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Once again, the biopharmaceutical industry had another banner year in 2015...in comparing the approvals of 1996 to 2015, a lot has changed over the years...the vast majority of drugs approved in 1996 were small molecule drugs...The drug approvals for 1996 are a reflection of the corporate strategy and the research philosophy embraced by Big Pharma at the time: find drugs that would be utilized by physicians to treat millions of patients suffering from common ailments...The “blockbuster” business model back then focused on having moderately priced drugs broadly prescribed...Companies have not totally abandoned this approach. Last year saw the approval of drugs expected to be billion dollar blockbusters by virtue of treating big populations of patients...What is stunning, however, is to see the number of drugs approved for small or “niche” populations, where high revenues are expected to be generated not by patient numbers but by price. Nowhere is this more evident than in the 14 new cancer drugs...I suspect that, for those who suffer from rare diseases or from certain forms of cancer, this shift in biopharma’s R&D priorities has been welcomed. As shown by the 2015 drug approvals, the promise of favorable pricing did stimulate innovation and improved the health of many. It will be interesting to see if political pressures, particularly in an election year in the U.S., impact this going forward.

Skyrocketing drug costs became the stuff of congressional hearings and presidential campaign speeches in 2015...The federal government announced this month that prescription drug spending hit $297.7 billion last year -- up more than 12 percent...A new generation of specialized drugs and price hikes on existing medications helped to drive that spike...If there's a bright spot amid the troubling rise in the cost of prescription drugs, perhaps it is this: Many of the most widely used generic drugs actually were cheaper at the end of 2015 than when the year began, according to an analysis released...by...GoodRx...The reality is that about 85 percent of drugs taken in this country are generic...Those are surprisingly inexpensive and getting less expensive, in many cases...For [many] generic drugs, there's a lot of competition...while the retail price of some drugs decreased by 30 percent or more, some generic drug products had...extraordinary, price increases...the rate of generic price declines has been slowing for the past decade, indicating that the era of consistent generic drug price decreases may be coming to an end...it's a complicated...exercise to determine what any person, company or insurer pays for a particular drug...The system is opaque...Between changing insurance premiums, greater overall health-care costs, the arrival of new high-priced therapies and the ongoing possibility of price spikes in once-cheap drugs, many patients can count on continuing worries about the impact on their pocketbooks.

The number of U.S. physicians who say they are suffering "burnout" has jumped to more than half of doctors as the practice of medicine becomes more complicated and millions more Americans gain health coverage under the Affordable Care Act...An analysis from researchers at the Mayo Clinic and the American Medical Association say doctors’ work-life balance is worsening, with the percentage of physicians who say they are suffering burnout rising to 54% in 2014 from 45% in 2011..."disturbing trend"..."Burnout and satisfaction with work-life balance among U.S. physicians are getting worse,"..."American medicine appears to be at a tipping point with more than half of U.S. physicians experiencing professional burnout...has effects on quality of care, patient satisfaction, turnover, and patient safety, these findings have important implications for society at large."

• Atezolizumab/Nab-Paclitaxel Highly Effective in Breast Cancer
• Pembrolizumab Effective in ER-Positive Breast Cancer
• Neratinib 3-Year ExteNET Data Similar to Primary Analysis
• Buparlisib Modestly Effective in Breast Cancer
• Avelumab Effective in PD-L1-Positive Breast Cancer
• Adding Denosumab Improves DFS in Breast Cancer
• FDA Approves Alectinib for ALK-Positive NSCLC
• FDA Approves Cooling Cap to Prevent Hair Loss
• Priority Review Granted to Palbociclib Plus Fulvestrant
• FDA Approves Bendamustine Hydrochloride for CLL, NHL
• Priority Review to Crizotinib for ROS1 NSCLC
• FDA Approves Uridine Triacetate for Chemo Overdose

The new imaging adds information on 3 million cavities on the surfaces of nearly 110,000 human molecules to the canSAR database...A large database used for cancer drug development has been improved to include three-dimensional structures...which scientists say could improve approaches to treating cancer...The...database...is used by more than 140,000 researchers around the world to research the effects of more than a million drugs on human proteins....Scientists need to find all the information there is about a faulty gene or protein to understand whether a new drug might work...These data are vast and scattered, but the canSAR database brings them together and adds value by identifying hidden links and presenting the key information easily...Finding new treatments for cancer can be a long and expensive process, so anything that cuts times and costs will help to bring the next generation of therapies to patients even sooner...

