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Humana tumbles, UnitedHealth and CVS slide on Medicare Advantage hit

The health insurance sector took yet another blow Tuesday as investors see narrowing near-term profits.

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Humana  (HUM)  shares fell sharply in early Tuesday trading, while rivals UnitedHealth UNH and CVS Health  (CVS)  traded firmly in the red, as the health insurance industry received yet another blow to its 2024 profit forecasts. 

All three major health insurance groups have trailed the broader market this year, with Humana down nearly 25%, amid concern that profit margins will be hit by a surge in medical costs tied to a rise in elective procedures. Those procedures had been delayed by the covid pandemic. 

UnitedHealth's medical-cost ratio, a key industry metric, rose nearly 3 percentage points, to 85%, over the final three months of last year, suggesting that a larger portion of its collected premiums were paid out on insurance claims.

Humana said its benefit-expense ratio rose more than 3 percentage points, to 90.7% over the 2023 fourth quarter compared with the year-earlier period. It also was up more than 3 percentage points from third-quarter 2023 levels.

President Joe Biden has vowed to protect Medicare and strengthen the program's ability to negotiate with big drug and health insurance companies. 

The group noted "elevated Medicare Advantage utilization trends," which it said "further increased in 4Q23, driven by higher-than-anticipated inpatient utilization, primarily for the months of November and December, as well as a further increase in noninpatient trends, predominantly in the categories of physician, outpatient surgeries and supplemental benefits."

Humana health cost warning

Humana in fact sought to mitigate those pressures late last year when it unveiled merger talks with Cigna Group  (CI) , noting that the group "continued to experience an increase in covid admissions in the third quarter." 

The talks were ultimately scrapped, however, amid concern that the Federal Trade Commission, which has taken a far more active role in challenging megamergers under the leadership of Chairwoman Lina Khan, would block the proposed $120-plus billion tie-up.

Related: UnitedHealth hit by antitrust probe and ransomware hacker report

The FTC is also continuing its probe into the three largest pharmacy-benefit managers – CVS's Caremark, Cigna's Express Scripts and UnitedHealth's OptumRx – and has warned the group of likely changes to the industry's broader regulation.

Medicare Advantage payouts flat

Further pressure was added to profit margins Tuesday when the U.S. Centers for Medicare & Medicaid Services said Medicare Advantage payments would rise only by an average of 3.7% next year.

Analysts were looking for an increase of around 4.7%, based on the CMS's January proposal of 3.7% following increases of around 1.22% each year between 2019 and 2024 to preliminary CMS figures. 

The payments, which reimburse insurers for treatment of U.S. patients over age 65, will be effectively lower than current levels when adjusted for costs and inflation.  

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"We see Humana as most-exposed both from its 84% revenue exposure to Medicare Advantage, and on sentiment given its challenging turnaround of the Medicare book," said Cantor Fitzgerald analyst Sarah James. 

"We would also flag CVS as more exposed on sentiment than the 17% revenue exposure would imply, particularly given the outsized investor focus on 2024 Medicare Advantage margins and 2025 bid strategy for the company," she added.

Humana shares were marked 9.2% lower in premarket trading to indicate an opening bell price of $318.70 each. CVS shares slumped 5% to $75.56 each while UnitedHealth was marked 4% lower at $469.95 each.

Related: Veteran fund manager picks favorite stocks for 2024

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Gritstone bio stock drops after Phase 2 cancer vaccine data

Gritstone bio’s stock took a tumble in premarket trading Tuesday morning following mixed data from a Phase 2 study of its cancer vaccine, but it’s…

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Gritstone bio’s stock took a tumble in premarket trading Tuesday morning following mixed data from a Phase 2 study of its cancer vaccine, but it’s still moving ahead with a public offering of its stock and Phase 3 planning.

In a late Monday release, Gritstone touted the data as positive from the Phase 2 portion of its Phase 2/3 GRANITE trial of its neoantigen cancer vaccine in front-line metastatic microsatellite stable colorectal cancer (MSS-CRC). Progression-free survival favored Gritstone’s vaccine in an early trend, even though the dataset is “immature,” the company said in its presentation.

