We trust you have your own busy agendas. So join us as we hoist the ever-present cup of stimulation — our choice today is gingerbread — and attack the fast-growing to-do list. We hope you have a smashing day and, of course, do stay in touch. Our settings are adjusted to accept postcards and telegrams. …

Activist investor Carl Icahn plans to oust directors at Illumina, laying the groundwork for a second board challenge at the gene-sequencing company months after shareholders elected one of his director candidates, Reuters writes. Icahn disclosed his plans without offering details in a letter to other shareholders less than 24 hours after Illumina said it will divest blood test maker Grail. In Monday’s letter, Icahn blamed the Grail acquisition, which has faced regulatory challenges since 2021, for a 75% drop in Illumina’s share price that he says wiped away $55 billion in value for shareholders. The stock was up more than 2% at $130.39 on Monday.

As more data emerge that obesity drugs like Wegovy can reduce complications from heart and kidney problems as well, scientists have been wondering whether these benefits are driven by weight loss alone or also by other mechanisms. A new study suggests that one possible contributor is the drugs’ ability to reduce inflammation independent of weight loss, STAT tells us. In mice experiments, scientists found that the treatments, known as GLP-1-based drugs, acted through the brain to reduce inflammation throughout the body. This was over a short period of time before the mice lost weight, according to the study, published Monday in Cell Metabolism.

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This year’s selection is so deservingly obvious that I won’t fabricate suspense by starting with an honor roll of runners-up. More on those high-achieving folks later. Let’s get right to the main course: David Ricks of Eli Lilly is the runaway, rock star, who-else-could-it-be Best Biopharma CEO of 2023.

What an incredible year it’s been for Ricks and the Lilly executive team who helped him achieve so much. My colleague Matt Herper wrote earlier this year about the “dynamic duo” of Ricks and Chief Scientific Officer Dan Skovronsky.

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Since states started rolling back pandemic-inspired flexibilities that allowed physicians to easily practice telehealth across state lines, virtual health care providers have criticized state-based medical licensure rules as unnecessarily burdensome, expensive, and detrimental to patient care.

Now, two of them are arguing in a lawsuit that they can also be unconstitutional.

On Wednesday, a neurosurgeon, an oncologist, and two New Jersey-based patients sued the state’s medical board, alleging that the state’s licensure requirements for doctors practicing via telemedicine restrict livesaving access to specialty care. The case marks a newly aggressive strategy as health care systems and regulators continue to debate the role of state medical licensing in an increasingly virtual health care system.

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The drug for which spending increased the most due to a price increase was Humira, which is used to treat rheumatoid arthritis, plaque psoriasis, and other disorders. AbbVie raised the wholesale price by 7.1%. The net price — after rebates and discounts — rose by 1.9%, most likely because the company offered more concessions than previously.

Consequently, spending for this drug climbed by $386 million, according to the report issued by the Institute for Clinical and Economic Review, a nonprofit that assesses the cost-effectiveness of medicines. The report noted that the manufacturer disputed the findings, calling the methodology “flawed” and arguing that the analysis was “subjective.”

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Pharmalot and the rotation will likely include this, this, this, and this. And what about you? With holidays unfolding, you could head to your local temple of consumption and give the economy a boost. You could also plan an end-of-year getaway or, perhaps, you might soak in the great outdoors with a ride in the country or a walk in the park. Well, whatever you do, have a grand time. And be safe. Enjoy, and see you soon. …

After months of deliberation, the Biden administration disclosed plans to sidestep patents in order to lower costs for some pricey medicines that were discovered with taxpayer money. But the move, which must still be finalized by an inter-agency working group, is already causing uncertainty over the extent to which drugmakers may lose valuable monopolies and consumers will save money, STAT explains. This reflects the seemingly contradictory approach the administration has taken toward the controversial concept, as well as open-ended language in the proposal. As a result, there is a mix of fear and doubt as the pharmaceutical industry and patients try to envision the eventual terms.

The $32,000 cost of a crucial drug to treat severe lead poisoning drew ire from U.S. Sen. Amy Klobuchar (D-Minn.), who wrote a letter to Rising Pharmaceuticals seeking answers on how the company reached its price, CNN says. The drug costs almost 10 times more than an imported version of the medicine from France, which the U.S. Food and Drug Administration had allowed to be used in the U.S. while the drug was in shortage. Toxicologists says the price can make it difficult for hospitals to stock the medicine, called calcium disodium EDTA, potentially leading to delays of days when patients need urgent treatment. EDTA is used for the most severe cases of lead poisoning.

