Thursday, October 09, 2014

Price Transparency Benefits Hospital Patients

Internet access has ushered in an era of price transparency, where shoppers wielding smartphones check prices before deciding where to buy items such as washing machines and flat-screen televisions. Could making price information readily available contribute to a reduction in certain health-care costs, too? Research suggests so. 

To date, while some may suspect that price-transparency initiatives would reduce health-care costs, there has been little published evidence to support the supposition. Part of the difficulty is that patients don’t respond to health-care prices as they do to the prices of other consumer goods. Patients with health insurance are mostly insulated from actual care costs, so they have little incentive to choose care based on price. Patients may also believe, sometimes wrongly, that the more expensive the health care, the better the quality. 

Associate Professor Hans B. Christensen, Assistant Professor Mark G. Maffett, and PhD student Eric Floyd examine the effects of price transparency on costs associated with hip-replacement surgery. The procedure is relatively standardized, produces similar outcomes, and is often obtained on an elective basis, allowing the patient flexibility and sufficient time to shop for an orthopedic surgeon and site prior to receiving the operation. 

The variation in price tags for hip-replacement procedures illustrates the need for greater transparency: despite the seeming homogeneity of the operation, the researchers document total charges ranging from $16,269 to $93,805. Would a consumer, cognizant of this variation, seek out the less-expensive services? 

Relying only on data obtained from states with price-transparency regulations, Christensen, Maffett, and Floyd find evidence that implementing price-transparency regulations reduced the prices charged for elective, uncomplicated hip replacements by an average of about 7%.

Read more at Capital Ideas: With price transparency, hospitals charge less

Monday, September 29, 2014

Watching Television for Allergy Relief

Looking to master the quiet sneeze or get relief from those itchy, watery eyes? If so, consider watching television, at least long enough to catch an allergy commercial. Research by Professor Emir Kamenica, with Robert Naclerio of the Pritzker School of Medicine, and Anup Malani of the University of Chicago Law School, suggests these advertisements may improve the efficacy of drugs for some allergy sufferers.

Pharmaceutical companies spent $4.8 billion in 2006 alone on direct-to-consumer advertising in the United States, four times more than they spent in 1996. The spending is controversial, as commercials can motivate patients to seek prescriptions for the drugs advertised, regardless of whether that’s medically necessary. Kamenica, Naclerio, and Malani wondered if the commercials cause placebo-like effects in patients. 

Read more at Capital Ideas: Itchy, watery eyes? Try watching TV

Friday, September 26, 2014

Can Conatus Pharmaceuticals Duplicate Intercept's Success?

Conatus Pharmaceuticals (CNAT-$6.03) is developing a first-in-class, orally active pan-caspase protease inhibitor, called emricasan, which is designed to reduce the activity of the caspase family of related enzymes that mediate inflammation (measured as serum ALT) and cell death, or apoptosis (measured as biomarker cCK18).

It is postulated that by inhibiting hepatocyte apoptosis and subsequent profibrogenic activity, emricasan’s dual mechanism of action could offer a viable therapeutic option to slow progression across the entire spectrum of fibrotic liver disease(s).  

The share price of CNAT has slipped some 35% from its summer high of $9.48 a share, due to a pullback in small capitalization stock valuations and an announced delay for release of topline results from a pivotal NASH trial.

To read about possible upside, value-creating catalysts at CNAT, subscribe to, one of the top-rated biotech stock blogs: WHY CONATUS FELL OUT OF BED IN THE SECOND HALF

Editor David J Phillips no longer holds a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Monday, September 08, 2014

Keryx Biopharmaceutical's Kidney Drug Approved - What Now?

Keryx Biopharmaceuticals, Inc. (KERX-$17.01) announced that the FDA approved Ferric Citrate (formerly known as Zerenex) for the control of elevated serum phosphorus levels in patients with chronic kidney disease (CKD) on dialysis. The share price declined more than 5% on the news, however, on investor concerns that an unexpected safety warning – the drug package label must include the potential risk of “iron-overload” – could slow market share uptake.

Given hemochromatosis is a known risk with the iron-based phosphate binding, the sell-off had more to do with a “profit-from-the-news” event than the putative warning label.

Premium subscribers at were one-step ahead of Wall Street, having been told earlier: “Given uncertain commercialization prospects for the oral phosphate binder Zerenex in obtaining meaningful market share in the dialysis-treatment space due to managed care and competitive risks, investors might look to lock in existing gains with a suggested options hedge strategy – at least until a clearer picture emerges on the potential use of Zerenex in managing elevated serum phosphorus levels and iron deficiency anemia in non-dialysis dependent (NDD) CKD patients.”