But the primary endpoint of the study — the short-term circulating tumor DNA (ctDNA) response — was described as “negative” and the data utility as “low” by Gritstone in a Monday presentation. The short-term ctDNA response analysis didn’t show a difference between study arms.

Immediately after the announcement, Gritstone priced a $32.5 million public offering of 8.3 million shares of its stock $GRTS at a price of about $1.65 per share, below its previous close. The stock tumbled as much as 33% and was trading at around $1.56 premarket Tuesday. The offering is expected to close on April 4.

The company suggested that it had made a mistake in defining the original clinical trial protocol and setting the primary endpoint.

Andrew Allen

“Pioneering new spaces carries inherent risks, and with regard to defining molecular response, we simply got it wrong,” Gritstone president and CEO Andrew Allen said in a statement. “ctDNA levels in both arms decreased on chemotherapy for longer than we anticipated, generating similar short-term molecular response rates across arms and rendering our protocol measure of ctDNA change uninformative.”

Allen added that “long-term analysis demonstrates the expected correlation of ctDNA with clinical benefit and favors GRANITE patients,” with the potential to share mature progression-free survival data in the third quarter of this year and then enter regulatory discussions regarding the Phase 3 portion of the study.

Randolph Hecht, director of the UCLA GI Oncology Program and an investigator in the GRANITE Phase 2/3 study, noted that the progression-free survival difference shows a “potential” for clinical benefit as well as a reason to move into a confirmatory Phase 3 trial.

“Furthermore, we are learning how to better analyze ctDNA continuously to study the efficacy of this novel immunotherapy,” Hecht added.

As for safety, Gritstone said that no patients discontinued due to an adverse event, and “most” adverse events were grade 1 or 2.

Earlier this year, Gritstone laid off about 40% of its staff following a delay in a Phase 2b trial (and its expected funding) of its next-gen Covid-19 vaccine. The trial won’t start until the fall of this year.

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Vaccinated People Show Long COVID-Like Symptoms With Detectable Spike Proteins: Preprint Study

Vaccinated People Show Long COVID-Like Symptoms With Detectable Spike Proteins: Preprint Study

Authored by Marina Zhang via The Epoch Times…

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Vaccinated People Show Long COVID-Like Symptoms With Detectable Spike Proteins: Preprint Study

Authored by Marina Zhang via The Epoch Times (emphasis ours),

Spike protein could remain in immune cells for more than 245 days following vaccination, according to a recent preprint. The study evaluated 50 patients who developed long COVID-like symptoms after the COVID-19 vaccine; none had been infected with the virus.

(Design_Cells/Shutterstock)

The authors extracted immune cells from 14 post-vaccine patients and found that 13 had spike protein in their immune cells. Asymptomatic vaccinated people had no spike present.

Researchers from InCellDx, a research company that produces panels and protocols that test for and treat long COVID and post-vaccine syndrome, authored the paper.

Their previous study published in 2022 showed that unvaccinated long-COVID patients could have spike protein persist in their immune cells for 15 months.

In both papers, the spike proteins were detected in monocytes, immune cells that circulate the body.

These findings indicate that the persistence of these spike proteins was likely the driver for the symptoms of long COVID and post-vaccine syndrome, InCellDx founder and lead study author Dr. Bruce Patterson told The Epoch Times.

These cells bind to the blood vessels. They cause endotheliitis (inflammation of endothelium) and vascular inflammation, which I think now has been corroborated by many as being probably one of the most important pathogenic mechanisms in long COVID,” Dr. Patterson said.

Spike Protein Reservoirs

Monocytes are scavenger cells of the immune system,” Dr. Patterson said. Monocytes function similarly to how the video game character Pac-Man does: They roam the body and gobble up proteins they come across in their way.

In long COVID, monocytes gobble up spike protein, the virus’ viral debris. In post-vaccine syndrome, the monocytes engulf spike proteins, which the body makes from the COVID-19 vaccine.

These spike proteins are then stored inside the monocytes, which causes the cells to live longer than they should. The prolonged longevity can cause inflammation, leading to various long-lasting symptoms.

