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Sunday, August 7, 2022

Biotech M&A is picking back up

 In the business of drug development, deals can be just as important as scientific breakthroughs. Many of today’s most influential medicines, from the life-saving cancer treatment Keytruda to the anti-inflammatory agent Humira, might not have become so without mergers and acquisitions.

Over the last few years, pharmaceutical M&A hit record highs as larger companies turned again and again to young biotechs for innovation. Often, these deals focused on cancer, rare diseases and immune system disorders — areas of drug research that were seeing major victories in clinical trials and huge profits for treatments that made it to market.

These deals haven’t come cheap, however. Biotech companies have had an easy time raising huge sums of money from private investors and, until recently, the public markets. That funding can make them less receptive to a buyout offer and force would-be acquirers to offer more to lock down deals. Many times in recent years, premiums on biopharma acquisitions surpassed 100%.

While M&A was plentiful in 2018 and 2019, and even held up during a year gripped by the coronavirus pandemic, 2021 was much quieter. In fact, the second quarter hit a five-year low in both the value and number of biopharma transactions. This year has seen a modest rebound after a slow start, and analysts believe a resurgence is likely. Whether M&A activity continues will have a significant effect on which startups and drug programs get funded and advanced.

BioPharma Dive is tracking these deals below. The database, which shows drugmaker acquisitions that happened since 2018 and were valued at $50 million or more in upfront consideration, will be regularly updated.

Click on an acquiring company to pull up more information, and scroll to the bottom of the page to read how this information was collected and organized. If there’s anything we’ve missed, or any additional information you’d like to see, please reach out and let us know.

Editor’s note: If tables or values do not display, please try clearing your browser’s cache and reloading the page.