Editor David J Phillips no longer holds a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Tuesday, August 19, 2014

PropThink Readers Profit from Amicus Therapeutics Buy Recommendation

Premium readers over at are already up 15% since our buy recommendation was issued on Amicus Therapeutics [FOLD] on August 7 at $4.00 per share.

Though the investment premise remains intact, investors might want to either lock in existing short-term gains, or buy September 5 calls as downside insurance against any near-term clinical surprises.
Investment Thesis
Albeit the investment thesis is focused on monotherapy use of its proprietary, pharmacological chaperone migalastat in Fabry Disease, there are value-creating assets that should become more visible in late 2015. In the treatment of Pompe disease (a glycogen storage disorder caused by deficiency of an enzyme called acid α-glucosidase), Amicus is looking to leverage its proprietary Chaperone-Advanced Replacement Therapy  platform to improve currently marketed ERTs through co-administration of a pharmacological chaperone prior to ERT infusion, and/ or to develop next-generation ERTs that consist of a proprietary lysosomal enzyme therapy co-formulated with a pharmacological chaperone.
Those investors looking for additional insight into our thoughts on FOLD and visible catalysts, such as Study 012, might consider opening their wallets and purchasing a subscription to

 Editor David J Phillips no longer holds a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Tuesday, August 12, 2014

OncoGeneX Checkup

Ignore OncoGeneX’s (OGXI-$3.15) reported second-quarter 2014 loss of 47 cents per share. Investors, instead, should focus on existing positives and visible price catalysts coming up in the next 12-months, including:

  • Management: "Based on our current expectations, we believe our capital resources will be sufficient to fund our currently planned operations into the third quarter of 2016. " Company recently completed a $22.4 million cash raise.
  • The SYNERGY Trial: Results of the SYNERGY trial will be presented at the European Society for Medical Oncology (ESMO) 2014 Congress (September) in Madrid.
  • Management addressed previous unknown  raised in a recent PropThink article on ENSPIRIT trial too: "We expect to evaluate both progression-free survival, or PFS (PFS rate at 14 weeks in 170 patients), and overall survival, or OS (OS at 100 events), during the first interim futility analysis"; The first of two analyses is expected to be conducted in 2014.
  • The Borealis-2 Trial (investigator-sponsored, randomized Phase 2 trial evaluating apatorsen in combination with docetaxel treatment compared to docetaxel treatment alone in patients with advanced or metastatic bladder cancer who have disease progression following first-line platinum-based chemotherapy) could be a big win, as more than 50% of patients with urothelial cancer of bladder discontinue FIRST-LINE treatment with cisplatin either due to non-responsiveness and/ or toxicity.


Editor David J Phillips holds a financial interest in OncoGenex common stock. The 10Q Detective has a Full Disclosure Policy.

Thursday, July 31, 2014

Making Sense on OncoGeneX

OncoGeneX’s (OGXI - $2.98) stock collapsed in the last four months, losing almost 80% in market value after reporting that its lead asset, the antisense drug custirsen, failed in a pivotal phase III prostate cancer trial. Sporting a market cap of just $60 million and holding more than enough days’ cash on-hand to fund visible clinical catalysts for a second drug that might prove useful in combination with chemotherapy, the company could make for an interesting turnaround play

OGXI is a speculative, micro-cap oncology company – now, essentially a call option with multiple shots on goal: $60 million in cash/equivalents provides a backdrop to a market capitalization of just $60 million; excluding dilutive effect of outstanding options and warrants, and OGXI trades essentially at cash.

Despite an off-putting non-response from management (detailed in article), risk-tolerant investors can own OGXI at its all-time lows ahead of incremental value-driving events. ESMO 2014 may provide hope for failed lead candidate, custirsen, as management should present further analysis from its phase 3 SYNERGY trial. A positive efficacy signal in a subset of patients may drive interest in OGXI once again, ahead of more catalysts into early 2015.

Wednesday, June 11, 2014

Conatus Pharma Breaks From Intercept's Shadow?

Bloggers and traders alike are scratching their heads, looking for answers as to why Conatus Pharmaceuticals (CNAT) is up more than 48% intraday today.

