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Sunday, August 7, 2022

Lilly CEO in growing refrain on price negotiations: 'We’ll focus our resources on other areas'

 Eli Lilly had some dreary Q2 numbers to report Thursday. And they kept analysts and investors on hold for an hour before attempting an explanation, blaming the delay on outside tech issues.


The late Q2 call didn’t help make the top and bottom line look any better. Sales dropped to $6.49 billion for the quarter, a bad miss from the $6.85 billion consensus. According to Lilly, that was due to both lower prices for some products — insulin was the standout — as well as a foreign exchange hit as a strong dollar bites and a drop of 13% on Covid-19 revenue.


Alimta generics also began to carve into revenue.


As a result, Lilly dropped their guidance on adjusted earnings for 2022 downward by 25 cents a share, something investors always hate to see. And Lilly was punished for it, with its stock price taking a 3%-plus hit early in the day.



Ahead of the call, Lilly announced that the FDA had accepted the donanemab filing for Alzheimer’s, ready to provide a fast assessment under priority review as the pharma giant sought an accelerated approval with biomarker data, ahead of a Phase III efficacy readout. And neuroscience chief Anne White said during the call that they were committed to seeing it through, even though the decision by Medicare to restrict coverage on Aduhelm — and any other essentially experimental drugs — would confine access to a “very limited” group of patients.


Like every other Big Pharma CEO, David Ricks endorsed the cap on out-of-pocket drug costs for Medicare members. But drug pricing rules — which are anathema in the pharma world, when tied to mandated pricing — came in for criticism.


Echoing a remark by AbbVie CEO Rick Gonzalez, Ricks essentially said that the new rules as proposed now would shift R&D resources out of small molecules and into biologics, which are better protected.


Here’s Ricks:


The negotiation piece is a problem. I think in the short term it doesn’t do much; they don’t really start until ’26 anyway… Probably to me the most damaging thing about it is that it sends a signal to investors and capital allocators like us that small molecules and particularly small molecules in diseases that require stepwise development, like cancer, where we start in later stages and work our way to adjuvant or even in some orphan conditions, really aren’t wanted and are worth a lot less. So we’ll focus our resources on other areas of innovation, we have plenty of those, and so will the rest of the sector. And I think that’s a miss for the patients that probably want better oral cancer drugs in the future.


Lilly set the stage for the awkward H1 call on Wednesday evening, announcing that as federal supplies of its Covid-19 antibody dwindle with no funds available for any new contracts ahead, they’ll shift over to commercial sales. Now states and hospitals will be able to order bebtelovimab through a sole distributor.


One of the bright spots at Lilly was on the dual GIP/GLP-1 receptor agonist Mounjaro (tirzepatide) front, which got a green light for diabetes a few months ago. Expectations are running high that Lilly can make this one into a major new drug franchise, particularly if they can get approved to market it for obesity.


David Risinger of SVB Securities was happy.


Sales were $16mm vs. SVBS’s $10mm and cons’ $12mm; we assume upside was due to initial channel fill. Lilly indicated that it expects to have sufficient supply for launch, which is important in light of Novo Nordisk’s (Not Rated) Wegovy production challenges.


The spotlight now shifts to the regulatory plan on obesity as they pursue other indications in the clinic, much like Novo Nordisk is doing with Wegovy (semaglutide). Lilly is setting up a head-to-head study with Novo’s drug on obesity, but today there’s still no timeline available on that score.

https://endpts.com/eli-lilly-ceo-ricks-echoes-a-growing-refrain-on-price-negotiations-well-focus-our-resources-on-other-areas/

FDA Weekly Review

 The U.S. Food and Drug Administration has had a busy week, accepting drug applications, approving clinical trials and granting various special designations. Continue reading for more details.

Gamida Cell Ltdannounced that the FDA accepted its Biologics License Application for omidubicel. The therapy is being developed for the treatment of patients with blood cancers who need an allogeneic hematopoietic stem cell transplant.

