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Deaths Of Despair Afflict More Cohorts Than Case-Deaton Originally Found

Deaths Of Despair Afflict More Cohorts Than Case-Deaton Originally Found

Authored by Yves Smith via NakedCapitalism.com,

At the risk of over-hoisting…

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Deaths Of Despair Afflict More Cohorts Than Case-Deaton Originally Found

Authored by Yves Smith via NakedCapitalism.com,

At the risk of over-hoisting from an important piece of analysis, below are some of the key sections from Anusar Farooqui, who writes as Policy Tensor, on the extent of the “death of despair” catastrophe. His piece, Yes, High-School Graduates Are Dying of Despair, is important because he demonstrates that the rising death rates over time extend even into those with some college education.

Farooqu got in an argument with Matt Yglesias on Twitter over the body of work by Ann Case and Angus Deaton on so-called deaths of despair, in which they found what they called an AIDS-level surge of mortality among less-educated whites in middle age. Not only have Case and Deaton refined their analysis, but other studies have identified an increase in early deaths from suicide and addiction in other groups.

For background, from our first post in 2015 on Case-Deaton findings:By Pressreach

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The authors found that from 1999 to 2013, the death rate among non-Hispanic whites aged 45 to 54 with a high school education or less rose, while it fell in other age and ethnic groups. This is an HIV-level silent epidemic: AIDS killed an estimated 650,000 from the mid-1980s to present, while an estimated close to half-million died in half that time period who would have lived had their mortality rates fallen in line with the rest of the population. It is hard to overstate the significance of these findings. From the New York Times:

“It is difficult to find modern settings with survival losses of this magnitude,” wrote two Dartmouth economists, Ellen Meara and Jonathan S. Skinner, in a commentary to the Deaton-Case analysis that was published in Proceedings of the National Academy of Sciences.

This cross-country comparison from the study shows how extreme an outlier these middle aged whites are:

The big culprits are linked to despair, namely “poisoning” which is opioid abuse first and alcoholism second, and suicides. Case and Deaton dug into the underlying statistics, and found distressingly high levels of pain and impaired health in this age group, so pain and physical impairment may well be bigger culprits than economic distress:

And the rise in death rates took place among men and women, in all of the four major regions of the country the authors examined, and obesity rates were not a driving factor.

These pathologies have been showing up in other demographics. For instance, the Wall Street Journal reported in May 2023 that death rates in the 1 to 19 year old age group had risen at an unprecedented rate from 2019 to 2021 due to guns, suicides, car accidents, and drugs.

Now to the immediate discussion. Farooqui took issue with a claim by Matt Yglesias, bolstered by Eric Levitz, that the Case-Deaton data was less significant that it might seem because it lumped together those with no high school degrees with high school diplomas. Yglesias and Levitz argued that the “deaths of despair” were only taking place among high school dropouts and so the white working class was not in as terrible shape as it might seem.

Farooqui pointed out that Case and Deanton had shown that death rates among the middle aged were rising, albeit relatively modestly, even among those with some college education. But then he turns to the crux of the disagreement:

However, they [Case and Deaton] do not distinguish between [less than] HS and HS, and therefore do not address the specific issue highlighted by Levitz: “… it is actually an acute crisis of mortality of the bottom 10%.”

This is an empirical question. We attack this problem using CDC data collated by Wharton. They have age-specific mortality rates by educational attainment. The ordinal categories are

In order to obtain a more representative graph, we use age-specific population weights to combine age-specific hazard ratios. The next graph displays the population-weighted average of hazard ratios for our age-specific cohorts. By construction, this weighted average of hazard ratios is not confounded by any increase in average age within discrete age brackets. And, as explained above, because we’re looking at hazard ratios, it is also not confounded by the common component. This is as kosher as it gets in this business.

We can see that the upward trend in hazard ratios is not confined to high-school dropouts. It is true that the trend is most pronounced for them. But the upward trend is also significant for high-school graduates and those with some college under their belt. The all-cause hazard ratio has increased by 3.28 for high-school dropouts, 2.08 for high school graduates, and 1.27 for those with some college. The upshot is that, on the wrong side of the diploma divide, despair goes very far up indeed.

