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Clean Energy Is Bringing Electricity to Many in the Navajo Nation

Thousands of homes in Navajo and other tribal lands don’t have access to electricity. A $200-million federal funding effort aims to fix that problem with solar power and other clean energy




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Rainwater Could Help Satisfy AI’s Water Demands

A few dozen ChatGPT queries cost a bottle’s worth of water. Tech firms should consider simpler solutions, such as harvesting rainwater, to meet AI’s needs




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Let African Communities Manage Their Climate Adaptation Plans

Outside groups often offer their solutions for climate adaptation in Africa. But the best people to manage the climate crisis are the people in those communities themselves. For climate adaptation to succeed in Africa, let communities and local leaders show the way




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The Lucy Fossil’s Extraordinary Journey to Becoming an Icon of Human Evolution

The 3.2-million-year-old human ancestor known as Lucy rose to fame through an incredible combination of circumstances




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A Wearable to Manage Parkinson’s Motor Symptoms: Interview with Lucy Jung, CEO at Charco Neurotech

Charco Neurotech, a medtech company based in the United Kingdom, has developed CUE1, a non-invasive wearable that is intended to assist those with Parkinson’s disease to manage their motor symptoms. The device is typically affixed to the sternum, and provides vibratory action in a focused region of the body. The technology is based on the […]




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Hospitals Are Relying More on PBMs to Manage Manufacturers' 340B Contract Pharmacy Restrictions: DCI's 2024 Market Analysis (rerun)

This week, I’m rerunning some popular posts while we put the finishing touches on DCI’s new 2024-25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Click here to see the original post from June 2024.



The 340B contract pharmacy market shows little sign of slowing down. Drug Channels Institute’s exclusive analysis of the 2024 market reveals that:
  • About 33,000 pharmacy locations—more than half of the entire U.S. pharmacy industry—act as contract pharmacies for the hospitals and federal grantees that participate in the 340B program. 
  • Five multi-billion-dollar, for-profit, publicly traded pharmacy chains and pharmacy benefit managers (PBMs)—Cigna (via Express Scripts), CVS Health, UnitedHealth Group (via OptumRx), and Walgreens, Walmart—continue to dominate the 340B contract pharmacy market.
  • Federal grantees are aligned primarily with the vertically intergated organizations' retail pharmacies, while hospitals rely on mail and specialty pharmacies.
Over the past four years, manufacturers’ restrictions on 340B contract pharmacies have led hospitals to deepen their relationships with the largest PBMs—even as those PBMs have simultaneously limited hospitals’ direct participation in specialty pharmacy networks.

For an updated look at what’s next for the 340B contract pharmacy market, join Adam J. Fein, Ph.D., on June 21 for his latest live video webinar: The 340B Drug Pricing Program: Trends, Controversies, and Outlook.
Read more »
       




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New On-Demand Training Platform




I am pleased to announce the availability of on-demand training about FDA's regulation of advertising and promotion. So, you are now able to learn about the wonderful world of FDA ad-promo from the comfort of your home, office, or campsite. 

At PhillyCooke.Thinkific.com, you can see the courses that are currently available and sign up. In the video above, there's a special discount code to celebrate the launch of this new platform.

If you are interested in providing access to the training for your full team, then please email me at DCooke@PhillyCooke.com or fill out the contact form on the website. I can provide all of the information about the corporate licensing.
 
Every course comes with access for a full year. You can view, and review, the content as often as you like. In addition, every module on the platform is reviewed in its entirety at least twice per year. If something changes, new modules will replace the old ones, and students will be notified of the update. Those new modules will be available at no additional cost! That way you can rest assured that the information you are learning is always current with the latest developments in the world of ad-promo.




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Establishing efficacy - without humans?

The decade following passage of FDAAA has been one of easing standards for drug approvals in the US, most notably with the advent of “breakthrough” designation created by FDASIA in 2012 and the 21st Century Cures Act in 2016.