DATABASE
SUMMARY TABLES
ACQUIRER
COMPANY ACQUIRED
DATE OF DEAL
TOTAL CONSIDERATION
PRICE PER SHARE
PREMIUM
Amgen
ChemoCentryx
8/4/22
$4,000M
$52.00
116%
Therapeutic focus:
Immune
Financial advisors:
PJT Partners, Goldman Sachs
Legal advisors:
Wachtell, Lipton, Rosen & Katz; Latham & Watkins
Additional consideration:
Enterprise value of $3.7 billion
Gilead
MiroBio
8/4/22
$405M
N/A
N/A
Therapeutic focus:
Immune
Financial advisors:
Cowen, Centerview Partners
Legal advisors:
Davis Polk & Wardwell; Mayer Brown; Mishcon de Reya; Goodwin Procter, Wilson Sonsini Goodrich & Rosati
Ultragenyx Pharmaceuticals
GeneTx BioTherapeutics
7/18/22
$75M
N/A
N/A
Therapeutic focus:
Rare
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Ultragenyx exercised an option to acquire GeneTx. Milestone payments worth up to $115 million
Vertex
ViaCyte
7/11/22
$320M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Innoviva
La Jolla Pharmaceutical Co.
7/11/22
$149M
$6.23
84%
Therapeutic focus:
Other
Financial advisors:
Cowen & Co., Moelis & Co.
Legal advisors:
Gibson, Dunn & Crutcher; Willkie Farr & Gallagher
AstraZeneca
TeneoTwo
7/5/22
$100M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Milestone payments worth as much as $1.165 billion
Ipsen
Epizyme
6/27/22
$247M
$1.45
53%
Therapeutic focus:
Cancer
Financial advisors:
Barclays, Jefferies, MTS Health Partners
Legal advisors:
Orrick, Herrington & Sutcliffe; WilmerHale
Additional consideration:
Additional consideration in contingent value right worth $1/share
Gurnet Point Capital, Patient Square Capital
Radius Health
6/23/22
$890M
$10.00
12%
Therapeutic focus:
Other
Financial advisors:
J.P. Morgan Securities, Goldman Sachs
Legal advisors:
Ropes & Gray; Latham & Watkins; Kirkland & Ellis; Covington & Burling
Additional consideration:
Total deal value includes assumption of Radius Health’s debt and a contingent value right worth $1/share
invoX Pharma
F-Star Therapeutics
6/23/22
$161M
$7.12
79%
Therapeutic focus:
Cancer
Financial advisors:
PJT Partners, Morgan Stanley
Legal advisors:
Sherman & Sterling; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo
Galapagos
CellPoint
6/21/22
€125M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Milestone payments worth as much as 100 million euros
Bristol Myers Squibb
Turning Point Therapeutics
6/3/22
$4,100M
$76.00
122%
Therapeutic focus:
Cancer
Financial advisors:
Gordan Dyal & Co., Goldman Sachs
Legal advisors:
Kirkland & Ellis; Cooley
GSK
Affinivax
5/31/22
$2,100M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Milestone payments worth as much as an additional $1.2 billion
Innoviva
Entasis Therapeutics
5/23/22
$113M
$2.20
22%
Therapeutic focus:
Other
Financial advisors:
Moelis & Company, MTS Health Partners
Legal advisors:
Willkie Farr & Gallagher; Covington & Burling
Additional consideration:
Innoviva already owned 60% of Entasis common stock; equity valued at $113 million on a fully diluted basis
Pfizer
Biohaven Pharmaceuticals
5/10/22
$11,600M
$148.50
79%
Therapeutic focus:
CNS
Financial advisors:
J.P. Morgan, Centerview Partners
Legal advisors:
Ropes & Gray; Sullivan & Cromwell
Additional consideration:
Biohaven common shareholders to receive 0.5 shares of “New Biohaven” per Biohaven share held
Opko Health
ModeX Therapeutics
5/9/22
$300M
N/A
N/A
Therapeutic focus:
Immune
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Upfront consideration paid in Opko common stock
Regeneron
Checkmate Pharmaceuticals
4/19/22
$250M
$10.50
335%
Therapeutic focus:
Cancer
Financial advisors:
Centerview Partners
Legal advisors:
Watchell, Lipton, Rosen & Katz; Goodwin Procter
Halozyme
Antares Pharma
4/13/22
$960M
$5.60
50%
Therapeutic focus:
Other
Financial advisors:
Bank of America Securities, Wells Fargo Securities, Jefferies
Legal advisors:
Weil, Gotshal & Manges; Skadden, Arps, Slate, Meagher & Flom
GlaxoSmithKline
Sierra Oncology
4/13/22
$1,900M
$55.00
39%
Therapeutic focus:
Cancer
Financial advisors:
PJT Partners, Lazard
Legal advisors:
Cleary Gottlieb Steen & Hamilton; Wilson Sonsini Goodrich & Rosati
Pfizer
Reviral
4/7/22
$525M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
Centerview Partners, Bank of America Securities
Legal advisors:
Clifford Chance; Goodwin Procter
Additional consideration:
Deal value of $525 million includes development milestones that may not be paid
Eagle Pharmaceuticals
Acacia Pharma
3/28/22
€95M
€0.90
N/A
Therapeutic focus:
Other
Financial advisors:
William Blair & Company, Greenhill & Co. International, Jefferies International
Legal advisors:
Cooley; NautaDutilh; Sullivan & Cromwell; Eubelius CVBA
Additional consideration:
23 million euros of upfront consideration paid in Eagle Pharma common stock. Eagle also guaranteed 25 million euros of Acacia Pharma debt
AbbVie
Syndesi Therapeutics
3/1/22
$130M
N/A
N/A
Therapeutic focus:
CNS
Financial advisors:
Lazard
Legal advisors:
Cleary Gottlieb Steen & Hamilton; Goodwin Procter; Deloitte Legal, Belgium
Additional consideration:
Conditional milestone payments worth up to $870 million
Biohaven Pharmaceutical
Channel Biosciences
2/25/22
$100M
N/A
N/A
Therapeutic focus:
CNS
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
$65 million of upfront consideration paid in Biohaven common stock. Conditional milestone payments worth up to $1.1 billion
Collegium
Biodelivery Sciences
2/14/22
$604M
$5.60
54%
Therapeutic focus:
Other
Financial advisors:
Jefferies, Moellis & Company
Legal advisors:
Troutman Pepper Hamilton Sanders; Goodwin Procter
UCB
Zogenix
1/19/22
$1,900M
$26.00
66%
Therapeutic focus:
Rare
Financial advisors:
Lazard, Barclays, Bank of America Securities, SVB Leerink
Legal advisors:
Covington & Burling; Latham & Watkins
Additional consideration:
Contingent value rights worth $2 per share
Novartis
Gyroscope
12/22/21
$800M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Conditional milestone payments worth up to $700 million
Sanofi
Amunix Pharmaceuticals
12/21/21
$1,000M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
Centerview Partners
Legal advisors:
Weil, Gotshal & Manges; Fenwick & West
Additional consideration:
Conditional milestone payments worth up to $225 million
CSL Ltd
Vifor Pharma
12/14/21
$11,700M
$179.25
19%
Therapeutic focus:
Other
Financial advisors:
Centerview Partners, PJT Partners, Bank of America, Goldman Sachs, Credit Suisse
Legal advisors:
Homburger AG; Simpson Thacher & Bartlett; Allens
Pfizer
Arena Pharmaceuticals
12/13/21
$6,700M
$100.00
100%
Therapeutic focus:
Immune
Financial advisors:
Bank of America, Centerview Partners, Guggenheim Securities, Evercore
Legal advisors:
Ropes & Gray; Arnold & Porter Kaye Scholer; Cooley
Recordati
EUSA Pharma
12/3/21
€750M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Aquisition price of 750 million euros reflects enterprise value of EUSA Pharma
Blueprint Medicines
Lengo Therapeutics
11/29/21
$250M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
Goldman Sachs, Centerview Partners
Legal advisors:
Goodwin Procter; Cooley
Additional consideration:
Conditional milestone payments worth up to $215 million
Twist Biosciences
Abveris
11/22/21
$150M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
Edgemont Partners
Legal advisors:
Nutter, McClennen & Fish
Additional consideration:
Conditional payments worth up to $50 million in cash and Twist common stock
Vifor
Sanifit
11/22/21
€205M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Conditional milestone payments worth up to 170 million euros
Novo Nordisk
Dicerna
11/18/21
$3,300M
$38.25
80%
Therapeutic focus:
Other
Financial advisors:
Evercore
Legal advisors:
Davis Polk & Wardwell
Organon
Forendo Pharma
11/11/21
$75M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Debt and conditional milestone payments worth up to $879 million
Supernus Pharmaceuticals
Adamas Pharmaceuticals
10/11/21
$400M
$8.10
76%
Therapeutic focus:
CNS
Financial advisors:
Jefferies, Lazard
Legal advisors:
Saul Ewing Arnstein & Lehr; Cooley
Additional consideration:
Contingent value rights worth $1 per share
Pacira Biosciences
Flexion Therapeutics
10/11/21
$425M
$8.50
47%
Therapeutic focus:
CNS
Financial advisors:
J.P. Morgan, Lazard, Goldman Sachs
Legal advisors:
Cooley; Perkins Cole
Additional consideration:
Contingent value right worth $8 per share
Merck & Co.
Acceleron
9/30/21
$11,500M
$180.00
3%
Therapeutic focus:
Rare
Financial advisors:
Credit Suisse, Goldman Sachs, Centerview Partners, J.P. Morgan Securities
Legal advisors:
Covington & Burling; Gibson, Dunn & Crutcher; Ropes & Gray
AstraZeneca
Caelum Biosciences
9/29/21
$150M
N/A
N/A
Therapeutic focus:
Rare
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Conditional milestone payments worth up to $350 million
Hikma Pharmaceuticals
Custopharm
9/27/21
$375M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Conditional milestone payments worth $50 million
Grifols
Biotest
9/17/21
€1,086M
€43.00
23%
Therapeutic focus:
Other
Financial advisors:
Nomura Securities International, UBS Europe
Legal advisors:
Osborne Clarke Spain Germany and UK; Proskauer Rose
Additional consideration:
Grifols to acquire Tiancheng Pharmaceutical Holdings’ stake in Biotest, representing 90% of Biotest ordinary shares and 1% of preferred shares.
Sanofi
Kadmon Holdings
9/8/21
$1,900M
$9.50
79%
Therapeutic focus:
Other
Financial advisors:
Cantor Fitzgerald, Moelis & Company
Legal advisors:
Weil, Gotshal & Manges; DLA Piper
Pfizer
Trillium Therapeutics
8/23/21
$2,260M
$18.50
204%
Therapeutic focus:
Cancer
Financial advisors:
Bank of America, Centerview Partners
Legal advisors:
Ropes & Gray; Norton Rose Fulbright Canada; Goodwin Procter; Baker McKenzie
Bayer
Vividion Therapeutics
8/5/21
$1,500M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
Credit Suisse, Centerview Partners
Legal advisors:
Baker McKenzie; Cooley
Additional consideration:
Conditional milestone payments worth up to $500 million
Sanofi
Translate Bio
8/3/21
$3,200M
$38.00
30%
Therapeutic focus:
Other
Financial advisors:
Morgan Stanley, Centerview Partners, Evercore, MTS Health Partners
Legal advisors:
Weil, Gotshal & Manges; Paul, Weiss, Rifkind, Wharton & Garrison
Amgen
TeneoBio
7/27/21
$900M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
Goldman Sachs
Legal advisors:
Latham & Watkins; Gunderson Dettmer Stough Villeneuve Franklin & Hachigian
