Alzheimer's Drug Raises Hopes, Costs --- Results of Biogen's treatment breathe new life into anti-amyloid drugs that were partially written off

"The Alzheimer's drug data released Tuesday night aren't going to be transformative only for Biogen, which is struggling to get love from investors after its botched launch of Aduhelm.

The results are breathing new life into a class of anti-amyloid drugs that was partially written off, increasing investor confidence that drugs from Eli Lilly and Roche Holding could deliver positive results.

Biogen's results sent its shares up 40% Wednesday, adding more than $10 billion to its market cap. Eli Lilly traded 7.4% higher while Roche's U.S. traded shares were up 4.1%, adding more than $30 billion to the combined market value of the two pharmaceutical companies and reflecting the potential competition a Biogen therapy (together with Japanese partner Eisai) could face.

The reversal in investor sentiment is nothing short of massive.

After so many drugs targeting amyloids had failed in clinical trials in recent years, there was growing skepticism of the "amyloid hypothesis," the idea that targeting a buildup of the protein in patients' brains should slow dementia.

The results released Tuesday were unequivocal though. The drug reduced cognitive and functional decline by 27%, compared with a placebo. The data, which haven't yet been published in a peer-reviewed medical journal, hit all of the trial's primary and secondary endpoints, with many analysts calling it a best-case scenario. Importantly, while the drug did show safety concerns such as brain swelling, it looked safer than other candidates now making their way through clinical trials, wrote Michael Yee of Jefferies. Results for late-stage trials of Roche's gantenerumab and Eli Lilly's donanemab are expected within the next year, and investors re-evaluated their probability of success. Lilly investors can justifiably raise the chances of success from 30% to 40% to closer to the 70%-to-75% range on peak annual sales of $8 billion-$10 billion, wrote Seamus Fernandez of Guggenheim. That justifies a 5%-to-7% increase in its stock price, Mr. Fernandez wrote before the market opened on Wednesday. "Net-net, what's good for the goose is good for the gander," Mr. Fernandez said.

The positive data make it likely that the Food and Drug Administration will grant Biogen accelerated approval in January, with full approval coming later next year. The bigger question for investors, patients and society is what the Centers for Medicare and Medicaid Services will do. Biogen's last approved drug for the disease, Aduhelm, received the FDA nod, but CMS effectively killed its commercial prospects by restricting it due to lack of meaningful improvement in health outcomes.

This time will be different, with CMS unlikely to "dig in and refuse coverage" due to the highly successful clinical data, wrote Brian Skorney at Baird. With about two million Americans suffering from early-stage Alzheimer's, the costs to the insurance program could be meaningful, leading to higher healthcare costs for most seniors. Just Tuesday, CMS said premiums and deductibles would be declining next year due to lower-than-projected spending on Aduhelm specifically. Now, the government might find itself paying for another pricey Alzheimer's drug.

Just how pricey will be an important question. Biogen has probably learned some hard lessons from the backlash it got to the Aduhelm launch at $56,000 a year, so expect it to price lecanemab at closer to $20,000. Still, the costs -- and the payoff for investors -- are likely to be astronomical." [1]

1. Alzheimer's Drug Raises Hopes, Costs --- Results of Biogen's treatment breathe new life into anti-amyloid drugs that were partially written off
Wainer, David. 
Wall Street Journal, Eastern edition; New York, N.Y. [New York, N.Y]. 29 Sep 2022: B.12.

Kai kurie darbdaviai kovoja prieš „tyliai darbą metančius darbuotojus“

„Gali jaustis taip, lyg tu išsisuki.

 

    Sumažinai darbo intensyvumą, vėlyvus vakarus ir papildomas užduotis be neigiamų pasekmių. Tiesą sakant, tavo viršininkas gerbia tavo naujas ribas ir sumažino tavo darbo krūvį.

 

    Atsargiai. Tavo „tylus pasitraukimas“ gali lemti tavo „ramų atleidimą“, o galiausiai ir faktinį atleidimą. O tai jau vyksta kai kuriose įmonėse, teigia žmogiškųjų išteklių specialistai.