Although, as of this writing, there is no nominee for FDA Commissioner, it appears to be safe to say that the current administration intends to accelerate the pace of deregulation, mostly through further lowering of approval requirements. In fact, some of the leading contenders for the position are on record as supporting a return to pre-Kefauver-Harris days, when drug efficacy was not even considered for approval.

Build a better mouse model, and pharma will
beat a path to your door - no laws needed.

In this context, it is at least refreshing to read a proposal to increase efficacy standards. This comes from two bioethicists at McGill University, who make the somewhat-startling case for a higher degree of efficacy evaluation before a drug begins any testing in humans.
We contend that a lack of emphasis on evidence for the efficacy of drug candidates is all too common in decisions about whether an experimental medicine can be tested in humans. We call for infrastructure, resources and better methods to rigorously evaluate the clinical promise of new interventions before testing them on humans for the first time.
The author propose some sort of centralized clearinghouse to evaluate efficacy more rigorously. It is unclear what they envision this new multispecialty review body’s standards for green-lighting a drug to enter human testing. Instead they propose three questions:
  • What is the likelihood that the drug will prove clinically useful?
  • Assume the drug works in humans. What is the likelihood of observing the preclinical results?
  • Assume the drug does not work in humans. What is the likelihood of observing the preclinical results?
These seem like reasonable questions, I suppose – and are likely questions that are already being asked of preclinical data. They certainly do not rise to the level of providing a clear standard for regulatory approval, though perhaps it’s a reasonable place to start.

The most obvious counterargument here is one that the authors curiously don’t pick up on at all: if we had the ability to accurately (or even semiaccurately) predict efficacy preclinically, pharma sponsors would already be doing it. The comment notes: “More-thorough assessments of clinical potential before trials begin could lower failure rates and drug-development costs.” And it’s hard not to agree: every pharmaceutical company would love to have even an incrementally-better sense of whether their early pipeline drugs will be shown to work as hoped.

The authors note
Commercial interests cannot be trusted to ensure that human trials are launched only when the case for clinical potential is robust. We believe that many FIH studies are launched on the basis of flimsy, underscrutinized evidence.
However, they do not produce any evidence that industry is in any way deliberately underperforming their preclinical work, merely that preclinical efficacy is often difficult to reproduce and is poorly correlated with drug performance in humans.

Pharmaceutical companies have many times more candidate compounds than they can possibly afford to put into clinical trials. Figuring out how to lower failure rates – or at least the total cost of failure - is a prominent industry obsession, and efficacy remains the largest source of late-stage trial failure. This quest to “fail faster” has resulted in larger and more expensive phase 2 trials, and even to increased efficacy testing in some phase 1 trials. And we do this not because of regulatory pressure, but because of hopes that these efforts will save overall costs. So it seems beyond probable that companies would immediately invest more in preclinical efficacy testing, if such testing could be shown to have any real predictive power. But generally speaking, it does not.

As a general rule, we don’t need regulations that are firmly aligned with market incentives, we need regulations if and when we think those incentives might run counter to the general good. In this case, there are already incredibly strong market incentives to improve preclinical assessments. Where companies have attempted to do something with limited success, it would seem quixotic to think that regulatory fiat will accomplish more.

(One further point. The authors try to link the need for preclinical efficacy testing to the 2016 Bial tragedy. This seems incredibly tenuous: the authors speculate that perhaps trial participants would not have been harmed and killed if Bial had been required to produce more evidence of BIA102474’s clinical efficacy before embarking on their phase 1 trials. But that would have been entirely coincidental in this case: if the drug had in fact more evidence of therapeutic promise, the tragedy still would have happened, because it had nothing at all to do with the drug’s efficacy.

This is to some extent a minor nitpick, since the argument in favor of earlier efficacy testing does not depend on a link to Bial. However, I bring it up because a) the authors dedicate the first four paragraphs of their comment to the link, and b) there appears to be a minor trend of using the death and injuries of that trial to justify an array of otherwise-unrelated initiatives. This seems like a trend we should discourage.)