Additional consideration:
Conditional milestone payments worth up to $1.6 billion
UniQure
Corlieve Therapeutics
6/22/21
€46M
N/A
N/A
Therapeutic focus:
CNS
Financial advisors:
SVB Leerink
Legal advisors:
Morgan Lewis; McDermott, Will & Emery
Additional consideration:
Conditional milestone payments worth up to 204 million euros
MorphoSys
Constellation Pharma
6/2/21
$1,700M
$34.00
68%
Therapeutic focus:
Cancer
Financial advisors:
Goldman Sachs, Centerview Partners
Legal advisors:
Skadden, Arps, Slate, Meagher & Flom; Wachtell, Lipton, Rosen & Katz
Xeris Pharmaceuticals
Strongbridge BioPharma
5/24/21
$267M
$2.72
13%
Therapeutic focus:
Rare
Financial advisors:
SVB Leerink, MTS Health Partners
Legal advisors:
Goodwin Proctor; A&L Goodbody; Skadden, Arthur & Cox
Additional consideration:
Contingent value right worth $1.00 per share
Relay Therapeutics
ZebiAI
4/16/21
$85M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Conditional milestone payments worth up to $85 million
Sanofi
Tidal Therapeutics
4/9/21
$160M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Conditional milestone payments worth up to $310 million
Amgen
Rodeo Therapeutics
3/30/21
$55M
N/A
N/A
Therapeutic focus:
Immune
Financial advisors:
N/A
Legal advisors:
Cooley, Gundersen Dettmer
Additional consideration:
Conditional milestone payments worth up to $666 million
Amgen
Five Prime Therapeutics
3/4/21
$1,900M
$38.00
79%
Therapeutic focus:
Cancer
Financial advisors:
Goldman Sachs, Lazard
Legal advisors:
Sullivan & Cromwell; Cooley
Merck & Co.
Pandion Therapeutics
2/25/21
$1,850M
$60.00
134%
Therapeutic focus:
Immune
Financial advisors:
Credit Suisse, Centerview Partners
Legal advisors:
Covington & Burling; Skadden, Arps, Slate, Meagher & Flom
Beam Therapeutics
Guide Therapeutics
2/23/21
$120M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Conditional “technology and product success” milestones worth up to $320 million
Jazz Pharmaceuticals
GW Pharma
2/3/21
$7,200M
$220.00
50%
Therapeutic focus:
Rare
Financial advisors:
Evercore, Guggenheim Securities, Bank of America, J.P. Morgan, Goldman Sachs, Centerview Partners
Legal advisors:
Watchell, Lipton, Rosen & Katz; Macfarlanes; Arthur Cox; Cravath, Swaine & Moore; Slaughter and May
Horizon Pharmaceuticals
Viela Bio
2/1/21
$3,050M
$53.00
53%
Therapeutic focus:
Rare
Financial advisors:
Morgan Stanley, Goldman Sachs
Legal advisors:
Cooley; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo
Sanofi
Kymab
1/11/21
$1,100M
N/A
N/A
Therapeutic focus:
Immune
Financial advisors:
J.P. Morgan
Legal advisors:
Weil, Gotshal & Manges; Goodwin Proctor
Additional consideration:
Conditional milestone payments worth up to $350 million
Chimerix
Oncoceutics
1/8/21
$78M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
Evercore
Legal advisors:
Cooley; Morgan Lewis
Additional consideration:
Conditional milestone payments worth up to $360 million
Angelini Pharma
Arvelle Therapeutics
1/4/21
$610M
N/A
N/A
Therapeutic focus:
CNS
Financial advisors:
Centerview Partners
Legal advisors:
Sidley Austin; NautaDutih; White & Case
Additional consideration:
Conditional milestone payments worth up to $350 milion
Novartis
Cadent Therapeutics
12/17/20
$210M
N/A
N/A
Therapeutic focus:
CNS
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Conditional milestone payments worth up to $560 million
Eli Lilly
Prevail Therapeutics
12/15/20
$880M
$22.50
80%
Therapeutic focus:
CNS
Financial advisors:
Lazard, Centerview Partners
Legal advisors:
Weil, Gotshal & Manges; Ropes & Gray; Cooley
Additional consideration:
Contingent value right worth $4.00 per share
AstraZeneca
Alexion Pharmaceuticals
12/12/20
$39,000M
$175.00
45%
Therapeutic focus:
Rare
Financial advisors:
Evercore, Centerview Partners, Ondra, Morgan Stanley, J.P. Morgan, Goldman Sachs, Bank of America
Legal advisors:
Freshfields Bruckhaus Deringer; Wachtell, Lipton, Rosen & Katz
Gilead
Myr Pharmaceuticals
12/10/20
$1,200M
N/A
N/A
Therapeutic focus:
Infectious
Financial advisors:
Goldman Sachs, UBS
Legal advisors:
Gibson, Dunn & Crutcher; Mayer Brown; Flick Gocke Schaumburg; Freshfield Bruckhaus Deringer
Additional consideration:
Conditional milestone payments worth up to $360 million
Sumitomo Dainippon
Urovant
11/13/20
$584M
$16.25
N/A
Therapeutic focus:
Other
Financial advisors:
Citi, Lazard
Legal advisors:
O’Melveny & Myers; Jones Day
Merck & Co.
VelosBio
11/5/20
$2,750M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
J.P. Morgan, Centerview Partners
Legal advisors:
Gibson, Dunn & Crutcher; Cooley
Sanofi
Kiadis Pharma
11/2/20
€308M
€5.45
272%
Therapeutic focus:
Cancer
Financial advisors:
PJT Partners, Moelis & Co.
Legal advisors:
NautaDutih, Allen and Overy
Bayer
Asklepios Biopharmaceuticals
10/26/20
$2,000M
N/A
N/A
Therapeutic focus:
Rare
Financial advisors:
Credit Suisse, J.P. Morgan
Legal advisors:
Baker McKenzie; Ropes & Gray
Additional consideration:
Conditional milestone payments worth up to $2 billion
Retrophin
Oprhan Technologies
10/22/20
$90M
N/A
N/A
Therapeutic focus:
Rare
Financial advisors:
Barclays, Cantor Fitzgerald
Legal advisors:
Cooley; Hogan Lovells
Additional consideration:
Conditional milestone payments worth up to $427 million
Endo International
Biospecifics
10/19/20
$540M
$88.50
45%
Therapeutic focus:
Other
Financial advisors:
PJT Partners
Legal advisors:
Skadden, Arps, Slate, Meagher & Flom
Bristol Myers Squibb
Myokardia
10/5/20
$13,100M
$225.00
61%
Therapeutic focus:
Other
Financial advisors:
Gordon Dyal, Centerview Partners, Guggenheim Securities
Legal advisors:
Kirkland & Ellis; Goodwin Procter
Covis Group
AMAG Pharma
10/1/20
$647M
$13.75
46%
Therapeutic focus:
Other
Financial advisors:
Goldman Sachs
Legal advisors:
Goodwin Procter; Paul, Weiss, Rifkind, Wharton and Garrison
Roche
Inflazome
9/21/20
€380M
N/A
N/A
Therapeutic focus:
Immune
Financial advisors:
Lazard
Legal advisors:
Goodwin Procter; Byrne Wallace
Additional consideration:
Unspecified conditional milestone payments
Gilead
Immunomedics
9/13/20
$21,000M
$88.00
108%
Therapeutic focus:
Cancer
Financial advisors:
Lazard, Morgan Stanley, Centerview Partners, Bank of America, Cowen
Legal advisors:
Davis Polk & Wardwell; Watchell, Lipton, Rosen & Katz
Nestle
Aimmune Therapeutics
8/31/20
$2,160M
$34.50
174%
Therapeutic focus:
Other
Financial advisors:
J.P. Morgan, Lazard
Legal advisors:
Latham & Watkins
Ionis Pharmaceuticals
Akcea Therapeutics
8/31/20
$500M
$18.15
60%
Therapeutic focus:
Rare
Financial advisors:
Goldman Sachs, Stifel, Nicolaus & Company, Cowen
Legal advisors:
Skadden, Arps, Slate, Meagher & Flom; Ropes & Gray
Acadia Pharmaceuticals
CerSci Therapeutics
8/25/20
$53M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
Bank of America, Evercore
Legal advisors:
Paul Hastings; Skadden, Arps, Slate, Meagher & Flom
Additional consideration:
Conditional milestone payments worth up to $887 million
Johnson & Johnson
Momenta Pharmaceuticals
8/19/20
$6,500M
$52.50
70%
Therapeutic focus:
Immune
Financial advisors:
Goldman Sachs, Centerview Partners
Legal advisors:
Latham & Watkins; Skadden, Arps, Slate, Meagher & Flom
Sanofi
Principia Biopharma
8/17/20
$3,680M
$100.00
10%
Therapeutic focus:
Immune
Financial advisors:
Evercore, Centerview Partners, Bank of America
Legal advisors:
Weil, Gotshal & Manges; Cooley
Bayer
KaNDy Therapeutics
8/11/20
$425M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
Morgan Stanley, Goldman Sachs
Legal advisors:
Linklaters; Goodwin Procter
Additional consideration:
Conditional milestone payments worth up to $450 million
Ligand Pharmaceuticals
Pfenex
8/10/20
$438M
$12.00
57%
Therapeutic focus:
Other
Financial advisors:
William Blair, Barclays
Legal advisors:
Wilson Sonsini Goodrich & Rosati; Latham & Watkins
Additional consideration:
Contingent value right worth $2.00 per share
Novo Nordisk
Corvidia Therapeutics
6/11/20
$725M
N/A
N/A
Therapeutic focus:
Immune
Financial advisors:
J.P. Morgan
Legal advisors:
Davis Polk & Wardwell; Goodwin Procter
Additional consideration:
Conditional milestone payments worth up to $1.375 billion
UCB
Engage Therapeutics
6/5/20
$125M
N/A
N/A
Therapeutic focus:
Rare
Financial advisors:
Lazard, BMO Capital Markets
Legal advisors:
Covington & Burling; Morgan, Lewis & Brockius
Additional consideration:
Conditional milestone payments worth up to $145 million
Alexion Pharmaceuticals
Portola Pharmaceuticals
5/5/20
$1,440M
$18.00
132%
Therapeutic focus:
Other
Financial advisors:
RBC Capital Markets, Centerview Partners
Legal advisors:
Cooley
Menarini Group
Stemline Therapeutics
5/4/20
$677M
$11.50
163%
Therapeutic focus:
Cancer
Financial advisors:
Goldman, PJT Partners, Bank of America
Legal advisors:
Fried, Frank, Harris, Shriver & Jacobson; Skadden, Arps, Slate, Meagher & Flom; Alston & Bird
Additional consideration:
Contingent value right worth $1.00 per share
Gilead
Forty Seven
3/2/20
$4,900M
$95.50
81%
Therapeutic focus:
Cancer
Financial advisors:
Citi, J.P. Morgan, Centerview Partners
Legal advisors:
Skadden, Arps, Slate, Meagher & Flom; Cooley
BioNTech
Neon Therapeutics
1/16/20
$67M
$2.18
77%
Therapeutic focus:
Cancer
Financial advisors:
Ondra Partners
Legal advisors:
Covington & Burling; Goodwin Procter
Eli Lilly
Dermira
1/10/20
$1,100M
$18.75
2%
Therapeutic focus:
Immune
Financial advisors:
Evercore, Citi, SVB Leerink
Legal advisors:
Weil, Gotshal & Manges; Fenwick & West
Sanofi
Synthorx
12/9/19
$2,500M
$68.00
172%
Therapeutic focus:
Cancer
Financial advisors:
Morgan Stanley, Centerview Partners
Legal advisors:
Weill, Gotshal & Manges; Cooley
Merck & Co.
ArQule
12/9/19
$2,700M
$20.00
107%
Therapeutic focus:
Cancer
Financial advisors:
Bank of America, Centerview Partners
Legal advisors:
Covington & Burling; Skadden, Arps, Slate, Meagher & Flom
Astellas Pharma
Audentes Therapeutics
12/2/19
$3,000M
$60.00
110%
Therapeutic focus:
Rare
Financial advisors:
Morgan Stanley, Centerview Partners
Legal advisors:
Covington & Burling; Fenwick & West
Novartis
The Medicines Co.
11/24/19
$9,700M
$85.00
24%
Therapeutic focus:
Other
Financial advisors:
Goldman Sachs, J.P. Morgan
Legal advisors:
Paul, Weiss, Rifkind, Wharton & Garrison
Alkermes
Rodin Therapeutics
11/18/19
$100M
N/A
N/A
Therapeutic focus:
CNS
Financial advisors:
N/A
Legal advisors:
WilmerHale; Goodwin Procter
Additional consideration:
Conditional milestone payments worth up to $850 million
