VentureBeat

Is the bell tolling for EPO? – The news keeps going from bad to worse for the wonder drugs of biotech — the anemia treatments known as ESAs or EPO, shorthand for “erythropoiesis stimulating agents” and “erythropoietin,” respectively. Earlier today, an FDA advisory panel recommended new warnings for the drugs, which stimulate the production of oxygen-carrying red blood cells, as well as fresh clinical studies on their safety. Recent studies in kidney-dialysis patients linked higher doses of ESAs to heart problems and strokes, while studies in cancer patients treated for chemotherapy-related anemia have suggested that the treatments don’t improve patient survival, and may even cut lives short — possibly by encouraging tumor growth.

New restrictions, which the panel didn’t spell out, could put a serious crimp in ESA sales, which currently amount to billions of dollars for Amgen and Johnson & Johnson. The two companies have also been taking a public-relations battering in terms of how they promote the drugs. Yesterday, the NYT ran a front-page piece that detailed how rebates offered by Amgen and J&J encourage doctors to overuse the drugs, and today the WSJ followed with a look at whistleblower allegations that J&J boosted EPO sales by pushing higher-than-approved doses.

It’s worth remembering that while the storm is currently walloping industry giants like Amgen and J&J, plenty of smaller biotechs that have staked their hopes on getting into the anemia-treatment game could eventually be affected as well. These companies include Affymax, FibroGen and Neose. Only Affymax is public; another potential ESA competitor, GlycoFi, was acquired by Merck last year.

First embryonic stem-cell trial edges forward – By early next year, Geron plans to be injecting recent spinal-injury patients with nerve cells grown from embryonic stem cells, in hopes of regenerating damaged nerve pathways. This trial was supposed to be underway already, but last year the FDA requested more animal data for safety purposes. Geron CEO Thomas Okarma says the treatment will have been tested in 2,000 animals before it ever reaches humans. The FT’s Clive Cookson has the story.

Aggressive treatment leads to worse “quality of death” in cancer patients – File this one under things you already knew but didn’t want to think about. A study of 243 advanced cancer patients revealed that a greater number of aggressive treatments — including the use of ventilators and non-palliative chemotherapy — in the last week of life was associated with greater physical and psychological distress and a lower chance of dying in a preferred location (often home). Money quotes:

[Said study lead author Gabriel Silverman:] “These results suggest that when patients are actively dying, the use of aggressive treatments should be considered with caution and only pursued with the full understanding of patients or their surrogate decision makers.

[...]

“As a doctor, if I had a patient or family who wanted aggressive, life-sustaining care toward the end of their life, I would view it as a red flag warning of patient or caregiver distress,” Dr. [Robert] Arnold [of the University of Pittsburgh] concluded. “Often patients and their families are suffering, sad, or distressed at the end of life, and when dying occurs in medical settings they may hope that aggressive treatment will help the suffering, but often it doesn’t.”

Tau gets a little respect – For the past decade or so, Alzheimer’s researchers have concentrated their attention on beta amyloid, the protein that clumps around neurons in “tangles” visible in the autopsied brains of many — though not all — Alzheimer’s patients. Now comes evidence that a dark-horse protein called tau may also bear some responsibility for the disease. Researchers reported last week in Science that they reversed memory loss in mice by tinkering with their genes to produce lower levels of the tau protein. It’s heartening to see competing theories getting some attention in the Alzheimer’s community, which has had an unfortunate tendency to shun researchers who strayed from the majority opinion, but don’t expect beta-amyloid supporters to give much ground until they have to. That might be soon, as a new batch of drugs designed to block formation of beta-amyloid tangles should begin reporting data from human trials later this year.

New genetic heart-disease link – Another whole-genome association study has identified a new genetic variation that appears to increase heart-attack risk by 60 percent in European populations. The catch is that the variation doesn’t appear to be associated with any known gene, and instead exists in the long stretches of non-coding, or “junk,” DNA, meaning that no one has any idea why it should have any effect on heart-attack rates. The NYT has more.

Stem-cell researchers make like Willie Sutton – Near the end of this otherwise unremarkable account of a talk by James Thomson, the Wisconsin researcher who first isolated and grew human embryonic stem cells, comes this interesting nugget: Thomson will open a “satellite laboratory” on the UC Santa Barbara campus for stem-cell collaborations with UCSB researchers. Coincidentally enough, having a presence in the state might also qualify Thomson for funding by California’s $3 billion stem-cell program. Willie Sutton, you’ll recall, is the outlaw who once proclaimed that he robbed banks “because that’s where the money is.” Some sentiments, it seems, are universal.

