Related: HealthWhat’s normal for the abnormal? A close look at NBA players’ hearts It’s well-known that the heart changes with long-term athletic activity. It becomes bigger, heavier, and thicker. “But we don’t know where the boundaries are,” said Dr. David Engel of Columbia University Medical Center and New York-Presbyterian Hospital, who led the research team. “There’s a gray zone between the athletic changes that you [typically] see versus underlying cardiac conditions that put people at risk.” His team’s goal was to draw a sharper line in that gray zone.Take the case of power forward Channing Frye.advertisement Channing Frye’s recent trade to the Cleveland Cavaliers from the Orlando Magic took a couple extra days to clear because of additional testing related to his enlarged heart. Christian Petersen/Getty Images Tags athletescardiologyheart disease A change of heart on athletes with life-threatening conditions Professional basketball players are, by definition, taller and stronger and more physically active than the rest of us. Their hearts are different, too.Now, a new analysis of cardiac tests on more than 500 active NBA players offers the first solid look at what’s normal for these abnormal individuals.The findings, published Wednesday in JAMA Cardiology, could prove helpful to teams trying to make sense of their players’ stress echocardiograms, which the NBA began requiring in 2006.advertisement At last week’s NBA trade deadline, the Cleveland Cavaliers acquired Frye from the Orlando Magic to bolster their bench and make a title run.But Frye was diagnosed in 2012 with an enlarged heart, which forced him to miss a full regular season. Players must pass a physical before trades are finalized, and Frye’s trade to Cleveland took a couple extra days to clear because of additional testing related to his heart issue.The new data will make it easier in the future for doctors to figure out whether an athlete’s heart size is within the realm of normal for NBA players — or if there is a real medical issue, as Frye had.“That’s a spot-on perfect example,” said Dr. Aaron Baggish of the Massachusetts General Hospital Heart Center, who wrote a commentary to accompany the new analysis.Without the right data set — and the right doctor, he noted — “you end up with a lot of uncertainty that can get in the way of healthy people getting on the basketball court.”Another recent example: forward Jeff Green, who was just traded from the Memphis Grizzlies to the Los Angeles Clippers. In 2012, Green was diagnosed with an aortic aneurysm and had season-ending surgery.Green’s aorta condition was “right on the borderline,” Baggish said, and many doctors who specialize in treating athletes “scratched their head around that case.” The new data will help in the future by laying out “the upper level of normal” for NBA players’ aortas, Baggish said. Can you exercise too much? Engel, too, singled out the aorta finding as particularly notable. Scientists already knew that the aorta, which pumps blood from the heart to the rest of the body, widens in diameter with more athletic activity. They had relied on a formula to predict how wide it should be in bigger athletes.But Engel and his colleagues found that the widening actually plateaued at the top end of the body scale for NBA players. That means the formula might not be reliable for very tall players — and doctors should take a close look at extra-wide aortas, and not assume they’re normal just because the athlete is tall.The new analysis could also help in diagnosing players with Marfan syndrome, a genetic disorder that affects connective tissue and is more often seen in very tall people. The blood vessels of people with Marfan can become “very stretchy,” as Engel put it, and that can be particularly dangerous if it leads to tears in the aorta.It is a real concern: At the 2014 NBA Combine, where incoming rookie players are evaluated, Baylor University center Isaiah Austin was diagnosed with Marfan syndrome. Out of concern for his health, he did not pursue a player career in the league.The analysis also found variation in heart muscle thickness and geometry between African-American and white players. “This is new information, because people of this size haven’t been studied,” Engel said. Most research on athletes and heart health has been based on European athletes from sports such as soccer.The bottom line: “There’s no one type of athlete’s heart,” Baggish said. But the picture of what’s normal for the atypically athletically gifted just got a little clearer. Related: By Dylan Scott Feb. 24, 2016 Reprints