And then he drives the point home (I’ve omitted the charts in this section, but Farooqui showed he has the goods):

All-cause mortality has a very strong signal. But the evidence for American working class despair is not confined to mortality. Prime-age labor force participation contains the same signal of despair: four out of every nine Americans with only a high-school diploma are not even looking for a job. It’s not like high-school graduates can survive on one pay-check! These are obviously discouraged workers in despair.

Take family reproduction—perhaps the most important factor in human well-being. Following the Sixties revolution in behavioral norms, the rate of family reproduction stabilized for college graduates by the 1990s. But it has continued to fall for high school graduates. See my note from three years ago. And if you’re interested a deeper dive, see Andrew Cherlin’s work.

Or, take divorce rates. For college graduates, 29.7 percent of first marriages end in divorce by age 46. For high-school graduates, 48.2 percent of first marriages end in divorce. (The table’s from here.)

We can keep going. The truth is that American working-class despair is such a robust, large-scale pattern that one can recover the signal from practically anything we care to measure—mortality, morbidity, BMI, labor force participation, marriage rates, child-out-of-wedlock rates, you name it.

So, I stand by my challenge to Matthew Yglesias.

Well-off Americans are so removed from these cohorts, usually encountering them in various service, as in servile, positions where they have to put on a good face as a condition of getting paid, that they can pretend that the lesser orders aren’t suffering in financial and emotional terms.

One proof is despite Case’s and Deaton’s landmark work, there’s no interest in what to do to alleviate this personal and collective disaster. Our version of “Let them eat cake” has gone from “let them learn to code” to “Deprogram them all”.

Tyler Durden Tue, 10/17/2023 - 18:45

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Glimpse Of Sanity: Dartmouth Returns Standardized Testing For Admission After Failed Experiment

Glimpse Of Sanity: Dartmouth Returns Standardized Testing For Admission After Failed Experiment

In response to the virus pandemic and nationwide…

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Glimpse Of Sanity: Dartmouth Returns Standardized Testing For Admission After Failed Experiment

In response to the virus pandemic and nationwide Black Lives Matter riots in the summer of 2020, some elite colleges and universities shredded testing requirements for admission. Several years later, the test-optional admission has yet to produce the promising results for racial and class-based equity that many woke academic institutions wished.

The failure of test-optional admission policies has forced Dartmouth College to reinstate standardized test scores for admission starting next year. This should never have been eliminated, as merit will always prevail. 

"Nearly four years later, having studied the role of testing in our admissions process as well as its value as a predictor of student success at Dartmouth, we are removing the extended pause and reactivating the standardized testing requirement for undergraduate admission, effective with the Class of 2029," Dartmouth wrote in a press release Monday morning. 

"For Dartmouth, the evidence supporting our reactivation of a required testing policy is clear. Our bottom line is simple: we believe a standardized testing requirement will improve—not detract from—our ability to bring the most promising and diverse students to our campus," the elite college said. 

Who would've thought eliminating standardized tests for admission because a fringe minority said they were instruments of racism and a biased system was ever a good idea? 

Also, it doesn't take a rocket scientist to figure this out. More from Dartmouth, who commissioned the research: 

They also found that test scores represent an especially valuable tool to identify high-achieving applicants from low and middle-income backgrounds; who are first-generation college-bound; as well as students from urban and rural backgrounds.

All the colleges and universities that quickly adopted test-optional admissions in 2020 experienced a surge in applications. Perhaps the push for test-optional was under the guise of woke equality but was nothing more than protecting the bottom line for these institutions. 

A glimpse of sanity returns to woke schools: Admit qualified kids. Next up is corporate America and all tiers of the US government. 

Tyler Durden Mon, 02/05/2024 - 17:20

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Four burning questions about the future of the $16.5B Novo-Catalent deal

To build or to buy? That’s a classic question for pharma boardrooms, and Novo Nordisk is going with both.
Beyond spending billions of dollars to expand…

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To build or to buy? That’s a classic question for pharma boardrooms, and Novo Nordisk is going with both.

Beyond spending billions of dollars to expand its own production capacity for its weight loss drugs, the Danish drugmaker said Monday it will pay $11 billion to acquire three manufacturing plants from Catalent. It’s part of a broader $16.5 billion deal with Novo Holdings, the investment arm of the pharma’s parent group, which agreed to acquire the contract manufacturer and take it private.