Roche
Promedior
11/15/19
$390M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
Goodwin
Additional consideration:
Conditional milestone payments worth up to $1 billion
Alexion Pharmaceuticals
Achillion Pharmaceuticals
10/16/19
$930M
$6.30
73%
Therapeutic focus:
Immune
Financial advisors:
Centerview Partners
Legal advisors:
Skadden, Arps, Slate, Meagher & Flom
Additional consideration:
Contingent value right worth $2.00 per share
UCB
Ra Pharma
10/10/19
$2,100M
$48.00
111%
Therapeutic focus:
Rare
Financial advisors:
Bank of America, Lazard, Centerview Partners
Legal advisors:
Covington & Burling; Latham & Watkins
Swedish Orphan Biovitrum (Sobi)
Dova Pharmaceuticals
9/30/19
$868M
$27.50
36%
Therapeutic focus:
Other
Financial advisors:
Morgan Stanley
Legal advisors:
Cravath, Swaine & Moore; Mannheimer Swartling Advokatbyrå
Additional consideration:
Contingent value right worth $1.50 per share
Lundbeck
Alder Biopharmaceutical
9/16/19
$2,000M
$18.00
79%
Therapeutic focus:
CNS
Financial advisors:
MTS Health Partners, PJT Partners, Centerview Partners
Legal advisors:
Skadden, Arps, Slate, Meagher & Flom; Baker McKenzie; Cooley
Additional consideration:
Contingent value right worth $2.00 per share
Vertex
Semma Therapeutics
9/3/19
$950M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Amgen
Otezla
8/26/19
$13,400M
N/A
N/A
Therapeutic focus:
Immune
Financial advisors:
Dyal, Goldman Sachs
Legal advisors:
Sullivan & Cromwell
Zogenix
Modis Therapeutics
8/26/19
$250M
N/A
N/A
Therapeutic focus:
Rare
Financial advisors:
SVB Leerink
Legal advisors:
Lantham & Watkins; Fenwick & West
Additional consideration:
Conditional milestone paymnets worth up to $150 million
Bayer
Bluerock Therapeutics
8/8/19
$240M
N/A
N/A
Therapeutic focus:
CNS
Financial advisors:
N/A
Legal advisors:
Orrick
Additional consideration:
Conditional milestone payments worth up to $360 million
AbbVie
Allergan
6/25/19
$63,000M
$120.30
45%
Therapeutic focus:
Other
Financial advisors:
Morgan Stanley, PJT Partners, J.P. Morgan
Legal advisors:
Kirkland & Ellis; McCann FitzGerald; Wachtell, Lipton, Rosen & Katz and Arthur Cox
Pfizer
Array Biopharma
6/17/19
$11,400M
$48.00
62%
Therapeutic focus:
Cancer
Financial advisors:
Guggenheim Securities, Morgan Stanley, Centerview Partners
Legal advisors:
Wachtell, Lipton, Rosen & Katz; Skadden, Arps, Slate, Meagher & Flom
Vertex
Exonics
6/6/19
$245M
N/A
N/A
Therapeutic focus:
CNS
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Conditional milestone payments worth approximately $755 million
Merck & Co.
Peloton Therapeutics
5/21/19
$1,050M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
Credit Suisse, Centerview Partners
Legal advisors:
Covington & Burling; Wilson, Sonsini, Goodrich & Rosati
Additional consideration:
Conditional milestone payments worth up to $1.15 billion
Pfizer
Therachon Holding
5/8/19
$340M
N/A
N/A
Therapeutic focus:
Rare
Financial advisors:
Goldman Sachs
Legal advisors:
Cooley; Homburger; Arnold & Porter; Lenz & Staehelin
Additional consideration:
Conditional milestone payments worth up to $470 million
Novartis
Xiidra
5/8/19
$3,400M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
Evercore
Legal advisors:
Davis, Polk & Wardwell
Additional consideration:
Conditional milestone payments worth up to $1.9 billion
Lundbeck
Abide Therapeutics
5/6/19
$250M
N/A
N/A
Therapeutic focus:
CNS
Financial advisors:
Credit Suisse, Bank of America
Legal advisors:
Baker McKenzie; Goodwin Proctor
Additional consideration:
Conditional milestone payments of worth to $150 million
Novartis
IFM Tre
4/1/19
$310M
N/A
N/A
Therapeutic focus:
Immune
Financial advisors:
N/A
Legal advisors:
Hogan Lovells
Additional consideration:
Conditional milestone payments of worth to $1.265 billion
Biogen
Nightstar Therapeutics
3/4/19
$800M
$25.50
68%
Therapeutic focus:
Rare
Financial advisors:
Goldman Sachs, Centerview Partners
Legal advisors:
Ropes & Gray; Skadden, Arps, Slate, Meagher & Flom
Sarepta Therapeutics
Myonexus Therapeutics
2/27/19
$165M
N/A
N/A
Therapeutic focus:
CNS
Financial advisors:
William Blair
Legal advisors:
Thompson Hine; Fenwick & West
Roche
Spark Therapeutics
2/25/19
$4,800M
$114.50
122%
Therapeutic focus:
Rare
Financial advisors:
Citi, Centerview Partners, Cowen
Legal advisors:
Davis Polk & Wardwell; Goodwin Proctor
Ipsen
Clementia Pharmaceuticals
2/25/19
$1,040M
$25.00
67%
Therapeutic focus:
Rare
Financial advisors:
Centerview Partners, Morgan Stanley
Legal advisors:
Goodwin Proctor; Davies, Ward, Phillips & Vineberg; Davies; Skadden, Arps, Slate, Meagher & Flom; Stikeman Elliott
Additional consideration:
Contingent value right worth $6.00 per share
Merck & Co.
Immune Design
2/21/19
$300M
$5.85
312%
Therapeutic focus:
Cancer
Financial advisors:
Credit Suisse, Lazard
Legal advisors:
Gibson, Dunn & Crutcher; Cooley
Eli Lilly
Loxo Oncology
1/7/19
$8,000M
$235.00
68%
Therapeutic focus:
Cancer
Financial advisors:
Deustche Bank, Goldman Sachs
Legal advisors:
Weil, Gotshal & Manges; Fenwick & West
Bristol Myers Squibb
Celgene
1/3/19
$74,000M
$102.43
54%
Therapeutic focus:
Cancer
Financial advisors:
Morgan Stanley, Citi, Evercore, Dyal, J.P. Morgan
Legal advisors:
Kirkland & Ellis; Wachtell, Lipton, Rosen & Katz
Additional consideration:
Contingent value right worth $9.00 per share (terminated)
GlaxoSmithKline
Tesaro
12/3/18
$5,100M
$75.00
62%
Therapeutic focus:
Cancer
Financial advisors:
PJT Parners, Bank of America, Citi, Centerview Partners
Legal advisors:
Shearman & Sterling; Slaughter and May; Hogan Lovells; Ropes & Gray
Roche
Jecure Therapeutics
11/27/18
CHF150M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Novartis
Endocyte
10/18/18
$2,100M
$24.00
54%
Therapeutic focus:
Cancer
Financial advisors:
Centerview Partners, Jefferies
Legal advisors:
Faegre Baker Daniels
Roche
Tusk Therapeutics
9/27/18
€70M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
N/A
Legal advisors:
N/A
Additional consideration:
Conditional milestone payments worth up to 585 million euros
Alexion Pharmaceuticals
Syntimmune
9/26/18
$400M
N/A
N/A
Therapeutic focus:
Immune
Financial advisors:
N/A
Legal advisors:
Foley Hoag; Goodwin Proctor; Sullivan & Cromwell
Additional consideration:
Conditional milestone payments worth up to $800 million
Amicus Therapeutics
Celenex
9/20/18
$100M
N/A
N/A
Therapeutic focus:
Rare
Financial advisors:
RBC
Legal advisors:
Skadden, Arps, Slate, Meagher & Flom; Fenwick & West
Additional consideration:
Conditional milestone payments worth up to $352 million
Boehringer Ingelheim
ViraTherapeutics
9/13/18
$210M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
N/A
Legal advisors:
Gleiss Lutz
Additional consideration:
The total transaction value is based on an option and share purchase agreement signed in August 2016
Emergent Biosolutions
Adapt Pharma
8/28/18
$635M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
Morgan Stanley, Bank of America
Legal advisors:
Covington & Burling; Mayer Brown
Additional consideration:
Conditional milestone payments worth up to $100 million
Sangamo Therapeutics
TxCell
7/23/18
$80M
$2.99
177%
Therapeutic focus:
Immune
Financial advisors:
N/A
Legal advisors:
N/A
Otsuka
Visterra
7/11/18
$430M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
N/A
Legal advisors:
N/A
Akebia Therapeutics
Keryx Biopharmaceuticals
6/28/18
$528M
N/A
N/A
Therapeutic focus:
Other
Financial advisors:
MTS Health, Evercore, J.P. Morgan Perella Weinberg Partners
Legal advisors:
Lantham & Watkins; Goodwin Proctor
Eli Lilly
AurKa Pharma
5/14/18
$110M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
Baird
Legal advisors:
N/A
Eli Lilly
Armo Biosciences
5/10/18
$1,600M
$50.00
68%
Therapeutic focus:
Cancer
Financial advisors:
Credit Suisse, Centerview Partners, Jefferies
Legal advisors:
Wachtell, Lipton, Rosen & Katz; Gunderson Dettmer
Takeda
Shire
5/7/18
$62,000M
$30.33
27%
Therapeutic focus:
Rare
Financial advisors:
Evercore, JP Morgan, Nomura, Goldman Sachs, Citi, Morgan Stanley
Legal advisors:
Linklaters; Nishimura & Asahi; Ogier; Slaughter and May; Davis, Polk & Wardwell; Nagashima Ohno & Tsunematsu; Mourant Ozannes
Johnson & Johnson
BeneVir Biopharm
5/2/18
$140M
N/A
N/A
Therapeutic focus:
Cancer
Financial advisors:
N/A
Legal advisors:
N/A
United Therapeutics
SteadyMed
4/30/18
$141M
$4.46
68%
Therapeutic focus:
Rare
Financial advisors:
Wedbush PacGrow
Legal advisors:
Gibson, Dunn & Crutcher; Herzog, Fox & Neeman; Cooley; Yigal Arnon & Co.
Additional consideration:
Conditional milestone payment worth $2.63 per share, or a total of $75 million
Alexion Pharmaceuticals
Wilson Therapeutics
4/11/18
$855M
$28.00
N/A
Therapeutic focus:
Rare
Financial advisors:
Bank of America, Deutsche Bank, DNB Markets, Lazard
Legal advisors:
Advokatfirman Cederquist; Ropes & Gray; Vinge
Novartis
AveXis
4/9/18
$8,700M
$218.00
88%
Therapeutic focus:
CNS
Financial advisors:
Goldman Sachs, Centerview Partners, Dyal
Legal advisors:
Cravath, Swaine and Moore; Cooley
Merck & Co.
Viralytics
2/21/18
$394M
$1.37
185%
Therapeutic focus:
Cancer
Financial advisors:
Credit Suisse, Lazard
Legal advisors:
Baker & McKenzie; McCullough Robertson
SeaGen
Cascadian Therapeutics
1/31/18
$614M
$10.00
69%
Therapeutic focus:
Cancer
Financial advisors:
Leerink Partners, Barclays, J.P. Morgan Perella Weinberg Partners
Legal advisors:
Sullivan & Cromwell; Reed Smith; Goodwin Procter
Sanofi
Ablynx
1/29/18
$4,800M
$56.00
21%
Therapeutic focus:
Rare
Financial advisors:
Lazard, J.P. Morgan, Morgan Stanley
Legal advisors:
Weil, Gotshal & Manges; NautaDutilh; Eubelius CVBA; Goodwin Procter; Linklaters
Sanofi
Bioverativ
1/22/18
$11,600M
$105.00
64%
Therapeutic focus:
Rare
Financial advisors:
Lazard, Guggenheim Securities, J.P. Morgan
Legal advisors:
Weil, Gotshal & Manges; Paul, Weiss, Rifkind, Wharton & Garrison
Celgene
Juno Therapeutics
1/22/18
$9,000M
$87.00
29%
Therapeutic focus:
Cancer
Financial advisors:
J.P. Morgan, Morgan Stanley
Legal advisors:
Proskauer Rose; Hogan Lovells; Skadden, Arps, Slate, Meagher and Flom
Takeda
TiGenix
1/4/18
€520M
€1.78
82%
Therapeutic focus:
Other
Financial advisors:
Centerview Partners, Cowen & Co.
Legal advisors:
Osborne Clarke CVBA; Davis, Polk & Wardwell; DLA Piper
*Premiums are calculated from the closing price of the acquired company’s shares on the previous trading day.

