With more than 3.0 million page views and more than 5,000 items, this blog provides news and commentary on public policy, business and economic issues related to the $3 billion California stem cell agency. David Jensen, a retired California newsman, has published this blog since January 2005. His email address is djensen@californiastemcellreport.com.
Thursday, July 25, 2013
California Stem Cell Board Meeting Delayed
The business portion of today's meeting of the governing board of the California stem cell agency was scheduled to begin at 9 a.m. PDT. However, that session has been delayed as the board hears a presentation on MS. The business session may begin about 15 minutes or so.
Coming Up: Live Coverage of Today's California Stem Cell Meeting
The California Stem Cell Report will
provide live, wall-to-wall coverage of today's meeting of the
governing board of the $3 billion California stem cell agency.
At the top of the agenda is a $70
million proposal aimed at creating a string of Alpha stem cell clinics in
California that would serve as a foundation for the state's stem cell
business. Also on tap are other proposed grant programs, including a
$23 million expansion of a researcher recruitment effort and a $35 million round aimed at removing roadblocks to turning research into
cures.
Stories will be filed as warranted
throughout the day based on the Internet audiocast of the proceedings.
Interested parties can also listen in
on the meeting via the Internet. Instructions can be found on the agenda.
Wednesday, July 24, 2013
Stem Cell Lines and Paid-for Eggs: Stem Cell Agency Delays Action on Easing Restrictions
A key panel of the California stem cell
agency today balked at approving a plan to ease restrictions on
using stem cell lines derived from women who were paid for their
eggs.
The proposal had been scheduled to be
taken up tomorrow by the governing board of the $3 billion agency,
but the board's standards working group delayed action.
In response to a question, Kevin
McCormack, a spokesman for the agency, said in an email,
“It was felt that more discussion was needed before moving to a vote so another meeting is going to be scheduled.”
In 2006, the CIRM governing board
approved regulations that banned the use of CIRM funds for stem cells
lines derived using compensation. That rule would be modified under
today's plan, which would permit the CIRM governing board to approve
the use of such lines following a staff study evaluating scientific and ethical issues.
Their use would be allowed if the lines would “advance CIRM's
mission.”
The delay came after four organizations, including the Center for Genetics and Society in Berkeley, argued that the plan is vague and did not adequately address safety issues.
The four-page statement by the groups
said that the plan does not appear to have met “numerous concerns”
raised in 2009 in a document co-authored by the CIRM staff. Those
concerns include long-term risk and ethical issues.
Under the proposal, the groups said
that the agency governing board
“...will decide whether to approve a grantee’s request to use a stem cell line created with paid-for eggs on the basis of whether doing so 'will advance CIRM’s mission.' This criterion is much too vague, and doesn’t include consideration of the health or welfare of the women who undergo egg retrieval. Protecting the well-being of women providing eggs is not even mentioned (though perhaps it could be considered as an element of the fifth of five 'factors to be considered by the ICOC(the agency board),' 'whether the donation…was consistent with `best practices’ at the time of donation').”The standards group also heard from a UCLA researcher who argued on behalf of the change. Kathrin Plath said she and her colleagues wanted to use a paid-for stem cell line from the Oregon experiment that cloned human stem cells.
(An earlier version of this item said the change under consideration would ease restrictions on "purchasing" stem cell lines. The word "purchasing" was changed to "using.")
Here is the text of the statement by
the four organizations.
$70 Million Alpha Stem Cell Clinic Project Garners Mainstream Media Attention
California's $70 million plan for a
chain of “Alpha” stem cell clinics today received its first major
attention from the mainstream media.
The story came in the state's largest
circulation newspaper, appearing this morning on the home page of the
website of Los Angeles Times.
The Alpha project would create five clinics
around the state and a coordination/information center under a
concept that comes before the governing board of the state's $3
billion stem cell agency at its meeting tomorrow in Burlingame, Ca. Funds could be
awarded as early as a year from now. (For more information, see here
and here.)
Reporter Eryn Brown quoted Natalie
DeWitt, special projects officer for CIRM, as the stem cell agency is known, and Maria Millan, a CIRM
medical officer. Brown wrote,
“Clinics to conduct trials of stem cell therapies have different needs than clinics designed to deliver conventional therapies, DeWitt and Millan said. They need special facilities for handling the cells safely, as well as imaging equipment to track the cells once they're delivered into a patient’s body. Some of this infrastructure already exists, but other parts of it still need to be perfected. Establishing clinics to house multiple trials might create the critical mass needed to get the infrastructure in place, they said....
"Additionally, they said, CIRM hopes that such collaboration would encourage stem cell companies to share information -- speeding their own work and also helping out policymakers and insurers who are trying to figure out how they'll pay for stem cell therapies in the future.”
The Times quoted the
California Stem Cell Report as saying last week,
“The Alpha clinics are aimed at creation of a sturdy foundation for the stem cell industry in California, capitalizing on the burgeoning, international lure of stem cell treatments.”
The proposal envisions Alpha stem cell
clinics at major, established institutions around the state. It is
possible that two could be located in the Los Angeles area at
institutions such as UCLA, USC, Cedars-Sinai or the City of Hope, all
of which have representatives on the stem cell agency's governing
board. Other likely locations are in the San Francisco Bay area and
San Diego, again at facilities such as Stanford, UC San Francisco and
UC San Diego that have representation on the agency board.
