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Dew,
Condolences. Sorry for your loss.
Jon
How's about 60?
Jon
My guess is 59. Agree with your logic.
Jon
Economic explanations to share of GDP growth for healthcare I have seen say it is probably not too big an issue as most increased spending is resulting from luxury good effect. And don't forget, this growth in spending is driving GDP growth (while bankrupting GM, etc.) and jobs.
Jon
I still cannot understand the fascination with drugs. At 10%-15% of the cost of the system, a 30% savings only saves 1/3 of one year's growth in health spending. I thought this quote interesting from your post, Dew.
But they could not immediately say how they would guarantee that result. In the absence of detailed instructions from Congress, lower drug prices could mean lower costs and higher profits for the insurers that operate Medicare drug plans.
Meddling without a concrete plan always has undesired effects - heck even having a concrete plan leads to undesired effects.
Jon
There are a couple of ways to come back to your post on healthcare costs and innovation.
First, the rest of the world has access to US innovation almost at the same point.
Second, I thought drugs were like 10% (not 15%) AND staying fairly constant as a percentage while being demonized (as compared to HMOs and insurers who are increasing share).
Third, US spending is a bit out of control and no one has solved the issue to my satisfaction (or even explained it). Adding another 45 million to the system with no check on their spending levels does not seem a good way to help but taking these 45 million off of only emergency care and treating chronic conditions would be good. I am distrustful about govt in the loop though - deficit spending, rationing, controlling, etc.
It seems to me the biggest causes of higher US spending are:
1. higher incomes leading to "luxury good" spending with no real effect
2. higher doctor costs
3. higher insurance costs
4. worse lifestyles
I have a couple of other odder observations.
1. The evidence would suggest we are fairly far off the holy grail of truly extending human life. If we were making steady progress, one would expect the US to be seeing some evidence given its higher spending. Of course, these things happen as step changes.
2. My wife, when we had our baby, had much more modern care than received in US when doing check-ups here in Hong Kong. Ultrasound at each 4 week checkup (some say could cause learning disorders by the way). Total cost of each checkup only about $125 USD. My statin only costs $30 per month here. Going to hospital with stomach flu in middle of night only costs $25-30 with a shot to reduce stomach cramping. I cannot explain the differences but they do exist.
Jon
And the old ICN has already missed once. One of these newer compounds should work. But of more interest would be getting rid of the ribavirin (ribavirin-like) piece of the cocktail altogether.
Jon
Some concrete issues that I can see with testing in Third World countries:
1. Following/compliance with proper protocol at physician level
2. Difference in controls vs. in first world (diet, health, etc)
3. Overall health levels in one vs. other
4. Difference in physiologies between different ethnic groups
5. Patient compliance
In my years studying bios, those companies trying overseas testing in third world have almost uniformly failed. Some that come to mind: ICN and ribavirin for AIDS - did eventually work for Hep C but probably delayed, SCLN for Hep C, EMIS for diabetes.
Jon
Isn't that statement pretty self-obvious? I am surprised they have to go so far as put it in writing.
Jon
[EDIT] I note you also reference Krugman.
There was also one by Krugman who has been very critical of anything not liberal for years. He has been trying go get to govt paying for many things for years. Wants higher taxes, govt funded healthcare, higher safety nets, transfers to poor, etc. I used to respect him and thought him one of economic's brightest lights but he has seemed to become single-minded recently. As for his stance, he ignores impact of single payer on innovation and on rationing of treatments.
In the op-ed, he refers to paying for the new care mainly with savings. But also notice the comment about how most will pay no more than they do today - a veiled reference to a tax increase on the wealthy. As a hint to where he might want to go, he has been calling for repeal of the ceiling on SS taxes for a few years.
Jon
Interesting very different reaction here than in Tysabri. I think genentech controls rituxan if I remember right. Too bad for ELN they got such a shite partner.
Jon
Numbers probably not that bad as you are dealing with geometrical math (.91*.91 - gives those left with 2 periods of 9% losses which works to just under 83% vs. 82% using addition). Also, I have to assume those who cannot tolerate the regimen probably show up more at beginning - this could be way wrong but would seem to make sense to me.