In the study, Dr. Patterson and his team observed that post-vaccine patients had significantly higher monocyte levels than those without post-vaccine symptoms. The symptomatic post-vaccine patients also had a clear elevation in inflammatory biomarkers, whereas the asymptomatic patients did not.

Dr. Patterson believes that at the time of the study, viral replication or spike protein production from vaccinations was no longer occurring. Instead, the spike proteins persisted for months because they were being stored.

He reasoned that once the monocytes engulfed the spike proteins, the spike hijacked the cells’ cell death program, turning off cell death “so they become long-lived cells.”

A similar phenomenon occurs with the HIV and hepatitis C viruses.

Monocyte cells can cause inflammation. Particularly, nonclassical monocytes, which traverse the blood vessels, can lead to blood vasculature inflammation and damage.

Several studies have identified inflamed and damaged vasculature as central features of long-COVID symptoms. These patients have a high level of inflammatory chemicals, which can promote fatigue, blood clotting, immune and nervous system dysregulation, and more.

Long COVID vs. ‘Long Vax’

The recent preprint also shows how long COVID and post-vaccine syndrome may be differentiated.

While the same thing—spike protein persistence—likely causes both conditions, the conditions have slightly differing chemical profiles, especially regarding the level of interleukin-8, or IL-8.

IL-8 is a type of cytokine that aids in attracting immune cells to areas of inflammation, Dr. Patterson explained.

He said that medication that blocks these different cytokines should resolve symptoms. For example, his team found that tumor necrosis factor-alpha (TNF-alpha) is a cytokine that, when elevated, induces fatigue. Therefore, reducing that cytokine can help diminish fatigue.

Other cytokines shared between long COVID and the condition dubbed “long vax” include sCD40L and CCR5, which drive vascular inflammation. Another cytokine, IL-6, signals systemic inflammation.

Dr. Patterson explained that the two conditions’ distinct chemical profiles may be due to their different delivery mechanisms: Viral infection causes long COVID, while inoculation causes post-vaccine syndrome.

Treatment Protocol

Dr. Patterson uses the same protocol for treating long COVID and post-vaccine syndrome. Both treatments entail curbing inflammation in the blood vessels and throughout the body.

His protocol includes using maraviroc, an HIV drug, and atorvastatin, a type of statin, to target vasculature inflammation.

Maraviroc blocks CCR5, a type of inflammatory cytokine that causes blood vessel inflammation, while statins can bind to the receptors inside the blood vessels, blocking them from binding to inflammatory monocytes.

Many doctors have found successes with ivermectin, N-acetylcysteine (NAC), and nattokinase, all of which are drugs and nutraceuticals that help break down outside spike protein. However, Dr. Patterson reported the opposite in his practice. He explained that the drugs cannot target the spike protein stored inside cells.

In February, the U.S. Food and Drug Administration (FDA) approved Dr. Patterson’s clinical trial to test a maraviroc and statin combination for treating long COVID.

Long Vax Masked as Long COVID

The study findings imply that some people diagnosed with long COVID may actually be suffering from post-vaccination symptoms.

Evidence they blame vaccine injury on ’long covid’?,” Dr. Lynn Flynn, a virology and infectious disease expert, wrote on X, citing the preprint.

Dr. Patterson said that the symptoms being reported in these post-vaccine patients “were almost identical to the symptoms in long COVID,” with the predominant symptoms being fatigue, neuropathy, brain fog, and headache. Long-COVID patients in another cohort also reported these symptoms.

[Long vax] has a very low prevalence, but because billions of [people] are vaccinated, there’s a great number of individuals who have long vax,” he added.

Apart from post-vaccine syndrome, Dr. Patterson said that patients with an exacerbation of Lyme disease and myalgic encephalomyelitis (chronic fatigue syndrome) have also been labeled as long-COVID patients due to a symptoms-based diagnosis.

Tyler Durden Tue, 04/02/2024 - 03:30

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Distressed pioneer telecom company files Chapter 11 bankruptcy

The Boca Raton, Fla., telecommunications company files for Chapter 11 bankruptcy after several telecom firms filed in 2023.

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The telecommunications industry faced a significant amount of distress in 2023, with several firms filing for bankruptcy.