Short of any company comments and my own hubris, Premium subscribers over at profitably know why: "Intercept  Isn't the Only Way to Play Liver Disease."

To wit: [excerpt] "Similarly focused on liver disease treatments, Conatus Pharmaceuticals (CNAT) has risen and fallen on parallel developments for Intercept Pharmaceuticals’ (ICPT) obeticholic acid (OCA). A series of favorable emricasan updates in the next 12 months, including Phase 2 updates in patients with nonalcoholic fatty liver disease (NAFLD) or fibrotic nonalcoholic steatohepatitis (NASH), could allow investors to better assess the commercial opportunities of CNAT’s lead compound – and finally free the stock price from Intercept’s shadow."

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Friday, May 02, 2014

Agios Impresses With Leukemia Drug: Investor Beware

Agios Pharmaceuticals (AGIO-$43.35) moved substantially higher in price last month after reporting Phase 1 data demonstrating that its cancer metabolism drug AG-221, a first-in-class inhibitor of IDH2 mutations, generated promising clinical activity, including complete remissions in several patients whose blood cancers harbored the IDH2 mutation. 

What has investors excited is that in addition to being well-tolerated, a “substantial” reduction of plasma 2-HG was achieved: Called an “oncometabolite” for its role in cancer metabolism, the metabolite 2-hydroxygluturate (2HG) is a by-product of the mutated IDH2 gene. The initial findings support the theory that inhibiting mutant forms of IDH2 suppresses the growth of these 2HG-producing tumor cells.

Investors are making the quantum leap – based on a small safety/dosing trial – that curtailing 2-HG supply will normalize gene expression….

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Biotech Losers of 2013: AVEO, INFI, AFFY, and ARIA -- Where Are They Now?

Despite having lost more than 90% of its market valuation in the last 21 months, AVEO Pharma’s (AVEO-$1.24)  management believes it can drive shareholder creation by moving forward with other early-stage, oncology assets, principally by securing partnerships after providing proof-of-concept data. Though attractive commercial opportunities do exist, even in highly competitive markets, for targeted cancer therapies, we question this management team’s ability to develop their putative “first-in-class clinical assets” following the debacle of the VEGF receptor tyrosine kinase inhibitor, tivozanib, last year.

Evolving Phase 1 data presented at the American Society of Hematology (ASH) meeting held in early December 2013 showed not only that earlier safety concerns on Infinity’s (INFI-$9.20) lead asset, IPI-145, had been overblown, but that the drug demonstrated impressive efficacy in patients with either relapsed or refractory CLL (81% of patients had been treated with three or more systemic therapies), too.

Unfortunately, we’ll never know the “would of, could of” commercial potential for Affymax’s (AFFY-$0.70) anemia treatment, brand-name Omontys. After posting sales of $34.6 million for the nine-month period ending December 31, 2012 – slightly below analyst forecasts, suggestive of the contract-grip Amgen held on dialysis centers – Omontys was recalled on February 23, 2013 following reports of severe hypersensitivity reactions including anaphylaxis in 0.2% (or about 50 patients) — including fatal reactions in 0.02% of the 25,000 patients –within 30 minutes of their first IV dose in the post-marketing phase. Almost a third of the reported cases required prompt medical intervention and in some cases hospitalization, according to an FDA safety alert issued at the time.

Though the stock price of Ariad Pharma (ARIA-$7.25) has rallied off its 52-week low of $2.15 per share (October 31, 2013) to the $7.00 level, it still trades significantly below its 52-week high of $23.00 (September 11, 2013). The relief rally has stalled for two reasons:
  • Iclusig competes in an already crowded market for just two rare cancers. According to National Cancer Institute statistics, approximately 5,200 new cases of CML and 1,800 new cases of Ph+ ALL are diagnosed each year in the United States; and,
  • Ariad has discontinued – after consulting with the FDA – its EPIC trial, which had been designed to investigate the use of Iclusig in the front-line settings.

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Thursday, April 03, 2014

AbbVie's IV Lifeline Still Humira

Investors in AbbVie (ABBV-$53.34) are reminded each quarterly earnings release of the continued importance of Humira to the drug maker's success.  AbbVie's flagship drug, an efficacious treatment for autoimmune diseases like rheumatoid arthritis (RA) and psoriasis, contributed $10.7 billion in global sales (56% of worldwide revenue of $18.8 billion) last year.