Institutions competing for the grants,
including businesses, will be subject to closed-door. peer review
prior to final action by the full governing board.
UCLA Researcher Calls for Easing of Restrictions on Stem Cell Lines Derived from Eggs From Paid Providers
A UCLA researcher has spoken out in
support of a proposal to allow use of California stem cell agency
funds to purchase stem cell lines derived from eggs provided by women
who have been paid for the service.
Kathrin Plath, an associate professor, said in a letter to the agency that she and her colleagues would like to use a line from the Oregon SCNT
experiment by Shoukhrat Mitalipov in which human stem cells were cloned. Currently agency funds cannot be used for that purpose as
a result of regulations that are the extension of a state law that
bars use of agency funds for payment for eggs.
The agency's standards group meets later today to consider changing those regulations. The proposal will
then go before the full board tomorrow.
Plath, who has received $5 million from CIRM, said,
“In my lab, we are ... interested in understanding what happens to the somatically silenced X chromosome when differentiated cells are reprogrammed by SCNT. The key question is: are these SCNT-ESCs more similar to iPSCs or fertilization-derived ESCs with respect to the epigenetic state of the X chromosome. Furthermore, it has been shown in mouse reprogramming that the active X chromosome becomes deregulated during SCNT-based reprogramming, and we would like to address this problem in the human system as well.
“We believe that the comparison of the epigenetic states between fertilization-derived ESCs, SCNT-ESCs and human iPSCs is important for a better characterization of these cells and understanding of their epigenetic nature.”
Co-vice Chairman of California Stem Cell Agency Remains in Critical Condition
Duane Roth, the co-vice chairman of the
California stem cell agency, remains in critical condition with brain
injuries following a weekend bicycle accident.
According to a report by Bradley Fikes
in the San Diego U-T, Roth's family is preparing for a recovery that
will take weeks. Roth is currently in a medically induced coma.
Roth's wife, Renee, released a
statement through the UC San Diego Medical Center that said,
“His condition is currently listed as critical. Duane is in the great hands of the university’s doctors and nurses and we are very happy with the outstanding care he is receiving. We do ask that our privacy be respected as Duane heals. We will be in touch to share more.”
The accident occurred Sunday in the
mountains east of San Diego when Roth hit a rocky embankment or
outcropping and his helmet split open on the impact.
Roth is CEO of Connect, a technology
business group. He has served on the stem cell agency board since
2006.
(An earlier version of this item incorrectly described Roth as CEO of Current instead of Connect.)
(An earlier version of this item incorrectly described Roth as CEO of Current instead of Connect.)
Tuesday, July 23, 2013
Correct Link to CIRM Report on Business Aspects of Alpha Clinics
The "Inside Alpha Clinics' Business" item yesterday had a bad link to the CIRM report on the proposal. Here is the correct link. A thank you to Kevin McCormack of CIRM for pointing this out.
How to Stay On Top of California's Stem Cell Research Cash Cow -- At Least This Week
Persons interested in listening to
Thursday's hearing on California's $70 million “Alpha” stem clinic proposal can do so by two different methods via the Internet.
In addition to Internet access, the
public can participate in the meeting in Burlingame, Ca., and also at
two teleconference locations in Los Angeles. The Internet access does
not allow two-way participation.
If you have money in the game, our
advice is to attend the meeting in Burlingame. Only a handful of
business people and scientists attend the agency's governing board
meetings, but they seem to benefit from the information and
discussion as well as from the ability to meet face-to-face with CIRM officials
and board members.
Of particular interest may be a
scheduled discussion of CIRM's goals and direction this year and next along with
other proposals that will funnel $128 million to researchers in California, including the clinic plan.
If stem cell agency fans do not have
time to sit through the day-long proceedings, they can follow
developments via the California Stem Cell Report, which will be
covering the meeting live via the Internet and filing stories as warranted.
Instructions for Internet access can be
found on the meeting agenda. One method is a relatively
straightforward audiocast. The other involves WebEx, which may
involve some configuration of your computer. However, the method also
shows the Power Point presentations that are used during the meeting
and are otherwise not available in advance or on the day of the
meeting. They often contain valuable information that informs the
discussions of the board of the $3 billion agency.
In either case, you will want to check
out the procedures in advance if you have not used them before. The
dial-in number for the audiocast is 866-320-4708 with the password of
297273. Here is the link for the WebEx connection:
https://cirm.webex.com/cirm/onstage/g.php?d=286602980&t=a&EA=acheung%40c...
As for the teleconference locations,
the specific addresses are on the agenda. But you should ask in
advance for more information on the Cedars-Sinai location to be sure
you can find it on the day of the meeting. The Cedars complex is very
large.
Tomorrow the agency's standards group
will take up a proposal to allow CIRM grant recipients to purchasestem cell lines derived from eggs from paid donors. Unfortunately,
that session is not available either by Internet or teleconference,
but only in San Francisco. The proposal is expected to move forward
to the full board on Thursday but it could be modified.
Monday, July 22, 2013
Co-vice Chairman of California Stem Cell Agency Hospitalized with Brain Injury
Duane Roth Connect Photo |
Roth hit a rock embankment and broke
his helmet, according to news reports. He was flown to the UC San
Diego Medical Center, where he underwent surgery to remove a piece of
his skull to relieve pressure on his brain, according to an account by Bruce Bigelow on Xconomy.
