Cancer drains individuals of their physical, emotional, and financial health. Given the impact on both patients and the people in their lives — including their employer — it’s time that CEOs take note and take action to reduce the burden of cancer.

In a study from the American Cancer Society Cancer Action Network, nearly half of cancer patients and survivors reported being extraordinarily burdened by medical debt. Many respondents carried a negative balance of at least $5,000 from their cancer treatment for more than one year, and 42% of people with cancer deplete their life savings within the first two years after diagnosis.

Financial hardship caused by cancer can also contribute to “financial toxicity,” wherein the cost of treatment forces individuals to make tradeoffs that impact their chances of survival. These may include non-biologic factors such as skipping or halving cancer medications to stretch their supply, or being unable to complete cancer care as planned due to the high costs of transportation to or housing near cancer treatment centers. This model isn’t sustainable, and rising costs of new, life-saving cancer therapies will impose additional financial toxicities — and an increasingly large threat to patients’ lives.

Not only does financial toxicity of cancer care affect the individual, it can also negatively impact their employer. As the providers of health insurance coverage for nearly half the country, employers and unions shoulder much of cancer’s financial burden. Today, cancer is the leading health-care cost for mid- and large-sized organizations in the U.S., and the burden is growing.

For the first time in history, more than 2 million Americans will receive a new cancer diagnosis in 2024. While increasing cancer incidence can be attributed in part to our aging population (cancer risk increases with age), we also see a disturbing national trend in which younger people are being diagnosed with 17 major cancers. These are people who would still likely be in the workforce, using employer-sponsored health insurance. As a result, employers are asking what they can do to reduce the burden of cancer on their populations — and their bottom line.

Patients, families, and employers all “win” when cancers are diagnosed at an early stage. Detecting cancer early not only improves chances of survival, it significantly lowers the cost of care. Overall, treatment costs for someone diagnosed at stage IV — when cancer has spread throughout the body — are an average of $156,000 higher than for those diagnosed at stage I, when the disease is localized. The first year of treatment for colorectal cancer, which affects over 150,000 individuals each year in the United States and is on the rise in younger populations, costs an average of $111,000 when diagnosed at stage I, with about a 90% five-year survival rate. By contrast, stage IV colorectal cancer drives average treatment costs of $256,000 in the first year, and five-year survival rates are under 20%. Evidence suggests that if individuals could only take advantage of the prevention, early detection, and cancer treatment strategies that exist today, the cancer mortality rate would decline by 30% to 50%.

These statistics are profound and strongly suggest that concerted efforts from employers and individuals to encourage cancer prevention and early detection would improve health and reduce health-care costs. Today, our best tool to achieve this is screening. Adherence to recommended screening guidelines — like those published by ACS — could save the U.S. health-care system $26 billion per year in avoided treatment costs.

Despite the importance of early detection and proven value of screening, access to preventive care remains a barrier to better outcomes. At present, a staggering 65% of eligible Americans are out-of-date with recommended cancer screenings. Covid-19 restrictions delayed or prevented 9.4 million cancer screenings in 2020 alone, likely leading to later-stage diagnoses that would have normally been caught earlier.

There are also logistical and societal barriers that contribute to financial toxicities and impact a person’s ability to get screened. People may need to take time off work or arrange childcare to attend a screening appointment. They may need to weigh potential future treatment costs against their need to pay rent. Some may not be aware they’re eligible for screening, and stigma and fear associated with cancer screening hinders some people from seeking care. Inequities according to one’s socioeconomic status — including where they live, their income, education level, access to healthcare and healthy foods, and other social determinants of health — create roadblocks to preventive care. To realize the benefits of early detection on individuals and organizations, it’s important that we develop new strategies to remove these barriers.

ACS is committed to tackling cancer, approaching the challenge of improving access to care and reducing financial toxicity from multiple angles. Similar or supportive action from U.S. employers will increase our collective impact against cancer’s burden.

Toward the goal of increasing early detection, ACS recently partnered with Color Health in a joint venture to improve access to screening and preventive care through employers and unions. By making it easier and more convenient for employees to get care — with at-home testing kits and care navigation support across their cancer journey — this program aims to increase awareness, accessibility, and affordability of cancer screening and early detection. Notably, organizations taking advantage of the ACS-Color program have witnessed a 77% increase in cancer screening adherence.

