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UnitedHealth gains fed monies, just not through ObamaCare

UnitedHealth Group Inc. is doing well doing business with the U.S. government. Just not in Obamacare.

 

The company has added more than a million customers in its federally-funded Medicare and Medicaid businesses since Dec. 31, bringing the total in the company’s public programs and seniors unit to 14.9 million, it said in a statement Tuesday announcing first-quarter results. It had a total medical membership of 49.3 million people, even after largely quitting the Affordable Care Act’s markets that many insurers once regarded as a source of millions of new customers.

Shares of the biggest publicly traded U.S. health insurer gained 1.7 percent to $170 at 6:58 a.m. in New York, before the markets opened. They’re up 31 percent in the last 12 months, as of Monday’s close.

 

The company has been expanding in Medicare, where it offers private health plans for the elderly, and in Medicaid, where it helps states manage low-income individuals. Those businesses have proven to be more lucrative than Obamacare’s individual market, where UnitedHealth broadly retreated after offering plans on the health law’s exchanges in 34 states last year.

The trends in UnitedHealth’s government business will help boost profits. The Minnetonka, Minnesota-based company predicted that earnings for the full year, excluding some items, will be $9.65 to $9.85 a share. That’s well above the $9.51 projected by analysts, according to an average of estimates compiled by Bloomberg, and above the company’s January forecast.

First-quarter earnings excluding some items were $2.37 a share, topping the $2.17 average of analysts’ estimates.

Distracted rivals

UnitedHealth has also benefited from the entanglement of its major rivals in two massive deals. Humana Inc. and Aetna Inc., the No. 2 and No. 3 sellers of private Medicare plans, in February ended their long effort to combine, after the transaction was blocked by a federal judge. Anthem Inc. and Cigna Corp. are embroiled in several legal challenges tied to their merger attempt, and a key ruling could come this week.

 

Health insurers are also getting a boost from a one-year pause of a tax on the industry under the Affordable Care Act. UnitedHealth said the tax holiday pushed the company’s tax rate down to 30 percent, and that it expects the full-year rate now to be 32.5 percent.

The company’s technology, consulting and medical-care arm, known as Optum, contributed to growth in the quarter. Optum posted operating earnings of $1.28 billion, 16 percent higher than a year earlier. Operating earnings at the health-insurance business climbed 15 percent to $2.13 billion.

UnitedHealth has used a series of acquisitions to expand Optum. In the first quarter, it acquired medical provider Surgical Care Affiliates Inc. in an about $2.3 billion deal. Surgical Care said it serves about 1 million patients a year at its 205 facilities. The OptumHealth medical unit mainly consists of urgent care and primary care, and saw revenue climb 18 percent in the quarter.

Growth was slower at the OptumRx pharmacy-benefits operation, where revenue increased 4.7 percent. The company acquired rival pharmacy-benefits manager Catamaran Corp. in 2015.

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Using CRISPR to reverse retinitis pigmentosa, restore visual function

Using the gene-editing tool CRISPR/Cas9, researchers at University of California San Diego School of Medicine and Shiley Eye Institute at UC San Diego Health, with colleagues in China, have reprogrammed mutated rod photoreceptors to become functioning cone photoreceptors, reversing cellular degeneration and restoring visual function in two mouse models of retinitis pigmentosa.

 

The findings are published in the April 21 advance online issue of Cell Research.

Retinitis pigmentosa (RP) is a group of inherited vision disorders caused by numerous mutations in more than 60 genes. The mutations affect the eyes’ photoreceptors, specialized in the retina that sense and convert light images into electrical signals sent to the brain. There are two types: rod cells that function for night vision and peripheral vision, and cone cells that provide central vision (visual acuity) and discern color. The human retina typically contains 120 million rod cells and 6 million cone cells.

In RP, which affects approximately 100,000 Americans and 1 in 4,000 persons worldwide, rod-specific genetic mutations cause rod photoreceptor cells to dysfunction and degenerate over time. Initial symptoms are loss of peripheral and night vision, followed by diminished visual acuity and color perception as cone cells also begin to fail and die. There is no treatment for RP. The eventual result may be legal blindness.

In their published research, a team led by senior author Kang Zhang, MD, PhD, chief of ophthalmic genetics, founding director of the Institute for Genomic Medicine and co-director of biomaterials and tissue engineering at the Institute of Engineering in Medicine, both at UC San Diego School of Medicine, used CRISPR/Cas9 to deactivate a master switch gene called Nrl and a downstream transcription factor called Nr2e3.

CRISPR, which stands for Clustered Regularly Interspaced Short Palindromic Repeats, allows researchers to target specific stretches of genetic code and edit DNA at precise locations, modifying select gene functions. Deactivating either Nrl or Nr2e3 reprogrammed to become cone cells.