Bradley Fikes of the San Diego U-T
reported that Roth is expected to kept in a coma for at least several
days until his condition improves.
J.T. Thomas, chairman of the stem cell
agency, said in a statement,
“Our thoughts, prayers and best wishes for a full recovery are with Duane and his family.”
Roth, CEO of Connect, an organization
that supports the technology industry, has served on the
governing board of the $3 billion California stem cell agency since
2006. He has been a strong voice for business at the agency and likely would have been active participant in board discussion this Thursday of one of the agency's major initiatives
that will benefit business – a $70 million stem cell clinic plan.
Inside the Business in California's $70 Million Alpha Stem Cell Clinic Proposal
Want to know more
about the business aspects of a $70 million proposal to create a
chain of “Alpha” stem cell clinics in California?
More details can
be found in a report from the California stem cell agency titled
“Alpha Stem Cell Clinics: Delivering a New Kind of Medicine.”
Among other
things, the 23-page report discusses how the plan would guide efforts
to build profits into stem cell therapies and to develop strategies
to attract investors and philanthropists. Not all of the business
questions are answered. However, the report does paint a more
complete picture of how the clinics would lead to actual production
and marketing of a therapy. Overall, the proposal is aimed at
creating a sturdy foundation for the stem cell industry in
California, one that surpasses anything found elsewhere in the world.
The stem cell
agency's governing board is set to move forward on the Alpha clinics at its meeting on Thursday. This week's action involves approval of
the concept with an RFA coming in October. Awards to six recipients
could be made as early as July of next year.
The business aspects of the proposal are critical because without a clear pathway to profits no stem cell therapies will be available on anything approaching a significant scale.
The business aspects of the proposal are critical because without a clear pathway to profits no stem cell therapies will be available on anything approaching a significant scale.
CIRM President
Alan Trounson first advanced the Alpha concept two years ago. Last
fall the $3 billion agency brought together 70 folks from the stem
cell world to ponder the idea and to make suggestions. CIRM's report
on the discussions at the workshop served as the basis for the
proposal to be considered by its governing board this week. Here are excerpts from the report.
“Workshop participants...emphasized the need for engaged experts who can consider and implement strategies for reimbursement (i.e.generating profits) for stem cell therapies, and to gather evidence for their value and effectiveness that will be important for coverage by payers. Having clear pathways in place will help in building financially sustainable clinics as stem cell therapies gain approval and are implemented as standard medical practice. The Alpha Coordinating Center (funded at $15 million) would work with Accountable Care Organizations (funding gouprs that tie performance to payment) and multi-stakeholder collaborations to generate evidence for informing coverage and payment policies.”
“Incentivizing company sponsors of clinical trials to participate in data sharing will be challenging, and it will be important to protect their interests as appropriate, by respecting confidentiality of proprietary information, while at the same time requiring an appropriate degree of data sharing to advance the mission of the Alpha Stem Cell Clinics Network(five clinics funded at $11 million each). It is interesting to note that at this time, the landscape of disclosing clinical trial results is in flux, and there is increasing international pressure for companies to disclose information on safety and efficacy to the research and medical communities.”
“Alpha Stem Cell Clinics will create unique models for assessing the financial viability of stem cell therapies in a clinical setting. Cost and revenue data may serve as the basis for developing reimbursement options among the public and private sector as therapies accumulate. Identification of reimbursement options can reduce investor uncertainties and encourage further investment by pharmaceutical companies, investors, funding agencies and philanthropists.
“The elements of the Alpha Stem Cell Clinics Network, namely the clinical sites and central coordinating center, will interact with external entities to generate revenue streams that would ultimately ensure financial sustainability independent of CIRM funding (Figure 3).”
“The Coordinating and Information Management Center could develop a fee for service model for its consulting services, and operate like a CRO. Sponsors could choose whether to use the consulting services and whether to use the Alpha Stem Cell Clinics Sites. The Alpha Stem Cell Clinics Sites would generate operating revenue by running the clinical trials and could perhaps support the Center with revenues, as the volume of trials grows and the Network builds steam.
“In a second model, clinical trial sponsors would all contract with the Coordinating and Information Management Center, which would then set prices according to services needed. From this revenue, the Center would pay the Alpha Stem Cell Clinics Sites for costs associated with the clinical trials.
“By the time the CIRM seed money is depleted, the clinics should have established a strong track record and brand for excellence in conducting clinical trials in stem cell therapies, which would attract more clinical trial sponsors, including companies. To have the largest possible impact on healthcare, it will be desirable to increase industry involvement for cell therapies. However engaging corporate involvement could be challenging, given that many cell therapies are not considered patentable, and many of the ongoing trials are conducted in academic settings. It was suggested that the Alpha Stem Cell Clinics Network align as much as possible with corporate “mentality” to maximize corporate participation.
“Overall, the Alpha Stem Cell Clinics Network will help companies increase their 'bandwidth' and run stem cell therapy clinical trials more effectively and successfully. Many companies will already have sufficient in-house expertise for administration and regulatory guidance, and may not need to engage the Center’s consulting services. They would be attracted to the Alpha Stem Cell Clinics Network because of advantages for clinical trials such as benefiting from the collective databases, know-how and experience of the 'brain trust,' positive interactions and lines of communication with the FDA and regulatory experts, positive branding, quality control, accreditation for their trials, access to patient registries for outreach and patient recruitment and, through its clinical trial management resources, help with enrollment.