In addition to direct screening initiatives, programs like Road to Recovery and ACS Hope Lodges remove the cost burdens of transportation and lodging for cancer treatment. Other partnerships through BrightEdge, ACS’s donor-funded innovation and investment arm, provide access to a wide range of solutions that help people navigate the financial complexities of cancer across the continuum of care. One BrightEdge portfolio company, TailorMed, offers a platform to help patients find resources to cover the cost of treatment and reduce out-of-pocket expenses. Further investments aim to bring the patient voice into therapy and diagnostic development, to enable a future generation of sustainable cancer innovations that reduce patients’ financial distress.

Advocacy is also key to reducing financial toxicity. ACS’s Cancer Action Network advocates for Medicaid expansion to help currently uninsured individuals access screening and preventive care. To bring down the cost of prescription drugs, ACS CAN has also successfully advocated for “smoothing,” a policy that allows Medicare beneficiaries to spread out their prescription drug costs over the course of the year. By making payments more manageable for patients, we remove a crucial element of the cancer financial challenge.

Cancer will impact one in two women and one in three men at some point in their lifetime. By facilitating guideline-recommended screening and activating programs that make early detection affordable and accessible, employers can offset financial toxicities and improve outcomes for people across the country. When employers help their employees get screened, they bring us one step closer to ending cancer — and its costs — as we know it.

—By Karen Knudsen, CEO of the American Cancer Society. She is also a member of the CNBC CEO Council.

Tobacco product use among middle and high school students has dropped to a 25-year low, the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration announced on Thursday.

The CDC and FDA recorded data on youth tobacco product use through the National Youth Tobacco Survey, which found that 2.25 million middle and high school students reported they had used any tobacco product in the last 30 days, down from 2.8 million in 2023.

The drop reflected a decline in students who said they were using electronic cigarettes, down to 1.63 million in 2024 from 2.13 million in 2023.

“We’re headed in the right direction when it comes to reducing tobacco product use among our nation’s youth,” Brian King, director of the FDA’s Center for Tobacco Products, said in a press release on Thursday. “But we can’t take our foot off the gas. Continued vigilance is needed to continue to reduce all forms of tobacco product use among youth. Addressing disparities remains an essential part of these efforts to ensure that we don’t leave anyone behind.”

Female students reported the biggest decline in use across the board, and Hispanic students also reported a drop in use of any tobacco product. Evidence-based strategies, including price increases, media campaigns and smoke-free policies, are likely part of what caused tobacco product use to drop, according to the agencies.

E-cigarettes continue to be the most used among students who reported tobacco product use, at 5.9%, but nicotine pouches are now the second most commonly used tobacco product, at 1.8%, followed by cigarettes at 1.4%.

Nicotine pouch use actually grew among students, though not enough to be considered significant, from 1.2% in 2023 to 1.8% in 2024, the CDC said in September.

“Youth use of tobacco products in any form — including e-cigarettes and nicotine pouches — is unsafe,” Deirdre Lawrence Kittner, the director of the CDC’s office on smoking and health, said in a press release in September. “It’s essential that we remain vigilant and committed to public health efforts to ensure all youth can live healthy, tobacco-free lives.”

Zyn was the most popular nicotine pouch brand, at 68.7%, compared with the next most popular brand On at 14.2%.

Zyn, the oral nicotine pouch brand owned by Philip Morris International, exploded in popularity on social media earlier this year which led to a nationwide shortage. Philip Morris in July announced plans to invest $600 million into a new Zyn production facility in Colorado in response to the spike in demand.

The survey was distributed among 29,861 students from 283 schools from Jan. 22 to May 22.

A version of this article first appeared in CNBC’s Healthy Returns newsletter, which brings the latest health-care news straight to your inbox. Subscribe here to receive future editions.

Good afternoon and happy Tuesday! To no surprise, expanding Medicare coverage of costly weight loss drugs could come at a steep cost for the federal government. 

