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Biotech / Medical : Pharma News Only (pfe,mrk,wla, sgp, ahp, bmy, lly) -- Ignore unavailable to you. Want to Upgrade?


To: Anthony Wong who wrote (1564)5/20/1999 10:12:00 AM
From: Anthony Wong  Respond to of 1722
 
Large-cap prescription aids top performance
AIM Global Health Sciences favours U.S.
pharmaceutical giants, figuring risks in small
firms are greater than rewards big ones offer.

Thursday, May 20, 1999
GORDON POWERS
Special to The Globe and Mail

If anything about the future is predictable, it's this:
Everybody's getting older.

And while 33-year-old John Schroer, manager of
the $554.7-million AIM Global Health Sciences
Fund, doesn't worry too much about his own
long-term health needs, he does know that a lot of
other people do. And that, he says, can only mean
continuing opportunity ahead for the
pharmaceutical and health-care firms in which his
fund invests.

In calendar 1998, AIM Global Health Sciences
was the top performer among the six health-care
sector funds in Canada, chalking up a
43.7-per-cent return. The fund also boasts an
extremely attractive annualized return of 26.3 per
cent over the five years ended April 30.

Such returns, however, can change quickly. Last
month alone, for instance, the fund dropped
almost 10 per cent. Its one-year return of 13.2 per
cent to April 30 didn't lead the pack.

This demonstrates why industry analysts are
forever cautioning about how the lack of
diversification in theme funds can make them
volatile.

"Buying a sector fund means making a
concentrated bet on a market niche," says Ian
Filderman, a Toronto-based fund analyst with
Scotia McLeod Inc. Nevertheless, the benefit is
that "it gives you more downside protection than
you might get with an individual stock, and much
greater potential than a more broadly diversified
fund," he says.

All of this makes the choice of a fund's manager
much more important, he says. And he casts a
strong vote in Mr. Schroer's favour.

Mr. Filderman, who speaks to several portfolio
managers each month, says he's always impressed
with Mr. Schroer's exhaustive knowledge of the
health-care industry. "John always seems to know
who is doing what and has an excellent rapport
with the FDA [U.S. Food and Drug
Administration] and other regulators."

Mr. Schroer joined Denver-based Invesco Trust
Co. Inc. in 1992 and has been the lead manager of
its $1.6-billion (U.S.) Invesco Health Sciences
Fund in the United States since 1994. AIM Global
Health Sciences is a duplicate of that fund.

During his tenure, he has transformed the fund
from a collection of small biotech companies into
a package of U.S. pharmaceutical giants. The
move has driven the fund's top performance.

As in the rest of the market, performance in the
health-care sector has been dominated by a small
group of stocks, particularly the big
pharmaceutical companies. Small-company stocks
in areas such as biotech, medical devices and
health-management services have struggled, hit
hard by U.S. government cuts in insurance
payments and rising medical costs.

"We're primarily interested in volume-driven
companies and most pharmaceuticals have high
single- or low-double-digit revenue growth," he
says. "That's not something you see a lot of with
HMOs, physician practice management groups or
smaller biotechs."

The risks involved in smaller companies trying to
develop the next wonder drug are far greater than
the rewards the industry giants offer, Mr Schroer
says. Drug developers in early clinical trials have
roughly a 10-per-cent chance of receiving FDA
approval and, even then, many lack the means to
capitalize on their investment, he maintains.

"The mature companies have the global reach that
smaller companies simply can't match," he says.
"As a result, even when the smaller players do
come up with a viable product, they frequently
have to step back to get it finally approved and in
the market."

As a result, he only buys biotech companies with
products in late-stage clinical trials, preferably
phase III, or that have products already on the
market, like Amgen Inc., North America's largest
biotech company.

Mr. Schroer typically puts 50 per cent to 60 per
cent of the fund's assets in its top 10 holdings.
Right now, the overall mix is roughly 65 per cent
in major pharmaceuticals, 22 per cent in medical
equipment, 10 per cent in biotechnology, and the
rest in cash.

Recently, he has been adding to positions in
several big-name stocks on the hope that a fresh
round of mergers and acquisitions might drive
prices skyward once again. One current favourite
is American Home Products Corp., whose failed
marriage with Monsanto Co. sent its stock price
reeling last fall.

While the company has developed few
blockbuster drugs relative to competitors like
Pfizer Inc. and Merck and Co. Inc. (which he also
owns), it's poised to launch several new products,
including a new sleeping pill and a treatment for
rheumatoid arthritis that should prove popular.