Hypocrisy in the generic-biologics fight? – The prospect of legislation that clears a path for “generic” versions of expensive biotech drugs appears to have dimmed significantly. But biotech consultant and blogger David Williams — no fan himself of the push for “biogenerics” — notes that biotech companies and their lobbyists may be shooting themselves in the foot when they argue that biogenerics could never be “identical” to branded products now on the market. It’s worth reading his entire post — it’s not long — but the gist is that changing the manufacturing process for name-brand biotech drugs, which happens all the time, opens up the same “equivalence” issues that BIO and its allies find insurmountable where biogenerics are concerned. The main difference is that name-brand manufacturers can handle the issue with short, inexpensive “bioequivalence” trials — but they insist that biogenerics must undergo expensive, full-blown clinical testing to assure their efficacy and safety. If the biogenerics issue heats up again, don’t be surprised to see this argument make a comeback.

Surgical robots in space, stem cells in rodent eyes – These are just two interesting stories from the San Jose Mercury News I haven’t yet had a chance to mention. Last Sunday, the Merc ran this piece on efforts to automate surgery, with the ultimate goal of building robots that could operate on astronauts in space or soldiers on the battlefield. Far off and far out stuff. Similarly, this piece outlined the possibility of growing new blood vessels using an early and highly regenerative stem cell called a hemangioblast. Ultimately, these fast-growing cells could one day regrow blood vessels in the heart, eyes or limbs that were damaged by injury or disease.

Having survived prostate cancer and now facing a mild form of Parkinson’s disease, former Intel chairman Andy Grove has turned his analytical eye on the increasingly dysfunctional U.S. healthcare system.

Unfortunately, his recommendations are disappointingly small-scale and reflective of the inordinate faith that many high-tech aficionados place in technological “fixes” for complex social phenomena. I’ll explain why in a moment.

To Grove’s tremendous credit, he argues in a recent interview with Wired News that the most pressing issue facing the U.S. healthcare system is the growing number of uninsured Americans — 44.8 million, or nearly one-sixth of the population, according to the latest Census Bureau data — and the subsequent stress that treatment of the uninsured puts on the nation’s emergency rooms.

As he says:

As the population ages, people are being thrown out of the insurance boat at a faster and faster rate and it’s the forgotten part of medicine.

We have the Human Genome Project, personalized medicine, war on cancer, CyberKnife, stem cell research on one hand — no doctor to be found or to take care of your sore throat on the other. That’s a pretty ugly picture. It’s pretty ugly today but it’s going to be uglier five years from now.

Now Grove is one of the smartest people around, and it’s refreshing to see him diagnose the failure of U.S. healthcare so succinctly. It’s equally hard to argue with his preference for breaking this hairball of a problem into manageable chunks while favoring “doability as opposed to desirability.” And, of course, the Wired News interview may not have fully captured the depth of his thinking on the subject.

That said, Grove’s proposed solutions strike me as so much whistling past the graveyard. At best, his ideas might improve access to healthcare on the margins, but without really addressing the plight of the uninsured, the breakdown of employer-provided insurance or soaring healthcare costs. At worst, they might even aggravate some of the trends he deplores.

Starting from the top, Grove dismisses the notion of universal health care on the grounds that it would disenfranchise insurance companies and that no one knows exactly how to bring healthcare cost inflation under control. No one doubts that insurance companies would fight any plan that threatened their role in the system, although Grove doesn’t acknowledge that some universal-coverage plans envision a prominent — in some cases, even central — role for insurers. (Whether that’s a good idea or not is a subject for another day.)

As for his second point, there’s no shortage of ideas — good, bad or indifferent — for cost control, such as allowing Medicare to bargain down drug prices or limiting the use of costly, intrusive and frequently wasteful medical procedures on elderly patients near the end of their lives. What’s more, most other industrial nations have already implemented some form of cost control, which helps account for the fact that their per capita healthcare spending is so much lower than in the U.S.