AbbVie is spending more than 16% of annual sales to develop a pipeline -- including promising treatments for multiple sclerosis, blood cancers, and hepatitis-C (across all patient types) - with the goal of reducing its dependence on Humira. Fortunately, the Chicago-based drug manufacturer has a stable of off-patent, legacy drugs that contribute sizable sales to this R&D effort.

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Tuesday, March 18, 2014

AbbVie Hums with Humira

AbbVie (ABBV - $53.10) Chief executive Rick Gonzalez told analysts on the fourth-quarter earnings call that management expects global Humira sales this year will continue growing at a (low) double-digit pace, excluding the impact of foreign exchange. The pursuit of additional indications currently in late stage clinical trials, such as Uveitis (inflammation of the eye and the third leading-cause of blindness), is expected to augment growth too.

Humira – like Johnson & Johnson's (JNJ) Remicade – is a manufactured monoclonal antibody that treats autoimmune diseases by interfering with (blocking) tumor necrosis factor (TNF), an inflammatory protein over-expressed in a wide range of progressive inflammatory disorders that can result in permanent tissue and joint damage over time. 

Could Humira lose share to biosimilars?  Read more at The Motley Fool: AbbVie's Humira Still a Growth Engine

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Pfizer's Strategic Move into Opioid Analgesics

Pfizer's (PFE-$31.93) management stated during the fourth-quarter 2013 earnings call last month that a move toward opioid analgesics and a promising anti-nerve growth factor (NGF) drug in its pipeline, a monoclonal antibody called tanezumab, could help to mitigate the impact Celebrex's loss of market exclusivity will have on sales going forward.

Looking to capitalize on the growing need for abuse-deterrent formulations, Pfizer is looking to entrench itself in the $5.1 billion market for extended-release (ER) opioid formulations prescribed by physicians to chronic pain sufferers (30% of the $18.1 billion in annual sales for all opioid-based therapies). 

Chief executive Ian Read confirmed on the conference call that Embeda, an ER morphine/naltrexone formulation that was voluntarily benched in 2011, would be back on pharmacy shelves in second-quarter 2014 after the FDA approved both an updated manufacturing process and a risk evaluation and mitigation strategy (REMS) – which is now required for all ER and long-acting opioid medications.

Read more at The Motley Fool: Pfizer Stubs Toe Without Celebrex

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Ignore the Zogenix Buzz

Though Zogenix (ZGNX-$3.55) is entering a chronic pain market with estimated annual sales worth an estimated $15.5 billion, the market is saturated with reformulations of well-established short and long-acting products that include generic and branded hydrocodone (e.g. Vicodin), oxycodone (e.g. OxyContin), hydromorphone (e.g. Exalgo), morphine (e.g. Avinza), oxymorphone (e.g. Opana ER), and fentanyl (Duragesic transdermal patch).

Undaunted, chief executive officer Roger Hawley judiciously opines that Zohydro ER has the potential to fulfill an unmet clinical need: similar efficacy to a combination-entity hydrocone that contains the analgesic acetaminophen or ibuprofen, such as AbbVie's (ABBV) Vicoden or Vicoprofen – but without the risk of liver toxicity.

Continue reading at The Motley Fool: Zogenix Stockholders Facing World of Pain?

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Thursday, February 20, 2014

Progenics Pharmaceuticals: New Front in War Against Cancer

Investors’ bearish sentiment that further testing of the clinical utility of Progenics Pharma’s (PGNX-$5.00) PSMA-ADC might be pointless due to toxicity concerns is unfounded: Robert Israel, MD, one of the study authors and executive vice president of medical affairs at Progenics, pointed out to Medscape Medical News that both of the patients who died had predisposing conditions.

"One had an indwelling central line [known to increase risk of developing sepsis] and the other had repeated urinary tract infections," said Dr. Israel. "The patients were also heavily pretreated and didn't have much in the way of other options."

As a new class of biological therapeutics, the ADC market is still in its infancy. Nonetheless, skeptics might want to spend a Saturday reading up on the managed benefits of these highly potent drugs in the context of understood off-target toxicities.

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Monday, February 17, 2014

The New Old Yahoo Under Marissa Mayer

Yahoo (YHOO-$38.23) continues to fall further behind Google (GOOG) and Microsoft (MSFT) in organic growth for inquiring eyes (and potential customer dollars). In June 2012, the respective share of the U.S. search engine market held by Google, Bing and Yahoo stood at 66.8%, 15.6%, and 13%; data released by comScore for December 2013 showed Google and Microsoft continue gaining voice at Yahoo’s expense: Google and Microsoft expanded their market shares to 67.3% and 18.2% -- while during Mayer’s tenure, Yahoo’s market has fallen further to a 10.8% share.