[Update 2/23: I posted this last night, not realizing that only a few hours earlier, John LaMattina had published on this same article. His take is similar to mine, in that he is suspicious of the idea that pharmaceutical companies would knowingly push ineffective drugs up their pipeline.]

Kimmelman, J., & Federico, C. (2017). Consider drug efficacy before first-in-human trials Nature, 542 (7639), 25-27 DOI: 10.1038/542025a




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A human bird flu case is thought to be found in Canada for the first time

A person has tested positive in British Columbia, Canadian health officials said, though the results must be sent to another lab for confirmation.




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Remarkably resilient refugees: A teen on his own, a woman who was raped

Sudan's civil war has displaced 10 million citizens. Here are profiles of two young people from the most vulnerable groups: an unaccompanied minor caring for twin brothers, a woman who was raped.




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An Integrated Approach to Optimizing Specialty Pharmacy and Accelerating Performance

Top challenges impacting specialty pharmacy outcomes, and how health systems may achieve efficiencies and enhance performance for optimal outcomes.

The post An Integrated Approach to Optimizing Specialty Pharmacy and Accelerating Performance appeared first on MedCity News.




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Researchers Explore How the Human Body Senses Temperature

As winter arrives and daylight hours decrease, it gets easier to hit the snooze button and stay in bed. It turns out that there’s a scientific reason behind this phenomenon that helps to explain why people struggle to adjust their internal clocks—also known as circadian rhythm or sleep-wake cycle—when the weather turns colder.




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En Banc: Federal Circuit Provides Guidance on Application of On-Sale Bar to Contract Manufacturers

Pharmaceutical and biotech companies breathed a sigh of relief Monday when the Federal Circuit unanimously ruled in a precedential opinion that the mere sale of manufacturing services to create embodiments of a patented product is not a “commercial sale” of the invention that triggers the on-sale bar of 35 U.S.C. § 102(b) (pre-AIA).[1]  The en banc opinion...… Continue Reading




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Pain Management in Crisis: Why Hospitals Are Limiting Pain Medications and What This Means for Patients

Hospitals across the U.S. have significantly restricted the use of pain medications containing narcotics. This shift comes amid […]

The post Pain Management in Crisis: Why Hospitals Are Limiting Pain Medications and What This Means for Patients appeared first on World of DTC Marketing.




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J&J must pay $19m to man who says its talc caused his cancer, jury finds

Johnson & Johnson must pay US$15 million (S$19.6 million) to a Connecticut man who alleges that he developed mesothelioma, a rare form of cancer, as a result of using the company's talc powder for decades, a jury found on Tuesday (Oct 15). Plaintiff Evan Plotkin sued the company in 2021 soon after his diagnosis, saying he was sickened by inhaling J&J's baby powder. The jury in Fairfield County, Connecticut Superior Court also found that the company should pay additional punitive damages, which will be determined later by the judge overseeing the case. "Evan Plotkin and his trial team are thrilled that a jury once again decided to hold Johnson & Johnson accountable for their marketing and sale of a baby powder product that they knew contained asbestos," Ben Braly, a lawyer for Plotkin, said in an email. Erik Haas, J&J's worldwide vice president of litigation, said in a statement that the company would appeal "erroneous" rulings by the trial judge that kept the jury from hearing critical facts about the case.




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'I try not to think about myself': Woman battles breast cancer while caring for mum who has gall bladder cancer

To mark Breast Cancer Awareness Month, we speak to inspiring Singaporeans about their journey in battling and overcoming cancer.  Warda Ismail gets anxious about things easily, especially when it comes to her health.  So much so that her doctor once told her that she is a "borderline hypochondriac", she shared with AsiaOne in an interview.  For the uninitiated, hypochondria is a condition where a person is excessively and unduly worried about having a serious illness. To keep her mind at ease, the 44-year-old preschool educator has the habit of going for regular medical checkups.  Though she was vigilant, her worst nightmare came true — she was diagnosed with breast cancer on May 8 this year.  And in the midst of her recovery journey, she got more terrible news — her mother, who had been caring for her, was diagnosed with stage-three gall bladder cancer.  Despite the string of unfortunate events, Warda persevered and tried to have a more positive outlook on life and her health. 




