July 20, 2023

The need-to-know this morning

Vir Biotechnology said its experimental antibody treatment reduced the occurence of seasonal flu by 16% compared to a placebo — a result that failed to achieve the goal of the mid-stage clinical trial.

reimbursement

How hospitals might save money on CAR-T

Although CAR-T treatments are wildly expensive, they still are rarely profitable for the hospitals who use them. But if drug companies are able to make these cellular therapies safer, hospitals might be able to offer them in outpatient settings, where Medicare reimbursement tends to be higher. Safer administration would mean fewer complicated cases and more predictable business for hospitals.

Hospitals have long been frustrated with how Medicare reimburses them for CAR-T therapies. It took two years for the government payer to figure out how it would pay for these treatments, and even still, hospitals lose money on two-thirds of cases. The drug costs $465,000 for a single course of treatment, and that doesn't include ancillary costs like cell collection and reengineering, or the cost of hospitalization and side effect management.

But if CAR-T drugs are provided on an outpatient basis, Medicare would pay the average sales price of the drug, plus 6% — which would cover all the other expenses.

antitrust

DOJ, FTC to scrutinize health mergers more intently

There have been some questionable major mergers in the health care sector — and regulators have taken notice. New draft guidelines outline how federal antitrust agencies will begin policing mergers across all sectors. But this will have strong implications for hospitals, physician practices, private equity firms, health insurers, pharmacy benefit managers, pharmaceutical companies, medical device firms, and others.

Research has shown that this siloing in health care is one key reason why prices are skyrocketing. Hospital mergers and private equity acquisition of physician clinics will be particularly vulnerable.

Climate

Tornado damages Pfizer drug-making facility

A Pfizer manufacturing plant in Rocky Mount, N.C. that is one of the largest facilities for sterile injectable products in the world was heavily damaged Wednesday by a tornado, the company said.

None of the plants 4,500 employees were seriously injured, Pfizer said, which is assessing the situation to determine the impact on production. Video from the scene showed the roof torn off a portion of the building, with debris scattered across the ground.

The Pfizer facility makes anesthesia and other drugs as well 25-30% of all sterile injectable medications used in U.S. hospitals.

research

New insights on cancer drug resistance

Natural selection allows the hardiest cancer cells to become resistant to existing therapies. But Darwinian principles don't paint the entire picture of resistance. New research shows that cancer cells can survive intensive therapies when certain of their genes are turned on — even if they're nearly identical to other cancer cells that died. The difference in survival is the cell's transcriptional profile — that is, whether or not specific genes are or are not activated.

"Let's say you have a cancer cell. It becomes resistant, and most of the time we use additional therapies to address the resistance," said a Northwestern cancer researcher whose work on the subject was just published in Nature. "You can begin designing therapies or new molecules that target the transitions that lead to resistance before you add the drug."

dementia

Proteins that might help predict dementia

Certain plasma proteins could help explain why some adults develop dementia and others don't. Over the course of 25 years, researchers found that 32 proteins played a role in cognitive decline — and were present years before symptoms arose. These findings, published in Science Translational Medicine, have implications for developing early interventions for Alzheimer's disease and other neurodegenerative conditions.

"Imagine telling a 45- or 50-year-old that your plasma biomarker profile is suggestive that you would connect to dementia in the next 10 to 15 years — what a profound thing to say."

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