Instead, Grove favors tinkering around the edges of the system. He suggests that “retail clinics” — essentially nurse-practitioner-staffed outlets in Wal-Marts or drugstore chains designed to handle everyday ailments quickly and without fuss — might be a “disruptive technology” that could solve the emergency-room crowding problem. For instance, Grove says:

There is an incredible need of medical help for the 70 (percent) or 80 percent of medical care that is routine … where the diagnosis is straightforward and treatment is basically codified. They are conveniently located to where people live or shop or show up for emergency care. And by concentrating on effective delivery of standard care, they can do it conveniently but also much less expensively than doing the standard production. That’s the complex manufacturing logic…. You wouldn’t think about building a toy on the same production line as putting up airplanes. The factories will be different and the cost structure will be different.

Well, retail clinics are certainly on their way, so we’ll presumably know soon enough if they can lower healthcare costs by treating large numbers of people cheaply and effectively. On the other hand, the major problems facing the uninsured have less to do with the inability to see a doctor when they have the sniffles than with the crippling hospital bills they can face after a severe accident or the onset of an unexpected health problem like heart trouble or diabetes.

What’s more, some experts already worry that the spread of these clinics might further erode the financial health of community hospitals by drawing off healthier — meaning “cheaper to treat” — patients. Hospitals tend to subsidize care for the uninsured by charging higher prices to insured patients. If healthier insured folks take off for retail clinics, that means less money to cover expensive conditions of the uninsured that no clinic can touch.

Furthermore, the bulk of U.S. healthcare spending covers the treatment of a minority of chronically ill and typically elderly patients who won’t be candidates for these clinics in the first place. Here, Grove has another solution: Advanced sensor and communications technology with which to wire up the homes of the elderly. This would allow them to stay home, with medical personnel monitoring them remotely and reminding them to take their meds, instead of moving to long-term care facilities. So far as it goes, that vision is laudable and humane — assuming, of course, that you’re willing to overlook exactly how long the tech industry has been promising us the sort of “ubiquitous computing” that would be necessary to make it work. According to Wired News, Grove estimates that shifting one-fourth of the nursing-home population back home could save $12 billion a year.

Let’s extend the benefit of the doubt and assume that those savings are net of the expense of building out this information infrastructure in the first place. They’re still a drop in the bucket compared to the $207 billion spent on U.S. long-term care in 2005, according to Georgetown University’s Long-Term Care Financing Project. (Of that, $130 billion went for nursing-home care, the rest for home care.) Unless there’s something very screwy in the numbers here, the overall cost impact of wiring up seniors’ homes seems likely to be negligible.

Grove’s final idea is another technological fix — standardized, Web-based electronic health records that any doctor could access once a patient “unlocks” them. Once again, assuming it satisfies relatively straightforward privacy and reliability concerns, there’s nothing at all wrong with this idea. Theoretically, at least, electronic health records could promote cooperation between medical specialists, reduce medical errors and improve the long-term health of patients via better preventive care.

At the moment, however, few players in the healthcare system have a financial incentive to implement such a system, which is one of the main reasons it doesn’t yet exist. Any insurer that invests in an electronic-record system — which, even with off-the-shelf technologies, will generally cost more and work less well than expected — is likely to bear the costs without reaping many of the benefits. That’s because many of its presumably healthier customers are likely to change jobs at some point and move on to competitor health plans, who will then garner any savings. Nor do the competitive insurance and hospital industries have much reason to adopt the universally compatible, Internet-based systems Grove favors, since that would just make it easier for their customers or patients to take their records — and their business — elsewhere. Grove doesn’t even seem to acknowledge these fundamental adoption issues, much less address them.

Since last November, Grove has apparently offered similar thoughts to a variety of audiences, including a Stanford lecture crowd and my former WSJ colleague Lee Gomes. Which is too bad, in a way, because it suggests to me that no one has seriously challenged his rather glib prescriptions in that time. The healthcare crisis is real and urgent, and we could all benefit from the best thinking of a sharp-witted “rational capitalist” of Grove’s stature. Unfortunately, I don’t think he’s really offered it to us yet.

Two fascinating papers in the open-access journal PLoS Medicine turn a spotlight on the practice of “detailing” — the office visits that drug-industry salespeople use to flatter and manipulate their way into the good graces of the doctors they want to influence.

The first and most eye-opening paper is co-authored by Shahram Ahari, a former Eli Lilly sales rep, and Adriane Fugh-Berman, a Georgetown University professor who researches drug marketing. Together, the two outline a variety of tactics that sales reps use on detail visits to disarm doctors and to indirectly — sometimes all but imperceptibly — nudge them into prescribing their company’s drugs more freely. This is one of those papers that best speaks for itself, so I’ve excerpted some key passages below. For the full effect, though, read the whole paper; Table 1 alone is worth the price of admission.