Cellectis reported the FDA cleared its Investigational New Drug (IND) application to initiate a Phase I/IIa trial of UCART20x22 for patients with relapsed or refractory Non-Hodgkin Lymphoma (r/r NHL). UCART20x22 features TALEN-mediated disruptions of the TRAC gene and of the CD52 gene.

Scynexis announced that the FDA accepted its sNDA for Brexafemme for the treatment of vulvovaginal candidiasis (WC) and the prevention of recurrent WC. It was accepted for Priority Review with a PDUFA date of November 30, 2022.

The Janssen Pharmaceutical Companies of Johnson & Johnson announced the FDA approved Stelara (ustekinumab) for the treatment of children six and older with active psoriatic arthritis (PsA). The drug is a fully human monoclonal antibody that selectively inhibits IL-12 and IL-23.

Krystal Biotech reported that the FDA had accepted its IND application for KB407 for cystic fibrosis. KB407 is a modified HSV-1 vector carrying two copies of the CF transmembrane conductance regulator (CFTR) gene to the respiratory cells in the lungs.

Beam Therapeutics announced the FDA placed a clinical hold on its IND application for BEAM-201 for relapsed/refractory T-cell acute lymphoblastic leukemia (T-ALL)/T cell lymphoblastic lymphoma (T-LL). No reason for the hold was supplied. BEAM-201 is a donor-derived CAR-T cell therapy that has undergone multiplex base editing to become universally compatible and resistant to rejection by the host.

Celyad Oncology reported the FDA has lifted its clinical hold on the Phase Ib KEYNOTE-B79 trial. The hold was placed in February after two patient deaths. CYAD-101 is an allogeneic CAR-T cell therapy designed to express the NKG2D receptor, generally found on NK cells, and the novel inhibitory peptide TIM. It is being tested with Merck’s Keytruda.

Marius Pharmaceuticals announced that the FDA approved Kyzatrex (testosterone undecanoate) as an oral testosterone replacement therapy for adult males for conditions associated with deficiency or absence of endogenous testosterone (hypogonadism).

MAIA Biotechnology received Orphan Drug Designation from the FDA for THIO. THIO is a telomere-targeting agent in development for multiple cancers, including small-cell lung cancer.

Biosight was granted Orphan Drug Designation by the FDA for asparcytarabine for treatment of myelodysplastic syndromes. Asparcytarabine is a novel proprietary anti-metabolite made up of cytarabine covalently bound to asparagine.

Calidi Biotherapeutics announced that City of Hope received FDA authorization to proceed with a Phase I trial of Calidi’s oncolytic virotherapy platform, NSC-CRAd-S-pk7. The therapy is made up of tumor-tropic neural stem cells delivering an oncolytic adenovirus selectively to tumor sites in patients with recurrent high-grade glioma.

Twist Bioscience and Biotia’s EUA for its Next-Generation Sequencing Assay for SARS-COV-2 received expanded authorization.

Avenge Bio announced the FDA cleared its IND for AVB-001 in peritoneal malignancies. The drug is designed to secrete native IL-2 in immune-activating alginate capsules.

Amylyx Pharmaceuticals reported that the FDA’s Peripheral and Central Nervous System Drugs Advisory Committee will reconvene to review its NDA for AMX0035 (sodium phenylbutyrate and taurursodiol) for ALS. It previously met on March 30 but is reconvening to discuss additional data analysis.

Allergan Aesthetics, an AbbVie company, announced the FDA approved Juvederm Volux XC for the improvement of jawline definition in adults over the age of 21 with moderate to severe loss of jawline definition.

AnHeart Therapeutics received Breakthrough Therapy Designation from the FDA for taletrectinib for adults with advanced or metastatic ROS-1-positive non-small cell lung cancer (NSCLC) who are ROS1 TKI treatment naïve or previously treated with crizotinib. Taletrectinib is a ROS-1 inhibitor.