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Canada detects its first presumptive human H5 bird flu case

OTTAWA - Canada has detected its first presumptive case of H5 bird flu in a person, a teenager in the western province of British Columbia, health officials said on Saturday (Nov 9). The teenager likely caught the virus from a bird or animal and was receiving care at a children's hospital, the province said in a statement. The province said it was investigating the source of exposure and identifying the teenager's contacts. The risk to the public remains low, Canada's Health Minister Mark Holland said in posting on X. "This is a rare event," British Columbia Health Officer Bonnie Henry said in a statement. "We are conducting a thorough investigation to fully understand the source of exposure here in B.C." H5 bird flu is widespread in wild birds worldwide and is causing outbreaks in poultry and US dairy cows, with several recent human cases in US dairy and poultry workers. There has been no evidence of person-to-person spread so far. But if that were to happen, a pandemic could unfold, scientists have said.




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My Chemical Romance teases new project

My Chemical Romance teased a new project on social media. The Welcome to the Black Parade rockers — who broke up in 2013 before releasing new song The Foundations of Decay nine years later — have largely kept things quiet since their reunion tour ended in March 2023, besides a headline slot at When We Were Young Festival last month. On Monday (Nov 11), the band's official Instagram shared an image of a hazy skyline and confetti alongside Russian letters which translate to "TPK". The cryptic post was captioned: "If you could be anything, what would you be?" https://www.instagram.com/p/DCPw84izQkN/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA== While there are no further hints about the message and what it could mean, fans have suggested it may refer to MCR's scrapped record The Paper Kingdom, which was ditched in 2013 and would have been their fifth album.




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Teen in critical condition with Canada's first presumptive human case of bird flu

TORONTO — A teenager is in critical condition in a British Columbia children's hospital, sick with Canada's first presumptive human case of avian influenza. "This was a healthy teenager prior to this, so no underlying conditions," said provincial health officer Bonnie Henry in a news conference on Tuesday (Nov 12). "It just reminds us that in young people this is a virus that can progress and cause quite severe illness and the deterioration that I mentioned was quite rapid." British Columbia health officials said on Saturday the province had detected Canada's first human case of H5 bird flu in a teenager.




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Trump's Day One: Deportations, border wall, scrapping Biden humanitarian programs

WASHINGTON — Donald Trump is expected to take a slew of executive actions on his first day as president to ramp up immigration enforcement and roll back signature Biden legal entry programs, a sweeping effort that will be led by incoming "border czar" Tom Homan and other Republican immigration hardliners, three sources familiar with the matter told Reuters. The executive actions would give federal immigration officers more latitude to arrest people with no criminal records, surge troops to the US-Mexico border and restart construction of the border wall, the sources said. Homan, who served as acting director of US Immigration and Customs Enforcement from 2017-2018 under Trump, will bring a deep understanding of the US immigration system after a four-decade career that took him from a frontline Border Patrol agent to head of the agency that arrests and deports immigrants in the US illegally.




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Man admits to forging Grab receipts to make over $16,000 worth of claims

SINGAPORE — On more than 460 occasions, a man forged Grab receipts and sent them to his company, causing the firm to disburse over $16,400 to him. He also made false medical certificates and an electronic letter purportedly from the Singapore Armed Forces, causing the Ministry of Health (MOH), where he worked as a temporary staff, to excuse him from reporting for work. On Nov 12, Muhammad Fariz Shaik Sha Marican, 33, pleaded guilty to two forgery charges. Two other similar charges will be taken into consideration during sentencing. Deputy Public Prosecutor Kelly Ng said that Fariz was employed by recruitment firm Persolkelly (PSK), which worked with MOH to provide manpower. Fariz was deployed by PSK in November 2021 to work as a temporary staff for MOH to support the ministry's Covid-19 operations. In April 2023, MOH checked on Fariz's annual leave balance as the ministry wanted to convert him into a staff member.




