Here’s an unreality check to give some perspective of the carnage on Wall Street: The market cap of biotech upstart ImClone Systems is nearly double that of General Motors.

ImClone, the company whose insider trading scandal made Martha Stewart infamous, is trading today around $65 a share. Don’t hold us to precise numbers in trading this volatile but that translates to a market value of about $5.6 billion. The $70-a-share that Eli Lilly agreed to pay to acquire the company early this week values it at $6.5 billion, including shares now held as options by insiders.

GM, meantime, hit an intraday low of $2.26 a share yesterday, a level that hasn’t been seen since 1951. It has been trading this afternoon around $4.85 a share, which works out to a market cap of about $2.75 billion. See the diverging value of shares of ImClone (red) and GM (blue) in the chart above.

Maybe General Motors shareholders should pray that Carl Icahn gets interested in the stock. ImClone rejected a $36-a-share offer from an unnamed pharmaceutical company in October, 2006 amid a squabble with Icahn, who controls 14% of ImClone shares and who was then a dissident board member. He subsequently took over as chairman and installed new management to support the company’s blockbuster cancer drug Erbitux.

The result was the deal with Lilly, which came in $8 a share more than an unsolicited $62-a-share bid from Bristol-Myers Squibb that Icahn called ‘absurd.’

Are hair transplants really covered by health insurance? The Health Blog wondered after hearing presidential hopeful Sen. John McCain slam the procedure for the follicularly challenged during the presidential debate this week.

In case you missed it, McCain claimed that his plan for insurance tax credits would give 95% of Americans the funds to shop around for the insurance of their choice, adding:

McCain next said, “I might need one of those myself.”

Serious critique, a shot at a Democratic rival who had some work done, or an attempt at humor? We’re not sure.

But the notion that hair transplants symbolize profligacy in the U.S. health-care caught our fancy. So we called William Parsley, a dermatologist who is president of the International Society of Hair Restoration Surgery, a nonprofit group of about 700 hair-restoration doctors world-wide. Parsley laughed out loud at McCain’s remark: “I thought it was funny that hair transplants would come up in a presidential debate.”

But insurance payment for cosmetic hair is the real joke. Parsley said that only hair restoration as part of reconstructive surgery necessitated by severe burns, serious injuries and accidents is customarily covered by insurance.

Such reconstructive surgeries account for about 1 to 2% of hair transplants performed, he said. What about the gold-plated health insurance, we asked. Ever see any of that? Yes, he said, twice in 34 years of practice that insurers paid for a patients’ cosmetic hair transplant. The most recent instance was two decades ago, though.

Are we alone in withholding payment for hair loss? Parsley says no, cosmetic hair transplants aren’t covered in countries with government-run health systems. “They don’t even offer that in Canada,” he said.

Boston Scientific said the company’s founders had to dump 13 million shares of stock earlier this week because they got hurt by the market turmoil.

The announcement was clearly meant to calm the fears of Boston Scientific investors who may have worried that the high volume of selling was tied to problems at the company.

“These sales are involuntary and related to personal planning objectives and the current extraordinary circumstances in the financial markets,” Pete Nicholas said in the statement. “They in no way reflect on the Company.” The statement had a similar comment from Nicholas’s co-founder John Abele.

Both men, as well as a trust that holds shares for Abele’s children, were forced to sell shares to cover collateralized loans, the statement said. Part of the reason was the inability to access money tied up in the bankrupt Lehman Brothers. There may be more forced sales to come, the statement said.

But, amid the broader rout of global markets, the statement didn’t stop Boston Scientific’s slide. Shares in the company — burdened by the debt it took on to buy Guidant, and by sluggish sales of stents and cardiac devices — were down more than 8% this morning.

The sands of the drug business shift quickly. The entry of a generic competitor, the launch of a new brand-name drug, even a big advertising push can drive sales up or down in a hurry.

Those kinds of trends show up in all kinds of data dredges — even a look at the visits to the most popular sites for individual prescription drugs, released yesterday by comScore.

Not surprisingly, AstraZeneca’s heavily marketed heartburn pill Nexium drew the most traffic, with over a million unique visitors.

Takeda’s diabetes medicine Actos came in second, with traffic up more than 20-fold as many diabetics switched from GlaxoSmithKline’s Avandia to Actos because of safety concerns about Avandia.

Sanofi-Aventis’s sleeping pill Ambien CR came in third, but unique visitors were down 61% year-over-year. Last year, Sanofi made a big push for the long-acting CR version of the drug, as regular Ambien faced generic competition. But sales fell sharply anyway.