Pharmacists ranked No. 2 in Gallup's 2015 Honesty and Ethics of Professions Ratings, falling behind No. 1 ranked nurses and ahead of No. 3 ranked medical doctors...This annual Gallup survey presents another data point in the strong and growing case for pharmacy patient care...those who have more first-hand experience with pharmacist-provided services feel even more strongly about their value. These positive attitudes are translating into ever-stronger bipartisan support for pro-patient and pro-pharmacy initiatives in the U.S. Congress, as well as an expansion of the pharmacists’ scope of practice in the states.

"Don’t Believe the Hype."...It’s good advice for people operating in the R&D side of pharmaceuticals. Many exciting things are happening today in the science, so it’s easy to get carried away. But this year’s market correction–driven in part by systemic concerns about drug pricing, a few clinical trial blowups and shenanigans—should serve as a vivid reminder. No matter how good the fundamentals are, biotech still hasn’t figured out how to carefully calibrate perceptions to keep the steam engine steadily chugging along, without letting things get too hot or too cold...Hype has always been part of biotech because investments must be made on glimmers of promise, otherwise known as incomplete data. Without hype and hope, the industry couldn’t exist...There’s no good way to quantify perceptions, and things change fast in biotech, but I do talk every day to lots of different people with their fingers on the pulse of different things. So I thought it would be fun to try again this year with plotting various biotech platforms and concepts along the Gartner hype curve.

Peak of inflated expectations

• CRISPR/Cas9 genome editing.
• Microbiome everything.
• Genomic wellness.
• Conquering antibiotic resistance.

Trough of Disillusionment

• Digital health.
• Stem cell therapies.

Climbing up the Slope of Enlightenment

• Immuno-oncology.
• Viral Vector Gene Therapy.
• Long-read sequencing.

Doctors are more likely to give smokers antibiotics for an infection, a bad habit that may endanger public health by promoting antibiotic resistance...Smokers were 20 percent to 30 percent more likely than non-smokers to get an antibiotic prescription when they were diagnosed with infections...If smokers are being prescribed antibiotics...if not indicated, it’s going to contribute to that antibiotic resistance...and bacteria are going to become more and more resistant...You would think that the number of bacterial infections where antibiotics are clinically indicated should be evenly distributed among smokers and non-smokers...The study can't say why smokers are more likely to get antibiotics for infections...it may be due to an inaccurate belief among doctors that people who smoke are more susceptible to infections.

Big valuations, big investments, and big price tags drove lots of the news in health care in 2015 — and you can bet they’ll do the same in the new year. For signs of where things are headed, keep an eye on these three influencers:

1. Jeffrey Marrazzo, chief executive of Spark Therapeutics - Can gene therapy work — and can the system afford to pay for it?...The idea that a one-time treatment could replace a broken gene has generated plenty of scientific and commercial interest.
2. Deborah DiSanzo, general manager of Watson Health -  IBM’s big bet on health care analytics...use high-powered computing to sift through massive amounts of data to find useful and cost-saving nuggets for medical researchers, doctors, and insurers.
3. Vivek Ramaswamy, chief executive of Axovant Sciences - has recruited some top Alzheimer’s researchers to join his...company...they initiated a late-stage clinical trial testing the GSK reject in combination with another Alzheimer’s drug.

According to an annual report from the United Health Foundation, Nevada is ranked 38th in the U.S. when it comes to health...Nevada’s rank in 2014 was 39, so the state has improved over the past year. Here are some snapshots of how Nevada compares to national numbers for health-related topics:

• In Nevada, 17 percent of people smoke compared to the 18 percent national average.
• Drug deaths are significantly higher in Nevada, with 22.4 overdose deaths per 100,000 people compared to a 13.5 death average nationally.
• Nevada is average when it comes to the inactivity of adults. 22.5 percent of adults in Nevada are physically inactive compared with 22.6 nationally.
• Infant mortality is lower in Nevada, with 5.1 deaths per 1,000 live births compared to the 6 national average.
• In Nevada, 27.7 percent of adults are obese compared to the national average of 29.6. For diabetes, 9.6 percent of Nevadan adults have diabetes compared to 10 percent nationwide.
• For children’s vaccinations, 67.7 percent of children in Nevada are immunized compared to 71.6 nationally.

The top five healthiest states in the nation, according to the report, include Hawaii, Vermont, Massachusetts, Minnesota and New Hampshire