Jon
But magnitude of numbers is probably close, I would think.
Thanks Dew. I enjoyed the writing in that article to be honest. Very well done - liked showing how the old man related to the teen. But more importantly, it does raise important moral issues especially as the Dems try to nationalize healthcare. Who is entitled to the best? Who should be? Do it by lottery? Those who pay own private dollars? Those in chosen professions - like lawyers and politicans (NOT!)? No one - stone the best and bury them?
Jon
Dew -
This goes back to your discussions of what you would do in your own treatment of disease if needed (in your theoretical discussion of DES vs BMS stents). Great article about CF treatments and top quartile care.
http://www.siliconinvestor.com/readmsg.aspx?msgid=23098493
Jon
That was supposedly the plan per every Wall Street analyst out there - so I assume SNY (which I do not follow personally) must have said this.
Jon
This is bad news for SEPR to a small extent as it means the salesforce unlikely to switch off of trying to switch Ambien users to Ambien CR prior to generic launch.
Jon
Thanks - that was great!! Having just been through a title issue which almost lost me my apartment, it was even funnier!
Jon
My analysis of price on Monday - may be wrong but one has to try.
http://www.siliconinvestor.com/readmsg.aspx?msgid=23065524
Jon
Thank goodness for no subset analysis, etc.
Jon
I think this is part of the crackdown on illegal trading coming from crooks hijacking online accounts and instead of trying to steal the money (hard to do), using the account to buy thinly trades stocks while they sell. Unfortunately, it gets us good guys too (well actually not some of us who don't trade these stocks).
Jon
I would only note that I read somewhere in the last week (think it was Street.com) that the price to sales ratio of the US markets (particularly S*P 500) are trading below the average levels. That is a base measure without reflecting high NI margins and without reflecting lower levels of debt.
Jon
That makes PANC even more interesting with angle that Roche could preempt move by TRMS or vice-versa. Thanks for that thought - I had been hearing of squabbles elsewhere also. What I find amusing is that PANC has halved (or so) as their drugs continue to advance. Of course losing the head of the company from a heart attack at a healthcare conference . . .
Jon
Should probably merge with PANC.
Jon
Thanks Dew. FWIW, and bringing this back on topic, these types of issues are why ELN and SEPR both collapsed in stock price so much back in 2001/2002. Also, why ELN collapsed post-Tsyabri. Folks usually understate the risk of debt in capital structures until the debt hits. Interesting that ELN is out with refi HY debt right now. Be interested to see pricing (guess barely in single digits for coupon) but the debt is taking event risk of severe order - gets paid off in limited PML and does not otherwise.
I think you made a comment a few days ago about companies not knowing what they were doing issuing CBs. That is my view too. It is equity in good times and has all the bad features of debt in bad times.
Jon
OT No, I was a corporate guy and do not understand all of the nuances to the mortgage stuff - very precise mathematical formulas for origination and packaging and syndicating. If the models are slightly wrong, then you can have hedgies blowing up. It happened around the time of LTCM, but I now forget the name of the hedge that blew up. Leverage of some of these hedgies can go 10-20 to 1.
Jon
OT
I used to create the junk product for my clients in Asia. I must say that standards for these bonds have loosened tremendously (but I have thought so for a long time and have been wrong about pricing collapsing). I sold my portfolio of individual junk credits and funds three years ago and the product since then has probably averaged the coupon or about 7-8% per annum.
There was a time when junk spreads widened to about 1000 bps over Treasuries. Now we are talking 300-350 bps. Still a sellers mkt in my view and when things go wrong it will transmit into the corporate loan market, and both effects will then transmit into the LBO market and hedge fund markets. Something on order of Fridson's view (and he is the grandfather of evaluating the sector - very good) would not bode well for whole financial system. But in this case, banks would be fine (except investment banking earnings would collapse) but hedge funds would be in real trouble. And most of these hedge funds use 10-15 to 1 leverage. Many would go way of Amaranth and others would shut because of distance to high water mark. Let's hope his view is too bearish. But I fear direction-wise, he is right and that that direction, could trigger something ugly.