Belite Bio, small, under-the-radar drugmaker, emerges as one of biotech’s best performing IPOs

 Biotechnology startups are under pressure. After years of plentiful funding, few young drug companies are going public, and those that do are struggling to hold onto their value in a market downturn that’s forcing biotech executives and their venture backers to adjust.

One notable outlier is Belite Bio, an under-the-radar biotech incorporated in the Cayman Islands and controlled by a Taiwanese drug company. Since Belite raised $36 million via a small initial public offering in April, shares in the company have soared by almost 500% in value — the best performance of any biotech to go public in the U.S. over the past two years that still remains independent.

The share price jump means Belite is now valued at $835 million, more than better-known drugmakers like Agenus and Sangamo Therapeutics and Century Therapeutics. Its market capitalization is almost two-thirds that of Verve Therapeutics, the buzzy gene editing company.

As with most new drug companies, Belite’s medicines are experimental and unproven. But it’s further along than many newly public biotechs, with an eye disease treatment in late-stage clinical testing — an advantage Belite’s CFO Hao-Yuan Chuang said has helped its market debut. By comparison, two-thirds of biotechs that went public over the last two years had drugs either in preclinical or Phase 1 trials.

“We wouldn’t choose to go for an IPO unless we had good clinical trial data,” said Chuang.

Belite’s lead drug candidate, dubbed LBS-008, was first studied at Columbia University over a decade ago. An oral medicine, LBS-008 is designed to reduce accumulation of toxic vitamin A byproducts in the eye. Belite thinks it could treat Stargardt disease, a genetic disorder that causes progressive vision loss, as well as the more common dry age-related macular degeneration, or AMD.

The drug was included in a National Institutes of Health program aimed at providing funding for certain medicines, and was put up for bid in 2016. Belite CEO Tom Lin bid on the drug and convinced Columbia he could prove it first in Stargardt disease, and then test it further in dry AMD as well.

At the time Lin was the CEO of Lin BioScience, a Taiwan-listed drugmaker he founded. As the Taiwanese market differs from the U.S., Lin decided to form Belite and incorporate it in the Cayman Islands in 2018. According to Chuang, Belite chose the Cayman Islands because incorporating there gives “more flexibility in terms of adapting listing rule requirements from different stock exchanges.”

Lin BioScience remains Belite’s controlling shareholder through a wholly owned holding company and “was willing to invest in the IPO with the same terms with other investors,” Chuang said.

The IPO was also a way to draw attention to Belite’s pipeline. No treatments currently exist for either Stargardt or the dry form of AMD, and Belite’s medicine is one of a handful being advanced for the conditions.

“If we kept this pipeline only [listed in] Taiwan, first I think the question people will ask is what is the target disease?” Chuang said. “Because [they] probably have not heard about it. But in the Nasdaq market, you have several companies working on that as well.” Chuang says that, due to the competition, investors can better assess the company’s data.

Apellis Pharmaceuticals and Iveric Bio are both developing treatments for geographic atrophy, an advanced form of dry AMD, while Iveric is also testing its lead drug in Stargardt disease. The Food and Drug Administration is currently reviewing Apellis’ treatment for geographic atrophy. Iveric’s prospect is in late-stage trials.

Other biotechs, such as Aequus Pharmaceuticals and reVision Therapeutics, are also working on treatments for Stargardt.

So far, testing has found Belite’s drug to have mild side effects. Data from a Phase 2 trial showed eight of 13 patients gained visual acuity in one eye, two of whom had improvements in their other eye as well. According to Chuang, only Belite has so far been able to show this kind of improvement for Stargardt disease.

Chuang says Belite remains focused on Stargardt and dry AMD to ensure it has enough cash on hand to reach its next milestones.

The company is enrolling a Phase 3 trial for LBS-008 in Stargardt disease and expects to start a second in dry AMD later this year, according to Chuang.

Belite’s shares are currently about $34 each, nearly six times the $6 they were priced at in April.

https://www.biopharmadive.com/news/belite-bio-stargardt-dry-AMD-drugmaker-biotech-best-performing-ipo/628589/

Lilly takes long view on Alzheimer’s drug as FDA starts expedited review

 The Food and Drug Administration has agreed to an expedited review of Eli Lilly’s experimental Alzheimer’s disease medicine donanemab, the pharmaceutical company said Thursday.

The agency’s acceptance of Lilly’s application starts a six month clock, setting up a potential decision from the regulator by early February. Lilly had not previously disclosed completion of the application, which it began submitting last fall but slowed after Medicare finalized a restrictive coverage policy for Alzheimer’s drugs like Lilly’s.

Donanemab is one of several drugs in late-stage clinical testing that are aimed at a protein called amyloid beta, which accumulates in sticky plaques in the brain. Targeting this protein has been the dominant approach toward treating Alzheimer’s for decades, but has yielded a long list of failed drugs and unsuccessful studies.

Last summer, Biogen won a controversial FDA approval for its amyloid-targeting drug Aduhelm, despite contradictory clinical trial evidence it worked. Rather than rule directly on the drug’s impact on cognitive decline in patients with Alzheimer’s, the FDA granted an accelerated approval based on its ability to reduce amyloid levels.

Lilly is applying for a similar accelerated approval. Its application is supported by results from a mid-stage study that showed donanemab substantially cleared out amyloid plaques in the brains of trial participants. Data also suggested a cognitive and functional benefit to treatment, which Lilly is seeking to confirm with a larger Phase 3 study that’s now ongoing.

While approval would be a major milestone for Lilly, the company doesn’t expect significant use of the drug right away due to a coverage policy instituted by the Centers for Medicare and Medicaid Services. Unconvinced by the evidence for Aduhelm, CMS restricted Medicare coverage of the drug, as well other amyloid-target medicines like it, to patients in certain types of clinical trials.

“In the near term, of course, we have to acknowledge that patient access will be very limited under the current CMS [policy] with accelerated approval,” said Anne White, head of Lilly’s neuroscience division, on an earnings call Thursday.

“What we’ll do in the near term, following a potential approval ... is use that time to build out the diagnostic ecosystem, to help physicians with the referral process and infusion systems,” she added.

Should Lilly’s ongoing Phase 3 study succeed, Lilly would be in position to ask the FDA for full approval of donanemab, potentially allowing more favorable coverage under the CMS policy.

“We remain optimistic that with traditional FDA approval, CMS would not continue to limit coverage for on-label treatments,” White said.

In between now and when Lilly’s trial is set to read out early next year, results are expected to become available for two other amyloid-targeting drugs: Eisai and Biogen’s lecanemab, and Roche’s gantenerumab. As the drugs belong to the same family of treatments, those results could influence how analysts and investors view the likelihood of a positive Phase 3 outcome for donanemab.

On Thursday’s call, White sought to set expectations. “There’s a chance that we’ll see mixed results in some of these readouts due to the differences in the medicines and their trial designs,” White said. “We won’t be discouraged if others miss their primary endpoints.”

https://www.biopharmadive.com/news/eli-lilly-donanemab-fda-priority-review-alzheimers/628954/

Drug Price Controls Will Embolden China at Your Expense

 In late July, the Senate passed the $280 billion CHIPS Act to give the semiconductor industry funding to compete with China and protect U.S. national interests. Then, on the same day, Senate Majority Leader Chuck Schumer and Sen. Joe Manchin announced a deal to revive a budget reconciliation bill with drug price controls that, in stark contrast, would help China compete and take market share from the U.S. biopharma industry.

The short supply of microchips and need for broad access to COVID-19 vaccines plainly shows how both the semi-conductor industry and the biopharma industry are critical to U.S. national interests. Yet, there’s not enough discussion on how drug price controls would undermine those interests. This discussion is especially important now that a deal appears to be moving forward after gaining approval from Sen. Kyrsten Sinema.

To help jumpstart that discussion, I coauthored a new report with my colleague John Phelan at Center of the American Experiment which highlights how drug price controls would weaken the U.S. drug industry’s global leadership position and give China the opportunity to control greater market share to advance their national interests. 

The package of price controls in the budget reconciliation bill would require Medicare to set prices for certain high-cost drugs and require drug manufacturers to pay rebates to the federal government when price increases exceed inflation. It uses the term “negotiation,” but it operates as a strict price control. That’s because excessive penalties on drug manufacturers for not negotiating make it a negotiation drug companies can’t refuse. Meanwhile, the inflation rebates impose price controls on nearly all drugs covered by Medicare Part D, as well as brand drugs and biologics covered by Medicare Part B. 

Europe’s drug manufacturing industry used to be the global leader, but this leadership position eroded over the past three decades and the U.S. now stands on top.  Over the most recent five-year period from 2016 to 2020, the U.S. accounted for 138 of the new chemical and biological drug entities, followed by Europe at 64. Twenty years ago, Europe was on top.

The budget reconciliation bill’s strict price controls create a serious risk that the U.S. drug industry might follow in Europe’s footsteps. 

Price controls are regularly cited as one factor behind Europe’s decline. Research shows price controls impact where drug companies decide to locate and invest. By adopting price controls in line with other countries, the U.S. would be giving up this competitive advantage.

Without this competitive advantage, other countries will be positioned to better compete for greater market share and China is possibly best poised to take advantage for several reasons. 

To start, China’s communist government has more power and drive to increase industrial policy spending to support this critical sector. When urging congressional support for the CHIPS Act, Commerce Secretary Gina Raimondo and Defense Secretary Lloyd Austin highlighted how China “has already spent $150 billion on its semiconductor industry.” Likewise, as our report shows, China has prioritized a portion of its industrial policy spending to support the biopharma sector in each of its major industrial policy initiatives since the mid-2000s.

China’s growing share of the global pharmaceutical market also puts it in a stronger position. Domestic markets tend to be easier and less costly to enter, meaning this growing market share will give companies headquartered in China more opportunities to use this domestic advantage.

Finally, China’s active efforts to steal intellectual property from drug companies gives it another ongoing advantage. 

As China gains a control over a greater share of new drugs, it will undoubtedly use that control for diplomatic leverage just as it did with access to COVID vaccines. Last year China pressured several countries to sever ties with Taiwan in return for vaccines and, in December, Nicaragua eventually capitulated.

In gaining successful passage of the Endless Frontier Act through the Senate last year, Senate Majority Leader Chuck Schumer noted, “Whoever harnesses the technologies like AI, quantum computing, and innovations yet unseen, will shape the world in their image.” He then fittingly asked, “Do we want that image to be a democratic image? Or do we want it to be an authoritarian image, like the one [Chinese] President Xi would like to impose on the world?”

That’s exactly the question the U.S. Senate must address as it debates imposing price controls on U.S. drug manufacturers.