 

    „Jei staiga pamatysite, kad nesate pakviesti į susitikimus, kuriuose buvote anksčiau, arba jums nepasiūlomi projektai, tai rodo, kad vadovybė į jus nežiūri taip gerai, kaip anksčiau“, – sako buvęs Viktoras Assadas. „Medtronic PLC“ ir „Honeywell International Inc.“ personalo direktorius, kuris dabar yra konsultantas.

 

    Panašiai kaip tylus darbo metimas, madingas terminas sumažinti pastangas, tylus atleidimas reiškia darbuotojo reikšmės sumažinimą. Įmonės visada turėjo subtilių būdų išstumti žmones pro duris. Taktika apima jų atmetimą nuo atsakomybės arba atsisakant paaukštinimo, kad kas nors būtų pakankamai apgailėtinas, kad galėtų išeiti – tai, ką gauja teisiškai vadina „konstruktyviu atleidimu“, o kai kurie iš mūsų žino kaip tai susitvarkyti.

 

    Dabar skirtumas yra mastelis. Daugelis įmonių atnaujina savo dėmesį į tai, ką darbuotojai išleidžia tuo pačiu metu, kai daugelis darbuotojų iš naujo kalibruoja tai, ką įdėjo.

 

    „Gallup“ praneša, kad įsidarbinusių ir aktyviai neįdarbintų darbuotojų santykis yra žemiausias per dešimtmetį ir kad pusė JAV darbo jėgos tariamai tyliai išeina iš darbo, ty dirba tik tai, kas nurodyta jų pareigų aprašymuose, ir ne daugiau.

 

    Didžiąją pastarųjų dvejų metų dalį vadovai iš esmės su tuo susitaikė. Įtemptoje darbo rinkoje geriau šiltas kūnas, nei jo nėra.

 

    Be to, įmonės nori, kad jos būtų jautrios darbuotojams, kurie siekia subalansuoto darbo ir asmeninio gyvenimo, sako Paulas Lesseris, praėjusiais metais įkūręs talentų konsultavimo įmonę po ilgos karjeros žmogiškųjų išteklių srityje Fidelity Investments. Pasak jo, tokie įvykiai, kaip pandemija ir policijos nužudymas George'o Floydo atveju, paskatino daugelį iš naujo įvertinti savo prioritetus, ir būtų buvę bloga verslo ir prastesnė vadovybės optika reikalauti didesnio dėmesio darbui pačiais aštriausiais laikotarpiais.

 

    Kadangi vis daugiau įmonių tikisi nuosmukio, „kiekviena įmonė turi partnerių, kurie dirbo prastai arba nebuvo tokie produktyvūs“, – sako p. Lesser. „Šiuo metu turimoje rinkoje į juos žiūrint, yra gera įmonės higiena“.

 

    Visų lygių vadovai turėtų sudaryti darbuotojų sąrašus, kuriuos atleistų, jei atsiras geresnių ar darbingesnių talentų, sako Jay McDonald, kelių Atlantos srities įmonių valdybos vadovas.

 

    „Lyderis visada turėtų turėti tą sąrašą, bent jau savo galvoje“, – sako jis.

 

    Taigi, ar esate viršininko sąraše? Sunku žinoti, ypač dabar, kai kai kurie vadovai tvirtina, kad tikrai neprieštarauja, kad darbuotojai neduoda 150 proc.

 

    Kai kurie pakeitimai, pavyzdžiui, prašymas padaryti mažiau, gali tiesiog parodyti, kad jūsų vadovas rimtai žiūri į ribas ir supranta, kad kiekvienai komandai, be visų žvaigždžių, reikia vaidmenų atlikėjų. Arba jūsų dienos gali būti suskaičiuotos.

 

    Bosams taip pat gresia pavojus, sako Ashas Wendtas, „Cowen Partners Executive Search“ prezidentas. Jis sako, kad kai kurios įmonės, kurios pandemijos metu atitolino vadovybės pokyčius, pasamdė jo įmonę, kad ji atsargiai ieškotų atnaujinimų.

 

    Šios paieškos, skirtos pakeisti vadovus, kurie netrukus bus priversti pasitraukti, vadinami „konfidencialiais užpildais“. Praėjusiais metais jie sudarė 15% Cowen verslo; šiemet jų yra 30 proc., priduria jis. Jie gali prilygti tyliam šaudymui, nes dabartiniai operatoriai gali būti neutralizuoti keletą mėnesių, kol jie bus nušalinti.

