversal score,” a measure of the extent to which they were able to reverse the gene expression signature of preterm birth.
The other drugs identified by the computational screen included progesterone, which is already used to treat recurrent spontaneous preterm birth, folic acid, which is given to women during pregnancy to prevent birth defects, three antibiotics, an antifungal, an antidepressant, an anti-diabetic, and a blood pressure medication.
The fact that predictable drugs like progesterone came up in the screen gave the scientists confidence that the drugs they identified may turn out to be effective once they are tested in pregnant women. Three of the other drugs that came up in the screen–folic acid, clotrimazole and metformin–have also been shown in previous studies to be effective against preterm birth.
“Finding progesterone on the list was a promising validating step,” said Brian Le, PhD, a postdoctoral scholar in the UCSF Department of Pediatrics and the Bakar Computational Health Sciences Institute, and the first author of the study. “Four of the drugs on our list have seen effectiveness in past studies that were either experimental or retrospective. This leads us to believe in the biology behind the identification of these drugs.”
The scientists chose lansoprazole for further testing because, in addition to its high reversal score, it is available over the counter, and they know from their previous work that it affects a stress-response protein, heme oxygenase-1, that has been linked with pregnancy disorders. Lansoprazole, which is a proton-pump inhibitor marketed as Prevacid, had the second-highest reversal score of the 13 drugs identified as being safe and effective. Progesterone was further down the list.
The scientists tested lansoprazole in pregnant mice that had been given a bacterial component to induce inflammation, which causes some fetuses to die in utero, where they are reabsorbed. When these mice were given lansoprazole, they had more viable fetuses. Lansoprazole also worked better in these mice than progesterone.
Although it is a good measure of how inflammation affects pregnancy in mice, the scientists said the fetal resorption mouse model is not an adequate model of human preterm birth. They said more work, including studies in people, would need to be done before lansoprazole or any of the dozen other drugs they identified could be proven effective in pregnant women at risk for preterm birth. But the computational study provides leads for a condition that currently has few treatment options.
“This, basically, is a proof of concept that this drug has anti-inflammatory properties, which are not the properties the drug was designed for,” said David K. Stevenson, MD, a professor of pediatrics at Stanford University and an author of the study. “This is a short way to get to new therapeutics for known diseases.”

###

Authors: Brian L. Le, PhD, and Marina Sirota, PhD, of UCSF; and Sota Iwatani, PhD, Ronald J. Wong and David K. Stevenson, MD, of Stanford University.
Funding: This project was in part supported by the March of Dimes and NIH NLM K01LM012381.
Disclosures: Marina Sirota is a scientific advisor to twoXAR.
https://www.eurekalert.org/pub_releases/2020-02/uoc–ard021120.php

AMN Healthcare Services EPS beats by $0.11, beats on revenue

AMN Healthcare Services (NYSE:AMN): Q4 Non-GAAP EPS of $0.85 beats by $0.11; GAAP EPS of $0.58 beats by $0.02.

Revenue of $586.9M (+11.0% Y/Y) beats by $11.52M.

Press Release

https://seekingalpha.com/news/3541971-amn-healthcare-services-eps-beats-0_11-beats-on-revenue