PharmalotPharmalot, Pharmalittle: Senate committee holds hearing on drug prices Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Hello, everyone, and how are you today? We are doing just fine, thank you, although moving a bit slower than usual and apologize for the delay. Sometimes, life intrudes. Nonetheless, we are gathering steam this morning as we attempt to tackle our to-do list, which seems to grow by the minute. We trust you can relate. So to cope, why not join us for a cup of stimulation? Meanwhile, here are some tidbits. Hope you have a successful day …The US Senate Special Committee on Aging Thursday holds its second hearing on prescription drug prices and plans to focus on two drug makers that were run by Martin Shkreli — Turing Pharmaceuticals and Retrophin. At both companies, Shrkeli oversaw a strategy to buy older medicines and then significantly raise prices. Among those scheduled to testify are former and current Turing executives, although not Shrkeli.GlaxoSmithKline says Andrew Witty will retire as chief executive in March 2017. Investors have pressured the drug maker to replace him due to a lagging stock price, sluggish US sales, and lingering concerns over a bribery scandal in China that led to a $500 million fine. Witty has attempted a turnaround by reorganizing, a move that involved swapping its cancer drugs unit to Novartis for a vaccine business, as well as forming a consumer health joint venture.advertisement [email protected] @Pharmalot Amgen won a significant victory after a jury Wednesday ruled two patents on its new injectable cholesterol drug are valid. The decision is a setback for Sanofi and Regeneron Pharmaceuticals. Amgen filed a patent-infringement suit against the companies to prevent them from selling a rival PCSK9 inhibitor treatment. Sanofi and Regeneron say they will appeal, although Wall Street analysts expect a settlement will be reached and Amgen will receive a sales royalty.One-third of Americans believe doctors are mainly responsible for widespread abuse of prescription painkillers, which nearly matches the number who blame users, according to a new poll by STAT and the Harvard T.H. Chan School of Public Health. And only 10 percent blame drug makers, which have been accused of downplaying risks in numerous lawsuits.advertisement By Ed Silverman March 17, 2016 Reprints Valeant Pharmaceuticals lenders are starting to demand new terms that could further pressure the drug maker, Reuters reports. Two days ago, the company revealed it would not meet a March 15 deadline for filing its annual financial statements with the US Securities and Exchange Commission, which means it could default on more than $30 billion in debt.McKesson, the big wholesaler, is laying off 1,600 employees, or about 4 percent of its US workforce, to cut costs after losing some key customers, Bloomberg News reports.Johnson & Johnson chief executive Alex Gorsky received a nearly 5 percent drop in his compensation last year, to $23.8 million, according to The Wall Street Journal.Novartis is having trouble getting doctors to prescribe its new Entresto treatment for heart failure and has missed sales targets, MarketWatch tells us.An Illinois psychiatrist was sentenced to nine months in federal prison and ordered to pay nearly $600,000 for accepting hundreds of thousands of dollars in kickbacks from drug makers, MedScape reports.The Food and Drug Administration approved a Bayer therapy called Kovaltry for hemophilia A, the most common form of the illness, about three weeks after European regulators approved the drug, Reuters writes.The UK’s National Institute for Health and Care Excellence rejected an Amgen drug for melanoma that has spread and can’t be surgically removed due to uncertainty over its effect on survival, Pharma Times says. Ed Silverman About the Author Reprints Alex Hogan/STAT Tags drug pricesGlaxoSmithKlineMartin Shkreli
Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED [email protected] GET STARTED Ed Silverman Alex Hogan/STAT @Pharmalot Pharmalot, Pharmalittle: Generic drug makers sued for price fixing over skin cream By Ed Silverman Dec. 22, 2016 Reprints Pharmalot About the Author Reprints STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What is it? What’s included? Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Good morning, everyone, and how are you today? We are just fine, thank you, especially as it appears to be rather quiet out there. Of course, looks can be deceiving. After all, the world is still spinning, yes? So despite the looming holidays, we are as busy as ever foraging for interesting items. Toward that end, we have assembled a few tidbits for you. Hope you have a grand day and, of course, keep us in mind if you hear something juicy …A benefit plan for an electrical workers’ union filed a lawsuit accusing three drug makers — Perrigo, Taro Pharmaceutical, and Teligent — of fixing the price of a generic skin cream used for treating inflammatory skin infections and raising the cost by 539 percent. In less than six months in 2014, the companies increased their list prices per unit from between 49 cents and 59 cents to $4.59 to $4.72. Log In | Learn More Tags drug pricingfinancepharmaceuticalsSTAT+