“Workshop participants also emphasized that attaining reimbursement for stem cell therapies will be necessary for delivering approved therapies into medical practice. It is likely that the business models for at least some of the clinics will resemble bone marrow/HSC transplant clinics, where for stem cell therapies that are proven superior to the standard of care, the clinic will directly receive reimbursement from insurers for the procedure and follow-up care.
“Reaching this point will require advance advocacy and preparation, and the engagement with the CMS at an early stage of product development. It was recommended that the Alpha Stem Cell Clinics Coordinating and Information Management Center should employ experts in reimbursement methodologies to facilitate entry of approved products into healthcare delivery. One workshop participant, Jeff Sheehy(a stem cell agency board member), suggested that early engagement with Accountable Care Organizations (ACOs) could be helpful, given that stem cell therapies offer the promise of cures, which in the long run will offer high value and effectiveness, albeit with ' high front end costs and the necessity of developing the appropriate infrastructure for delivering complex cell based procedures.' Consortiums such as the Green Park Collaborative are being established to develop methodological standards to demonstrate the effectiveness and value of new technologies. These data could be used to inform healthcare payers of the overall benefits of cell therapies and their long-term value, as compared with existing therapies."
“In 2016 and beyond, CIRM will initiate the 'Delivery' phase, in which priorities will be 'facilitating commercialization (and non-commercial adoption, where appropriate) of therapies, advancing therapies to patients, and enabling business models for stem cell-based therapies.' Connecting this network to other networks and centers with a similar mission outside of California will further accelerate the development and delivery of stem cell therapies, through the global exchange of information and expertise. International testing of experimental therapies developed in California will be essential for ensuring their sustainability, as regulatory approval and widespread delivery of these products in major markets throughout the world will ensure commercial viability and sustainability of companies and universities that produce them, which will in turn help deliver returns to investors. Ultimately, establishing a solid foundation for investor engagement will ensure the viability of stem cell therapies as they move into clinical practice.'”
Friday, July 19, 2013
Paying for Human Eggs, Ivan Illich and Jerry Brown
California's pay-for-eggs bill is
stalled in a technical parliamentary process as opponents continue to
wage their campaign urging Gov. Jerry Brown to veto the proposal,
which swept easily through the legislature.
The latest volley against the
industry-sponsored measure appeared this week as an op-ed in The Sacramento Bee. The legislation would allow women to be paid for eggs for scientific research. The op-ed piece invoked the philosopher Ivan Illich, a
longtime friend of Jerry Brown and much respected by him.
The July 16 article was written by Diane Tober of the Center for Genetics and Society of Berkeley and Nancy Scheper-Hughes, a professor of medical anthropology at UC Berkeley and director of Organs Watch, a medical human rights documentation project.The piece said,
“The late historian of science and technology, Ivan Illich, warned against the processes of medical industries which 'create new needs and control their satisfaction and turn human beings and their creativity into objects.'"
The op-ed said,
“Women's research eggs (have) become the hot new bio-product, increasing the profits of the multibillion-dollar-per-year infertility industry at the expense of women's health, safety and possibly, their future fertility. Is this the 'equity' we want for ourselves, our sisters and our daughters?”
In 2003, Brown wrote a remembrance of
Illich, whom he first met in 1976. Brown said that Illich
“...bore witness to the destructive power of modern institutions that 'create needs faster than they can create satisfaction, and in the process of trying to meet the needs they generate, they consume the earth.'”
The egg compensation bill (AB926 by
Assemblywoman Susan Bonilla, D-Concord) would remove a ban in
California on paying women who provide their eggs for scientific
research. Currently women who provide eggs for fertility purposes can
be paid, sometimes as much as $50,000, depending on the
characteristics of the woman providing the eggs. The bill would not
alter the ban on using research funds from the California stem cell
agency to pay for eggs. However, the agency next week will consider a proposal to allow use of agency funds to purchase stem cell lines
derived from eggs through compensation. (For
more information on
the bill,
see here, here and here.)
The egg bill received final legislative
approval on July 1. The governor has 12 days to act on the measure
once it actually reaches his desk. However, as of this morning, the
legislation remained in what is known as the “engrossing and
enrolling” process. It could be a routine delay but the process can
also be used to manage the flow of legislation to the governor. Brown
is currently on a two-week trip to Germany and Ireland and is not
expected to return until near the first of August.
(An earlier version of this item incorrectly identified Nancy Scheper-Hughes as with the Center for Genetics and Society.)
(An earlier version of this item incorrectly identified Nancy Scheper-Hughes as with the Center for Genetics and Society.)
Thursday, July 18, 2013
California Stem Cell Agency to Commit 20 Percent of Remaining Cash
The California stem cell agency next
Thursday is expected to move forward with plans to give away $128
million, roughly 20 percent of its remaining funds.
The programs include the $70 million Alpha clinic plan, an ambitious five-year project that would be one
of the $3 billion agency's hallmark efforts. The other “concept”
rounds up next week include a $35 million “tools and technology”RFA and $23 million to recruit four more star, stem cell scientists to California.
The agency has committed about $1.8
billion of its $3 billion so far with about $700 million available
for future spending. The remainder is going for the agency's
administrative expenses. Cash for new grants is expected to run out
sometime in 2017. Total cost of the agency's efforts run to about $6
billion because it operates with money borrowed by the state and must
pay interest.
