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iShares Global Healthcare ETF (IXJ)

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  • Dec. 5, 2014, 7:19 AM
    • Doctors say that simple intravenous fluid drips could save the lives of many Ebola patients, but they are not being deployed due to a perception that no treatment will work.  Many patients are succumbing to extreme dehydration and electrolyte depletion caused by vomiting and diarrhea, according to Ian Roberts of the London School of Hygiene and Tropical Medicine and Anders Perner of Copenhagen University. "Ebola treatment must be more that just a setting for quarantine. Patients will be reluctant to attend treatment centers unless the care they receive...is superior to the care provided by family members."
    • The epidemic in West Africa has claimed more than 6,000 lives out of ~17,000 that have been infected. All but 15 of the deaths have occurred in Sierra Leone, Guinea and Liberia.
    • ETFs: IRY, IXJ
    • Ebola-related tickers: (NYSE:GSK) (NYSE:JNJ) (NYSE:MRK) (NASDAQ:NLNK) (OTCQB:AEMD) (NASDAQ:TKMR) (NYSEMKT:HEB) (NASDAQ:SRPT) (NASDAQ:BCRX)
    | 8 Comments
  • Dec. 2, 2014, 10:22 AM
    • Based on data collected from the analysis of medical records, the Centers for Medicare and Medicaid Services (CMS) report that U.S. hospitals saved 50,000 lives in 2013 by making 17% fewer medical mistakes. The improvement includes a 9% decline in hospital-acquired conditions such as infections, bedsores and pneumonia.
    • Secretary of Health and Human Services (HHS) Sylvia Burwell is scheduled to announce the findings today at the CMS Healthcare Quality Conference in Baltimore.
    • In 1999, the Institute of Medicine estimated that almost 100K people die each year from medical mistakes and poor quality of care. In 2010, the HHS inspector general estimated that poor care contributed to the deaths of 180K Medicare patients.
    • One motivator for the improvement is a change in the way Medicare pays hospitals. Under updated rules, CMS reduces the reimbursement rate for hospitals that readmit too many patients within 30 days of discharge, an indicator of substandard care the first time.
    • ETFs: IRY, IXJ,
    • Hospital tickers: (HUM)(HCA +0.2%)(UHS -0.3%)(SEM +0.8%)(LPNT +0.4%)(CYH +0.3%)(SSY -0.2%)
    | 7 Comments
  • Nov. 28, 2014, 9:23 AM
    • The European Commission approves Boehringer Ingelheim's Vargatef (nintedanib), in combination with docetaxel, for the treatment of adult patients with locally advanced, metastatic or locally recurrent non-small cell lung cancer (NSCLC) of adenocarcinoma tumor histology, after first-line chemotherapy. Adenocarcinoma is the most common form of lung cancer.
    • Nintedanib is an oral angiokinase inhibitor which simultaneously inhibits endothelial growth factor receptors (VEGFR), platelet-derived growth factor receptors (PDGFR) and fibroblast growth factor receptors (FGFR) signalling pathways. It is currently being investigated in various other cancers.
    • Earlier this month, Europe's Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion supporting approval of nintedanib, branded as Ofev, for the treatment of ideopathic pulmonary fibrosis (IPF). The FDA approved it for IPF in October.
    • Previously: Europe Ad Comm supports approval for BI pulmonary fibrosis drug
    • Previously: BI begins enrollment in Phase 3 CRC trial
    • ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS
    • Lung cancer-related tickers: (NYSE:BMY) (NYSE:MRK) (NASDAQ:CLVS) (NASDAQ:FPRX) (NASDAQ:BIND) (NYSE:GSK) (NASDAQ:ARIA) (NASDAQ:ECYT) (NYSE:AZN) (OTC:MKGAF) (OTCPK:MKGAY) (NASDAQ:ONTY) (NYSE:PFE) (NASDAQ:HTBX) (OTCQX:RHHBY) (NASDAQ:INCY)
    | 1 Comment
  • Nov. 25, 2014, 8:18 AM
    • Pharmacy benefits manager Express Scripts (NASDAQ:ESRX) is at the forefront of an increasing wave of resistance to the high prices of new drugs from pharma and biotech firms, some which cost as much as $50K per month. Pharmaceutical spending in the U.S. is $270B and may breach $500B in five years. ESRX's method of controlling costs is to refuse to pay for them. For 2015, for example, it is excluding 66 branded drugs from its main formulary, an increase of 18 from 2014's 48. On the list is Johnson & Johnson's (NYSE:JNJ) rheumatoid arthritis drug Simponi (golimumab) which costs $3K per month.