Here’s the complete list of the top 10 drug sites: (more…)

Hong Kong’s opening a 24-hour hotline to help people deal with “emotional and family problems arising from personal financial crisis amid the recent global financial turmoil,” a government statement said today.

Associated Press

The government’s providing $1.2 million Hong Kong dollars (about $150,000 U.S.) to fund the hotline, which will be staffed by social workers. Callers will receive counseling over the phone, and they’ll be referred to face-to-face counseling sessions, support groups and welfare services, as needed.

Hong Kong’s Hang Seng index fell more than 7% today, to close at its lowest level since January, 2006, the WSJ reports.

The government statement lays out the human toll: “Some people may face personal financial crisis as a result of investment failure and unemployment as well as difficulties with their emotions, family relationship, and accommodation, etc.”

Still, the most urgent question (to the Health Blog’s provincial eyes, anyway) went unanswered: Will the hotline take calls from Manhattan?

Photo: Associated Press

It was only in March of last year that a national experts’ committee recommended that teenage girls get vaccinated with Merck’s Gardasil, which protects against some of the HPV viruses that cause cervical cancer. By the last few months of last year, 25% of teenage girls had received at least one dose of the vaccine, which is given in a three-dose series.

The figure comes telephone survey results published yesterday in the CDC’s weekly report.

Higher vaccination rates for other vaccines suggest there’s room for growth for Gardasil (and for GlaxoSmithKline’s competing HPV vaccine, if/when that makes it to market in this country).

More than 70% of teens had received some sort of tetanus shot after age 10 (as part of combination vaccines that also protect against other diseases such as diphtheria and whooping cough), and about a third had received a meningitis vaccine.

“For a new vaccine, 25% coverage is really very good,” a CDC official said yesterday, the WSJ reports.

But the uptake of the vaccine — which retails for $360 for a three-dose series — appears to be slowing this year. Sales were off 9% in the second quarter, Merck said, and down 34% in July and August, according to IMS Health figures cited by the Los Angeles Times.

Photo: Associated Press

A number of health reformers, including Sen. John McCain, call for insurance tax credits that people could use to shop for individual health policies on the open market.

Competition and freedom of choice would be tonics for the health system, the thinking goes. But there may be a problem. Findings from a survey of individual insurance shoppers show that 15% of people looking for insurance online were deemed “uninsurable” for standard coverage by most insurance carriers.

The survey, conducted by Norvax, an online service for health insurance, analyzed data from 446,500 online insurance shoppers who either requested a quote or to be contacted by an insurance broker this summer. The people deemed uninsurable either had a pre-existing medical condition or provided height and weight information that produced a body mass index of 39 or higher, indicating serious obesity.

The report’s authors point out that the findings don’t necessarily mean the uninsurable will never get health insurance. But if they do, it would be extremely expensive and probably wouldn’t cover the pre-existing condition at issue.

The Norvax study found that two-thirds of all uninsurable insurance shoppers were women. Pregnancy or a prior c-section often put women on the pre-existing condition blacklist, according to a report last month from the National Women’s Law Center.

Then again, according to the Norvax study, nearly two-thirds of people shopping for individual health insurance in the first place are…women.

Robert Cialdini, a noted psychologist who studies persuasion, stopped by to talk with the Health Blog recently. We asked him how people could be persuaded to make better health choices.

The author of a new book “INFLUENCE: Science and Practice,” Cialdini worked his persuasive magic on us. The first step, he told the Health Blog, is for people to make their health goals public. “It’s not enough to keep them in our heads, but if we tell our best friend, we’re much more likely to stay consistent,” Cialdini said. How does it work? Being inconsistent can make us seem wishy-washy or even unstable, which isn’t how we like to appear.

Doctors need to frame the health message properly to make a difference for patients. If patients are unsure or equivocal about a health choice, it’s better to tell them what they will lose rather than what they will gain. For smokers who are debating quitting, Cialdini explained, reminding them about the cost of smoking — like getting lung cancer — is more persuasive than telling them about the benefits of stopping.

Also, people are influenced by those in positions of authority, so health messages that come from experts appear more effective. Got that, doc? Cialdini points to a study from an HMO that sent out letters signed by a member of the “health team staff” vs. the chief medical officer. Compliance jumped by more than 19% when it was signed by the big shot M.D. (more…)

Sheri McCoy (Photo: J&J)

Johnson & Johnson has named Sheri McCoy, the new head of its pharmaceutical unit. McCoy, now in charge of surgical products at J&J, will take over for Christine Poon, who’s retiring next March.