Good details are dynamic; the best reps tailor their messages constantly according to their client’s reaction. A friendly physician makes the rep’s job easy, because the rep can use the “friendship” to request favors, in the form of prescriptions. Physicians who view the relationship as a straightforward goods-for-prescriptions exchange are dealt with in a businesslike manner. Skeptical doctors who favor evidence over charm are approached respectfully, supplied with reprints from the medical literature, and wooed as teachers. Physicians who refuse to see reps are detailed by proxy; their staff is dined and flattered in hopes that they will act as emissaries for a rep’s messages. (See Table 1 for specific tactics used to manipulate physicians.) [...]

The purpose of supplying drug samples is to gain entry into doctors’ offices, and to habituate physicians to prescribing targeted drugs. Physicians appreciate samples, which can be used to start therapy immediately, test tolerance to a new drug, or reduce the total cost of a prescription. Even physicians who refuse to see drug reps usually want samples (these docs are denigrated as “samplegrabbers”). Patients like samples too; it’s nice to get a little present from the doctor. Samples also double as unacknowledged gifts to physicians and their staff. The convenience of an in-house pharmacy increases loyalty to both the reps and the drugs they represent….

Pharmaceutical companies spend billions of dollars annually to ensure that physicians most susceptible to marketing prescribe the most expensive, most promoted drugs to the most people possible. The foundation of this influence is a sales force of 100,000 drug reps that
provides rationed doses of samples, gifts, services, and flattery to a subset of physicians. If detailing were an educational service, it would be provided to all physicians, not just those who affect market share…. Physicians are susceptible to corporate influence because they are overworked, overwhelmed with information and paperwork, and feel underappreciated. Cheerful and charming, bearing food and gifts, drug reps provide respite and sympathy; they appreciate how hard doctor’s lives are, and seem only to want to ease their burdens.

The second paper isn’t anywhere near so colorful, but compensates with depth of analysis. A research team at the University of California, San Francisco, studied market-research forms for the anti-seizure drug Neurontin (generically known as gabapentin), which became public as the result of a whistleblower lawsuit against Neurontin’s maker, Pfizer. That lawsuit contended that the former Parke-Davis — later acquired by Pfizer — had violated federal rules by promoting Neurontin outside its FDA-approved uses, and concluded with a $430 million out-of-court settlement.

By studying 116 of the market-research forms filled out by selected doctors following a sales rep visit — here’s an example:

– the researchers built a detailed picture of the way Neurontin detailing worked. In 44 percent of the visits, physicians reported at least one “off-label” message related to Neurontin use in an unapproved fashion — exactly the sort of thing sales reps are forbidden to introduce in such conversations. Almost a full quarter of the visits involved only discussion of unapproved uses of the drug. (The researchers acknowledge that they have no way to know if the sales reps initiated such conversations.) Ultimately, almost half of the doctors involved said they planned to increase their prescription of the drug following the visits, while none reported plans to decrease Neurontin use.

Interestingly enough, former Pfizer exec Peter Rost is now closely tracking what may be a similar scandal related to AstraZeneca’s promotion of its chemotherapy drug Arimidex. The story, which began with the firing of an AstraZeneca regional sales manager who compared doctors’ offices to “a big bucket of money” in an internal newsletter, then mushoomed to include a cabal of alleged whisteblowers and leaked audio recordings — supposedly of AstraZeneca sales-rep training sessions — is detailed at his sometimes quirky blog Question Authority. If you don’t mind working backward, start here and keep scrolling down. Way, way down if you want to get all the way to the beginning — Rost is nothing if not prolific.

Amgen’s anemia rollercoaster — Biotechnology titan Amgen may have dodged a bullet when a study released Thursday showed that its anemia drug Aranesp didn’t shorten the lives of patients, after several other studies had suggested the opposite. But its anemia franchise isn’t out of the woods yet. A Wednesday report in the Journal of the American Medical Association revealed that for-profit dialysis clinics prescribe far higher doses of anemia drugs to their patients than do their non-profit counterparts, suggesting a profit motive behind the overuse of drugs that have been linked to cardiovascular problems at high doses.