OliX Pharmaceuticals’s IND for OLX10212 was approved for age-related macular degeneration. OLX10212 targets inflammation pathways that play a key role in geographic atrophy and neovascular AMD. It is for a Phase I trial.

Sumitomo Pharma Oncology reported the FDA granted Orphan Drug Designation for DSP-5336 for acute myeloid leukemia. The drug is a small molecule inhibitor against the binding of minin and mixed-lineage leukemia (MLL) protein.

Pulse Biosciences announced they had received FDA clearance of expanded energy settings for use with the family of CellFX System treatments tips in dermatology. CellFX System uses the company’s Nano-Pulse Stimulation technology to deliver electrical energy to clear cells.

Vaxcyte reported the FDA granted Fast Track designation to VAX-24, its 24-valent pneumococcal conjugate vaccine candidate for adults 18 and older.

GenBody America announced that the FDA granted an extension of the shelf life for its COVID-19 Ag (antigen) test from 12 months to 21 months when stored at 2 to 30 degrees C (35-86 degrees F).

Acadia Pharmaceuticals announced they had received a Complete Response Letter from the FDA for its sNDA for Nuplazid (pimavanserin) for the treatment of hallucinations and delusions associated with Alzheimer’s disease psychosis (ADP). The agency recommended that the company run another trial in ADP.

ProfoundBio received the go-ahead from the FDA for its IND to evaluate PRO1184 in patients with advanced cancer in a Phase I trial. The drug is an antibody-drug conjugate made up of a folate receptor alpha directed antibody conjugated to an exatecan payload with a proprietary hydrophilic linker. 

https://www.biospace.com/article/fda-review-gamida-cell-cellectis-scynexis-and-more/

Despite Strict Gun Control, California Had The Most Active Shooter Incidents In 2021: FBI

 by Jason Blair via The Epoch Times,

In a report issued by the FBI, California ranked first for the most active shooter incidents in 2021. The state has been in the top spot in three of the past five years.

According to the study, a total of 61 active shooter incidents occurred across 30 states last year with 103 people killed and 140 wounded. This is up from 40 incidents and 38 killed in 2020.

California had 6 incidents that claimed the lives of 19 people with 9 wounded. Texas and Georgia each had 5.

California, which has some of the strictest gun laws, saw 0.015 shootings per 100,000 people. Texas, which has very unrestrictive state gun laws, had nearly the same at 0.0167 per 100,000 people. Georgia had 0.045 per 100,000 people.

Criminal attorney Arash Hashemi told NTD, a sister outlet of The Epoch Times, that in his opinion there’s no easy answer to how gun laws should be handled.

“We need both sides to sit down and listen to what’s going on. I know one side says we need to ban guns, one side said there would be no regulation. But there needs to be a meeting of the minds in the middle,” Hashemi said.

California is moving ahead to implement more gun restrictions. The new state Senate Bill 918, which is currently on its way through the legislature, would ban the carrying of guns in most public areas, regardless of whether someone has a carry license or not.

However Hashemi suggested a slightly different approach. He said the Second Amendment can’t be violated, but he thinks certain people should be restricted from owning a firearm.

“I think California needs to implement these background checks but at the same time make sure they don’t infringe on people’s rights to bear arms,” Hashemi said.

He said vetting gun buyers for red flags like mental illness or psychiatric medication is important.

He added that the importance of the Second Amendment is to give the civilians of the United States a check on the government.

The greatest number of casualties and injuries at an active shooter incident in 2021 was 15, at both a FedEx center in Indiana and a Kroger grocery store in Tennessee.

June had the most with 12, and December had the least with 1.

The FBI defines an active shooter as one or more people engaged in killing or attempting to kill people in a populated area. The 2021 report is limited to these incidents and does not include other gun-related situations like self-defense, drug violence, or gang violence.

https://www.zerohedge.com/political/despite-strict-gun-control-california-had-most-active-shooter-incidents-2021-fbi

Saturday, August 6, 2022

Manchin’s Medicare Disaster

 The goal of their ‘Inflation Reduction Act’ is as straightforward as it is cynical: Transfer billions from Medicare Part D to bankroll green energy projects and subsidize premiums for wealthy Obamacare enrollees. It must be stopped.