It’s a big deal for all parties, with potential ripple effects across the biotech ecosystem. Here’s a look at some of the most pressing questions to watch after Monday’s announcement.

Why did Novo do this?

Novo Holdings isn’t the most obvious buyer for Catalent, particularly after last year’s on-and-off M&A interest from the serial acquirer Danaher. But the deal could benefit both Novo Holdings and Novo Nordisk.

Novo Nordisk’s biggest challenge has been simply making enough of the weight loss drug Wegovy and diabetes therapy Ozempic. On last week’s earnings call, Novo Nordisk CEO Lars Fruergaard Jørgensen said the company isn’t constrained by capital in its efforts to boost manufacturing. Rather, the main challenge is the limited amount of capabilities out there, he said.

“Most pharmaceutical companies in the world would be shopping among the same manufacturers,” he said. “There’s not an unlimited amount of machinery and people to build it.”

While Novo was already one of Catalent’s major customers, the manufacturer has been hamstrung by its own balance sheet. With roughly $5 billion in debt on its books, it’s had to juggle paying down debt with sufficiently investing in its facilities. That’s been particularly challenging in keeping pace with soaring demand for GLP-1 drugs.

Novo, on the other hand, has the balance sheet to funnel as much money as needed into the plants in Italy, Belgium, and Indiana. It’s also struggled to make enough of its popular GLP-1 drugs to meet their soaring demand, with documented shortages of both Ozempic and Wegovy.

The impact won’t be immediate. The parties expect the deal to close near the end of 2024. Novo Nordisk said it expects the three new sites to “gradually increase Novo Nordisk’s filling capacity from 2026 and onwards.”

As for the rest of Catalent — nearly 50 other sites employing thousands of workers — Novo Holdings will take control. The group previously acquired Altasciences in 2021 and Ritedose in 2022, so the Catalent deal builds on a core investing interest in biopharma services, Novo Holdings CEO Kasim Kutay told Endpoints News.

Kasim Kutay

When asked about possible site closures or layoffs, Kutay said the team hasn’t thought about that.

“That’s not our track record. Our track record is to invest in quality businesses and help them grow,” he said. “There’s always stuff to do with any asset you own, but we haven’t bought this company to do some of the stuff you’re talking about.”

What does it mean for Catalent’s customers? 

Until the deal closes, Catalent will operate as a standalone business. After it closes, Novo Nordisk said it will honor its customer obligations at the three sites, a spokesperson said. But they didn’t answer a question about what happens when those contracts expire.

The wrinkle is the long-term future of the three plants that Novo Nordisk is paying for. Those sites don’t exclusively pump out Wegovy, but that could be the logical long-term aim for the Danish drugmaker.

The ideal scenario is that pricing and timelines remain the same for customers, said Nicole Paulk, CEO of the gene therapy startup Siren Biotechnology.

Nicole Paulk

“The name of the group that you’re going to send your check to is now going to be Novo Holdings instead of Catalent, but otherwise everything remains the same,” Paulk told Endpoints. “That’s the best-case scenario.”

In a worst case, Paulk said she feared the new owners could wind up closing sites or laying off Catalent groups. That could create some uncertainty for customers looking for a long-term manufacturing partner.

Are shareholders and regulators happy? 

The pandemic was a wild ride for Catalent’s stock, with shares surging from about $40 to $140 and then crashing back to earth. The $63.50 share price for the takeover is a happy ending depending on the investor.

On that point, the investing giant Elliott Investment Management is satisfied. Marc Steinberg, a partner at Elliott, called the agreement “an outstanding outcome” that “clearly maximizes value for Catalent stockholders” in a statement.

Elliott helped kick off a strategic review last August that culminated in the sale agreement. Compared to Catalent’s stock price before that review started, the deal pays a nearly 40% premium.

Alessandro Maselli

But this is hardly a victory lap for CEO Alessandro Maselli, who took over in July 2022 when Catalent’s stock price was north of $100. Novo’s takeover is a tacit acknowledgment that Maselli could never fully right the ship, as operational problems plagued the company throughout 2023 while it was limited by its debt.

Additional regulatory filings in the next few weeks could give insight into just how competitive the sale process was. William Blair analysts said they don’t expect a competing bidder “given the organic investments already being pursued at other leading CDMOs and the breadth and scale of Catalent’s operations.”