Now it appears that Congress may weigh in: The WSJ quotes Rep. Fortney “Pete” Stark, a California Democrat, calling for changes in Medicare reimbursement to eliminate any incentive to overuse the drugs, which stimulate production of the red blood cells that carry oxygen.

More on “generic” biologics — Here are two takes on the move to allow copycat versions of biotech drugs that I neglected to mention in yesterday’s post on the subject. Writing at Forbes.com, Scott Gottlieb — former FDA deputy commissioner for medical and scientific affairs, now a pundit at the neoconservative American Enterprise Institute — makes the counterintuitive argument that copycat biotech drugs will speed the development of new drugs, even if they’re just simply improved versions of older ones.

Meanwhile, pharma/biotech consultant David E. Williams dismisses the biogenerics push as “a bad bill that deserves to die” on his Health Business Blog, but suggests that Congress could adopt a more straightforward solution: Simply mandate price cuts on biotech drugs once their patents expire. It’s such a wacky but weirdly intriguing idea that I can’t even tell if it makes sense, but I certainly doubt that Congress could muster the political will for such a naked exercise of government power — it simply violates too many current assumptions about the usefulness and necessity of markets.

Stem cell divisions — The president of California’s $3 billion stem-cell research program resigned abruptly on Tuesday, citing both health concerns (a recent diagnosis of prostate cancer) and tensions between patient advocates and biomedical academics over plans to spend up to $300 million on new research facilities. Zach Hall’s departure will now come earlier than expected — he’ll depart at the end of April instead of the end of June — but plans to name a successor are already underway. Despite his title, Hall wasn’t the head honcho of the California institute; that honor is reserved for Robert Klein II, chairman of the inaptly named Independent Citizens Oversight Committee, who is also rumored to have clashed with Hall more than once. David Jensen of the estimable California Stem Cell Report has all the details.

Dollars for doctors (and everyone else) — Why does U.S. healthcare cost so much? The economics blog Marginal Revolution hosted a fascinating debate on the subject earlier this week, prompted by Tyler Cowen’s capsule review of a new book by Maggie Mahar titled Money Driven Medicine. The argument is too complex to do it much justice here; the best summary I can make without writing an essay myself is that the entrepreneurial instincts of doctors and medical-technology suppliers (including drug companies), combined with weak resistance from desperate patients, leads to market failure, including drastic overuse — and misuse — of medical services. Don’t miss Mahar’s contribution to the Marginal Revolution debate in comments. Two other takes on the book are here and here.

In a similar vein, this post from the group blog Health Care Renewal aims to explain why so many academic researchers seek out funding from pharmaceutical and biotech companies these days. Turns out it’s not just the greed of companies eager to co-opt paragons of the ivory tower; instead, blogger Roy Poses suggests that university incentives similar to the ones that motivate car salesmen are at fault. Definitely worth a read if the question has ever crossed your mind.

Research odds and ends from the week that was:
• Scientists discovered a gene that appears to be key to “self-renewal” in both embryonic and adult stem cells.

• Surgeons are exploring ways of conducting minimally invasive procedures using “natural openings” in the body such as the mouth, the rectum or the vagina.

• Take that, white supremacists: Physical anthropologists now believe that European skin only lightened up 6,000 to 12,000 years ago, suggesting that “our European ancestors were brown-skinned for tens of thousands of years” prior to that. The link is subscription-only, so here’s a brief snippet of the Science news article:

Researchers have disagreed for decades about an issue that is only skin-deep: How quickly did the first modern humans who swept into Europe acquire pale skin? Now a new report on the evolution of a gene for skin color suggests that Europeans lightened up quite recently, perhaps only 6000 to 12,000 years ago. This contradicts a long-standing hypothesis that modern humans in Europe grew paler about 40,000 years ago, as soon as they migrated into northern latitudes. Under darker skies, pale skin absorbs more sunlight than dark skin, allowing ultraviolet rays to produce more vitamin D for bone growth and calcium absorption. “The [evolution of] light skin occurred long after the arrival of modern humans in Europe,” molecular anthropologist Heather Norton of the University of Arizona, Tucson, said in her talk.

(Note: This item has been copied over to the Life Sciences page from its original location on the VentureBeat main page. To view it in its original context, with comments, click here.)