Allowing Medicare to cover obesity medications would increase federal spending by about $35 billion from 2026 to 2034, according to an analysis released by the U.S. Congressional Budget Office last week. 

The federal costs for covering those drugs would grow from $1.6 billion in 2026 to $7.1 billion in 2034, the CBO said. 

The analysis is all hypothetical, and comes as drugmakers and advocacy groups push for the government to expand coverage of – and give more seniors access to – the highly popular treatments. Those include GLP-1s for obesity such as Novo Nordisk‘s Wegovy and Eli Lilly’s Zepbound, which both carry hefty price tags of roughly $1,000 per month before insurance and other rebates. 

Right now, Medicare doesn’t cover weight loss treatments unless they are approved and prescribed for another health condition. For example, Medicare covers Wegovy for reducing the risk of serious cardiovascular complications in those with heart disease and obesity, but doesn’t cover the drug for weight loss.  

The CBO expects that savings from improved health among patients – mainly by reducing the incidence of obesity-related conditions – 

will grow over time. Still, it says those savings could be relatively small, totaling less than $50 million in 2026 and about $1 billion in 2034.

“Even though net federal savings per user are projected to be larger over the longer term, they would still be less than the cost of the medications,” the CBO said in the report.

The cost of drugs could also fall over time, according to the CBO.  

Here’s why: It expects generic versions of popular weight loss injections to enter the market and reduce prices. The CBO also anticipates average net prices for obesity medications will fall in 2027 due to Medicare drug price negotiations with manufacturers.

Semaglutide, the active ingredient in Wegovy and Novo Nordisk’s diabetes drug Ozempic, could be among the 15 prescription drugs selected for the next round of price talks, which will begin in 2025 and go into effect in 2027. 

But how could Medicare coverage of those treatments impact access? 

If Medicare covers those medications, more than 12.5 million beneficiaries would newly qualify for weight loss drugs beginning in 2026, according to the CBO. The analysis said around 2% of those patients are expected to use the treatments in the first year. 

More than two-thirds of Medicare beneficiaries are

classified as either obese or overweight, according to their

body mass index, the CBO said. 

Notably, spending could look slightly different beyond 2034. 

The CBO said Medicare spending on weight loss drugs would probably be lower on a per-user basis due to lower costs tied to the drugs and increasing savings. But Medicare coverage of those treatments would still increase net federal costs from 2034 to 2044, the CBO noted. 

A Novo Nordisk spokesperson said in a statement Tuesday that the medical and societal costs of obesity are “significant,” with some estimates exceeding $1.7 trillion annually in the U.S. 

“We know treatment of obesity is linked to better medical outcomes, even if bureaucrats haven’t figured out how to account for these savings,” the spokesperson said, adding that the company hopes Medicare will start to offer coverage for weight loss drugs. 

Eli Lilly did not immediately respond to CNBC’s request for comment. 

Feel free to send any tips, suggestions, story ideas and data to Annika at annikakim.constantino@nbcuni.com.

A version of this article first appeared in CNBC’s Inside Wealth newsletter with Robert Frank, a weekly guide to the high-net-worth investor and consumer. Sign up to receive future editions, straight to your inbox.

Wealthy millennials and Gen Zers are redefining the world of charitable giving, seeing themselves more as activists than donors, according to a new study.

Wealthy donors under the age of 43 are more likely to volunteer, fundraise and act as mentors for charitable causes rather than just give money, according to a new survey from Bank of America Private Bank. The survey of more than 1,000 respondents with more than $3 million in investible assets also found that young philanthropists want more public attention for their giving compared to Gen Xers and baby boomers.

The shift in the way the next generations give, as well as the causes they favor, is likely to remake the charitable landscape. Rather than simply writing checks to causes they care about, the next generation of givers wants to be deeply involved in trying to fix the biggest social and environmental problems.

“They view themselves as holistic social change agents,” said Dianne Chipps Bailey, managing director and national philanthropic strategy executive for philanthropic solutions at Bank of America Private Bank. “I think they have a better sense of agency in this world. They’re really looking to move their capital in a much more comprehensive robust way to achieve their social impact goals.”

Both younger and older multi-millionaires are highly charitable. According to the study, 91% of the respondents had given to charity in the past year. More than two-thirds of both older and younger respondents said they are motivated by “making a lasting impact.”