McCoy, 49, will have a big job of her hands. J&J’s pharma unit is the company’s largest in sales, and it’s also the one struggling hardest to achieve growth. Last quarter, a weak dollar helped the pharmaceuticals business eke out a 3.1% revenue increase compared with same period in 2007. But take out the foreign exchange boost and drug sales fell 1.3% on an operating basis.

McCoy, a chemical engineer by training, is a veteran J&Jer who was named chairman of the surgical group and a member of the J&J executive committee just last January. Earlier in her career she ran J&J’s Ethicon business and also served as head of the company’s medical devices division in Latin America.

Alex Gorsky, who early this year rejoined J&J from Novartis to run Ethicon, will succeed McCoy as chairman of surgical care.

Like the rest of the drug industry, J&J is grappling with poor performance in its labs generic competition, recently losing patent protection on the oral version of its blockbuster antipsychotic Risperdal.

What an executive with a diverse background at J&J –- but no particular expertise in pharmaceuticals –- will bring to the task is an obvious question. The Health Blog asked for an interview with McCoy but hasn’t heard back on that request yet.

Like many J&J execs, McCoy has kept a low public profile, though she has appeared at few meetings with investors and on conference calls recently. (Listen to a McCoy podcast from July by clicking here.) We can also tell you that she served on the board of TRI/Princeton, formerly the Textile Research Institute, for 10 years ending in 2007. She also led J&J’s sponsorship of the New Jersey’s FIRST Competition, a robot-building contest for high school students.

Update: J&J Chairman and CEO Bill Weldon emailed the Health Blog through a spokesman about the management moves. Here’s an excerpt:

The grim economy and quaking stock market are driving masters of the financial universe to seek professional help for anxiety, and eroding sense of identity or tips on how to deal with angry clients, the Boston Globe reports.

Therapists are seeing an 15% to 20% uptick in business from affluent clients around Boston, psychologist Jim Grubman told the Globe.

The financial crisis bruises the psyches of the wealthiest in particular because their sense of self can be so focused on making money, therapists say.

“It’s something that I call identity dissolution, their sense of identity dissolves,” Dennis Pearne, another Massachusetts psychologist, told the Globe. “The primary way they defined themselves and who they were and their values - what they can and can’t do in this world - disintegrates.”

In counseling, the rich (or formerly rich) may need to learn that who they are is more than raw purchasing power. Therapy may explore the idea of a different career or, alternatively, how to renew the patient’s motivation to compete again in the market. Grrrrr.

Photo by fakelvis via Flickr

Walgreen withdrew its bid for Longs Drug Stores, removing a hurdle for CVS Caremark as it tries to complete its purchase of the West Coast chain, the WSJ reports.

Associated Press

Work is done on a Walgreens sign below the Times Square news ticker yesterday.

Last month, drugstore chain Walgreen was snubbed in its attempt to snatch rival chain Longs Drug Stores for $2.7 billion when Longs chose to stick with a lower offer to CVS Caremark.

In a letter from chief executive Jeffrey Rein to Longs’s CEO Warren Bryant, Rein explained he pulled the bid due to the “repeated refusal to accept our invitation to engage in a constructive dialogue that could lead to a mutually beneficial transaction, and the substantial deterioration in the national economic outlook over the past few weeks.”

Despite the sad state of the economy, Walgreen says it has a “strong balance sheet and robust cash flow.”

CVS, which submitted a $2.6 billion with all the financing worked out, may still have a tough road ahead of it, as at least two major Longs shareholders say they won’t tender their shares to CVS.

First came evidence that stem cells could be not only harvested from embryos, but also “reprogrammed” from adult cells. Now, research suggests that stem cells can be collected from men’s testicles, which may mute the ethical debate about their scientific use, the AP reports.

Stem cells’ value derives from their ability to change into different types of cells in various parts of the body and thus may be a way to cure some diseases and repair damaged organs. Scientists are exploring their use to treat conditions like spinal cord injury, Parkinson’s disease and diabetes.

But the source of stem cells -– historically the embryo –- has been an ethical point of contention, with critics asserting it’s inappropriate to sacrifice a fertilized egg for scientific or medical purposes.