Peter J. Nelson is a Senior Policy Fellow at Center of the American Experiment where he focuses his attention on the intersection of state and national health care policy. From late 2017 until 2021, he served as a Senior Advisor to the Administrator at the Centers for Medicare & Medicaid Services (CMS).

https://www.realclearpolicy.com/articles/2022/08/05/drug_price_controls_will_embolden_china_at_your_expense_846562.html

The Corruption of Medicine

 The post–George Floyd racial reckoning has hit the field of medicine like an earthquake. Medical education, medical research, and standards of competence have been upended by two related hypotheses: that systemic racism is responsible both for racial disparities in the demographics of the medical profession and for racial disparities in health outcomes. Questioning those hypotheses is professionally suicidal. Vast sums of public and private research funding are being redirected from basic science to political projects aimed at dismantling white supremacy. The result will be declining quality of medical care and a curtailment of scientific progress.

Virtually every major medical organization—from the American Medical Association (AMA) and the American Association of Medical Colleges (AAMC) to the American Association of Pediatrics—has embraced the idea that medicine is an inequity-producing enterprise. The AMA’s 2021 Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity is virtually indistinguishable from a black studies department’s mission statement. The plan’s anonymous authors seem aware of how radically its rhetoric differs from medicine’s traditional concerns. The preamble notes that “just as the general parlance of a business document varies from that of a physics document, so too is the case for an equity document.” (Such shaky command of usage and grammar characterizes the entire 86-page tome, making the preamble’s boast that “the field of equity has developed a parlance which conveys both [sic] authenticity, precision, and meaning” particularly ironic.)

Thus forewarned, the reader plunges into a thicket of social-justice maxims: physicians must “confront inequities and dismantle white supremacy, racism, and other forms of exclusion and structured oppression, as well as embed racial justice and advance equity within and across all aspects of health systems.” The country needs to pivot “from euphemisms to explicit conversations about power, racism, gender and class oppression, forms of discrimination and exclusion.” (The reader may puzzle over how much more “explicit” current “conversations” about racism can be.) We need to discard “America’s stronghold of false notions of hierarchy of value based on gender, skin color, religion, ability and country of origin, as well as other forms of privilege.”

A key solution to this alleged oppression is identity-based preferences throughout the medical profession. The AMA strategic plan calls for the “just representation of Black, Indigenous and Latinx people in medical school admissions as well as . . . leadership ranks.” The lack of “just representation,” according to the AMA, is due to deliberate “exclusion,” which will end only when we have “prioritize[d] and integrate[d] the voices and ideas of people and communities experiencing great injustice and historically excluded, exploited, and deprived of needed resources such as people of color, women, people with disabilities, LGBTQ+, and those in rural and urban communities alike.”

According to medical and STEM leaders, to be white is to be per se racist; apologies and reparations for that offending trait are now de rigueur. In June 2020, Nature identified itself as one of the culpably “white institutions that is responsible for bias in research and scholarship.” In January 2021, the editor-in-chief of Health Affairs lamented that “our own staff and leadership are overwhelmingly white.” The AMA’s strategic plan blames “white male lawmakers” for America’s systemic racism.

And so medical schools and medical societies are discarding traditional standards of merit in order to alter the demographic characteristics of their profession. That demolition of standards rests on an a priori truth: that there is no academic skills gap between whites and Asians, on the one hand, and blacks and Hispanics, on the other. No proof is needed for this proposition; it is the starting point for any discussion of racial disparities in medical personnel. Therefore, any test or evaluation on which blacks and Hispanics score worse than whites and Asians is biased and should be eliminated.

The U.S. Medical Licensing Exam is a prime offender. At the end of their second year of medical school, students take Step One of the USMLE, which measures knowledge of the body’s anatomical parts, their functioning, and their malfunctioning; topics include biochemistry, physiology, cell biology, pharmacology, and the cardiovascular system. High scores on Step One predict success in a residency; highly sought-after residency programs, such as neurosurgery and radiology, use Step One scores to help select applicants.

Black students are not admitted into competitive residencies at the same rate as whites because their average Step One test scores are a standard deviation below those of whites. Step One has already been modified to try to shrink that gap; it now includes nonscience components such as “communication and interpersonal skills.” But the standard deviation in scores has persisted. In the world of antiracism, that persistence means only one thing: the test is to blame. It is Step One that, in the language of antiracism, “disadvantages” underrepresented minorities, not any lesser degree of medical knowledge.

The Step One exam has a further mark against it. The pressure to score well inhibits minority students from what has become a core component of medical education: antiracism advocacy. A fourth-year Yale medical student describes how the specter of Step One affected his priorities. In his first two years of medical school, the student had “immersed” himself, as he describes it, in a student-led committee focused on diversity, inclusion, and social justice. The student ran a podcast about health disparities. All that political work was made possible by Yale’s pass-fail grading system, which meant that he didn’t feel compelled to put studying ahead of diversity concerns. Then, as he tells it, Step One “reared its ugly head.” Getting an actual grade on an exam might prove to “whoever might have thought it before that I didn’t deserve a seat at Yale as a Black medical student,” the student worried.

The solution to such academic pressure was obvious: abolish Step One grades. Since January 2022, Step One has been graded on a pass-fail basis. The fourth-year Yale student can now go back to his diversity activism, without worrying about what a graded exam might reveal. Whether his future patients will appreciate his chosen focus is unclear.

Every other measure of academic mastery has a disparate impact on blacks and thus is in the crosshairs.

In the third year of medical school, professors grade students on their clinical knowledge in what is known as a Medical Student Performance Evaluation (MSPE). The MSPE uses qualitative categories like Outstanding, Excellent, Very Good, and Good. White students at the University of Washington School of Medicine received higher MSPE ratings than underrepresented minority students from 2010 to 2015, according to a 2019 analysis. The disparity in MSPEs tracked the disparity in Step One scores.

The parallel between MSPE and Step One evaluations might suggest that what is being measured in both cases is real. But the a priori truth holds that no academic skills gap exists. Accordingly, the researchers proposed a national study of medical school grades to identify the actual causes of that racial disparity. The conclusion is foregone: faculty bias. As a Harvard medical student put it in Stat News: “biases are baked into the evaluations of students from marginalized backgrounds.”

A 2022 study of clinical performance scores anticipated that foregone conclusion. Professors from Emory University, Massachusetts General Hospital, and the University of California at San Francisco, among other institutions, analyzed faculty evaluations of internal medicine residents in such areas as medical knowledge and professionalism. On every assessment, black and Hispanic residents were rated lower than white and Asian residents. The researchers hypothesized three possible explanations: bias in faculty assessment, effects of a noninclusive learning environment, or structural inequities in assessment. University of Pennsylvania professor of medicine Stanley Goldfarb tweeted out a fourth possibility: “Could it be [that the minority students] were just less good at being residents?”

Goldfarb had violated the a priori truth. Punishment was immediate. Predictable tweets called him, inter alia, possibly “the most garbage human being I’ve seen with my own eyes,” and Michael S. Parmacek, chair of the University of Pennsylvania’s Department of Medicine, sent a schoolwide e-mail addressing Goldfarb’s “racist statements.” Those statements had evoked “deep pain and anger,” Parmacek wrote. Accordingly, the school would be making its “entire leadership team” available to “support you,” he said. Parmacek took the occasion to reaffirm that doctors must acknowledge “structural racism.”

That same day, the executive vice president of the University of Pennsylvania for the Health System and the senior vice dean for medical education at the University of Pennsylvania medical school reassured faculty, staff, and students via e-mail that Goldfarb was no longer an active faculty member but rather emeritus. The EVP and the SVD affirmed Penn’s efforts to “foster an anti-racist curriculum” and to promote “inclusive excellence.”

Despite the allegations of faculty racism, disparities in academic performance are the predictable outcome of admissions preferences. In 2021, the average score for white applicants on the Medical College Admission Test was in the 71st percentile, meaning that it was equal to or better than 71 percent of all average scores. The average score for black applicants was in the 35th percentile—a full standard deviation below the average white score. The MCATs have already been redesigned to try to reduce this gap; a quarter of the questions now focus on social issues and psychology.

Yet the gap persists. So medical schools use wildly different standards for admitting black and white applicants. From 2013 to 2016, only 8 percent of white college seniors with below-average undergraduate GPAs and below-average MCAT scores were offered a seat in medical school; less than 6 percent of Asian college seniors with those qualifications were offered a seat, according to an analysis by economist Mark Perry. Medical schools regarded those below-average scores as all but disqualifying—except when presented by blacks and Hispanics. Over 56 percent of black college seniors with below-average undergraduate GPAs and below-average MCATs and 31 percent of Hispanic students with those scores were admitted, making a black student in that range more than seven times as likely as a similarly situated white college senior to be admitted to medical school and more than nine times as likely to be admitted as a similarly situated Asian senior.

Such disparate rates of admission hold in every combination and range of GPA and MCAT scores. Contrary to the AMA’s Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity, blacks are not being “excluded” from medical training; they are being catapulted ahead of their less valued white and Asian peers.

Though mediocre MCAT scores keep out few black students, some activists seek to eliminate the MCATs entirely. Admitting less-qualified students to Ph.D. programs in the life sciences will lower the caliber of future researchers and slow scientific advances. But the stakes are higher in medical training, where insufficient knowledge can endanger a life in the here and now. Nevertheless, some medical schools offer early admissions to college sophomores and juniors with no MCAT requirement, hoping to enroll students with, as the Icahn School of Medicine at Mount Sinai puts it, a “strong appreciation of human rights and social justice.” The University of Pennsylvania medical school guarantees admission to black undergraduates who score a modest 1300 on the SAT (on a 1600-point scale), maintain a 3.6 GPA in college, and complete two summers of internship at the school. The school waives its MCAT requirement for these black students; UPenn’s non-preferred medical students score in the top one percent of all MCAT takers.