Yet their reasons for giving and their methods vary widely by age. Donors under the age of 43 are slightly more likely to volunteer and are twice as likely to help raise charitable donations from friends or peers rather than just giving directly. They’re  more than four times as likely to act as mentors. And they’re more interested in serving on nonprofit boards rather than limiting their contributions to capital.

Older donors give from of a sense of responsibility. Those over the age of 44 were more than twice as likely to give due to “obligation” than younger donors. Those under 43 were more likely to cite self-education and the influence of their social circle as drivers of their philanthropy.

Some of the differences between generations may be rooted in life cycles and wealth. The younger wealthy are still building their fortunes and inheriting their wealth, so they’re more likely to give their time and help fundraise. Still, Bailey said the focus on peer networks and activism will likely endure even as they get older and wealthier.

“You can think of philanthropy as the five T’s – time, talent, treasure, testimony and ties,” she said. “The older generation is focused on the treasure (giving funds). The younger generations are leaning into the other four.”

The young wealthy also support different causes. They’re twice as likely to support efforts related to homelessness, social justice, climate change and the advancement of women and girls. Philanthropists over 44 were far more likely to support religious organizations, the arts and military charities.

“When you think about what [the younger generation] has been through in recent years, 2020, where they saw it all exposed, they’re leaning into the response,” Bailey said. “And it’s sustained. So many people move their giving with the headlines, but they’ve really dug in deeply. It’s not a moment but a movement.”

The implications of the generational shift in giving will be profound for wealth advisors and nonprofits, advisors say. Since many younger donors inherited their wealth, they’re far more likely to use giving vehicles created by their family. They were more than four times more likely to use charitable trusts, family foundations and donor advised funds.

Bailey said the next generation wants to talk about philanthropy as part of an initial discussion with a wealth advisor — even before talking about their investment plan.

“They have a hunger to know more, to learn more about philanthropy,” Bailey said. “They’ve already got these complex [giving] vehicles at the ready, so the education piece is critical both for nonprofits and for the advisors.”

With charity increasingly dominated by wealthy donors, and with the next generations expected to inherited over $80 trillion in the coming decades, courting the young rich will be critical.

“You need their perspective and you’re going to need their money,” Bailey said.

Advisors to the young rich also need to be generous with their praise. Younger donors are more than three times more likely to gauge the success of their philanthropic efforts by public recognition, according to the survey. Nearly half say they are likely to associate their names with their philanthropic efforts, while more than two-thirds of older donors give anonymously.

“Praise them, celebrate them, give them visibility,” she said.

Just don’t call them “philanthropists.” A report from Foundation Source found that 80% of young donors want to be seen as “givers,” while 63% also like the terms “advocate” or “changemaker.” Only 27% accepted the label of “philanthropist.”

The biggest names in sports are joining forces in a new campaign to combat antisemitism.

New England Patriots owner Robert Kraft and his foundation unveiled a star-studded ad titled “Time Out Against Hate” on Thursday in collaboration with Major League Baseball, Major League Soccer, the National Basketball Association, the Women’s National Basketball Association, the National Football League, the National Women’s Soccer League and NASCAR.

The campaign follows a new report out Sunday by the Anti-Defamation League that revealed there have been more than 10,000 antisemitic incidents in the U.S. in the year since the Oct. 7, 2023, Hamas terrorist attack in Israel. The Foundation to Combat Antisemitism, founded by Kraft, says 10% of U.S. adult males are blatantly prejudiced against Jewish people and tend to be outspoken about it.

“What’s going on now in the country — I’ve never seen anything like it,” Kraft told CNBC’s “Squawk Box” on Thursday. “And I’m concerned what will happen after the election.”

The ad spot, which includes names such as Billie Jean King, Shaquille O’Neal, Jim Harbaugh, Doc Rivers, Joe Torre, Ryan Blaney and Candace Parker, will premiere Thursday as part of Amazon’s Thursday Night Football programming featuring the NFL’s San Francisco 49ers and Seattle Seahawks. The campaign will also be seen on digital platforms and on billboards across the country.