    • Other prescription benefits managers are employing similar tactics. CVS Health (NYSE:CVS) will exclude 95 drugs from its 2015 formulary including Pfizer's (NYSE:PFE) multiple sclerosis med Rebif (interferon beta-1a) which costs $5K for a four-week supply.
    • Governments are pushing back as well. Among 42 state Medicaid programs, 27 pay for Gilead Sciences' HCV med Sovaldi (sofosbuvir) only for patients with severe liver damage while others impose coverage limitations for patients with recent substance-abuse problems. In the U.S., the full regimen cost is $84K. Recently, Britain's National Institute for Health and Care Excellence (NICE) balked at recommending reimbursement for Roche's (OTCQX:RHHBY) blood cancer drug Gazyvaro (obinutuzumab).
    • Ninety percent of commercial health plans require pre-approval of specialty drugs, up from 82% in 2011.
    • Previously: Roche's Gazyvaro not NICE in the UK
    • Previously: Global drug tab will breach trillion dollar mark this year
    • ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS
    • Related tickers: (NYSE:NVS) (NYSE:AZN) (NASDAQ:AMGN) (NASDAQ:BIIB) (NASDAQ:CELG) (NYSE:LLY) (NYSE:SNY) (NYSE:ABT) (NYSE:ABBV) (NYSE:BMY) (NYSE:MRK) (NYSE:GSK)
    | 24 Comments
  • Nov. 21, 2014, 11:46 AM
    • CB Pharma Acquisition Corp. (CNLMU) files for an IPO of 4M units priced at $10 per unit. Each unit consists of one share of common stock, one right to purchase 1/10 of a share of common stock on the consummation of an initial business combination and one warrant to purchase 1/2 of one share of common stock at a full-share price of $11.50.
    • The firm is a blank check company formed by Coronado Biosciences (CNDO +0.5%). It will seek business combinations via mergers, share exchanges, asset acquisitions, share purchases, recapitalizations or reorganizations.
    • It has 18 months from the consummation of this offering to complete its initial business combination (up to 21 months in certain circumstances) or it will liquidate the trust account, distribute the proceeds to shareholders and dissolve.
    • Per NASDAQ listing rules, the target business for the initial combination must have a fair market value equal to at least 80% of the value of the trust account.
    • ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS (NYSEARCA:IPO)
    | Comment!
  • Nov. 20, 2014, 8:03 AM
    • The Cystic Fibrosis Foundation sells the royalty stream it receives from Vertex Pharmaceutics (NASDAQ:VRTX) to Royalty Pharma for $3.3B. It plans to reinvest the money into new research efforts.
    • The transaction is an example of successful mission investing, a growing trend in philanthropy. Instead of giving charitable grants, the foundation acts as a business partner by making an investment and expecting a share of the profits.
    • Vertex's Kalydeco (ivacaftor), which helps CF patients with a rare genetic mutation, costs more than $300K per year. CF Foundation Chief Robert J. Beall says, "While the drug's high price may have boosted the royalties the foundation gets, we would give up our royalties in a second to drive down the prices. We were not at the pricing table." He adds that the foundation has no plans to subsidize the cost of drugs to patients. "What we're really excited about is the move to a one-time cure." At present, the meds are daily therapies.
    • ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS
    | 1 Comment
  • Nov. 20, 2014, 7:41 AM
    • According to IMS Health (NYSE:IMS) global drug spending will top $1T this year led by Gilead's (NASDAQ:GILD) Sovaldi (sofosbuvir) for hep C and new cancer drugs. The projected spend of $1.06T represents a 7% increase from last year.
    • By 2018, drug spending is projected to rise to $1.3T. Hepatitis C and cancer meds will add ~$100B each, while diabetes care will contribute $78B. Leading the charge in cancer will be Roche's (OTCQX:RHHBY) Perjeta (pertuzumab) and Kadcyla (ado-trastuzumab emtansine), Pharmacyclics' (NASDAQ:PCYC) Imbruvica (ibrutinib) and Amgen's (NASDAQ:AMGN) Kyprolis (carfilzomib).
    • The ever-increasing tab for meds will be controversial because payers' budgets are being stressed while drug developers defend their prices citing high development costs.