Last year, a study demonstrated that adults stem cells may be reprogrammed to have the characteristics of embryonic stem cells. Now, early evidence published in the current issue of the journal Nature shows that stem cells harvested from testicles (how’s that for a euphemism?) could be used for regenerative purposes as well –- at least for men.

“It’s exciting. We could do it for males; that leaves women without as easy a method,” stem cell scientist George Daley of Children’s Hospital in Boston and the Harvard Stem Cell Institute, who wasn’t involved in the research, told the AP.

Image of embryonic stem cell colony via Wikimedia Commons

Regulation is becoming all the rage these days, what with the second-guessing of the financial markets. Online pharmacies that sell controlled substances like pain pills to consumers are about to get a dose of tougher rules, the WSJ reports.

President Bush is poised to sign a law spelling out requirements for narcotics sales that could curb online commerce in the medicines. Under the new law, prescribing doctor must have seen the patient face-to-face at least once and the pharmacies have to supply registration numbers to the Drug Enforcement Agency, according to the WSJ. Web sites will also have to give contact information for the actual pharmacies supplying the drugs,

The idea is to make sure that real patients are getting the medications they need while others aren’t getting the substances inappropriately. The role these sites play in suppling drugs of abuse to teenagers is a particular concern, according to the WSJ.

The law “is really making explicit what has been implicit,” Sen. Dianne Feinstein, a California Democrat and the bill’s lead sponsor in the Senate told the WSJ. “We’ve tried to close this loophole by essentially addressing this problem of controlled substances being sold without any medical oversight or prescription.”

But the law won’t do anything about Web sites outside the US or for sales of medicines that aren’t considered controlled, such as Pfizer’s Viagra.

Photo: iStockphoto

Lincoln Park Hospital may be in one Chicago’s fanciest neighborhoods. But the tony location hasn’t spared the facility from the vicissitudes of the financial markets.

Chicago skyline as seen from Lincoln Park

The Chicago Tribune reports the aging hospital has put itself on the market after failing to come up with millions of dollars to finance improvements and fund operations. If no buyer surfaces, the money-losing hospital may close.

“There are some significantly expensive things that need to be done to bring it up to current architecture and fire codes,” Michael Curran, the Lincoln Park Hospital’s CEO, told the Tribune. He put the cost of necessary work at $7 million to $9 million minimum. “We don’t have that sort of capital.”

Lincoln Park Hospital is licensed for 420 beds but staffs only 145 of them.

The hospital, owned by Merit Health Systems, had been seeking additional financing without success. “Access to capital has been shrinking and shrinking and shrinking, and the outlook is worsening by the week,” Curran told the Trib.

Photo by jordanfischer via Flickr

Even as employers shift more health costs to their workers, some bosses do worry about what happens when employees don’t get adequate care.

It’s not necessarily altruism. Sick employees miss more work. What health conditions are most likely to lead to absences? The answers may not be obvious.

In a list of common conditions and behaviors contained in a forthcoming survey by the HR consulting firm Watson Wyatt Worldwide, the one with the biggest share of folks missing 10 or more days of work in the last year was heart disease — 30%. Next highest by that measure was diabetes at 22%. For depression, the figure was 18%, while high blood pressure and stress/anxiety were a bit lower.

Shelly Wolff, the firm’s North American practice leader for health and productivity, says that even though heart disease tends to have few obvious symptoms, the numbers are skewed by the big chunks of time off work that are needed when a patient has a heart attack or other serious problem. “When they’re out, they’re out for a long time,” she told the Health Blog.

For conditions like diabetes, she says, the pattern is more commonly one of occasional, unplanned absences that pop up when employees fail to manage their blood sugar. Stressed employees also tend to take unexpected “mental health days,” she says. That’s a category she expects will increase as people deal with their worries about the worsening economic downturn.

Photo by Kelley Mari via Flickr

This year’s Nobel Prize in Chemistry went to three guys who discovered and developed something called green fluorescent protein. A Nobel Prize for anything green and fluorescent calls for a little visual storytelling, so we put together this slide show.

The tale starts with Osamu Shimomura gathering thousands of jellyfish off the coast of North America in the early 1960s in order to isolate the protein that causes them to emit fluorescent light under ultraviolet rays.

Several decades later, the geneticist Martin Chalfie and his colleagues spliced the gene for GFP into C. elegans, the tiny worm beloved of biologists worldwide. This provided a fluorescent marker that allowed them to track cellular activity in the worm. Here’s their 1994 bombshell paper from Science.