“By uniting under a common cause, we amplify our message and demonstrate that the power of sports extends beyond stadiums, arenas and fields, and into our communities,” Kraft said in a statement announcing the campaign. “This initiative is a call to action for everyone to join us in creating a world where hate is met with a unified stand for empathy, understanding, and respect.”

Last year, Kraft organized a meeting of sports commissioners from nearly ever league to try and address the hateful dialogue taking place. The leaders discussed ideas and opportunities to work together.

The campaign has since expanded to include all hate, whether it is gender, religion or race.

“We wanted to make sure it included anti-Black, anti-LGBTQ, anti-Muslim,” said NBA Commissioner Adam Silver in the CNBC interview, alongside Kraft and NWSL Commissioner Jessica Berman. “Because hate is corrosive to our society and the underpinnings of our democracy,” Silver said.

Berman said Kraft asked the commissioners to lean in and change the narrative when it comes to hate.

“I think we have a responsibility as professional sports league leaders in that we have an outsized impact,” said Berman. “We know throughout history that sport has the power to change the world.”

Kraft founded the Foundation to Combat Antisemitism in 2019 to help address the rising hate against Jews in the U.S. His organization has been working with companies such as Bank of America and shoemaker Adidas as well as with colleges to raise awareness of on-campus incidents of antisemitism.

“We’re able to tell college campuses what’s going on in their campuses before their security people see it,” Kraft said.

In April, Kraft said he was no longer comfortable financially supporting his alma mater, Columbia University, over the administration’s handling of anti-Israel protesters on campus. In June, he announced a $1 million donation to Yeshiva University to cover tuition for Jewish students who wish to transfer.

Microsoft on Thursday announced new health-care data and artificial intelligence tools, including a collection of medical imaging models, a health-care agent service and an automated documentation solution for nurses. 

The tools aim to help health-care organizations build AI applications quicker and save clinicians time on administrative tasks, a major cause of industry burnout. Nurses spend as much as 41% of their time on documentation, according to a report from the Office of the Surgeon General. 

“By integrating AI into health care, our goal is to reduce the strain on medical staff, foster the collective health team collaboration, enhance the overall efficiency of healthcare systems across the country,” Mary Varghese Presti, vice president of portfolio evolution and incubation at Microsoft Health and Life Sciences, said in a prerecorded briefing with reporters. 

The new tools are the latest example of Microsoft’s efforts to establish itself as a leader in health-care AI. Last October, the company unveiled a series of health features across its Azure cloud and Fabric analytics platform. It also acquired Nuance Communications, which offers speech-to-text AI solutions for health care and other sectors, in a $16 billion deal in 2021.

Many of the solutions Microsoft announced on Thursday are in the early stages of development or only available in preview. Health-care organizations will test and validate them before the company rolls them out more broadly. Microsoft declined to share what these new tools will cost.

Health-care AI models 

Roughly 80% of hospital and health system visits include an imaging exam because doctors often rely on images to help treat patients.

Microsoft is launching a collection of open-source multimodal AI models that can analyze data types beyond just text, such as medical images, clinical records and genomic data. Health-care organizations can use the models to build new applications and tools.

For example, digitizing a single pathology slide can require more than a gigabyte of storage, so many existing AI pathology models have trained on small pieces of slides at a time. Microsoft and Providence Health & Services built a whole-slide model that improves on mutation prediction and cancer subtyping, according to a paper published in the peer-reviewed journal Nature.

Now, health systems can build on it and fine-tune it to meet their needs. 

“Getting a whole-slide foundation model for pathology has been a challenge in the past … and now we’re actually able to do it,” Sara Vaezy, chief strategy and digital officer at Providence, told CNBC in an interview. “It was really sort of a game changer.” 

The models are available in the model catalog within Azure AI Studio, which serves as Microsoft’s generative AI development hub. 

Health-care agent service

Microsoft also announced a new way for health systems to build AI agents.

AI agents vary in complexity, but they can help users answer questions, automate processes and perform specific tasks. 

Through Microsoft Copilot Studio, these organizations can create agents equipped with health-care-specific safeguards. When an answer contains a reference to clinical evidence, for instance, the source is shown, and a note indicates if the answer is AI-generated. Fabrications and omissions are also flagged, Microsoft said. 