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Proposed law could mandate treatment for community disturbances linked to mental health

The Community Disputes Resolution Tribunals (CDRT) will be able to mandate mental health treatment for those who cause unreasonable interferences in the community if a bill to amend the Community Disputes Resolution Act (CDRA) goes through.  The bill was proposed in Parliament by Minister for Community, Culture and Youth Edwin Tong on Tuesday (Nov 12). The CDRT currently hears disputes under CDRA between neighbours involving acts of unreasonable interference with the enjoyment or use of places of residence. Under the bill, the tribunal will be able to issue Mandatory Treatment Orders (MTO) should there be a belief that the acts of disturbance stem from an underlying psychiatric condition. "In those cases, the issue therefore is not just a disamenity one," Minister Tong said. "Hence, the MTO is intended to address the root cause of certain acts that a resident may engage in." Tong added that their priority remains in persuading the resident to go for treatment voluntarily, and that the CDRT-issued MTO is a measure of last resort. There are also criteria that must be met for the MTO to be issued.




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Taboo or not? Man's funeral-themed birthday celebration sparks controversy

As a group of friends circled a hearse, chants were heard. Then, they stopped and bowed to the portrait displayed at the front of the vehicle. This was not a typical Buddhist funeral, but rather the unconventional birthday celebration of a funeral director, reported Shin Min Daily News. According to the Chinese evening daily, a video circulating online showed the friends chanting a birthday song. The hearse's interior had been decorated with balloons and a birthday banner, with the man even laying inside for photos. The clip garnered criticism from netizens, with some deeming it overboard and disrespectful to the funeral industry. In an interview with Shin Min, director of Xin An Funeral Services Chen Weisong (transliteration) explained that he had celebrated his birthday at the company's premises with his friends and family last week. Halfway through the performances by singers, his employees and business partners had surprised him with the birthday-themed hearse bearing his portrait. Chen told 8world he was not angry and did not think it was taboo. "I was too embarrassed to turn down their gesture," he said. 




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Taiwan businessman Tsao to sue Chinese officials over sanctions

TAIPEI — Taiwanese businessman Robert Tsao said on Nov 11 that he would sue in a Taiwan court senior Chinese officials over sanctions they had placed on him, saying he was seeking to counter China's intimidation of lawful activity. China, which claims Taiwan as its own territory, said in October it would punish and sanction Tsao, the retired founder of chipmaker United Microelectronics Corp (UMC), for alleged criminal and pro-Taiwan independence activities. China's Taiwan Affairs Office said the "Black Bear Academy" that Tsao has helped fund was seeking to incite separatism that would endanger cross-strait ties. Tsao, one of Taiwan's richest men who has pledged to provide millions to two civilian defence training programmes, told a press conference that China was threatening the lawful holding of political views in Taiwan and his personal safety. The lawsuit will be lodged in a Taipei court against Song Tao, head of China's Taiwan Affairs Office, and also the office's spokesman Chen Binhua. Taiwan courts have no jurisdiction in China and senior Chinese officials do not visit the island.




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The Con-Man Realism of Vivek Ramaswamy

Stephen Walt critiques Vivek Ramaswamy's claim of being a foreign policy realist.




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A US Ambassador Working for Cuba? Charges Against Former Diplomat Victor Manuel Rocha Spotlight Havana's Importance in the World of Spying

Calder Walton writes that if proved, Victor Manuel Rocha's espionage would place him among the longest-serving spies in modern times. Allowing him to operate as a spy in the senior echelons of the U.S. government for so long would represent a staggering U.S. security failure.