The Blair analysts also noted the companies likely “expect to spend some time educating relevant government agencies” about the deal, given the lengthy closing timeline. Given Novo Nordisk’s ascent — it’s now one of Europe’s most valuable companies — paired with the limited number of large contract manufacturers, antitrust regulators could be interested in taking a close look.

Are Catalent’s problems finally a thing of the past?

Catalent ran into a mix of financial and operational problems over the past year that played no small part in attracting the interest of an activist like Elliott.

Now with a deal in place, how quickly can Novo rectify those problems? Some of the challenges were driven by the demands of being a publicly traded company, like failing to meet investors’ revenue expectations or even filing earnings reports on time.

But Catalent also struggled with its business at times, with a range of manufacturing delays, inspection reports and occasionally writing down acquisitions that didn’t pan out. Novo’s deep pockets will go a long way to a turnaround, but only the future will tell if all these issues are fixed.

Kutay said his team is excited by the opportunity and was satisfied with the due diligence it did on the company.

“We believe we’re buying a strong company with a good management team and good prospects,” Kutay said. “If that wasn’t the case, I don’t think we’d be here.”

Amber Tong and Reynald Castañeda contributed reporting.

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Petrina Kamya, Ph.D., Head of AI Platforms at Insilico Medicine, presents at BIO CEO & Investor Conference

Petrina Kamya, PhD, Head of AI Platforms and President of Insilico Medicine Canada, will present at the BIO CEO & Investor Conference happening Feb….

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Petrina Kamya, PhD, Head of AI Platforms and President of Insilico Medicine Canada, will present at the BIO CEO & Investor Conference happening Feb. 26-27 at the New York Marriott Marquis in New York City. Dr. Kamya will speak as part of the panel “AI within Biopharma: Separating Value from Hype,” on Feb. 27, 1pm ET along with Michael Nally, CEO of Generate: Biomedicines and Liz Schwarzbach, PhD, CBO of BigHat Biosciences.

Credit: Insilico Medicine

Petrina Kamya, PhD, Head of AI Platforms and President of Insilico Medicine Canada, will present at the BIO CEO & Investor Conference happening Feb. 26-27 at the New York Marriott Marquis in New York City. Dr. Kamya will speak as part of the panel “AI within Biopharma: Separating Value from Hype,” on Feb. 27, 1pm ET along with Michael Nally, CEO of Generate: Biomedicines and Liz Schwarzbach, PhD, CBO of BigHat Biosciences.

The session will look at how the latest artificial intelligence (AI) tools – including generative AI and large language models – are currently being used to advance the discovery and design of new drugs, and which technologies are still in development. 

The BIO CEO & Investor Conference brings together over 1,000 attendees and more than 700 companies across industry and institutional investment to discuss the future investment landscape of biotechnology. Sessions focus on topics such as therapeutic advancements, market outlook, and policy priorities.

Insilico Medicine is a leading, clinical stage AI-driven drug discovery company that has raised over $400m in investments since it was founded in 2014. Dr. Kamya leads the development of the Company’s end-to-end generative AI platform, Pharma.AI from Insilico’s AI R&D Center in Montreal. Using modern machine learning techniques in the context of chemistry and biology, the platform has driven the discovery and design of 30+ new therapies, with five in clinical stages – for cancer, fibrosis, inflammatory bowel disease (IBD), and COVID-19. The Company’s lead drug, for the chronic, rare lung condition idiopathic pulmonary fibrosis, is the first AI-designed drug for an AI-discovered target to reach Phase II clinical trials with patients. Nine of the top 20 pharmaceutical companies have used Insilico’s AI platform to advance their programs, and the Company has a number of major strategic licensing deals around its AI-designed therapeutic assets, including with Sanofi, Exelixis and Menarini. 

 

About Insilico Medicine

Insilico Medicine, a global clinical stage biotechnology company powered by generative AI, is connecting biology, chemistry, and clinical trials analysis using next-generation AI systems. The company has developed AI platforms that utilize deep generative models, reinforcement learning, transformers, and other modern machine learning techniques for novel target discovery and the generation of novel molecular structures with desired properties. Insilico Medicine is developing breakthrough solutions to discover and develop innovative drugs for cancer, fibrosis, immunity, central nervous system diseases, infectious diseases, autoimmune diseases, and aging-related diseases. www.insilico.com 


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