For example, a health-care organization could build an AI agent to help doctors identify relevant clinical trials for a patient. Microsoft said a physician could type the question, “What clinical trials for a male 55-year-old with diabetes and interstitial lung disease?” and receive a list of potential options. It would save the doctor the time and effort of finding each trial. 

AI agents that can help patients answer basic questions have been popular among the health systems that have already begun testing the service, Hadas Bitran, general manager of health AI at Microsoft Health and Life Sciences, said in a Q&A with reporters. Agents that can help doctors answer questions about recent guidelines and patients’ history are also common, she added.

Microsoft’s health-care agent service is available in a preview capacity starting Thursday.

Bringing automated documentation to nurses

In August, Microsoft announced that the next phase of its partnership with Epic Systems would be dedicated to building an AI-powered documentation tool for nurses, and the company detailed those plans on Thursday. 

Epic is a health-care software vendor that houses the electronic health records of more than 280 million people in the U.S. It has a yearslong relationship with Microsoft. 

Microsoft’s Nuance already offers an automated documentation tool for doctors called DAX Copilot, which it unveiled last year. It allows doctors to consensually record their visits with patients, and AI automatically transforms them into clinical notes and summaries.

Ideally, this means doctors don’t have to spend time typing out these notes themselves every time they see a patient. 

The technology has exploded in popularity this year. Nuance announced that DAX Copilot was generally available within Epic’s electronic health record in January – a coveted stamp of approval within the health-care industry. Integrating a tool like DAX Copilot directly into doctors’ EHR workflow means they won’t need to switch apps to access it, which helps save time and reduces administrative workload.

But so far, DAX Copilot has only been available to doctors. Microsoft said that’s changing. It’s building a similar tool optimized for nurses.

“The nursing workflow is very different from that of physicians, and any solution developed for nurses needs to integrate with the way they work,” Presti said during the briefing. “Our team has spent hours shadowing nurses during their shifts to see how they carry out their tasks and to discover where the greatest points of friction exist throughout their day.”  

Microsoft is working with organizations like Stanford Health Care, Northwestern Medicine and Tampa General Hospital to develop it.

A version of this article first appeared in CNBC’s Healthy Returns newsletter, which brings the latest health-care news straight to your inbox. Subscribe here to receive future editions.

Happy Tuesday! Pfizer‘s troubles may finally be coming to a head. 

Former executives of the pharmaceutical giant are backing a push by activist investor Starboard Value to turn around the struggling company, according to recent reports. 

Starboard has a roughly $1 billion stake in the drugmaker and approached former Pfizer CEO Ian Read and ex-CFO Frank D’Amelio, both of whom expressed interest in supporting the activist investor’s efforts to shake up the company, CNBC previously reported. As of late Tuesday, Pfizer has a market cap of roughly $165 billion. 

Read and D’Amelio relayed proposals from Starboard to several members of the company’s board on Sunday, the Financial Times reported on Monday, citing sources familiar with the conversations. Still, the details of the turnaround plan are scant. 

Read was Pfizer’s CEO from 2010 through 2018, while D’Amelio was Pfizer’s chief financial officer from 2007 to 2021.

Here’s why it matters: Read and D’Amelio’s reported involvement is a rare instance of former executives engaging in what could be an activist fight for the future of one of the largest pharmaceutical companies in the world.

Investors have been clamoring for change at Pfizer, whose shares are down more than 30% over the past two years. The company has struggled to recover from the rapid decline of its Covid business, which raked in record-breaking revenue during the peak of the pandemic. 

Pfizer CEO Albert Bourla is facing mounting pressure to improve the company’s performance after several commercial missteps over the past two years – including disappointing data on an experimental obesity pill and a slower-than-expected launch of a respiratory syncytial virus vaccine – along with a costly M&A strategy that has yet to yield significant returns. 

Pfizer is betting big on oncology, and particularly its whopping $43 billion acquisition of cancer drug developer Seagen, to regain its footing. But that deal may take years to pay off. Meanwhile, Pfizer last month pulled a key sickle cell disease drug from global markets – the centerpiece of its roughly $5 billion buyout of Global Blood Therapeutics in 2022. 