“Cone cells are less vulnerable to the genetic mutations that cause RP,” said Zhang. “Our strategy was to use gene therapy to make the underlying mutations irrelevant, resulting in the preservation of tissue and vision.”

The scientists tested their approach in two different mouse models of RP. In both cases, they found an abundance of reprogrammed and preserved cellular architecture in the retinas. Electroretinography testing of rod and cone receptors in live mice show improved function.

Zhang said a recent independent study led by Zhijian Wu, PhD, at National Eye Institute, part of the National Institutes of Health, also reached similar conclusions.

The researchers used adeno-associated virus (AAV) to perform the gene therapy, which they said should help advance their work to human clinical trials quicker. “AAV is a common cold virus and has been used in many successful treatments with a relatively good safely profile,” said Zhang. “Human clinical trials could be planned soon after completion of preclinical study. There is no treatment for RP so the need is great and pressing. In addition, our approach of reprogramming mutation-sensitive cells to mutation-resistant cells may have broader application to other human diseases, including cancer.”

Explore further: Scientists deploy CRISPR to preserve photoreceptors in mice

More information: Jie Zhu et al, Gene and mutation independent therapy via CRISPR-Cas9 mediated cellular reprogramming in rod photoreceptors, Cell Research (2017). DOI: 10.1038/cr.2017.57

http://bit.ly/2pLLez4

Gene that blocks spread of colon cancer found

Researchers from RCSI (Royal College of Surgeons in Ireland) and the University of Nice, France, have discovered the function of a gene called KCNQ1 that is directly related to the survival of colon cancer patients. The gene produces pore-forming proteins in cell membranes, known as ion channels. The finding is an important breakthrough towards the development of more effective therapies for colon cancer and new diagnostics that will provide a more accurate prognosis for colon cancer patients. The research is published this week in the prestigious journal Proceedings of the National Academy of Sciences (PNAS).

 

This is the first study of its kind to work out the molecular mechanisms of how the KCNQ1 ion channel gene suppresses the growth and spread of colon tumours.

Worldwide, there are 774,000 deaths from colorectal cancer each year and it is the third leading cause of death from cancer globally. In Ireland, almost 2,500 Irish people are diagnosed with bowel cancer annually and it is the second most common cause of cancer death.

The research team, led by Professor Brian Harvey, Department of Molecular Medicine, RCSI, have identified the by which the KCNQ1 gene suppresses the growth and spread of colon cancer cells. The KCNQ1 gene works by producing an ion channel protein which traps a tumour promoting protein called beta-catenin in the cell membranes before it can enter the nucleus of the cell causing more cancer cells to grow.

The study looked at the relationship between the expression of the KCNQ1 gene and patient survival from more than 300 colon cancer . Patients who had high expression of the KCNQ1 gene were found to have a longer survival and less chance of relapse.

Commenting on the significance of the discovery Professor Harvey said: “This study has demonstrated the ability of an ion channel gene to block the growth of . This is an exciting discovery as it opens up the possibility of a new kind of therapy that will target the KCNQ1 gene with drugs and also as a biomarker to improve diagnostics of colon cancer onset and development in patients. This information will help clinicians to identify the most effective treatment for the individual patient.”

“In the future, when we understand more about the KCNQ1 gene through further research, it will open up the possibility of developing new drug treatments that will be able harness the suppressive properties of the gene to target the colon specifically, without exposing other tissues in the body to unnecessary chemotherapy. The development of more targeted treatments for colon cancer is vital to improve the prognosis and quality of life for patients.”

Explore further: Among colon cancer patients, smokers have worse outcomes than non-smokers

More information: Raphael Rapetti-Mauss et al. Bidirectional KCNQ1:β-catenin interaction drives colorectal cancer cell differentiation, Proceedings of the National Academy of Sciences (2017). DOI: 10.1073/pnas.1702913114

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New types of blood cells discovered

Scientists have identified new classes of cells in the human immune system.

 

The cells are new classes of types of called dendritic cells and monocytes. Researchers have identified two new dendritic cell subtypes and two monocyte subtypes. They have also discovered a new dendritic cell progenitor.

Wellcome-funded researchers used a technique called single-cell genomics to analyse in individual human blood cells. Previously, different types of were investigated and defined by the set of marker proteins that they express on their surface. This new technique is much more powerful and can reveal previously unrecognised and rare cell types that would be otherwise difficult to find.

Dendritic cells display molecules called antigens on their surfaces. These molecules are recognised by T cells which then mount an immune response. Monocytes are the largest type of white blood cell and can develop into macrophages that digest debris in our cells.

Divya Shah, from Wellcome’s Infection and Immunobiology team, says: “Two important white blood cell types in our bodies help defend us from infection – and monocytes. In this study, scientists have used cutting-edge technologies to find that there are many more types of cell than we originally thought. The next step is to find out what each of these cell types do in our immune system, both when we’re healthy and during disease.”