Jon
Being added to Nas Bio index.
Jon
Nothing on timing for tablets. Ouch!
Jon
OT I must say that I am highly disappointed with Yahoo Finance now. I now use Google Finance as well as Yahoo Finance to check markets and stocks of interest. I have my ETrade platform but find myself tinkering with portfolio if I login. I think Yahoo aggregation of news is still better than Google but probably not for long - and Bloomberg is better than Reuters anyway.
Jon
PS The Boards are useless.
But too good of an IR program can also be bad (i.e., those which are obviously promotional - which some might call bad IR anyway).
Jon
For bios, not very. They do have ok aerospace (my old industry sector). But it is free.
Jon
I didn't know about CSFB at E-Trade until I found it by accident. It is there but may have account thresholds (my main trading account so I meet minimums). Schwab has minimums for sure to get the research. I do not have an account there. I can vouch for the Fido research though as you can see the headlines on their site.
Jon
Best bet is to have several accounts at different discounters:
Schwab can get you Goldman
Fido can get you Pru and Lehman
ETrade gives you Credit Suisse
There are others out there too.
A service like Reuters or Thomson also have research modules but one usually needs to have an arrangement with each shop to get research. The smaller shops which can be good for bio include Rodman & Renshaw and Piper (disagree with them quite a bit but nice to get different viewpoint) but not sure how to get their research absent an account there.
Jon
Thanks Dew - my favorite closed end site has stopped publishing the daily NAVs and discounts so I cannot go back - oh well.
OK - then that represents 2.1-2.2% of the discount and the rest of the discount is for the value of the rights. Fair value is currently about 97% due to right offering and 94 and high change post dividend.
And then this discount is not too terribly abnormal, nor does it represent a uniquely good price.
Jon
The discount to NAV is artificially large (and will remain so until after the 0.29/sh dividend payment on Sep 29) because HQL began trading ex-dividend on Sep 6.
I think that answer is mistaken as a liability is created the day it goes ex-d, reducing NAV by a like amount. I cannot find data to confirm this movement but if the NAV fell by 2% or so on 9/5 or 9/6 (relative to move it should have made), this interpretation is right. I will try to confirm.
As for the rest of the discount, part of the answer lies in fact that one share entitles you to 1 share at NAV plus the right to have a partial share at .95. So after the issue, HQL will have 100 cents from initial shares plus 1/3*(.95*94 cents) = 100+1/3*.89=1.298. Divide this by share count of 1.33333 = each current share being fairly priced at 97% of NAV. Add the 2% "normalized" discount of HQH and you have a 5% or so discount being ok. (Of course the "fair" discount should work through a feedback loop into the equation above where I have use .94, but that is too complicated and one has to determine which discount is right anyway.)
Jon
Is there a way to RSS that, dew? TIA.
Jon
Here are some of the ones I use (I cannot find the RSS handle that my reader is using so ultimate sites are listed):
http://pipeline.corante.com/
http://www.fda.gov/
http://biotech.seekingalpha.com/biotech/by/site/biotech/feed/
Jon
To traders -
Anyone ever seen rampant manipulation where 4-5 mms post patently false bids or asks in an attempt to shake out stock but don't get hid because their prices are 20% off mkt? If not, check out level 2 on MNTA - very strange way to trade expiry Friday.
Jon
Thanks Dew. That was what I was thinking. Probably not an issue looking at Hatch-Waxman as I have to assume the exanatide patents go out aways. Not being invested in AMLN currently, I have forgotten their patent situation for the base molecule but have to assume it goes out some time - although it was in clinicals forever.
Jon
Dew -
Another consideration would be patent life/protections. Any idea what the patent protection differences would be going BLA vs. 505b2? I assume there could be differences in defense as well as Hatch period. Although I assume the technology patents on formulation might have teeth in such a case. TIA
Jon