Starboard’s turnaround push raises questions about Bourla’s fate at the company. 

“We’ve sensed investor frustration with CEO Albert Bourla since at least the beginning of 2023,” BMO Capital Markets analyst Evan Seigerman wrote in a research note Monday. 

Still, he said, “While placing blame on one person may seem easy, rarely will it result in a quick turn-around.”

Other analysts similarly said there may be no quick fix by an activist investor. 

“We await future developments, but we do not see low-hanging fruit to boost shareholder value,” Leerink Partners analyst David Risinger wrote in a research note on Monday. 

Risinger said that’s because the company faces “revenue growth constraints” over the next five years, driven by patent expirations for top-selling drugs and pressure from competitors. Pfizer has also pursued significant cost-cutting efforts, he added. The company last fall announced that it would cut $4 billion in costs and in May disclosed another multi-year plan to slash roughly $1.5 billion in expenses by 2027. 

Pfizer’s debt levels are also relatively high, Risinger noted, with $57.5 billion in debt as of June 30. He said that may only be partially reduced by selling more shares from its assets, such as the consumer health business Haleon. 

We’ll continue to follow Starboard’s turnaround push, so stay tuned for our coverage.

Feel free to send any tips, suggestions, story ideas and data to Annika at annikakim.constantino@nbcuni.com.

A version of this article first appeared in CNBC’s Healthy Returns newsletter, which brings the latest health-care news straight to your inbox. Subscribe here to receive future editions.

Hello and happy Tuesday! Today, we’re unpacking a shocking move from Pfizer. 

The pharmaceutical giant last week announced it would voluntarily withdraw its sickle cell disease therapy, Oxbryta, from worldwide markets — to the surprise of doctors, patients and investors.

Here’s why the drug is important: Oxbryta is one of at least six treatments for the inherited blood disorder. The drug first won accelerated approval from the U.S. Food and Drug Administration in 2019, which requires further trials to confirm its benefits to patients. 

Oxbryta was one of the centerpieces of Pfizer’s $5.4 billion acquisition of Global Blood Therapeutics in 2022. 

Sickle cell disease causes red blood cells to become misshapen half-moons that get stuck inside blood vessels, which can restrict blood flow and cause what are known as pain crises. It impacts roughly 100,000 people in the U.S., many of whom are Black, according to data from the Centers for Disease Control and Prevention.

The company on Wednesday said the decision to withdraw Oxbryta was based on data showing a higher risk of deaths and complications in patients treated with the once-daily pill. In a release, Pfizer said the “totality of clinical data” on Oxbryta now indicates that its overall benefit “no longer outweighs the risk” in the patient population for which the drug is approved. 

As part of that move, Pfizer is also discontinuing all studies and access programs related to the treatment. 

The FDA on Saturday urged healthcare professionals to stop prescribing Oxbryta. The agency also said patients and caregivers should contact their healthcare professional about stopping the drug and starting another treatment option. 

European regulators on Thursday also said patients in trials had higher rates of pain crises after they started treatment with Oxbryta than they did before taking it. Those regulators recommended suspending the drug’s marketing authorization. 

That all may sound cut and dry. But Oxbryta’s withdrawal is raising concerns. 

Its sudden absence from the market leaves doctors, sickle cell disease patients and patient advocates scrambling for more information on the decision and guidance on what they should do next, STAT reported on Friday. And while taking Oxbryta could put patients at risk, it is not entirely clear what they may experience if they abruptly stop treatment with the drug. 

In a statement last week, the National Alliance of Sickle Cell Centers urged patients not to abruptly stop taking Oxbryta. The group, which supports health centers that administer treatments for the disorder, urged all patients currently taking Oxbryta to make an appointment with their doctor and develop a plan for gradually tapering off the medication.  

Oxbryta’s withdrawal will be a “significant blow” to patients with sickle cell disease “who have been historically underserved,” BMO Capital Markets analyst Evan Seigerman wrote in a research note last week. 