According to race advocates, differences in MCAT scores must result from test bias. Yet the MCATs, like all beleaguered standardized tests, are constantly scoured for questions that may presume forms of knowledge particular to a class or race. This “cultural bias” chestnut has been an irrelevancy for decades, yet it retains its salience within the anti-test movement. MCAT questions with the largest racial variance in correct answers are removed. External bias examiners, suitably diverse, double-check the work of the internal MCAT reviewers. If, despite this gauntlet of review, bias still lurked in the MCATs, the tests would underpredict the medical school performance of minority students. In fact, they overpredict it—black medical students do worse than their MCATs would predict, as measured by Step One scores and graduation rates. (Such overprediction characterizes the SATs, too.) Nevertheless, expect a growing number of medical schools to forgo the MCATs, in the hope of shutting down the test entirely and thus eliminating a lingering source of objective data on the allegedly phantom academic skills gap.

Meantime, medical professors need to be reeducated, to ensure that their grading and hiring practices do not provide further evidence of the phantom skills gap. Faculty are routinely subjected to workshops in combating their own racism. On May 3, 2022, the Senior Advisor to the NIH Chief Officer for Scientific Workforce Diversity gave a seminar at the University of Pennsylvania medical school titled “Me, Biased? Recognizing and Blocking Bias.” Senior Advisor Charlene Le Fauve’s mandate at NIH is to “promote diversity, inclusiveness, and equity in the biomedical research enterprise through evidence-based approaches.” Yet her presentation rested heavily on a supposed measure of bias that evidence has discredited: the Implicit Association Test (IAT).The IAT’s own creators have acknowledged that it lacks validity and reliability as a psychometric tool.

Increasing amounts of faculty time are spent on such antiracism activities. On May 16, 2022, the Anti-Racism Program Manager at the David Geffen School of Medicine at the University of California at Los Angeles hosted a presentation from the Director of Strategy and Equity Education Programs at the Icahn School of Medicine at Mount Sinai titled “Anti-Racist Transformation in Medical Education.” Mount Sinai’s Dean for Medical Education and a medical student joined Mount Sinai’s Director of Strategy and Equity Education Programs for the Los Angeles presentation, since spreading the diversity message apparently takes precedence over academic obligations in New York.

Grand rounds is a century-long tradition for passing on the latest medical breakthroughs. (Thomas Eakins’s great 1889 canvas, The Agnew Clinic, portrays an early grand rounds at the University of Pennsylvania.) Rounds are now a conduit for antiracism reeducation. On May 12, 2022, the Vice Chair for Diversity and Inclusion at the University of Pittsburgh’s Department of Medicine gave a grand rounds at the Cleveland Clinic on the topic “In the Absence of Equity: A Look into the Future.” Afterward, attendees would be expected to describe “exclusion from a historical context” and the effects of “hierarchy on health outcomes”; attendance would confer academic credit toward doctors’ continuing-education obligations.

The medical school curriculum itself needs to be changed to lessen the gap between the academic performance of whites and Asians, on the one hand, and blacks and Hispanics, on the other. Doing so entails replacing pure science courses with credit-bearing advocacy training. More than half of the top 50 medical schools recently surveyed by the Legal Insurrection Foundation required courses in systemic racism. That number will increase after the AAMC’s new guidelines for what medical students and faculty should know transform the curriculum further.

According to the AAMC, newly minted doctors must display “knowledge of the intersectionality of a patient’s multiple identities and how each identity may present varied and multiple forms of oppression or privilege related to clinical decisions and practice.” Faculty are responsible for teaching how to engage with “systems of power, privilege, and oppression” in order to “disrupt oppressive practices.” Failure to comply with these requirements could put a medical school’s accreditation status at risk and lead to a school’s closure.

Mandatory instruction in such politicized concepts will help diversify the faculty and administration—for who better to teach about oppression than a person of color? (Part of the appeal of diversity trainings and bureaucracy, whether in academia or the corporate world, lies in the creation of new employment slots dedicated to diversity activities, which can be filled without as great a sacrifice of meritocratic standards.) But being indoctrinated in “intersectionality” does nothing to improve a student’s clinical knowledge. Every moment spent regurgitating social-justice jargon is time not spent learning how to keep someone alive whose body has just been shattered in a car crash. Advocates of antiracism training never explain how fluency in intersectional critique improves the interpretation of an MRI or the proper prescribing of drugs.

The academic skills gap, confirmed in every measure of knowledge before and during medical school, does not close over the course of medical training, despite remedial instruction. Yet the lower representation of blacks throughout the medical profession is solely attributed to racism on the part of the profession’s gatekeepers. Nature accused itself of denying a “space and a platform” to black researchers, without naming any such researchers against whom it had discriminated or any editor who had done the discriminating. In April 2022, the Institute for Scientific Information decried the fact that the proportion of black authors in medical research did not match U.S. census data on the population at large. Black representation had not improved between 2010 and 2020, lamented the institute. If white supremacy lay behind that lack of progress, it was a mystery why the proportion of published Asian researchers over the same decade had outstripped Asian population changes.

Despite the persistent academic skills gap, a minority hiring surge is under way. Many medical schools require that faculty search committees contain a quota of minority members, that they be overseen by a diversity bureaucrat, and that they interview a specified number of minority candidates. One would have to be particularly dense not to grasp the expected result. In recent years, the Memorial Sloan Kettering Cancer Center, the Cleveland Clinic Taussig Cancer Center, the Uniformed Services University of the Health Sciences, the University of Chicago Cancer Center, the University of Pittsburgh Division of Medical Oncology, the Massey Cancer Center at Virginia Commonwealth University, the University of Miami Miller School of Medicine, and the Department of Medicine at UCLA’s medical school have hired black leaders.

These candidates may all have been the most qualified, but the explicit calls for diversity in medical administration inevitably cast a pall on such selections. In at least one case, the runner-up possessed a research and leadership record that far surpassed that of the winning candidate. But he lacked the favored demographic characteristics.

It matters who heads research ventures and medical faculties. Top scientists can identify the most promising directions of study and organize the most productive research teams. But the diversity push is discouraging some scientists from competing at all. When the chairmanship of UCLA’s Department of Medicine opened up, some qualified faculty members did not even put their names forward because they did not think that they would be considered, according to an observer.

College seniors, deciding whether to apply to medical school, can also read the writing on the wall. A physician-scientist reports that his best lab technician in 30 years was a recent Yale graduate with a B.S. in molecular biology and biochemistry. The former student was intellectually involved and an expert in cloning. His college GPA and MCAT scores were high. The physician-scientist recommended the student to the dean of Northwestern’s medical school (where the scientist then worked), but the student did not get so much as an interview. In fact, this “white, clean-cut Catholic,” in the words of his former employer, was admitted to only one medical school.

Such stories are rife. A UCLA doctor says that the smartest undergraduates in the school’s science labs are saying: “Now that I see what is happening in medicine, I will do something else.”

Funding that once went to scientific research is now being redirected to diversity cultivation. The NIH and the National Science Foundation are diverting billions in taxpayer dollars from trying to cure Alzheimer’s disease and lymphoma to fighting white privilege and cisheteronormativity. Private research support is following the same trajectory. The Howard Hughes Medical Institute is one of the world’s largest philanthropic funders of basic science and arguably the most prestigious. Airline entrepreneur Howard Hughes created the institute in 1953 to probe into the “genesis of life itself.” Now diversity in medical research is at the top of HHMI’s concerns. In May 2022, it announced a $1.5 billion effort to cultivate scientists committed to running a “happy and diverse lab where minoritized scientists will thrive and persist,” in the words of the institute’s vice president. “Experts” in diversity and inclusion will assess early-career academic scientists based on their plans for running “happy and diverse” labs. Those applicants with the most persuasive “happy lab” plans could receive one of the new Freeman Hrabowski scholarships. The scholarships would cover the recipient’s university salary for ten years and would bring the equivalent of two or three NIH grants a year into his academic department. If an applicant’s “happy lab” plan fails to ignite enthusiasm in the diversity reviewers, however, his application will be shelved, no matter how promising his actual scientific research.

The HHMI program and others like it amplify the message that doing basic science, if you are white or Asian, is not particularly valued by the STEM establishment. How many scientific breakthroughs will be forgone by such signals is incalculable.

The leaders of today’s medical schools, professional organizations, and scientific journals would reject the foregoing critique. Teaching racial justice concepts and advocacy is not a swerve from medicine’s core competencies and obligations, they would argue; it is the highest fulfillment of those obligations. Racial disparities in health, they would say, are the biggest medical challenge of our time, and they are a social, not a scientific, problem. If blacks have higher rates of mortality and disease, it is because systematic racism confronts them at every turn. Changing the demographics of the medical profession is essential to eliminating the sometimes-lethal racism that black patients encounter in health care. Changing the profession’s awareness of its own biases is also key to achieving medical equity. And changing the orientation of medical research—away from basic science and toward race theory—simply moves medicine to where it can be most effective.

And here we encounter a second a priori truth: health disparities are the product of systemic racism; any other explanation is taboo and will be ruthlessly punished.

On February 24, 2021, Ed Livingston, deputy editor for clinical reviews and education at the Journal of the American Medical Association (JAMA), recorded a podcast with Mitch Katz, president of New York City Health and Hospitals, called “Structural Racism for Doctors—What Is It?” Livingston, a UCLA surgeon, asked Katz to define structural racism. Katz gave as examples the routing of diesel trucks through poor neighborhoods and disparities in access to top-level medical care. Livingston responded that Katz had described a “very real” problem: impoverished neighborhoods with poor quality of life and little opportunity, where most residents are black and Hispanic. Livingston agreed with the urgency of making sure that all people “have equal opportunities to become successful.” His only quibble was with the current emphasis on “racism,” which “might be hurting” the cause of racial equality, he said. Livingston had been taught to revile discrimination and yet was being told that he was racist. The focus, as Livingston saw it, should be on socioeconomic disparities, not alleged racial animus.