This research is one of the first major findings to come out of the Human Cell Atlas initiative, announced last year. It offers a useful basis for conducting this kind of analysis on other and tissues.

Explore further: Understanding the origins and function of CD14+ immune cells

More information: Alexandra-Chloé Villani et al. Single-cell RNA-seq reveals new types of human blood dendritic cells, monocytes, and progenitors, Science (2017). DOI: 10.1126/science.aah4573

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Can diabetes be cured? Review of therapies and lifestyle changes

Diabetes is a condition that affects blood sugar levels and causes many serious health problems if not managed well. The health impacts of diabetes can be limited, but can it ever be “cured”?

Type 1 diabetes is an autoimmune disease that develops when the body destroys the cells in the pancreas that produce insulin. This means people with type 1 diabetes do not make insulin.

In those with type 2 diabetes, there is a decreased sensitivity to insulin and the body does not make or use as much insulin as it needs. Type 2 diabetes is much more common than type 1 diabetes.

This article reviews therapies and lifestyle changes that can help reduce the effects of diabetes on a person’s health.

It also explores whether these treatments can help “cure” diabetes, or if they are simply helpful ways to manage the condition.

Is diabetes curable?

[adolescent getting his blood sugar tested by a doctor or nurse]
While diabetes cannot technically be cured, it can go into remission.

Medically speaking, there is no cure for diabetes but it can go into “remission.”

Diabetes in remission simply means the body does not show any signs of diabetes. However, the disease is technically still there.

According to Diabetes Care, remission can take different forms:

  • Partial remission: When a person has had a blood glucose level lower than that of a person with diabetes for at least 1 year without any diabetes medication.
  • Complete remission: When the blood glucose level returns to normal, not simply pre-diabetic levels, for at least 1 year without any medications.
  • Prolonged remission: When complete remission lasts for at least 5 years.

Even if a person has had normal blood sugar levels for 20 years, their diabetes is still considered to be in remission rather than “cured.”

There is no known cure for diabetes. The good news is that remission is possible in many cases and can be as simple as making some lifestyle changes.

Managing type 1 diabetes

Type 1 diabetes is an autoimmune disease that is often diagnosed in childhood. It occurs when the body mistakenly attacks the beta cells of the pancreas, making it impossible for them to produce the insulin necessary to use sugars.

This can be a daunting diagnosis for someone, yet many people manage the condition well. Some individuals have diabetes that goes into remission after they have followed certain special therapies. These therapies aim to stop the body from attacking the pancreatic cells, allowing it to produce its own insulin.

Use of verapamil

[bottles of pills in a row]
Verapil has been tested in studies for its effectiveness in people with diabetes.

A recent study found that an old blood pressure drug called verapamil may be helpful for people with diabetes.

In the study, people with type 1 or late-stage type 2 diabetes were given verapamil. It was found that their fasting glucose levels were much lower than those who did not take the drug.

The results were enough to warrant a clinical trial. If the results of this clinical trial are positive, verapamil may be more widely used to treat diabetes.

Implantable devices

There has also been research into the use of implantable devices to manage type 1 diabetes.

An implantable device that could protect beta cells in the pancreas has been designed and tested on mice. Researchers found that the device protected a mouse’s pancreatic beta cells from being attacked by the immune system for up to 6 months.

This is a significant length of time considering the life span of a mouse. The research is considered a promising step towards a diabetes-free future for many people.

Further research

The City of Hope’s Diabetes and Metabolism Research Institute also recently announced a project called the Wanek Family Project for Type 1 Diabetes. This is a 6-year project that aims to cure type 1 diabetes. While more research needs to be done in this field, the current outlook for people diagnosed with type 1 diabetes is promising.

Managing type 2 diabetes

There is currently a better chance of reversing type 2 diabetes symptoms and putting the condition into remission than there is for type 1. This is because type 2 diabetes is not an autoimmune disease and a range of outside forces can affect it.

Dietary intake and obesity both play a big part in type 2 diabetes. As such, reversal is possible in people who adhere to certain lifestyle changes.

Research into reversal methods

A recent pilot study found that certain interventions can help put type 2 diabetes into remission, including:

  • personalized exercise routines
  • strict diets
  • glucose-controlling drugs

Four months after the intervention, 40 percent of the subjects were able to stop taking their medications, staying in partial or complete remission.

Lifestyle changes for type 2 diabetes

There are two main lifestyle changes that people can make to help manage type 2 diabetes. These are explained here:

Exercise and weight loss

A good diet and regular exercise are the first steps to managing conditions, such as type 2 diabetes. In fact, weight loss is the cornerstone of treatment for people with type 2 diabetes.

Research has shown that physical activity combined with modest weight loss can reduce the risk for type 2 diabetes by up to 58 percent.