Cyxtera Technologies, a provider of data center colocation, interconnection services and digital infrastructure, filed for Chapter 11 bankruptcy in the U.S. Bankruptcy Court for the District of New Jersey in June 2023 and sold its assets to Brookfield Infrastructure Partners in November 2023.

Related: Movie theater chain seeks sale after recovering from bankruptcy

QualTek Services, a provider of infrastructure services to 5G wireless, telecom, power grid modernization and renewable energy solutions, filed Chapter 11 bankruptcy in May 24, 2023, in the U.S. Bankruptcy Court for the Southern District of Texas to restructure debt and emerged from bankruptcy on June 30, 2023, after reducing its debt by $307 million.

Cloud-based data center provider Internap Holding filed for Chapter 11 bankruptcy on April 28, 2023 in the District of Delaware, with over $198 million in debt and emerged on Aug. 1, 2023, after a restructuring.

Starry Group, a licensed fixed wireless technology developer and internet service provider, filed for a prepackaged Chapter 11 in the District of Delaware on Feb. 20, 2023, seeking to reduce its debt and emerged from bankruptcy in August 2023.

A child using an Apple iPhone smartphone. (Photo by Peter Byrne/PA Images via Getty Images)

Peter Byrne - PA Images/Getty Images

Airspan files bankruptcy to hand majority ownership to Fortress

The bankruptcy trend has continued on from 2023 into 2024, as pioneering telecom company Airspan Networks Holdings  (MIMO)  on March 31, 2024, filed for a prepackaged Chapter 11 bankruptcy in the U.S. Bankruptcy Court for the District of Delaware that calls for handing majority ownership to funds managed by its senior secured prepetition lender Fortress Investment Group.

Under the debtor's restructuring support agreement, Fortress and certain key stakeholders will provide up to $95 million in new equity financing and eliminate all of the company's existing funded debt. Fortress affiliates have also committed to providing $53 million in debtor-in-possession financing, which, along with cash on hand, will fund the company's operations during restructuring. 

The Boca Raton, Fla.-based company had about $205.1 million in total funded debt obligations on the petition date, according to a declaration by CEO Glenn Laxdal. The firm in recent years had incurred sizeable operating losses in part because of a commitment of significant resources to research and development as well as competitive pressures. The company relied on funded indebtedness to cover the shortfall in its cash flow from operations.

Airspan during the Covid pandemic in 2020 suffered from supply chain disruptions, significant price increases for silicon-based components, increased transportation costs, inflation and stagnant growth, the declaration said.

Beginning in 2021, the company retained an investment banker to pursue strategic alternatives and engaged in talks for a potential sale of its assets or a restructuring transaction. In 2022, the company focused on reducing operating costs by reducing its workforce from 800 employees to 494 workers. Since then, the number of employees has decreased to about 370, the declaration said.

In March 2023, Airspan sold an affiliate Mimosa Networks to Radisys for about $60 million. It used $45 million to pay obligations and prepetition senior secured debt, allocated about $5 million for costs and fees and netted about $10 million for fund operations.

Airspan and its prepetition lenders in May 2023 amended senior secured debt, which provided the company with $25 million in delay-draw term loan commitments and granted the company  waivers on existing defaults and events of default. The company continued seeking a sale of all its assets until mid-December 2023, when it realized a sale would not happen.

Seeking comprehensive restructuring with senior creditors

It instead sought a comprehensive restructuring with its senior secured lenders and subordinated creditors. The company entered a restructuring support agreement with its lenders and creditors on March 29.

As part of the agreement, existing common stockholders have the option of receiving their pro rata share of $450,000 or, at their election, warrants in lieu of cash. If more than 150 shareholders  elect for warrants, no warrants will be provided. 

Founded in 1998, Airspan began its business in proprietary digital wireless access technology, primarily broadband wireless solutions.

Airspan provides a broad range of software defined radios, broadband access products and network management software to enable cost-effective deployment and efficient management of mobile, fixed and hybrid wireless networks. Its customers include leading mobile communications service providers, large enterprises, infrastructure operators, military communications integrators and internet service providers.

Related: Veteran fund manager picks favorite stocks for 2024

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