"Despite its decline last year, this group of new
products could transform American Home into
one of the fastest-growing drug companies in the
country," he predicts, adding that it could also
make the company attractive again as an
acquisition target.

Mr. Schroer has also overweighted his portfolio
with medical-device companies, now that U.S.
physicians, no longer leery of health-care reform,
have begun ordering these costly products again.

Medtronic Inc. and Guidant Corp., the No. 1 and
No. 2 suppliers of pacemakers and other
cardiac-rhythm products, are the types of
high-margin category killers he favours. Their
research and development spending is twice that
of their competitors, with the result that they
introduce a greater number of products more
quickly than their peers, he says.

"It's all about holding position. New products are
much less vulnerable to being turned into
commodities," he explains. "They sell on their
features, not price. That keeps weaker
competitors at bay."

Given the AIM fund's concentrated portfolio, it's
probably not suitable as a core holding, Mr.
Filderman says. Nevertheless, he notes that the
kinds of companies it favours are not available in
the Canadian market, which makes the fund a
great diversifier.

He considers AIM "an excellent fund that could
find its way into most portfolios. But for most
investors, 10 to 15 per cent of their overall
portfolio is likely the limit," he says.

Those investing outside an RRSP may instead
want to consider the identical $324.9-million
(Canadian) AIM GT Global Health Care Class,
he suggests. The reason: for tax purposes, it is part
of a larger umbrella fund, which allows investors
to switch among half a dozen other sector funds
that are also part of the umbrella fund without
triggering any capital gains. You don't get such a
tax-deferral opportunity with the health sciences
fund.

AIM GLOBAL HEALTH SCIENCES FUND

Category: Science and technology
Manager: John Schroer
Load status: Optional
Total assets: $554.7-million
Management expense ratio: 2.31%
Returns to April 30, 1999
1-month simple rate of return: -9.2%
3-month simple rate of return: -10.1%
6-month simple rate of return: -0.2%
1-year simple rate of return: 13.2%
2-year compound annual rate: 23.8%
3-year compound annual rate: 14.4
Telephone: 1-800-588-5684

Top 10 holdings

To April 30, 1999

1. Medtronic Inc 7.7%

2. Johnson & Johnson Inc 5.6

3. Merck & Co. Inc 5.6

4. Pfizer Inc 5.4

5. Guidant Corp 5.2

6. Warner-Lambert Co 5.1

7. Bristol-Myers Squibb Co 5.1

8. Pharmacia & Upjohn Inc 5.0

9. American Home Products 4.8

10. Schering-Plough Corp 4.3

Breakdown by sector

Pharmaceuticals 65%

Medical equipment 22%

Biotechnology 10%

Cash 3%

Copyright © 1999 The Globe and Mail

globeandmail.com



To: Anthony Wong who wrote (1564)5/20/1999 10:22:00 AM
From: Anthony Wong  Read Replies (1) | Respond to of 1722
 
Drugs to cure cancer have had little success. We
need new ones that prevent it.

Pills against cancer

By Philip E. Ross
Forbes Magazine May 31, 1999

Oncologists like to joke about cardiology envy:
While heart specialists now routinely prescribe
drugs that stop disease before it starts, cancer
specialists must resort to last-ditch heroics.

Numbers tell the story. The death rate for coronary
heart disease has declined 24% since 1986, but
cancer casualties have fallen just 3% from a peak
in 1990. Most of that gain comes not from high-tech
cures but from a simple preventative: quitting
smoking.

Sure, everyone should do that—and eat fruits and
vegetables, and get screened for cancer, and stay
out of the noonday sun. But what we really need is
a new generation of preventative drugs—newfangled
chemicals that will be taken, daily and over many
years, by people who are genetically predisposed
to cancer risk.

That isn't all that far-fetched. The world's first
cancer-preventing drug recently won approval:
Zeneca Pharmaceuticals' tamoxifen. Several other
promising drugs now are in human testing. As more
move down the pipeline, inevitable questions will
arise: Will the new drugs be worth the risk of side
effects in decades-long use? And will insurers
willingly pay now for pills to prevent disease, buying
the argument that they can save money on cancer
care in the long run?

"A daily pill for all? It could happen in 15 or 20
years," says the National Cancer Institute's chief of
prevention, Peter Greenwald. "This will be the
standard approach," says Harmon Eyre, head of
research at the American Cancer Society. "We'll be
addressing cancer before it becomes cancer."