Then Roger Tsien figured out how to tweak GFP to make fluorescent proteins in an array of colors. By using different colors, researchers can track multiple biological processes at once — think of how the different colored wires in the back of a computer make it easier to keep track of what’s what. Plus, all the colors together look pretty sweet (check out the mouse brain in the slide show).

Aesthetics aside, genetically engineered fluorescent proteins allow researchers to track lots of biological activity, which makes it easier to understand things like the spread of cancer and the development of Alzheimer’s. That, not the aesthetics, is why these guys got the Nobel.

The FDA has warned clinical-test giant LabCorp that it has been marketing an ovarian cancer test without approval, vindicating skeptics of the assay who worried it wasn’t ready for prime time.

OvaSure, developed by researchers at Yale, measures six proteins in blood samples and calculates the chances that a woman has ovarian cancer.

LabCorp made the $220 test available in June, without prior FDA review, by taking advantage of a technicality. The regulator doesn’t require a premarket review for tests developed and performed by a single lab.

But in a letter dated Sept. 29 and released today, the FDA determined that because the test was developed at Yale and that parts of it were manufactured elsewhere to the university’s specifications, it must meet the agency’s usual premarketing approval requirements, which could take up a year.

LabCorp spokesman Eric Lindblom told the Health Blog: “We are committed to working in partnership with the FDA to address the regulatory issues. and will provide an update as soon as we can.” (more…)

If you don’t expect to receive Medicare and Social Security benefits by the time you retire, you’ve got plenty of company.

Getty Images

We take for granted that Generations X, Y and Z take a pretty dim view of the likelihood those benefits will be around when they cash their last paychecks. But 61% of older workers say they aren’t confident in the government’s ability to provide health coverage even a few years down the road. Fifty-percent say the same about Social Security payments.

The pessimistic findings come from a recent analysis of a 2007 survey of 5,000 workers between the ages of 50 and 64 from HR consulting firm Watson Wyatt Worldwide.

Who has the least faith in Uncle Sam making good on Medicare and Social Security promises? Wyatt says workers between 50 and 54 years old are much less confident than their older counterparts, as are women in comparison to men.

Meanwhile, most of those who do expect the government to meet its obligations also said they have adequate personal resources to live comfortably for their first five years into retirement. Well, they said that last year, before steep market declines wiped out an estimated $2 trillion in the value of 401(k) plans.

Benefits Best Guess: How confident are you in getting the government’s support when you reach retirement age? If don’t expect to collect Medicare or Social Security benefits, what alternatives, if any, do you plan to rely on?

Lots of employees are getting pushed into high-deductible health plans that leave them on the hook for more of their health-care spending. But many doctors aren’t ready to step in as financial advisers to help patients hash out the costs of their health care.

Most primary care docs are ready to counsel patients on costs typically associated with primary care — office visits, medications, and laboratory tests. But only about half were ready to advise on the costs of the high-ticket items like CT scans, visits to specialists and hospitalizations. And only 48% were ready to discuss medical budgets with patients.

The findings come from survey results published this month in the American Journal of Managed Care.

The idea behind the high-deductible plans, which are often paired with tax-advantaged health-savings accounts, is to turn patients into savvy health care shoppers, seeking out high quality at low prices.

But the docs were pretty skeptical about some of the commonly cited sources consumers might use to compare the quality of care given by different providers. Only 21% of docs thought patients could trust health quality information from government Web sites, and 8% thought patients could trust quality information from insurance Web sites. (Docs don’t trust insurance companies? Go figure.) (more…)

Remember WellCare? The company didn’t get much national attention until last fall, when FBI agents raided its Florida headquarters and the company’s stock fell more than 60%.

The company provides managed care to Medicare and Medicaid recipients, and it emerged that the investigation had something to do with alleged Medicaid fraud, but the details have remained sketchy.

A bit more information came to light this week, as prosecutors unsealed a guilty plea by a WellCare employee who participated in an “elaborate scheme” from 2002 to 2006, sending Medicaid inflated bills for behavioral health care services, the Tampa Tribune reports.

The employee didn’t act alone, and faces 10 years in prison.

That doesn’t sound like good news for the company, but the market had been bracing for something worse. The plea “supports our view that the scope of the investigation appears limited to Florida Medicaid behavioral health and that a settlement could fall at the lower end of the potential outcomes,” Goldman Sachs analyst Daryn Miller said in a note cited by Dow Jones Newswires.

The company said the scope and pace of the investigation remain confidential. WellCare’s stock was up nearly 3% yesterday on the news, even as global markets plummeted.