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211549: Under Secretary Burns meets Indian Prime Minister Manmohan Singh

In a June 11 meeting, Prime Minister Singh assured Under Secretary Burns of his strong personal commitment to strengthening further India's ties to the United States.




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Terror threats keep me awake, Manmohan Singh told U.S. official



  • The India Cables

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‘Many Pakistans, so we need many Pakistan policies'

‘India does not want to play into the hands of terrorists by shunning dialogue.'



  • The India Cables

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153464: Pakistan campaigning for seat on UN Human Rights Council

Pakistan concern that freedom of expression be balanced with respect for religion as "we are not as advanced as you are" in terms of respect for freedom of religion and could not always control the reactions of sometimes ignorant crowds.




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Behind the Pakistan F-16 deal, a tale of many wheels

The sale was considered only ‘symbolically important' by the U.S., but had many strings attached






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Germany's government coalition breaks apart











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We All Fall Down: The Dismantling of the Warsaw Pact and the End of the Cold War in Eastern Europe

The non-Soviet members of the Warsaw Pact contributed to the end of the Cold War along with the superpowers. These Eastern European states recognized that their relationship with the Soviet Union would impede their success in the post–Cold War world, so they ended the Pact.




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Polls Show Record Low Number of Russians Willing to Permanently Move Abroad

The share of Russians who would like to leave Russia for permanent residence in another country has reached a record low, according to the results of a national poll conducted by Russia’s Levada Center on March 21-27, 2024.  Of the countries Russians were eager to relocate to, the U.S. topped the list (11%), followed by Germany (8%) and Italy and Turkey (6% each). China ranked 10-11 along with Canada.That seven out of the top 11 countries Russians would like to relocate to are members of the collective West, with 46% interested in moving to these countries, also shows the limits of the Kremlin’s efforts to instill anti-Western sentiments in the Russian public.




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Space Technology Advances: Catalysts for Conflict or Pathways for Human Progress?

Ensuring that space remains a domain for peaceful exploration and mutual benefit rather than a new frontier for conflict will significantly depend on the global community's ability to navigate the complex interplay of technological advancements, regulatory frameworks, economic opportunities, and geopolitical challenges. 

This paper was written for the final assignment of IGA-250, a Harvard Kennedy School course on emerging technology: security, strategy, and risk.




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The Historical Puzzle of US Economic Performance under Democrats vs. Republicans

We have heard much about the puzzle that US economic performance under President Joe Biden has been much stronger than voters perceive it to be.  But the current episode is just one instance of a bigger historical puzzle:  the US economy has since World War II consistently done better under Democratic presidents than under Republican presidents.  This fact is even less widely known, including among Democratic voters, than the truth about Biden’s term.  Indeed, some poll results suggest that more Americans believe the reverse, that Republican presidents are better stewards of the economy than Democrats.




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Global Players: The Role of International Humanitarian Organizations in Africa

On April 2, the study group met for the second time to evaluate the role of international humanitarian groups in shaping political and social outcomes in Africa. The group examined how these organizations deal with emergencies, crises, and conflict situations across the continent, and scrutinized their influence on policy decisions and discuss the potential benefits and drawbacks of their involvement. Discussions covered the expanding influence of organizations like the United Nations High Commissioner for Refugees (UNHCR), Médecins Sans Frontières (Doctors Without Borders), and the International Rescue Committee (ICR). The study group counted with the presence of external expert guest Professor Sabs K. Quereshi, a senior-level leader with 17+ years of experience in global health, gender equality, health policy and equity, national security, humanitarian response, and government and multilateral affairs sectors in the U.S., with the UN, and worldwide.







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Institutional investors' shifting allocation strategies are driving hedge funds towards new products - EY�s Natalie Deak on how hedge fund managers are pursuing growth

EY�s Natalie Deak on how hedge fund managers are pursuing growth