Revenue slumped for the fourth consecutive quarter at Yahoo, dipping 6% to $1.27 billion in the last three months of 2013, led by a similar 6% decline in all-important display-ad sales to $491 million (as a price-per-ad decline of 7% offset a 3% increase in total number of ads).

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Monday, February 10, 2014

Lobbying Momentum to Drive Pharmacyclics Success?

In addition to hard science, lobbying momentum could be another catalyst driving sales of Pharmacyclics (PCYC-$131.38) new blood cancer drug Imbruvica significantly higher in coming years. The National Comprehensive Cancer Network (NCCN), which is an alliance of leading global cancer centers, issues recommendation protocols reflecting the consensus standard-of-care practices in oncology. Irrespective of formal FDA regulatory approval, an NCCN endorsement can be highly determinative of which therapies are reimbursed by the Centers for Medicare & Medicaid Services (CMS) and private insurers in a given indication. In other words, forget ICD-9 diagnostics codes.

In addition to the formally approved indication of relapsed/refractory MCL, updated NCCN guidelines now already recommend Imbruvica for the “off-label” treatment of refractory and relapsed CLL and other NHL subtypes, according to JMS Securities. 

See more at YCharts: Pharmacyclics: FactsBehind $10B Market Cap

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Saturday, January 25, 2014

Pharmacyclic's Imbruvica: New Hope for Cancer Patients

Imbruvica, by Pharmacyclics (PCYC-$135.20), received accelerated approval for MCL based on a study where 111 participants were given Imbruvica daily until their disease progressed or side effects became intolerable. Results showed nearly 66 percent of participants had their cancer shrink or disappear after treatment (overall response rate).

Imbruvica blocks the function of Bruton’s tyrosine kinase (BTK), a key signaling protein of the B-cell receptor signaling complexes that stimulate malignant B-cells to grow and divide uncontrollably.

MCL affects the white blood cells called lymphocytes found in the “mantle zone” of a lymph node. A rare form of NHL, and most prevalent in older adults (mean age, 68), MCL is an aggressive B-cell malignancy affecting about 6% of the 72,000 new cases of NHL diagnosed in the U.S. annually.

To date, first-line treatment has usually consisted of Roche’s monoclonal antibody Rituxan (rituximab) – which is directed against the CD20 antigen found on Beta lymphocytes – combined with a multi-agent chemotherapy regimen, most often CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone).

Given the complex pathophysiology of the disease (multiple cell-signaling division triggers), combined with a late-stage diagnosis typically discovered after the spread to the GI tract and bone marrow, MCL is characterized by short median survival times (3 – 5 years).

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy. 

Saturday, January 11, 2014

Checking for Signs of Life at Vivus

Led by new chief executive Seth Fischer, Vivus (VVUS-$9.18) is walking a new path with its erectile dysfunction (ED) drug Stendra (avanafil), choosing to outsource promotion via licensing deals: in July 2013, VIVUS announced an exclusive pact worth up to $121 million (plus royalties) with the Italian pharmaceutical group Menarini to commercialize avanafil in Europe; Auxilium Pharma (AUXL), which already markets a portfolio of ED treatments, including testosterone and Xiaflex (recently approved for Peyronie’s disease – painful curvature of the penis caused by plaque buildup), inked a marketing deal worth up to $300 million to Vivus (plus royalties) for rights to Stendra in the U.S. and Canada.  

With ED afflicting up to 30 million men in this country alone, management opines that there remains significant commercial opportunity for Stendra to stake claim to a double-digit share of the $2.9 billion U.S. market. Unfortunately, peak sales estimates of $400 million - $500 million in 2016 (one-year prior to expiration of Cialis’ first key patent), could prove too optimistic.

Notwithstanding marketing claims, after adjusting for proper dosage, no one agent in the class has been shown to be more efficacious or safer than the others. How, therefore, are Vivus’s marketing partners going to surmount reimbursement challenges when therapeutic substitutions -- generic versions of Viagra -- are available at less than $2.00 per pill in most industrialized countries (save the U.S.)? Further, Auxilium has only about 150 sales representatives to sell the drug here at home.  

Editor David J Phillips does not hold a financial interest in any stocks mentioned in this article. The 10Q Detective has a Full Disclosure Policy.