The FDA last year approved two gene therapies to treat sickle cell disease, a landmark decision that gave hope to patients who suffer from the debilitating disease. But health officials have so far struggled to find a way to provide equitable access to the costly treatments. 

Vertex Pharmaceuticals‘ gene therapy Casgevy costs $2.2 million per patient, and Bluebird Bio‘s treatment Lyfgenia lists for $3.1 million per patient. 

Other companies such as Agios Pharmaceuticals and Fulcrum Therapeutics are developing new experimental treatments for sickle disease. Notably, some Wall Street analysts said Pfizer’s withdrawal of Oxbryta could accelerate the timeline for clinical trials on those rival drugs. 

If Agios’ experimental drug, mitapivat, shows a benefit in reducing pain crises in clinical trials, “We anticipate this will enable an easier regulatory review, especially now considering the greater demands from patients who can no longer access Pfizer’s drug,” Piper Sandler analyst Christopher Raymond said in a research note last week. 

Meanwhile, the financial impact of the Oxbryta withdrawal is “somewhat modest for a company of Pfizer’s size,” Guggenheim analysts said in a note last week. 

They said Oxbryta sales have been relatively modest for the company, amounting to $328 million last year. But the analysts noted that Oxbryta sales were expected to increase to around $750 million by the end of the decade, citing FactSet consensus estimates. 

Pfizer’s decision will likely raise questions around the company’s ability to grow through the end of the decade when it faces several drug patent expirations and “other challenges to their current growth drivers,” according to Guggenheim. The analysts also said the Oxbryta withdrawal raises questions about what will happen to Pfizer’s other sickle cell disease treatment in development, GBT-601. 

That oral drug, which Pfizer also acquired through the Global Blood Therapeutics deal, is seen as a successor to Oxbryta.

Feel free to send any tips, suggestions, story ideas and data to Annika at annikakim.constantino@nbcuni.com.

More than 13,000 immigrants convicted of homicide — either in the United States or abroad — are living freely in the U.S., outside of Immigration and Customs Enforcement detention, according to data ICE provided to Congress earlier this week.

The immigrants are part of ICE’s “non-detained” docket, meaning the agency has some information on the immigrants and they have pending immigration cases in the U.S., but they are not currently in detention either because they are not prioritized for detention or because ICE cannot find them.

Acting ICE Director P.J. Lechleitner sent the data, collected as of July 21, as part of a request sent in March from Republican Congressman Tony Gonzales of Texas. 

It is not clear when the first migrant of the 13,000 crossed into the U.S. Two law enforcement officials familiar with the data told NBC News many of the migrants on ICE’s non-detained docket, including serious criminals, crossed into the U.S. under previous administrations, including former President Donald Trump‘s. 

During a campaign stop in Michigan on Friday, Trump used the data to criticize Vice President Kamala Harris for current immigration policies.

“I can finally look at them and say ‘I told you so,’ to the fake news,” Trump said. “These are hard, tough, vicious criminals that are free to roam in our country.”

The White House has yet to comment on the data. One official told NBC News the release of the data came as a surprise to the White House.

The 13,099 immigrants convicted of homicide living in the U.S. may have never had contact with ICE, the two law enforcement officials said. Some may have crossed the border and then been released because Border Patrol lacks information on their criminal history. In many cases, the U.S. is not notified of someone’s criminal conviction until after they cross into the country.

In other cases, migrants convicted of crimes may be released by state and local officials after they serve their time without ICE being notified, as is policy in many sanctuary cities. ICE then has to locate the convict after release in order to detain and deport them.

The two law enforcement officials said ICE prioritizes migrants who have been convicted of serious crimes, like homicide, for arrest.

But the agency’s limited resources limit how many they can locate and arrest. There are currently more than 7.5 million immigrants on ICE’s “non-detained” docket, meaning they have pending immigration cases but are not currently in detention. 

Lechleitner told NBC News more local jurisdictions are cooperating and starting to rethink their sanctuary policies in light of increased attention on migrant crime.

NBC News joined ICE agents in Maryland earlier this year when they arrested a man convicted of murder in Colombia and a man convicted of attempted murder in El Salvador.

Agents explained that locating convicted criminals living at large takes an enormous amount of manpower, from locating them to the arrest.