 

    Pagrindinis skundas dėl šių lyderių: „Įmonės sako, kad jos pastebėjo vadovo produktyvumo kritimą arba jis nelaiko žmonių atsakingais, kaip kadaise“, – sako p. Wendtas.

 

    Darbuotojai, nežinodami, kur jie stovi ir ar daro pakankamai, ieško pagalbos dėl su darbu susijusių rūpesčių, sako Anisha Patel-Dunn, „LifeStance Health“, teikiančios psichikos sveikatos paslaugas 32 valstijose, vyriausioji medicinos pareigūnė.

 

    Ji perspėja, kad nereikėtų per daug analizuoti kiekvieno sprendimo – atsitraukimas nuo projekto nebūtinai rodo sumažėjusį vadovo akyse statusą.

 

    Vis dėlto neapibrėžta ekonomika ir plataus masto biurų grąža daugelyje pramonės šakų verčia hibridinius ir nuotolinius darbuotojus ypač įspėti dėl ženklų, kad jie bus suvaldomi.

 

    Šį mėnesį paskelbta plataus masto „Microsoft“ apklausa atskleidė didelį atotrūkį tarp darbuotojų vertinimo apie savo nuotolinį produktyvumą ir vadovų suvokimo, kiek daug nuveikiama ne biure. (Apie 87 % eilinių teigia, kad jie taip pat veiksmingi namuose, tačiau 80 % viršininkų nesutinka.) Microsoft generalinis direktorius Satya Nadella priekaištavo vadovams dėl "produktyvumo paranojos" ir prielaidų, kad žmonės nesunkiai dirba namuose, tačiau tyrimo išvados pabrėžia, kodėl tam tikri darbuotojai bijo iškristi iš palankumo.

 

    Kai kurios įmonės, įskaitant „Goldman Sachs“ ir „Meta“, nors sustabdė šią veiklą pandemijos metu, dabr pradėjo tikrinimus, kad padėtų nustatyti ir išnaikinti daug nepasiekusius asmenis.

 

    Pasak Gartner, trečdalis vidutinių ir didelių įmonių nuo 2020 m. taiko darbuotojų stebėjimo sistemas ir prisijungia prie kito trečdalio, kuris jau naudojo tokias priemones.

 

    Jei žmonės dar nebuvo atleisti, tai gali būti dėl to, kad viršininkas kaupia riebalų sluoksnį, kurį galima lengvai sumažinti, kai ateina laikas sumažinti darbuotojų skaičių, sako Leslie Tarnacki, „WorkForce Software“ pasaulinių žmogiškųjų išteklių vyresnioji viceprezidentė.

 

    „Mes juokaujame, jei nemanome, kad artėjame link nuosmukio, o vadovai mėgsta turėti tokią pagalvę, jei mato, kad kadrai gali būti mažinami“, – sako ji. „Jie gali turėti darbuotojų, kurie laikomi vidutiniškais, bet kol kas juos išlaikant, tai palengvina jų atleidimą.“ [1]

1. On the Clock: Employers Strike Back At 'Quitters' --- Workers who coast risk 'quiet firing' -- and eventual layoffs -- at the hands of bosses who have 'productivity paranoia'
Borchers, Callum. 
Wall Street Journal, Eastern edition; New York, N.Y. [New York, N.Y]. 29 Sep 2022: A.12.

Employers Strike Back At 'Quitters'

"It can feel like you're getting away with it.

You've dialed down the intensity at work, passing on late nights and extra assignments with seemingly no negative consequences. In fact, your boss appears to respect your new boundaries and has lightened your workload.

Careful. Your "quiet quitting" can lead to your "quiet firing" -- and eventually your actual firing. And it's already happening at some companies, human-resources specialists say.

"If all of a sudden you find you're not invited to the meetings you used to be, or being offered the projects, that's an indication that management is not viewing you as well as they used to," says Victor Assad, a former HR director at Medtronic PLC and Honeywell International Inc. who is now a consultant.