After the podcast became an instant totem of white supremacy, JAMA disappeared it from the web. Livingston himself was disappeared from JAMA shortly thereafter. (Back at his home base at the UCLA medical school, he faced a show trial from fellow faculty members.) JAMA’s editor-in-chief Howard Bauchner, a professor of pediatrics and public health at Boston University, apparently sensed that he might be next on the chopping block and started issuing serial apologies. The disappeared podcast, Bauchner declared, was “inaccurate, offensive, hurtful, and inconsistent with the standards of JAMA.” JAMA would be “instituting changes that will address and prevent such failures from happening again”—a “failure” being defined as deviation from racial justice orthodoxy. Bauchner genuflected further in an official statement: “I once again apologize for the harms caused by this podcast and the tweet about the podcast.” (JAMA had promoted the podcast with a tweet asking: “No physician is racist, so how can there be structural racism in health care?”) For good measure, Bauchner also released a letter dated March 4, 2021, apologizing for the “harm” caused by the tweet and podcast and expressing his “commitment” to call out “injustice, inequity, and racism in medicine.”

JAMA was once a leading forum for physicians and other scientists to present research to their peers. Now JAMA’s overseers regard a fundamental component of the scientific method—debate—as out of bounds, at least regarding the diversity agenda. Livingston’s disagreement with Katz and the “structural racism” conceit was over language, not substance. Yet because Livingston suggested taking the “racism” out of the “structural racism” phrase and focusing instead on equal opportunity, he had, in Bauchner’s widely shared view, harmed blacks and violated professional standards of journalism. No disagreement is tolerated.

Meanwhile, Bauchner’s efforts to distance himself from the “offensive” dialogue were not bearing fruit. Ominously, an AMA committee put him on administrative leave, pending an “independent investigation”—as if there were a complex backstory to what were clearly Livingston’s personal opinions. By June 2021, Bauchner, too, was out, even though, as he ruefully observed, he “did not write or even see the tweet, or create the podcast.”

The chance that the AMA would not appoint an intersectional editor-in-chief to replace the hapless Bauchner was zero. But just to be safe, the AMA named a black epidemiologist specializing in racial disparities to lead the search and staffed the search committee with suitably diverse members. The new editor, Kirsten Bibbins-Domingo, is a “health-equity researcher”—also an overdetermined fact, given the career course of many black M.D.s.

Bibbins-Domingo has already announced her determination to bring in “new voices” to ensure that JAMA‘s family of journals regularly “name” structural racism as the cause of health inequities. Will those new voices be conducting the most cutting-edge clinical science? It doesn’t matter: basic science is, at best, irrelevant to structural racism and, at worst, complicit in it.

Livingston’s challenge to the idea that health disparities are caused by racism was sui generis among medical journalists. The hold of that idea within medical publishing is otherwise absolute. The New England Journal of Medicine, another formerly august institution now in thrall to racial politics, presents a nonstop stream of articles on such topics as the “Pathology of Racism,” “Toward Antiracist Allyship in Medicine,” and “How Structural Racism Works—Racist Policies as a Root Cause of U.S. Racial Health Inequities.”

Entire issues of scientific journals have been devoted to racism. Scientific American published a “special collector’s edition” on “The Science of Overcoming Racism” in summer 2021. The edition was dominated by paeans to the IAT, denunciations of the police, and scorn for any suggestion of patient self-efficacy. (Prescribing weight loss to black women, for example, is a “racist” way to fight obesity, wrote a sociology professor and a nutritionist.) A special issue of Science in October 2021 addressed “Criminal Injustice” and “Mass Incarceration.” The issue opened with an editorial by a social work professor claiming that the U.S. crime rate is “comparable to those in many Western industrial nations.” This is a fanciful proposition, in light of the fact that the American firearm homicide rate is 19.5 times higher than the average of other high-income countries, and nearly 43 times higher among 15- to 24-year-olds.

Like the AMA’s Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity, many of these antiracism articles consist of the formulaic rhetoric of academic victim studies, supplemented by the personal narratives that characterized early critical race theory in law schools. Others, though, try to quantify the racism that allegedly produces higher levels of illness and mortality in blacks. Those efforts, done through regression analysis, do not capture the personal behaviors that affect the course of disease, such as compliance with a doctor’s orders, adherence to a medication regime, and showing up for follow-up appointments. In some cases, the regression analysis does not account for the differences in the illnesses suffered by black patients and white patients at the start of the study.

Nevertheless, the second a priori truth—that health disparities are necessarily the product of systemic racism—has devalued basic science and encumbered medical research with red tape. The fight against cancer has been particularly affected. White and Asian oncologists are assumed to be part of the problem of black cancer mortality, not its solution, absent corrective measures. According to the NIH, leadership of cancer labs should match national or local demographics, whichever has a higher percentage of minorities.

Cancer grant applications must now specify who, among a lab’s staff, will enforce diversity mandates and how the lab plans to recruit underrepresented researchers and promote their careers. As with the Howard Hughes Medical Institute’s Freeman Hrabowski scholarships, an insufficiently robust diversity plan means that a proposal will be rejected, regardless of its scientific merit. Discussions about how to beef up the diversity section of a grant have become more important than discussions about tumor biology, reports a physician-scientist. “It is not easy summarizing how your work on cell signaling in nematodes applies to minorities currently living in your lab’s vicinity,” the researcher says. Mental energy spent solving that conundrum is mental energy not spent on science, he laments, since “thinking is always a zero-sum game.”

A lab’s diversity gauntlet has just begun, however. The NIH insists that participants in drug trials must also match national or local demographics. If a cancer center is in an area with few minorities, the lab must nevertheless present a plan for recruiting them into its study, regardless of their local unavailability. Genentech, the creator of lifesaving cancer drugs, held a national conference call with oncologists in April 2022 to discuss products in the research pipeline. Half of the call was spent on the problem of achieving diverse clinical trial enrollments, a participant reported. Genentech admitted to having run out of ideas.

There is no evidence that racist researchers are excluding minorities from drug trials on nonmedical grounds, nor has anyone presented a theory as to why they would. The barriers to such drug trial diversity include a higher incidence among blacks of disqualifying comorbidities, higher levels of personal disorganization, and a suspicion of the medical profession, which suspicion that same profession constantly amplifies with its drumbeat about racism.

In May 2022, a physician-scientist lost her NIH funding for a drug trial because the trial population did not contain enough blacks. The drug under review was for a type of cancer that blacks rarely get. There were almost no black patients with that disease to enroll in the trial, therefore. Better, however, to foreclose development of a therapy that might help predominantly white cancer patients than to conduct a drug trial without black participants.

The requirement of racial proportionality in drug trials is perplexing, since diversity advocates insist that race is a social construct, without biological reality. Suggesting that genetic differences exist between racial groups will brand you a racist. The AMA’s Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity sneers at “discredited and racist ideas about biological differences between racial groups.” If race does not exist, as received wisdom now has it, then the racial makeup of clinical trials should not matter.

The proponents of the systemic racism hypotheses are making a large bet with potentially lethal consequences. In accordance with the idea that racism causes racial health disparities, they are changing the direction of medical research, the composition of medical faculty, the curriculum of medical schools, the criteria for hiring researchers and for publishing research, and the standards for assessing professional excellence. They are substituting training in political advocacy for training in basic science. They are taking doctors out of the classroom, clinic, and lab and parking them in front of antiracism lecturers. Their preferential policies discourage individuals from pariah groups from going into medicine, regardless of their scientific potential. They have shifted billions of dollars from the investigation of pathophysiology to the production of tracts on microaggressions.

The advocates of this change insist that it is essential to improving minority health. But what if they are wrong? If it turns out that individual behavior, pathogens that disproportionately infect certain groups, and other genetic dispositions have a more proximate influence on health than supposed structural racism, then this reorientation of the medical project will have impeded progress that helps all racial groups. Obstetricians working in inner-city hospitals report that black mothers have higher rates of complications during pregnancy and in delivery because of higher rates of morbid obesity, hypertension, and inattention to prenatal care and prenatal-care appointments. Packing those doctors off to diversity reeducation will not improve black childbirth outcomes. It will, though, divert attention from solutions that could improve those outcomes—whether offering help in keeping appointments and complying with a medication regime or encouraging exercise and weight loss. And yet we are told that efforts directed at behavioral change are racist and that convincing patients that they have power over their health is victim-blaming.

Higher rates of Covid fatalities among blacks is the latest favored proof of medical racism, amplified by a 2022 Oprah Winfrey and Smithsonian Channel documentary, The Color of Care. State and federal health authorities gave priority to minorities in vaccination and immunotherapy campaigns, however, and penalized the highest risk group—the elderly—simply because that group is disproportionately white. Those are not the actions of white supremacists. The likelier reasons for disparities in Covid outcomes are vaccine hesitancy and obesity rates. When the constant refrain about medical racism intensifies vaccine resistance among blacks, the widened mortality gaps will be used to confirm the racism hypothesis, in a vicious circle.

Medical science has been one of the greatest engines of human progress, liberating millions from crippling disease and premature mortality. It has also seen its share of dead ends and misconceptions. Science goes astray when politics becomes paramount, as in the denial of plant genetics and natural selection under Stalin. America’s very real history of structural racism, a history that took us too long to remedy, resulted in segregated hospitals and cruel disparities in treatment. That past is belatedly but thankfully behind us.

The scientific method is a natural corrective to such fatal errors. Now, tragically, when it comes to the contention that racism is the defining trait of the medical profession and the source of health disparities, opposing views have been ruled out of bounds and are grounds for being purged. The separation of politics and science is no longer seen as a source of empirical strength; it is instead a racist dodge that risks “reinforcing existing power structures,” according to the editor of Health Affairs.

The guardians of science have turned on science itself.

Amgen says Lumakras plus immunotherapy for lung cancer needs further study

 A small study of Amgen Inc's Lumakras drug combined with immunotherapy found it helped 29% of advanced lung cancer patients, but liver toxicity was high and further study is needed, the company said ahead of the data presentation on Sunday at the World Conference on Lung Cancer in Vienna.

https://www.reuters.com/business/healthcare-pharmaceuticals/amgen-says-lumakras-plus-immunotherapy-lung-cancer-needs-further-study-2022-08-07/