The agency is currently engaged in
developing a plan to develop new sources of funding with an eye on
some sort of public-private model. It solicited proposals in May for
help with the effort, with the goal of completing a plan by this
fall. At last report, however, the contract with the consultant had
not been let.
The “strategic roadmap,” as it is
called, is likely to come up at next week's governing board meeting
along with a review of agency goals for the 2013-14 fiscal year.
On the agenda is a proposal to modify the agency's ban on use of its funds to purchase stem cell lines derived from human eggs supplied by women who have been paid. That proposal will
also be heard by the agency's standards group next Wednesday.
The agency has additionally been busy
implementing recommendations from a performance audit in May 2012.
The audit said the agency was laboring under a range of problems that
include protection of its intellectual property and management of its
nearly 500 grants plus an inadequate ability to track its own
performance. A staff Power Point presentation seems to indicate that it is making substantial progress in solving the problems identified by the audit.
Next week's meeting will be in
Burlingame near the San Francisco Airport. Two remote locations where
the public can participate are also available in Los Angeles.
Addresses can be found on the agenda.
The California Stem Cell Report will
provide live coverage of the meeting based on the Internet audiocast
with stories filed as warranted.
Wednesday, July 17, 2013
California's $70 Million 'Alpha' Stem Cell Clinic Plan Headed for Approval Next Week
Alpha clinic organizational diagram Graphic by CIRM |
California's stem cell agency next week
is likely to approve a $70 million plan to build a taxpayer-financed
chain of “Alpha” stem cell clinics in what could be a major step
towards making California the stem cell capital of the world,
The proposal would create five centers
at existing institutions or businesses to be funded at up to $11
million each over five years. Also proposed is a coordination and
information center that would receive $15 million over five years.
A story in Nature Medicine said that
the Alpha clinics would be the first-ever “clinical trials network focused around a broad therapeutic platform.”
The clinics are expected to draw stem
cell projects from the around the world as well as those
funded by the $3 billion California stem cell agency. The proposal
would be one of the largest single research efforts funded by the
agency, formally known as the California Institute for Regenerative
Medicine (CIRM) and use about 10 percent of its remaining cash.
The Alpha clinics are aimed at creation
of a sturdy foundation for the stem cell industry in California,
capitalizing on the burgeoning, international lure of stem cell
treatments. Indeed, one of the objectives of the information center
is to divert people from dubious treatments elsewhere.
The plan would fill a “profound gap”
in quality information about stem cell treatments, according to a CIRM document, which said,
“By providing this resource, the public and potential patients would be better educated and informed, whether or not they should opt to enroll in clinical trials or approved treatments at any of the Alpha clinics.”
The Alpha concept was first broached two years ago publicly by
CIRM President Alan Trounson, a pioneer in IVF research and the IVF
business. His proposal has received early and heavy
attention on the CIRM website with a video, blog items and a white paper.
The plan has received little critical
attention although a researcher from an institution that could be a
candidate for an Alpha clinic commented harshly in May on the California
Stem Cell Report, calling the proposal “an irresponsible waste”and a “boondoggle for some medical schools.” The researcher, who
asked that he/she not be identified, said,
“CIRM will pay for an unneeded infrastructure that will be empty space and staff sitting on their hands 99 percent of the time. Or worse yet, CIRM will pay but the space will be used for other things, other clinic procedures paid for by insurance.”
Elie Dolgin's July 8 piece in Nature
Medicine quoted Mahendra Rao, director of the Center for Regenerative
Medicine at the US National Institutes of Health (NIH), as applauding the concept. However, Rao said he doesn't
anticipate the approach being tried nationally soon.
Dolgin wrote,
“Rao regularly asks researchers hoping to advance promising stem cell therapies whether they require additional clinical infrastructure. 'So far, what they've told us is they'll let us know if they need anything more than (the) programs that we have already established,' he says.”
The question of the size of the demand
for Alpha clinics is not addressed in the CIRM concept plan. Also
absent is much discussion of the business aspects of the proposal. It
does mention “corporate sponsors” in passing. In a CIRM blog item
yesterday, Natalie DeWitt, special project director at the agency,
touched on business elements, declaring,
“(The proprosal) will yield better clinical trial design, accelerated approval of high quality treatments, and data and know-how to inform regulatory and reimbursement decisions.”
Reimbursement is the industry euphemism
for creating ways to generate profits for stem cell firms.
The proposal said applicants would have
to bring substantial support from their own institutions and
“demonstrate the potential to bring in a pipeline of additional
stem cell-based therapeutic trials as well as future funding streams
to sustain the clinic.” Applicants would also be “evaluated in
their ability to create a positive 'brand' that would attract
clinical trials.”
Also up in the air was whether grant
reviewers, all of whom come from out-of-state, would have special
expertise to evaluate the business aspects of each applicant's
proposal along with their business track record.
What is before the CIRM directors July
25 at their meeting in Burlingame, Ca., is a request for approval of the concept, which
would be fleshed out for the RFA. The governing board almost always
approves staff concepts, although they may modify them slightly. A
number of directors come from institutions that are likely to be
applicants in the program. They can participate in voting on the
concept plan but would be barred from voting on any applications that
come in later. The two RFAs could go out as early as October with
approval of funding of applications one year from now.