    • There is already some push back in cancer. Britain's National Institute for Health and Care Excellence (NICE), which sets guidelines for the National Health Service on costs, procedures and technologies, is balking at approving Roche's Gazyvaro (obinutuzumab) and Kadcyla citing their high cost relative to additional benefits over existing therapies.
    • Previously: Roche's Gazyvaro not NICE in the UK
    • ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS
    | 7 Comments
  • Nov. 11, 2014, 2:06 PM
    • Raleigh, NC-based PRA Health Sciences (Pending:PRAH) is set for its IPO of 18.6M shares of common stock at $20 - 23.
    • The contract research organization provides clinical development services (Phases 1 - 4) to the biotech and pharmaceutical industries. Since 2000, the company has performed ~2,300 clinical trials.
    • KKR, one of the underwriters, acquired the firm in September, 2013 for $1.4B. KKR PRA Investors, L.P., will own ~64% of the stock after the IPO, ~59% if the underwriters' over-allotment is fully exercised.
    • The financials are difficult to compare due several transactions executed by KKR.
    • 2014 Performance (9 mo.) ($M): Revenues: 1,089.6 (+78.0%); Operating Income: 45.1 (+125.1%); Net Loss: (12.9) (+73.3%); CF Ops: 1.4 (-97.2%).
    • ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS (NYSEARCA:IPO)
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  • Oct. 17, 2014, 1:35 PM
    • In a purely political move, President Obama appoints former VP Joe Biden Chief of Staff Ron Klain to the post of Ebola "czar." No one knows for sure what the lawyer will do in the post since he knows next to nothing about Ebola, the scientific basis for the spread of highly contagious diseases and infection control protocols and procedures. He probably looks good on television, though.
    • The Ebola Small Cap Index is mostly down today: (HEB -1.7%)(TKMR -3.4%)(NLNK -11.3%)(NNVC -1.1%)(INO +3.9%)(OTCQB:GOVX -6.9%)(SRPT +3.7%)(CMRX -1.7%)(PLX -3%)(NSPH -5.5%)(BCRX -5.4%)(LAKE -13.5%)(APT -16.8%)(VSR -21.7%)(SMED -7.3%)
    • ETFs: IRY, IXJ
    | 90 Comments
  • Oct. 16, 2014, 8:46 AM
    • To assuage a nervous public, President Obama presented his plan yesterday for containing a potential outbreak of Ebola in the U.S. despite the fact that there are only three infected persons in the country.
    • Rapid response teams will now be on-site within 24 hours of any new Ebola diagnosis in the U.S. Also, CDC officials are reviewing every step taken by the medical staff at Dallas Presbyterian Hospital who cared for Thomas Eric Duncan to find out how the two nurses became infected. Doctors there misdiagnosed Mr. Duncan and sent him home after his initial visit. He was correctly diagnosed after returning to the ER in an ambulance.
    • The President said, "We are taking this very seriously at the highest levels of government. We are going to be able to manage this particular situation, but we have to look forward to the future."
    • ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS
    | 3 Comments
  • Oct. 13, 2014, 1:33 PM
    • Electronic Cigarettes International Group, Ltd. (OTCQB:ECIG) is set for its IPO of 33.3M shares of common stock at a prospective price of $4.50 per share. The firm is selling 28,443,133 shares and selling shareholders are offering 4,890,200.
    • The company markets and distributes electronic cigarettes and accessories through over 50K outlets in multiple countries.
    • Proforma 2013 financials: Revenues: $113.2M; Gross Profit: $55.5M; Operating Expenses: $48.9M; Operating Income: $6.5M; Net Loss: ($11.4M); Loss Per Share: ($0.11).
    • Proforma 1H 2014 financials: Revenues: $48.5M; Gross Profit: $26.8M; Operating Expenses: $57.9M; Operating Loss: ($31.1M); Net Loss: ($10.5M); Loss Per Share: (0.08).
    • Actual 1H 2014 financials: Revenues: $15.4M (+862.5%); Gross Profit: $8.2M (+780.1%); Operating Expenses: $92.8M (-999%); Operating Loss: ($84.6M); Net Loss: ($84.5M); Loss Per Share: ($1.23); Quick Assets: $5.6M (+166.7%); Cash Burn Ops: ($10.9M) (-999%).