By Jason J. Han and Neha Vapiwala Oct. 3, 2017 Reprints Neha Vapiwala APStock First OpinionDoctors need help managing their ‘perpetual state of transition’ Yet medical training — from the first day of med school and throughout a physician’s career — is a continuous series of transitions. Each rotation, perhaps even each day, builds upon the one before, not only with regard to competence but also in terms of the level of responsibility and extent of accountability toward patients, colleagues, and the profession. To train in medicine is to be in a perpetual state of transition, where each step brings a new set of expectations for the physician. Related: [email protected] To fight physician burnout, I’m making a binder of medical successes Some argue that these transitions help trainees quickly learn to adapt and gain the independence and self-motivation required to succeed in a field as arduous as clinical medicine. Many individuals thrive in this system.Even so, students, residents, and even experienced physicians struggle with the weight and the anxiety of facing these transitions on their own. Imagine having to constantly adapt to a completely foreign environment each month and having to learn a new workflow from scratch, all the while facing expectations to provide excellent care. This may partly explain the high rates of depression, burnout, and even suicide among medical trainees.Until the concept of transition is broadened to include the changes and transformations trainees undergo periodically, the support structure will continue to fall short of their needs.Many medical education programs have implemented wellness curricula for new trainees to help them learn self-care strategies like mindfulness practices, cognitive-behavioral strategies, emotion processing techniques, finding meaning reflections, dealing with death and dying and more. At our institution, the Perelman School of Medicine at the University of Pennsylvania, the internal medicine intern wellness program provides four sessions during the intern year. These focus on increasing awareness and ownership of physical and psychological well-being, recognizing signs of burnout and disability, and honing effective communications skills for navigating emotionally complex scenarios.Making self-care part of a physician’s daily life is a necessary first step. Yet, these initiatives have the potential to serve as more than Band-Aids that alleviate and patch the stresses that accompany medical students’ transitions to internship and beyond.Implementing a peer-to-peer support structure with oversight for the various transitions that span post-med school training, whether it be rotation-to-rotation or from semester-to-semester, can better address the root of the problem. Peers who have already experienced various rotations can be the most valuable resources in orienting future residents, but currently these conversations and collegial “orientations” are unofficial. How do young doctors find balance after a 28-hour workday? Transition points in patient care, like the handoff of a patient from a doctor ending his shift to one beginning hers, are widely recognized as periods of increased risk of error. Yet what many in medicine overlook are the hazards of transition points in physicians’ training.Each July, new medical school graduates and other physicians-in-training enter the next stages of their careers. Ranging from interns to residents and fellows, these rising physicians participate in orientation programs as a part of periodic, ongoing transitions into new, progressively expanding clinical roles.At every level of training beyond medical school, there is a strong assumption that these periods of transition are limited to big new beginnings, and that the trainees will rapidly settle in. Orientations tend to focus on the logistics of starting a new job, pivoting from a deluge of information about electronic medical records and human resources packets to ice breakers and password setups. After a few weeks, programs designed to aid in transitions taper off, aside from a few individual review meetings with the program director. Trainees are expected to take flight relatively independently.advertisement Tags educationhospitalsphysicians Related: Jason J. Han These sessions should specifically address the most practical concerns, particularly related to workflow, that accompany each transition: What are the day-to-day tasks an intern, resident, or fellow on a particular service is expected to perform? How does the individual fit into the team’s overall workflow structure? What are the skills and tasks that are essential to maintaining the day-to-day operations?Such matters are generally absent from the current orientation content. Including them could not only help optimize transitions and reduce stress for the staff, but could also contribute to patient care and safety.Existing orientation programs undeniably help physicians-in-training grow more attuned to their emotions and take ownership of their own well-being. Yet they address only the beginning of the cultural transition that medicine