In addition to the Burlingame meeting
site, members of the public can participate from two teleconference
locations in the Los Angeles area. The specific locations can be
found on the meeting agenda.
The California Stem Cell Report will
provide live coverage of the entire meeting, filing reports as
warranted based on the Internet audiocast.
Here are excerpts from CIRM's staff
document on the plan.
“To accelerate therapeutic development and delivery of stem cell therapies, CIRM proposes establishing the CIRM Alpha Stem Cell Clinics Network (CASC Network). The network will be designed to support projects emanating from CIRM’s funding pipeline, as well as scientifically outstanding stem cell products being developed worldwide and brought to California. Conceptually, the CASC Network is intended to be a sustainable infrastructure designed to support academic- and industry-initiated clinical trials, and delivery of therapies proven safe and effective.”
“The major thrusts (of the overall plan) will be:
• Development of clinical capacity and associated resources designed to support the effective implementation and execution of clinical trials and delivery of registered stem cell therapies
• Compilation of data and information concerning clinical trial experience and therapy outcomes to further inform the research, regulatory, and general community about the status of investigational stem cell interventions and long-term outcomes
• Dissemination of information to the public and counseling of patients and potential trial subjects about therapeutic options and clinical trials involving stem cells in the network and elsewhere.”
“The long-term vision is for the Alpha Clinics to expand and accommodate a broad array of stem cell-based clinical trials, where the trial meets the scientific, clinical trial design and ethical standards set forth by the Alpha Clinics Network, as well as FDA approved treatments.”
The coordinating and information center would be expected to :
“Build relationships with Accountable Care Organizations, and participate in initiatives for informing coverage and payment decisions
“Design strategies to attract investors and philanthropists to CASC network
“Create business plans, and marketing and branding strategies for financial sustainability of the Alpha Clinics Sites and (the coordination/information center)”.
Friday, July 12, 2013
Shestack Resignation Letter: Heartfelt and Eloquent
Jon Shestack(l) with J.T. Thomas, chairman of CIRM, at a 2012 board meeting California Stem Cell Report photo |
Patient advocate Jon Shestack , who
resigned this week as a director of the
California stem cell agency, was on board on Day One in December 2004
when the agency's work began with no offices, no desks, no chairs, no phones and
no ability to even write checks.
Shestack's appointment came as a result
of his work in the autism community. He and his wife, Portia Iversen,
founded Cure Autism Now in 1995. A Hollywood film producer, Shestack
rattled cages at CIRM from time to time during his eight years of
service. And earlier this week, he wrote a heartfelt, eloquent
resignation letter, which he provided to the California Stem Cell
Report. The full text can be found below. Here are some excerpts.
“Over eight years there were moments that were inspiring, some were contentious, and there was a bruising number of meetings but through it all, the board was involved, passionate and, will forever be for me, the gold standard when it comes to integrity.
“The same goes double for the staff – truly the most excellent, devoted, committed group of people I have ever had the pleasure of working with.”
“When I started at CIRM, my sweet son with autism was 12. Now he is 21. Over eight years our family has learned more about how many are the challenges that await him and how few the opportunities he has to look forward to. We have seen his world get smaller and smaller. While my son is special to me. He is not unique. There are thousands and thousands affected by mental illness who need a better life.
“Sometimes feel that I have failed these people, in particular those affected by autism or cerebral palsy. Though CIRM ran first-rate workshops on these disorders, we did not do all we could to follow up, put out disease-specific RFAs and get in proposals that addressed the workshop recommendations. I wish I had been more persuasive."
“In the movies, the third act is where the hero takes stock of all the previous wins and losses, all the hardships and lessons learned, and she puts all that knowledge together in new, and surprising ways until victory is within reach! As CIRM enters its third act, I hope it will do the same. I hope it will challenge itself, always put the urgency of the mission ahead of everything else and be willing to question the policies that have been so successful in the past, and consider that new ones may be needed for the future.
“And this is the future as I see it for CIRM. We will have faith, but we will continue to earn our miracles We will use our hearts and our minds to rip those miracles out of the dreamy future and make them real today. We will seek out the best scientists and encourage them to use all their wisdom, art and discernment to bring us cures. And when we have done that, we will do it again the next day. We will be optimistic, but not satisfied. We will question authority, despise complacency and above all love those among us in need of healing--this is the obligation without end, whose reward is also without end.”
TV News Piece on Pay-for-Eggs Airs in Los Angeles, San Francisco
The California pay-for-eggs legislation
yesterday picked up some mainstream media coverage, including a
two-minute, 24-second segment on two major television stations in Los
Angeles and San Francisco.
The piece stands out because the
mainstream media has largely ignored the bill, with a couple of
exceptions. The piece is also exceptional because it appeared on TV
news, which reaches many more people than print media.
Nannette Miranda, Sacramento bureau
chief for KABC-TV in Los
Angeles, KGTV in
San Diego, KGO-TV in San
Francisco and KFSN-TV in Fresno, prepared the segment, which included on-camera interviews with both
supporters and opponents. The video appeared on KGO and KABC
and may well appear later on the other stations. It can be seen at
the end of this item.
The legislation, AB926 by Susan
Bonilla, D-Concord, would remove the ban in California on paying
women for their eggs for stem cell and other scientific research.
Women can already be paid for their eggs for fertility purposes.