In their desperate pursuit of a ‘win’ before the mid-term elections, Senators Joe Manchin and Chuck Schumer are endangering one of America’s most popular, affordable health programs – the Medicare Part D drug benefit for seniors. Worse, they are inserting government bureaucrats and politicians into every medicine cabinet in America. As we struggle to hold down drug inflation, the last thing we should do is set up a bonanza for lobbyists and politicians.

Medicare Part D is extremely popular with seniors and the disabled. Before 2006, Medicare didn’t cover drugs. Since Part D’s enactment, science and medicine have experienced a renaissance, with more than 550 new products treating everything from Hepatitis C to cancer.

The average lifespan has increased as new medicines help people live longer, healthier lives.

Part D has played a big role in these advances since it created incentives for innovators to find new treatments for diseases afflicting the elderly and disabled. The result is that 9 out of 10 seniors are satisfied with their Medicare drug coverage, a stratospheric level of support for a government program.

One of Part D’s most attractive features is its affordability. The agency responsible for administering the program – the Centers for Medicare and Medicaid Services (CMS) – just released its premium estimate for 2023. Today, seniors pay, on average, $32.08 per month for a standard benefit plan. Next year, even with inflation raging, premiums are projected to decline to $31.50 with nearly 200 plans offering zero-dollar premiums for low-income enrollees. Where else in health care do you see that?

One reason Part D premiums are decreasing is that the program’s plans contract with the most experienced, aggressive drug discounters in America – national insurers like Cigna, Humana, and CVS Health. The Biden Administration’s own actuary estimates that these companies already negotiate drug discounts of between 20 to 30 percent.

The bill replaces private plan negotiators with government bureaucrats who make decisions based on policy in a political environment. It does so by eliminating the prohibition on government interfering in private sector price negotiations.

I was on the Congressional team that created the Part D program. We included this clause precisely because we didn’t want politicians and lobbyists making these decisions.

We empowered oversight of drug plans through pharmacy and therapeutics committees – physician and pharmacy experts with experience in clinical medicine – to ensure plans covered drugs in all categories to treat disease. And these committees cannot have a financial stake in the coverage or pricing decisions, they must make their determinations based on what is best for the patient.

Politicizing drug coverage and reimbursement, as the Manchin bill seeks to do, will lead to intense lobbying. More lobbying will lead to decisions based on power, not necessarily science or medicine.

This ‘inconvenient truth’ – that world-class, private sector discounters are already delivering substantial drug discounts – is rarely mentioned since it interferes with the government-knows best narrative. It’s doubtful that government bureaucrats with little or no experience in the prescription drug marketplace can save more without reducing the number of drugs seniors can access.

The Congressional Budget Office, University of Chicago, and CMS have all noted that price controls would result in fewer innovative products for seniors and the disabled. CBO has also noted prescription drug manufacturers will likely launch products at higher prices, leading to increased costs for employees, unions, and families.

After the incompetence shown by the government during COVID, it is surprising Democrats want to turn over the drug benefit seniors and the disabled rely upon to government agencies. As we saw with the Centers for Disease Control (CDC) during COVID-19, decisions by government bureaucrats are often driven more by politics than “science.”

Ultimately, this legislation sets the stage for a new federal government takeover of health care, starting with prescription drug benefits. Hospitals and doctors will be next on the price control list as Congress works to enact government-run health care one step at a time.

The best hope for seniors is that one or two Senators will stand up and protect Medicare Part D from becoming a casualty of the Democrats’ midterm election strategy.

Undermining a successful, popular Part D drug benefit to score political points in the guise of “fighting inflation” doesn’t pass the laugh test.