Amgen’s anemia rollercoaster — Biotechnology titan Amgen may have dodged a bullet when a study released Thursday showed that its anemia drug Aranesp didn’t shorten the lives of patients, after several other studies had suggested the opposite. But its anemia franchise isn’t out of the woods yet. A Wednesday report in the Journal of the American Medical Association revealed that for-profit dialysis clinics prescribe far higher doses of anemia drugs to their patients than do their non-profit counterparts, suggesting a profit motive behind the overuse of drugs that have been linked to cardiovascular problems at high doses.

Now it appears that Congress may weigh in: The WSJ quotes Rep. Fortney “Pete” Stark, a California Democrat, calling for changes in Medicare reimbursement to eliminate any incentive to overuse the drugs, which stimulate production of the red blood cells that carry oxygen.

More on “generic” biologics — Here are two takes on the move to allow copycat versions of biotech drugs that I neglected to mention in yesterday’s post on the subject. Writing at Forbes.com, Scott Gottlieb — former FDA deputy commissioner for medical and scientific affairs, now a pundit at the neoconservative American Enterprise Institute — makes the counterintuitive argument that copycat biotech drugs will speed the development of new drugs, even if they’re just simply improved versions of older ones.

Meanwhile, pharma/biotech consultant David E. Williams dismisses the biogenerics push as “a bad bill that deserves to die” on his Health Business Blog, but suggests that Congress could adopt a more straightforward solution: Simply mandate price cuts on biotech drugs once their patents expire. It’s such a wacky but weirdly intriguing idea that I can’t even tell if it makes sense, but I certainly doubt that Congress could muster the political will for such a naked exercise of government power — it simply violates too many current assumptions about the usefulness and necessity of markets.

Stem cell divisions — The president of California’s $3 billion stem-cell research program resigned abruptly on Tuesday, citing both health concerns (a recent diagnosis of prostate cancer) and tensions between patient advocates and biomedical academics over plans to spend up to $300 million on new research facilities. Zach Hall’s departure will now come earlier than expected — he’ll depart at the end of April instead of the end of June — but plans to name a successor are already underway. Despite his title, Hall wasn’t the head honcho of the California institute; that honor is reserved for Robert Klein II, chairman of the inaptly named Independent Citizens Oversight Committee, who is also rumored to have clashed with Hall more than once. David Jensen of the estimable California Stem Cell Report has all the details.

Dollars for doctors (and everyone else) — Why does U.S. healthcare cost so much? The economics blog Marginal Revolution hosted a fascinating debate on the subject earlier this week, prompted by Tyler Cowen’s capsule review of a new book by Maggie Mahar titled Money Driven Medicine. The argument is too complex to do it much justice here; the best summary I can make without writing an essay myself is that the entrepreneurial instincts of doctors and medical-technology suppliers (including drug companies), combined with weak resistance from desperate patients, leads to market failure, including drastic overuse — and misuse — of medical services. Don’t miss Mahar’s contribution to the Marginal Revolution debate in comments. Two other takes on the book are here and here.

In a similar vein, this post from the group blog Health Care Renewal aims to explain why so many academic researchers seek out funding from pharmaceutical and biotech companies these days. Turns out it’s not just the greed of companies eager to co-opt paragons of the ivory tower; instead, blogger Roy Poses suggests that university incentives similar to the ones that motivate car salesmen are at fault. Definitely worth a read if the question has ever crossed your mind.

Research odds and ends from the week that was:
• Scientists discovered a gene that appears to be key to “self-renewal” in both embryonic and adult stem cells.

• Surgeons are exploring ways of conducting minimally invasive procedures using “natural openings” in the body such as the mouth, the rectum or the vagina.

• Take that, white supremacists: Physical anthropologists now believe that European skin only lightened up 6,000 to 12,000 years ago, suggesting that “our European ancestors were brown-skinned for tens of thousands of years” prior to that. The link is subscription-only, so here’s a brief snippet of the Science news article:

Researchers have disagreed for decades about an issue that is only skin-deep: How quickly did the first modern humans who swept into Europe acquire pale skin? Now a new report on the evolution of a gene for skin color suggests that Europeans lightened up quite recently, perhaps only 6000 to 12,000 years ago. This contradicts a long-standing hypothesis that modern humans in Europe grew paler about 40,000 years ago, as soon as they migrated into northern latitudes. Under darker skies, pale skin absorbs more sunlight than dark skin, allowing ultraviolet rays to produce more vitamin D for bone growth and calcium absorption. “The [evolution of] light skin occurred long after the arrival of modern humans in Europe,” molecular anthropologist Heather Norton of the University of Arizona, Tucson, said in her talk.