Much like quiet quitting, the trendy term for reducing effort, quiet firing refers to minimizing an employee's significance. Companies have always had subtle ways to nudge people out the door. Tactics include sidelining them by cutting responsibilities or denying promotions and raises to make someone miserable enough to leave -- what the gang in legal calls a "constructive discharge" and some of us know as managing out.

The difference now is the scale. Many companies are renewing their focus on what employees put out at the same time that a lot of workers are recalibrating what they put in.

Gallup reports the ratio of engaged to actively disengaged workers is at the lowest level in a decade and that half of the U.S. workforce is allegedly quiet quitting -- that is, doing only what's in their job descriptions and no more.

For much of the past two years, executives have largely put up with this. In a tight labor market, a warm body is better than no body.

Plus, companies want to be seen as sensitive to employees who seek balanced work and personal lives, says Paul Lesser, who launched a talent-advisory firm last year after a long career in human resources at Fidelity Investments. Events like the pandemic and police killing of George Floyd prompted many to re-evaluate their priorities, he says, and it would have been bad business and worse optics for management to demand a greater focus on work during the most acute periods.

With more businesses expecting a recession, "every company has associates that have been poor performers or haven't been as productive," Mr. Lesser says. "In the marketplace we have right now, it's good corporate hygiene to be looking at them."

Managers at all levels should form lists of employees to let go if better or harder-working talent becomes available, says Jay McDonald, an executive coach who sits on the board of several Atlanta-area companies.

"A leader should always have that list, at least in their head," he says.

So, are you on the boss's list? It's hard to know, especially now, when some managers are insisting that they really, truly don't mind workers not giving 150%.

Some changes, like being asked to do less, could simply indicate that your supervisor takes limits seriously and understands that every team needs role players in addition to all-stars. Or your days might be numbered.

Bosses are at risk, too, says Ash Wendt, president of Cowen Partners Executive Search. He says some businesses that held off on leadership changes during the pandemic have hired his firm to discreetly hunt for upgrades.

These searches to replace executives who will soon get a shove toward the exit are called "confidential backfills." Last year, they were 15% of Cowen's business; this year, they're 30%, he adds. They can amount to quiet firings because the incumbents may be neutralized for months before they're ousted.

The top complaint about these leaders: "Companies are saying they've noticed a drop-off in an executive's productivity or they're not holding people accountable like they once did," Mr. Wendt says.

Workers, unsure where they stand and whether they're doing enough, are seeking help with job-related anxieties, says Anisha Patel-Dunn, chief medical officer of LifeStance Health, which provides mental-health services in 32 states.

She cautions against overanalyzing every decision -- being left off a project doesn't necessarily reflect diminished status with the boss.

Still, an uncertain economy and broadscale office returns in many industries put hybrid and remote workers on especially high alert for signs of being managed out.

A large-scale survey by Microsoft published this month revealed a wide gap between employees' assessments of their own remote productivity and managers' perceptions of how much gets done away from the office. (Some 87% of the rank and file say they're just as effective at home, but 80% of bosses disagree.) Microsoft CEO Satya Nadella scolded supervisors for "productivity paranoia" and assumptions that people aren't working hard at home, but the study's findings underscore why certain workers fear falling out of favor.

Some firms, including Goldman Sachs and Meta, have reinstated performance reviews to help identify and cull underachievers, after suspending that practice during the pandemic.

One-third of midsize-to-large businesses have adopted employee-surveillance systems since 2020, according to Gartner, joining another third that already used such tools.

If people who are coasting haven't been dismissed yet, that could be because the boss is storing a layer of fat that can easily be trimmed when it's time to downsize, says Leslie Tarnacki, senior vice president of global human resources at WorkForce Software.

"We're kidding ourselves if we don't think we're headed toward a recession, and managers do like to have that cushion if they see that cuts may be coming down the road," she says. "They may have employees that are considered mediocre, but keeping them around for now makes having to deal with those cuts a little bit easier."" [1]

1. On the Clock: Employers Strike Back At 'Quitters' --- Workers who coast risk 'quiet firing' -- and eventual layoffs -- at the hands of bosses who have 'productivity paranoia'
Borchers, Callum. 
Wall Street Journal, Eastern edition; New York, N.Y. [New York, N.Y]. 29 Sep 2022: A.12.