Joel White is the President of the Council for Affordable Health Coverage, a trade association that advocates for market-based reforms that promote more affordable health care for all Americans. He was Staff Director of the House Ways and Means Committee and helped write the Medicare Part D law.

https://www.realclearhealth.com/articles/2022/08/06/senator_joe_manchins_medicare_disaster_111387.html

Mitochondria rescue cells from ischemic injury



SUSANA CADENAS


Abstract

Ischemic diseases, such as myocardial infarction and stroke, are major causes of death worldwide. To date, therapies aimed at preventing ischemic damage or restoring functional tissue have not been successful. Kynurenic acid (KynA), a metabolite of tryptophan metabolism, is tissue protective in cardiac, cerebral, renal, and retinal models of ischemia, but the mechanism of this protection was unknown. On page 621 of this issue, Wyant et al. (1) report that KynA binds G protein–coupled receptor 35 (GPR35) to activate downstream signaling and, once internalized, indirectly interacts with adenosine triphosphate (ATP) synthase inhibitory factor 1 (IF1) to block ATP depletion during ischemia by promoting the dimerization and inactivation of ATP synthase. This cardioprotective mechanism could be further explored for preventing or treating ischemic injury.

SARS-CoV-2 protein shows promise for future vaccines

 ALBERTO DOMINGO LÓPEZ-MUÑOZ HTTPS://ORCID.ORG/0000-0003-1542-2153IVAN KOSIK HTTPS://ORCID.ORG/0000-0001-5756-5182JAROSLAV HOLLYAND JONATHAN W. YEWDELL

DOI: 10.1126/sciadv.abp9770

Abstract

SARS-CoV-2 nucleocapsid protein (N) induces strong antibody (Ab) and T cell responses. Although considered to be localized in the cytosol, we readily detect N on the surface of live cells. N released by SARS-CoV-2–infected cells or N-expressing transfected cells binds to neighboring cells by electrostatic high-affinity binding to heparan sulfate and heparin, but not other sulfated glycosaminoglycans. N binds with high affinity to 11 human chemokines, including CXCL12β, whose chemotaxis of leukocytes is inhibited by N from SARS-CoV-2, SARS-CoV-1, and MERS-CoV. Anti-N Abs bound to the surface of N-expressing cells activate Fc receptor–expressing cells. Our findings indicate that cell surface N manipulates innate immunity by sequestering chemokines and can be targeted by Fc-expressing innate immune cells. This, in combination with its conserved antigenicity among human CoVs, advances its candidacy for vaccines that induce cross-reactive B and T cell immunity to SARS-CoV-2 variants and other human CoVs, including novel zoonotic strains.

Bronx street boxing aims to end shootings with illegal bouts, booze and booty

We’re breaking the first and second rules of fight club.

The Post got a firsthand look at Rumble in the Bronx (RBX), an underground promotion that makes its money on amateur bloodlust, liquor and erotic dancing girls – which organizers insist doubles as a community safety project.

“I’m not a huge fan of people beating each other up, but this was pretty well orchestrated,” said Penny Lee, a professional webcam girl who twerked between rounds as audience members made it rain with wads of singles. “It was a cool, safe environment.”

Whether it’s a deli, a self-storage pod or the back of an 18-wheeler, the secret locations for RBX shows are always changing. The most recent venue was a Hunts Point junkyard where security checked IDs and patted people down for weapons.

Weed dealers were invited inside to sell strains called alien breath, jelly donut and captain cake. A merch station run out of a minibus hawked RBX T-shirts. A local woman supplied chicken and cheeseburger empanadas for $5 a piece.

Flatbed trucks became makeshift VIP sections where high rollers ordered hookahs and bottles of Don Julio for $300.

RBX leader “Killa” Mike Roman distributed 30 pies donated by Bruckner Pizza, who proudly sponsored the event along with The Print Lab and the Diamond Club strip joint.

“It’s about the community,” said Bruckner Pizza owner Oscar, who didn’t provide his last name. “I figured it was a good cause to give back to.”