Another piece on the bill appeared in
another mainstream media outlet this morning, the San Diego U-T.
Writing in an op-ed column, Leah Campbell said she sold her eggs at
age 25 and has since become infertile as the result of problems her
doctors believe involved the process of providing the eggs.
“Six months (after providing the eggs) my body began to fail me. I had always been a healthy and active woman, but suddenly I was crippled by pain and unable to live the life I had once enjoyed. I was soon diagnosed with stage IV endometriosis, a disease my doctors now believe was pushed into overdrive as a result of the potent hormones involved in my egg donation protocols.”
Campbell continued,
“AB 926 may open the doors for increased fertility research, but the potential costs for women’s lives and health far outweigh any compensation that could ever be offered.”
Sacramento Mental Health Advocate Appointed to Stem Cell Agency Board
Al Rowlett Turning Point photo |
Sacramento mental health advocate Al
Rowlett has been named to the governing board of the $3 billion
California stem cell agency, it was announced today.
Rowlett replaces Jonathan Shestack on
the 29-member panel. Shestack had served on the board since 2004,
when the agency was created by the Proposition 71 ballot initiative.
Rowlett is chief operating officer of Turning Point Community Programs in Sacramento. He was appointed to
the CIRM board by California Assembly Speaker John Perez, D-Los
Angeles. Rowlett will fill one of the 10 patient advocate slots on
the board. He will be only African-American on the panel. The board
had also included one African-American, Ted Love, from 2004 to April
2012, when Love resigned.
Rowlett is no stranger to public and
governmental service. He is in his second term as a member of the Elk
Grove school board, the fifth largest school district in California.
He has worked for Turning Point since 1981.
CIRM's press release said Rowlett also
serves on several other boards including Child Abuse Prevention
Center, California Institute of Mental Health and is a commissioner
for the United States Psychiatric Rehabilitation Association
Certification Program. In 2007, Rowlett won the National Association
of Social Work- California and California State University – Heart
of Social Work Award and the Asian Pacific Community Counseling –
Inspirational Mental Health Leadership Award.
Veto Campaign Launched on California Pay-For-Eggs Bill
Opponents of the California
pay-for-eggs bill have kicked off a campaign to urge Gov. Jerry Brown to veto the industry-backed legislation.
The Center for Genetics and Society of
Berkeley yesterday posted a pitch on its website urging readers to
contact the governor's office by email, fax, phone or letter. The
target is a bill that would remove the ban in California on paying
women for their eggs for stem cell and other scientific research.
Women can already be paid for their eggs for fertility purposes.
Diane Tober, associate executive
director of the center, wrote,
“If you agree that more research on short- and long-term risks is needed before expanding the market for women’s eggs, please act quickly. Contact Governor Brown and ask him to veto AB926.”
Also making the same pitch is the
Alliance for Humane Biology, another San Francisco Bay area
organization.
The bill, AB926 by Assemblywoman Susan
Bonilla, D-Concord, has literally been cloaked in motherhood/reproductive issues. The measure has easily swept through the legislature and is now on its
way to the governor. The bill is sponsored by the AssociationFew if any stem cell or other research
organizations have been heard from during hearings on the bill. (For
more information, see here, here and here.)
However, stem cell scientists have
complained in past years about the lack of eggs for research,
declaring that women want to be paid.
The measure would not affect the ban on
compensation for eggs in research funded by the $3 billion California
stem cell agency. However, the agency on July 24 will consider providing exceptions for stem cell lines derived from eggs that
involve compensation for women.
Thursday, July 11, 2013
"Comfort News" for California's Stem Cell Research Effort
The California stem cell agency has
enjoyed a spate of good financial and scientific news this week from
the biotech industry as the research effort pushes on with its
mission of turning stem cells into cures.
The $3 billion agency is
scheduled to make its last grants in less than three years and, given
the glacial pace of medical research, needs all the help it can get
by then to bring a stem cell therapy close to the marketplace – the
promise it made to voters when the agency was created nine years ago.
CIRM, as the agency is known, requires
not only steady scientific progress but also a rosy outlook for the
industry, which has languished in past years as major investors
shunned the field. This week, CIRM garnered good news on both fronts.
There was enough so that the agency
even touted it on the agency's research blog in an item by
Neil Littman, CIRM's business development officer. He said it all
helps to leverage CIRM investments and create a favorable investment climate. The good news included yesterday's announcement that
Viacyte, Inc., of San Diego, Ca., has come up with $10.6
million needed to match a $10.1 million, much-ballyhooed award from CIRM last fall. The Viacyte financing
includes important support from Big Pharma, in the form of Johnson &
Johnson. CIRM has pumped a total of $39.4 million into Viacyte.
Another CIRM award winner,
Cellular Dynamics International, Inc., of Madison, Wisc., yesterday
announced its price on its upcoming stock offering to raise up to $53
million. Cellular Dynamics scored $16 million from the agency last
March.
The “comfort news” for CIRM also included Monday's announcement that Capricor, Inc., a private Beverly Hills company benefiting from $27 million from the California stem cell agency, is merging with publicly traded Niles Therapeutic, Inc., of San Mateo. The merger is aimed at providing better access to capital.
And then there was Tuesday's news that a $20 million CIRM disease team award is paying off with the beginning of a clinical trial by Calimmune of Tucson, Az. for an HIV treatment.