    • The company expects Q3 2014 revenues to be $16M - 17M (pro forma net $22.9M - 24.3M).
    • S-1
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    • ETFs: IRY, IXJ (IPO -0.5%)
    | 4 Comments
  • Oct. 9, 2014, 4:08 PM
    • A 40-subject clinical trial to evaluate an experimental Ebola vaccine commences in Mali. The vaccine, which uses an modified adenovirus vector, was developed by investigators at the Vaccine Research Center of the National Institute of Allergy and Infectious Diseases in Bethesda, MD. GlaxoSmithKline (GSK -2.1%) Biologicals is the manufacturer.
    • The trial began yesterday with the vaccination of the first subject, a Malian health care worker. Two more health care workers will be dosed today.
    • ETFs: AFK
    • ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS
    | 1 Comment
  • Oct. 8, 2014, 1:23 PM
    | 9 Comments
  • Oct. 8, 2014, 7:19 AM
    • In an effort to assuage an anxious public, U.S. health officials will implement new Ebola screening procedures at airports. The initiative will go beyond the CDC's efforts to augment the screening of passengers leaving West African countries affected by the outbreak such as Liberia.
    • Passenger screening upon arrival in the U.S. could detect those who developed a fever during flight. This may create problems with border control officers and flight crews, however Since West African teams began screening passengers for fevers, 77 people out of 36,000 have been stopped from boarding flights. Of these, 74 had fever and 3 had other symptoms. Most turned out to have malaria. None had Ebola.
    • The new procedures will likely include more thorough pre-screening and more detailed questioning of passengers leaving Ebola hot spots such as Guinea and Sierra Leone.
    • ETFs: AFK
    • ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS
    | 1 Comment
  • Oct. 1, 2014, 10:05 AM
    • In response to the ever-increasing risk of security breaches, the FDA issues final guidance for device makers entitled, "Content of Premarket Submissions for Management of Cybersecurity in Medical Devices." The agency recommends that device manufacturers consider cybersecurity risks at part of the design and development of their products and submit documentation to the FDA about the risks identified and the controls in place to mitigate them. The agency also recommends that companies submit their plans for patches and upgrades to device operating systems and medical software.
    • The agency will hold a public workshop on October 21, 2014 to discuss how all the constituency groups can work together to improve cybersecurity in medical devices and protect the public health.
    • ETFs: IBB, BIB, IRY, IXJ, BIS, DRGS
    • Some related tickers: (MDT -0.2%)(BSX -0.9%)(STJ -0.3%)(ABT -0.6%)(JNJ -1.4%)(OTCQX:RHHBY +0.1%)
    | 1 Comment
  • Oct. 1, 2014, 8:21 AM
    • Yesterday, the U.S. Government released the first comprehensive disclosure of payments made by medical companies to doctors. Over the first five months of 2013, med firms paid $3.5B to doctors to fund items such as research, consulting, royalties to hospitals to help develop products and fees for speaking engagements. The monies were disbursed in two broad categories: research funding and fees to doctors for consulting and other non-research services.
    • Roche's (OTCQX:RHHBY) Genentech unit led the way in the non-research category with $135M. Most of this (90%) went to a Southern California hospital network for royalties.
    • Bristol-Myers Squibb (NYSE:BMY) was #1 in the research category with $329M which, according to the company, was largely the value of experimental medicines used in studies.
    • Medtronic (NYSE:MDT) paid one unidentified doctor ~$3M who was among a group of six physicians paid at least $500K by the device maker. The company's total outlay for the period was $30.1M.
    • Johnson & Johnson (NYSE:JNJ) paid $68M for non-research expenses.
    • The disclosures, mandated by Obamacare, cover 4.4M payments to ~550K doctors and 1,360 teaching hospitals from August to December 2013.
    • The disclosures are a bit controversial. Physicians complained that the government did not give them enough time to review the data to correct mistakes.
    • ETFs: IBB, BIB, IRY, BIS, IXJ, DRGS
    | 7 Comments
IXJ vs. ETF Alternatives
IXJ Description
The iShares S&P Global Healthcare Sector Index Fund seeks investment results that correspond generally to the price and yield performance, before fees and expenses, of companies that Standard & Poor's deems part of the healthcare sector of the economy and important to global markets, as represented by the S&P Global Healthcare Sector Index. The index is a subset of the Standard & Poor's Global 1200 Index.
See more details on sponsor's website
Sector: Healthcare
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