Rumble in the Bronx is not sanctioned by the state Athletic Commission and is considered illegal.
Rumble in the Bronx is not sanctioned by the state Athletic Commission and is considered illegal.
Steve Ferdman

Metal barricades with pool noodles wrapped around the bars as padding made up the “ring.” Instead of a canvas floor, they used puzzle-piece foam mats.

Novice fighters — some wearing jeans — relied more on heart and haymakers than technique while more than 100 rabid fans cheered and shouted “F–k him up!”

Roman jeered at tied-up fighters, saying, “If you want to hug someone, hug your girl after the match!” When a female boxer’s weave fell out, he donned it and strutted around the ring to a roar of laughter.

Winners are determined by audience.
Winners are determined by the audience.
Steve Ferdman
Novice and amateur fighters duke it out and throw wild haymakers,
Novice and amateur fighters duke it out and throw wild haymakers.
Steve Ferdman

DJ Shadow played G-Unit’s “I Smelly P—-y” for those who threw in the towel.

When fights went the distance — three three-minute rounds -— the winner was chosen by who got the most applause, and Roman always made sure to commend both fighters as “real ganstas” and “warriors.”

Charles “Kanye West” Woods won the night’s first match. After a 15-minute back-and-forth full of combos, uppercuts and jabs, he and his opponent hugged.

Marijuana dealers are invited to RBX ring bouts.
Marijuana dealers are invited to RBX ring bouts.
Steve Ferdman

“This seemed like a great way to test myself and maybe go viral,” Woods said. “I wish I could’ve done better, but I’m happy with the win.”

After a random callout, which is encouraged, one overzealous bruiser nicknamed “The Cuban Sandwich,” allowed his opponent free chin shots, resulting in a bloody, busted nose.

“I’ve only had one serious injury, but it was because one guy tried to bite another, like some real Mike Tyson stuff,” Roman said.

Rumble in the Bronx attracts more than a 100 rowdy fans cheering for blood.
Rumble in the Bronx attracts more than 100 rowdy fans cheering for blood.
Steve Ferdman

Fans who range from truck drivers and construction workers to artists and social media personalities see RBX as entertainment you can’t find anywhere else.

“It beats just chilling in the house or on the block,” said Jonas Leon, who works as a sound producer. “It’s a fun time, and you never know what is going to happen, but I also use it to network. Killa Mike is doing something positive. He’s good people.”

Despite all the borough support, RBX is illegal.

Penny Lee, a professional webcam girl, claims Rumble in the Bronx offers a “cool, safe environment.”
Penny Lee, a professional webcam girl, claims Rumble in the Bronx offers a “cool, safe environment.”
Steve Ferdman

RBX isn’t sanctioned by the state Athletic Commission, which aims to protect fighters from corrupt practices.

“In addition to the potentially serious health and public safety concerns, there are both criminal and civil consequences of hosting underground fights,” the agency said.

Martin Snow, who runs the Trinity Boxing Club in Tribeca, said it’s a recipe for disaster.

Penny Lee twerks between rounds as spectators rain wads of single dollar bills into the ring.
Penny Lee twerks between rounds as spectators rain wads of single dollar bills into the ring.
Steve Ferdman

“Running a legitimate club these days is not easy, and it’s not cheap, but it’s required” he said. “For the people that cut corners, it’s only a matter of time until someone gets hurt or killed.”

Roman, who said RBX’s motto is “Guns down, Gloves up,” insisted his goal is to deliver a one-two punch to gun violence and squash personal feuds.

“The drinking, the smoking, the girls – that’s all stuff people gravitate toward,” he said.

Amateur fighters see opportunity in competing at Rumble in the Bronx.
Amateur fighters see an opportunity in competing at Rumble in the Bronx.
Steve Ferdman

“I’ve done the activism thing before and walked around with signs that say, ‘Stop Shooting,’ but that only gets the attention of nonprofits and government types, not the people who might actually pick up a gun.”

https://nypost.com/2022/08/06/bronx-street-boxing-aims-to-end-shootings-with-booze-and-booty/