All on top of the news in June when bluebird bio of Masschusetts brought in $101 million on its stock offering. Bluebird is the recipient of a $9.4 million CIRM award.
The rosy news comes amid a generally
better outlook for biotech in general. John Carroll, editor of Fierce
Biotech, this week noted that there were only 11 biotech stock offerings last
year. He wrote,
“In the last 6 months, though, the industry has seen a tremendous rebound, with almost twice that number of IPOs in half the time. And there's no sign that the great leap into the public market is waning, with 10 more IPOs in the queue.”
Carroll's comments were echoed in a
piece by Peter Winter on Bioworld headlined “Bubbleology and Biotech's Bull Run.”
All of this plays into what some might
call the “everybody's-doing-it dance" or the “lemming
syndrome,” depending on your point of view. The reality is that
big investors and venture capitalists are timid souls and need the
comfort of companionship-in-risk as they fork over tens or hundreds
of millions of dollars on something that may not pay off for a decade
or more. No one wants to be the out-front pioneer who winds up with
financial arrows in his or her back. Being in a crowd provides an
illusion of safety.
Of course, there is always the caveat
about how markets and investors are fickle. A piece of bad news can
translate quickly into major reversals as Apple has learned over the
last year. Nonetheless, the folks at the stem cell agency have to be feeling good today.
Wednesday, July 10, 2013
Pay-for-Eggs Legislation: Strange Bedfellows and Existential Questions
The California pay-for-eggs bill
today generated a feature article that said the legislation has
“sparked an unusual lineup of partisans on both sides and resonates
far beyond” the Golden State.
The piece by Alex Mathews on Capitol
Weekly, a news service specializing in California government and
political coverage, said,
“(C)omplicating the issue is California’s role as a national leader in stem cell research, the existential question of who or what constitutes a research subject, and finally, the fact that compensation for fertility purposes is and has been legal for years in California.”
Mathews was writing about the measure
(AB926) by Assemblywoman Susan Bonilla, D-Concord, that removes a ban
in California on paying women for eggs for scientific research.
Currently women can be paid in California for providing eggs for IVF.
The measure would not alter a ban on compensation for eggs in
research financed by the $3 billion California stem cell agency.
However, later this month, the agency will consider modifying its position somewhat.
The bill has passed the legislature and
is on its way to Gov. Jerry Brown. The industry association
sponsoring the bill expects the governor to sign it later this month
although the governor, as a general rule, does not make public
commitments on legislation.
Mathews' article covered the background
and arguments on the bill and noted that it has received little
mainstream media attention.
Lisa Ikemoto UC Davis photo |
She also quoted Lisa Ikemoto, a law
professor and bioethicist at UC Davis, on the sensitive nature of the
issue. Ikemoto said,
“On the fertility side, it’s politically hard to touch because it’s all around family formation. Nobody wants to restrict family formation. On the research side, when the issue of payment for eggs came up, it was connected with human embryonic stem cell research, and human embryonic stem cell research was politicized from the outset.”
Mathews also wrote about the strange
bedfellows opposing the bill. She said,
“Groups that fundamentally oppose stem cell research such as the California Catholic Conference and other pro-life groups are natural opponents of the bill, but they are joined by a number of pro-choice groups who expressed concerns over the limited research on the effects of egg donation on women’s health.”
California Stem Cell Merger: Capricor and Niles Therapeutics
Capricor, Inc., a Beverly Hills company
benefiting from $27 million from the California stem cell agency,
this week announced that it is merging with Niles Therapeutic, Inc.,
of San Mateo.
Linda Marban Capricor photo |
The Capricor story and its treatment
for heart disease have been highlighted (see here and here) by the $3
billion state research agency, which is partially funding a clinical
trial for the firm. The firm sprang from work by Eduardo Marban of
Cedars-Sinai in Los Angeles, one of Capricor's founders. He received
$6.9 million for his early and current work. Capricor was awarded
$19.8 million more.
Capricor, a privately held firm, and
the publicly traded Niles announced on Monday that they were merging.
The new company will be known as Capricor Therapeutics, Inc., and will
be based in San Mateo.
The new firm will be publicly traded
with Capricor CEO Linda Marban as the new CEO.
The new board of directors will have
two members from Niles and seven from Capricor, including its
executive chairman, Frank Litvack, who was an unsuccessful candidate for chairman of the stem cell agency board in 2011.
The merger press release said that the
new company “should
have better access to capital, more potential for steady pipeline
development and more risk diversification."
On completion of the merger, a joint
press release said,
“Nile will issue to Capricor stockholders shares of Nile common stock such that Capricor stockholders will own approximately 90% of the combined company's outstanding shares, and Nile stockholders will own approximately 10%, calculated in each case on a fully-diluted basis assuming the issuance of shares underlying options and warrants. Options of Capricor will be assumed by Nile and become options to acquire stock of Nile.”
Linda Marban said,
"Capricor's and Nile's product portfolios complement each other well, as our therapies will address both the underlying causes and debilitating effects of heart disease. Capricor's CDCs are allogeneic cardiac derived stem cells that aim to attenuate and potentially improve damage to the heart that can result in heart failure, while Nile's cenderitide is intended to treat patients following hospital discharge from an acute episode of heart failure."
Niles' stock price stood at $0.04
recently. Its 52 week high was $0.20 and the 52-week low was $0.02.
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