Moderate exercise is considered 150 minutes a week of aerobic activities, including:

[happy older woman swimming in a pool]
Swimming and other moderate forms of exercise are a good way to manage the symptoms of diabetes.
  • swimming
  • brisk walking
  • bicycle riding

It is possible to meet this target by doing a 30-minute session 5 days a week. This may be enough to help the body manage diabetes symptoms.

Diet tips

Diet tips for controlling type 2 diabetes:

  • Limit carbohydrates: replacing carbohydrates with high-protein and high-fiber foods will help regulate blood sugar.
  • Eat less sugar: Sugar replacements such as stevia may help some people manage diabetes symptoms.
  • Fiber-rich food: Fiber can help slow the digestion of carbohydrates and sugars.

The U.S. National Library of Medicine also recommend eating a wide variety of foods as part of every meal, including:

  • vegetables
  • fruits
  • whole grains
  • proteins
  • low-fat dairy products

A varied diet ensures the body is getting all the nutrients it needs to stay healthy. People are also recommended to eat fewer calories and try to eat similar amounts of carbohydrates at each meal.

Foods high in healthy polyunsaturated fats, such as fish, nuts, and vegetable oils are also highly recommended.

Surgery

If making dietary changes and doing exercise are not possible or successful, weight loss can be achieved by bariatric surgery. This type of surgery involves reducing the size of the stomach, which helps people feel full. Some types of surgery also change a person’s anatomy and may alter hormones that contribute to weight gain.

Gastric band surgery and gastric bypass surgery are two common examples of this medical intervention. There are risks involved with these surgeries, so they are not usually seen as the first option.

Outlook

While there are no medical cures for diabetes, some very promising treatment methods are being researched.

New treatment options are being developed that could bring relief to even more people with diabetes. Working directly with a capable doctor may help people find treatment options that could put their diabetes into remission.

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Valeant put $3,500 a month price on psoriasis med

Troubled pharmaceutical company Valeant Pharmaceuticals Intl Inc VRX 4.17% announced on Friday pricing for its SILIQ (brodalumab) injection.

What Is SILIQ?

The U.S. Food and Drug Administration approved the Biologics License Application for SILIQ, which is a monoclonal antibody that targets the IL-17 receptor for patients with moderate-to-severe plaque psoriasis for the treatment of moderate to severe plaque psoriasis in adult patients.

Valeant’s Patient Access and Pricing Committee will list the SILIQ injection at $3,500 per month, which the company noted is the lowest injectable treatment currently on the market.

The company will also include SILIQ in its patient access program, which offers financial support and access to patients. Sales and marketing of the therapy are expected to begin in the United States in the bottom half of 2017.

SILIQ does have a Black Box Warning for risk in patients with a history of suicidal thoughts or behavior.

“The Patient Access and Pricing Committee was constructed to help our company ensure patients have the best possible access to our products. Our goal with SILIQ is to provide outstanding efficacy while being the most affordable injectable biologic for patients with moderate-to-severe plaque psoriasis,” said Joseph Papa, chairman and CEO of Valeant.

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Aurinia positive Phase 2 data implies big potential

Elemer Piros of Cantor Fitzgerald maintains an Overweight rating on Aurinia Pharmaceuticals Inc AUPH 1.57%‘s stock with a $14 price target after the company reported data from a Phase 2b study, which helped boost the stock higher by more than 5 percent.

During the National Kidney Foundation Spring Clinical Meeting on Thursday, the company discussed results from a 48-week secondary analysis from a Phase 2B study. The study, called AURA, is exploring a therapy called voclosporin for the treatment of lupus nephritis.

Aurinia reported that in addition to the therapy meeting its complete and partial remission endpoints at 48 weeks, all pre-specified secondary endpoints were also met, including speed of remission, reduction in Systemic Lupus Erythematosus Disease Activity Index, and reduction in urine protein creatinine ratio.

Piros: ‘Encouraged’ By Results

In a follow up from Piros’ initiation note in early April, the analyst stated that Aurinia’s data release is encouraging and supports a Phase 3 52-week primary endpoint design.

The analyst further noted that the company’s voclosporin happens to be the first development candidate to achieve a successful primary readout in a large trial. This also works in Aurinia’s favor since there is no approved therapy for lupus nephritis to-date.

The analyst’s $14 price target is based on a net present value (NPV) of future cash flows associated with voclosporin and also factors in an estimated $2 per share in cash.

At last check in Friday’s pre-market session, shares of Aurinia were up 4.86 percent at $7.34.

 

Latest Ratings for AUPH

Date Firm Action From To
Apr 2017 Cantor Fitzgerald Initiates Coverage On Overweight
Nov 2016 Mackie Research Initiates Coverage On Speculative Buy
Jun 2016 H.C. Wainwright Initiates Coverage on Buy

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