This strategy grows out of the emerging view of
cancer not as a state but as a process—a
decades-long trek to accumulate the six to ten
genetic mutations required to turn normal cells into
an invasive tumor. At any point the right chemical
intervention could derail this process, and the
sooner, the better. The first preventatives will aim at
patients whose risks are so high that they can
easily justify any threat of side effects from
long-term therapy. Those patients will then serve as
guinea pigs for the rest of us.

That's the story behind Zeneca's tamoxifen. It
began life in the 1970s as an oral contraceptive,
reached the market in 1977 as a treatment for
advanced breast cancer and won approval for earlier
stages of that disease. In November it got the nod
for preemptive use in women who don't have breast
cancer but are at high risk of getting it.

"We weren't looking for a preventative effect," says
Paul V. Plourde, the endocrinologist who runs
Zeneca's breast cancer program. But doctors
discovered that women taking tamoxifen to treat a
tumor in one breast also got fewer cancers in the
contralateral or healthy breast. And the drug had
remarkably mild side effects, making it a promising
prospect for prevention.

While other cancer chemotherapy kills all
cells—healthy and lethal—to try to rid the body of
cancer, tamoxifen works through hormonal trickery.
In breast cancer a woman's estrogen continuously
shouts a redundant message to certain cells:
"Grow!" Tamoxifen snaps onto breast-cell receptors
tailored to read signals from estrogen, thereby
blocking them from hearing the directive.

In a $60 million clinical trial, paid for by the U.S.
government, 13,000 healthy women took tamoxifen
or a sugar pill for five years. In the tamoxifen group
breast cancer appeared only half as frequently as in
the control group, a savings of about 280 cases.

It's too early to know how many years of life the
drug adds or whether it saves money. But just
putting off cancer by five years could offer a
significant financial payoff. The last year of cancer
care can easily cost $20,000; the $6,000 bill for five
years of tamoxifen begins to look cheap.

Yet insurers would have to pay for treating many
thousands of healthy women, all to avoid only a few
hundred cases of cancer. Keeping 6,500 women
(half the trial) on tamoxifen over five years would
cost almost $40 million; the 280 cases would cost
only $5.6 million for a final year of cancer care. How
much is a saved life worth?

Now researchers are studying whether a second
estrogen inhibitor, Eli Lilly & Co.'s raloxifene, might
work even better. Next month a five-year trial
begins, comparing the preventative effects of
tamoxifen and raloxifene in 22,000 women over age
35.It has already been approved for use against
osteoporosis, and some doctors already prescribe
it to at-risk women. Zeneca has sued Lilly for
allegedly encouraging such "off-label" uses.

Celebrex, the new arthritis drug, also shows
surprising promise as a cancer-stopper. Marketed
by Pfizer Inc. and G.D. Searle & Co., Celebrex is a
so-called cox-2 inhibitor that quells arthritis pain
without upsetting the stomach. Now the companies
are testing whether the drug can reduce the number
of precancerous polyps in people with familial
polyposis, a rare disease that often leads to colon
cancer. They refuse to discuss the project, but
landing quick approval for that narrow use could
pave the way for using the drug in lower-risk
groups.

A second arthritis drug, sulindac, already has been
found to fight polyposis, but it can cause serious
gastric problems in some patients. Cell Pathways,
a biotech boutique in Horsham, Pa., has found a
metabolic breakdown product of sulindac that has
no effect in blunting arthritis but does seem to
prevent cancer growth, both in animals and in
human cell cultures.

A year or so ago it looked as if it would do the
same in patients. In preliminary trials, a few
early-stage polyps left in a patient's colon shrank
over time, with no noticeable side effects. But in the
second of three major phases of clinical trials the
chemical was unable to demonstrate statistically
significant results.

Rifat Pamukcu, chief scientist for Cell Pathways,
blames the ambiguous results on the fact that the
company was able to sign up only 74 patients. He
says he still believes in the product. "We appear to
be hitting cells in the early as well as the late stage
of progression to cancer."

Indeed, in interim results just released from an
ongoing trial, Cell Pathways' drug showed
significant reductions of PSA, a marker for the
recurrence of prostate cancer.

None of these drugs is yet ready for those of us
who can't be pigeonholed into a high-risk
category—but the push for prevention has to start
somewhere. "Prevention offers an enhanced quality
of life, as well as an extension of it," insists
Michael Sporn of Dartmouth Medical School, a
pioneer in the field. "One day there'll be very large
numbers of people on chemopreventive therapy;
we'll begin with those at very high risk, then work
our way down."
forbes.com