needs to undergo.The road to competence in medicine is long, continuous, and stepwise. Only by recognizing the challenges and potential dangers in our own transitions can we one day find ourselves transformed into the health care providers we aspire to be.Jason J. Han, M.D., is a resident in cardiothoracic surgery in the Perelman School of Medicine at the University of Pennsylvania. Neha Vapiwala, M.D., is an associate professor and vice chair of education in the Department of Radiation Oncology and assistant dean of student affairs in the Perelman School of Medicine at the University of Pennsylvania. [email protected] Trainees tend to switch rotations monthly, often having to figure out how to survive and thrive on the job while constantly adapting to new environments with new bosses and sets of expectations. As soon as they master the workflow in one rotation, they transition to the next, repeating the cycle of starting from a blank slate. The experience of trainees is more akin to punctuated equilibrium than it is to gradual evolution. What is demanded of trainees is not transition but constant transformation.advertisement About the Authors Reprints
Biotech About the Author Reprints Biogen’s rain-making rare-disease drug hits a sales slump Damian Garde National Biotech Reporter Damian covers biotech, is a co-writer of The Readout newsletter, and a co-host of “The Readout LOUD” podcast. By Damian Garde April 24, 2018 Reprints Log In | Learn More [email protected] What’s included? STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. AP/Biogen @damiangarde Unlock this article — plus daily coverage and analysis of the biotech sector — by subscribing to STAT+. First 30 days free. GET STARTED GET STARTED Tags biotechnologyrare disease Biogen’s unexpectedly successful new rare-disease drug, Spinraza, delivered another surprise in the first quarter: flat sales.The drug, which treats spinal muscular atrophy, ran off to an impressive start last year, topping analyst estimates and beating even Biogen’s projections. But everything leveled off between the fourth quarter, when revenue hit $363 million, and the first three months of 2018, when Biogen booked $364 million in Spinraza sales. Analysts had expected first-quarter sales of about $383 million. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. What is it?
Pharmalittle: Existing drugs driving higher prices; Baselga lands at AstraZeneca By Elizabeth Cooney Jan. 8, 2019 Reprints GET STARTED [email protected] Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Tags drug developmentdrug pricingpharmalittleSTAT+ Log In | Learn More What is it? Good morning. Elizabeth Cooney here in Boston, filling in for Ed Silverman while he’s reporting from the J.P. Morgan Healthcare Conference in San Francisco. You can see STAT’s team coverage of the gathering in the Readout @ JPM. Here’s what we’re watching in biopharma today:The costs of oral and injectable brand-name, outpatient drugs increased annually between 2008 and 2016 by 9 percent and 15 percent, respectively, and the price hikes were largely driven by existing drugs, such as insulin, according to a new study described by STAT. When excluding new drugs — those that became available within three previous calendar years — annual costs rose by 8 percent and 16 percent for oral and injectable medicines. This was five to eight times the general rate of inflation in the same time period. General Assignment Reporter Liz focuses on cancer, biomedical engineering, and how patients feel the effects of Covid-19. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Alex Hogan/STAT STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. @cooney_liz About the Author Reprints Pharmalot What’s included? Elizabeth Cooney
GET STARTED Log In | Learn More [email protected] By Nicholas Florko April 10, 2019 Reprints ‘I don’t know how you people sleep at night’: Visibly irate lawmakers blast pharma, PBMs over insulin prices Rep. Jan Schakowsky (D-Ill.), right, walks with Rep. Anna Eshoo (D-Calif.) J. Scott Applewhite/AP @NicholasFlorko Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED WASHINGTON — Drug makers and their middlemen counterparts spent the first three months of the 116th Congress successfully dodging hard blows from members of Congress over the high cost of prescription drugs. That all changed Wednesday.Insulin makers and drug industry middlemen faced hours of hard questions Wednesday from an irate panel of lawmakers, many of whom appeared far more interested in threatening to blow up the entire drug pricing system than in hearing from the pharma company or pharmacy benefit manager executives who testified. Washington Correspondent Nicholas Florko reports on the the intersection of politics and health policy. He is the author the newsletter “D.C. Diagnosis.” What is it? About the Author Reprints What’s included? Nicholas Florko STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Politics Tags Congressdrug pricingpolicy