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Remember, a prescription is not required. So no need to mess with rebates. Our choice today is chocolate raspberry. Meanwhile, here are a few items of interest. Hope you have a smashing day and, of course, do stay in touch. …

The White House is throwing its support behind a controversial authority that allows the government to claw back patents for certain high-priced medicines, STAT tells us. The move is an early step that could have major ramifications for the pharmaceutical industry, depending on whether and how federal officials actually use the authority. The administration will issue a framework for the U.S. National Institutes of Health to more broadly use march-in rights, a policy that allows it to seize patents from drugmakers whose products rely on federally funded research. The framework will detail when the agency might assert this authority, and endorse using drug prices when deciding.

AbbVie announced plans to purchase Cerevel Therapeutics and its pipeline of experimental neurological and psychiatric medications for $8.7 billion, STAT writes. The deal marks the second billion-dollar acquisition by AbbVie in under a week. Facing the prospect of declining sales from two of its best-selling drugs, the company also acquired Immunogen and its ovarian cancer treatment for $10 billion last week. With this latest deal, AbbVie will acquire several clinical-stage molecules for Parkinson’s, schizophrenia, and epilepsy, among other disorders, many of which previously belonged to one of its biggest rivals.

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The deal marks the second billion-dollar acquisition by AbbVie in under a week. Facing the prospect of declining sales from two of its best-selling drugs, the company also acquired Immunogen and its ovarian cancer treatment for $10 billion last Thursday.

With the buyout, AbbVie will acquire several clinical-stage molecules for Parkinson’s, schizophrenia, and epilepsy, among other disorders, many of which previously belonged to one of the company’s biggest rivals.

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Please feel free to join us. Now, though, the time has come to get cracking. So here is the latest assembly line of items of interest for your enjoyment. We hope you find these useful and have a smashing day. Best of luck and, as always, do stay in touch. …

AbbVie will pay $10 billion for Immunogen, acquiring an approved treatment for ovarian cancer and buying into a burgeoning area of oncology, STAT writes. Under the agreement, AbbVie will pay $31.26 per share in cash, a nearly 100% premium. Central to the deal, which is expected to close in the middle of next year, is Elahere, an Immunogen product that won U.S. Food and Drug Administration approval for advanced ovarian cancer in 2022. Elahere is among a surging class of cancer medicines called antibody-drug conjugates, or ADCs, which are designed to deliver a targeted dose of chemotherapy directly to tumor cells while sparing healthy tissues.

Novo Nordisk filed lawsuits against two compounding pharmacies for selling adulterated and misbranded compounded drugs claiming to contain semaglutide, the active ingredient in Wegovy and Ozempic (see here and here). Testing of compounded drugs from these pharmacies revealed unknown impurities up to 33%, the company claims. To date, Novo Nordisk has filed a total of 12 lawsuits against medical spas, weight loss or medical clinics, and compounding pharmacies, claiming the businesses engaged in false advertising, trademark infringement, and unlawful sales of non-FDA approved compounded products that purportedly contain semaglutide.

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Under the agreement, AbbVie will pay $31.26 per share in cash for Immunogen, a nearly 100% premium to the company’s recent trading price. Central to the deal, expected to close in the middle of next year, is Elahere, an Immunogen product that won Food and Drug Administration approval for advanced ovarian cancer in 2022.

Elahere is among a surging class of cancer medicines called antibody-drug conjugates, or ADCs, which are designed to deliver a targeted dose of chemotherapy directly to tumor cells while sparing healthy tissues. AbbVie’s acquisition is the latest multibillion-dollar deal in the space, following Merck’s $22 billion agreement with ADC specialist Daiichi Sankyo and Pfizer’s $43 billion buyout of Seagen earlier this year.

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“Surprisingly fine,” said Conway-Anderson, a 36-year-old agroforestry professor at the University of Missouri. There was an 11-millimeter precancerous polyp that the doctors had discovered, but they’d snipped it out of her colon and recommended surveillance every three years. “Obviously, it’s big news to hear, but grateful this seems to be manageable. I’ll do it,” she said. “Then the bill came.”

She was being charged nearly $12,000 for the procedure after insurance. Conway-Anderson’s head spun. She couldn’t understand how it could cost so much, especially when she thought the colonoscopy was preventative for cancer and thus covered. “I was floored,” she said. “I was like I can’t pay this. I don’t know what you want me to do.”

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