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Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
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Paragraph: Sen. Charles Schumer of New York said the VA needs to provide Congress more information about a recent bulk order for $208,000 worth of hydroxychloroquine. President Donald Trump has heavily promoted the malaria drug, without evidence, as a treatment for COVID-19. Schumer’s request comes after a whistleblower complaint filed this past week by former Health and Human Services official Rick Bright alleged that the Trump administration, eager for a quick fix to the onslaught of the coronavirus, wanted to “flood” hot spots in New York and New Jersey with the drug. Major veterans organizations have urged VA to explain under what circumstances VA doctors initiate discussion of hydroxychloroquine with veterans as a treatment option. “There are concerns that they are using this drug when the medical evidence says it doesn’t help and could hurt,” Schumer said in an interview with The Associated Press. He said given the fact the malaria drug, despite being untested, had been repeatedly pushed publicly by Trump, VA Secretary Robert Wilkie must address whether anyone at the department was pressured by the White House or the administration to use hydroxychloroquine for COVID-19. Schumer said Wilkie also should answer questions about a recent analysis of VA hospital data that showed there were more deaths among patients given hydroxychloroquine versus standard care, including how much patients knew about the drug’s risks before taking it. In a statement Sunday, VA spokeswoman Christina Noel called it “preposterous” for anyone to suggest that VA would make treatment decisions based on anything other than “the best medical interests of patients.” “VA only permits use of the drug after ensuring veterans and caretakers are aware of potential risks associated with it, as we do with any other drug or treatment,” she said. Wilkie in recent weeks has denied that veterans were used as test subjects for the drug and that it was instead administered at government-run VA hospitals only when medically appropriate, with mutual consent between doctor and patient. Still, Wilkie and the department have repeatedly declined to say how widely the drug was being used for COVID-19, including how many veterans were given the drug, and whether VA doctors were given guidance by VA headquarters on specific scenarios when it should be used. In a weekly call with veterans’ groups this past week, Wilkie continued to defend VA’s use of hydroxychloroquine. He dismissed the recent analysis of VA hospital data showing no benefits to patients, suggesting the poor outcomes were because the cases involved older, very sick veterans. “Use of this medication for treatment of COVID-19 is considered ‘off label’ — perfectly legal and not rare,” he wrote in an April 29 letter to veterans’ groups. The analysis of hospital data, done by independent researchers at two universities with VA approval, was not a rigorous experiment. Researchers analyzed medical records of 368 older male veterans hospitalized with confirmed coronavirus infection at VA medical centers who died or were discharged by April 11. About 28% of veterans who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. The VA recently said most of its recent bulk order for hydroxychloroquine was being used for approved uses, such as treating lupus and rheumatoid arthritis, but it didn’t provide breakdowns. Wilkie in recent weeks took advocacy of the drug even further than Trump by claiming without evidence that it has been effective for young and middle-aged veterans in particular. In fact, there is no published evidence showing that. Veterans are “very concerned that we still do not have clarity on the VA’s past and present use of hydroxychloroquine in treating veterans with COVID-19,” Jeremy Butler, chief executive officer of Iraq and Afghanistan Veterans of America, told the AP. “Now that the federal government issued an emergency use authorization for remdesivir to treat COVID-19, we need answers to these questions as well as the VA’s plans for administering, or not administering, remdesivir,” he said. That action by the Food and Drug Administration came after preliminary results from a government-sponsored study showed that remdesivir shortened the time to recovery by 31%, or about four days on average, for hospitalized COVID-19 patients. In a tweet Sunday, former VA Secretary David Shulkin urged the department to immediately curtail use of hydroxychloroquine for COVID-19. “With studies showing no benefit, VA should restrict use exclusively to clinical trials,” he wrote. Shulkin was fired by Trump in March 2018, and Wilkie replaced him. Schumer said his main concern is determining whether the VA had conducted any “clandestine studies to determine whether hydroxychloroquine was effective without their permission.” He said there’s also concern that the department won’t address specifically where the drug was sent. “These are people who risked their lives for us,” Schumer said. “They should be treated only with the utmost dignity, respect and high standards of care.” The drug has long been used to treat malaria and other ailments. A few, very small preliminary studies suggested it might help prevent the coronavirus from entering cells and possibly help patients clear the virus sooner. But the FDA last month warned doctors against prescribing the drug for COVID-19 outside hospitals because of the risks of serious side effects and death. Claim: Schumer calls on VA to explain use of unproven drug on vets.
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The Senate’s top Democrat on Sunday called on the Department of Veterans Affairs to explain why it allowed the use of an unproven drug on veterans for the coronavirus, saying patients may have been put at unnecessary risk.


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Paragraph: The company earned $728 million, or 67 cents per share, in the fourth quarter. That compared with $827 million, or 74 cents per share, in the year-earlier quarter, when Lilly took charges for asset impairments and restructuring. “Company sales were stronger than thought, but a lot of that upside came from drugs that are already off patent or about to lose patent protection,” said Edward Jones analyst Judson Clark. Excluding special items, Lilly earned 74 cents per share, matching analysts’ average forecasts, according to Thomson Reuters I/B/E/S. Shares in the company dropped 1.4 percent to 53.21, after earlier reaching their lowest in two weeks at $53.05. Lilly’s global sales fell 2 percent to $5.81 billion, but topped Wall Street forecasts of $5.46 billion. Sales would have been flat if not for the stronger dollar, which lowers the value of sales in overseas markets. Sales of Cymbalta, which lost U.S. patent protection last month, fell 38 percent to $883 million. But they came in about $100 million higher than Wall Street expected, analysts said. Lilly’s sales, earnings, and its share price, have been badly hurt since late 2011, when its Zyprexa schizophrenia drug lost U.S. patent protection. Once Lilly’s biggest product, with annual sales of $5 billion, it now has sales of only $1.5 billion. The situation worsened last month, when Cymbalta - which also had $5 billion in annual sales at its peak - began facing cheaper generics in the United States. The company’s “patent cliff” will become more daunting in March, when $1 billion-a-year osteoporosis drug Evista faces U.S. generics. “We haven’t wasted the crisis,” Chief Executive John Lechleiter said Thursday in a conference call with industry analysts. “We’re more agile, we’re leaner and I believe we’re better operators today.”  Lilly has cut more than 5,000 employees from its workforce in order to reduce annual costs by $1 billion over the last three years to deal with patent expirations on its drugs. It has also restructured itself to focus on cancer and diabetes - lucrative specialties that are two of the company’s longstanding strengths. Clark said sales of Cymbalta could eventually decline 80 percent, which has been the case for many other blockbuster medicines in recent years. He questioned whether gains for other products seen in the fourth quarter will be sustainable. Sales of many products over the quarter showed double-digit sales increases, including Lilly’s Humalog insulin, Cialis anti-impotence treatment, Forteo and Evista osteoporosis drugs, and Straterra for attention deficit disorder. But price increases in the United States accounted for much of those sales gains. The Indianapolis drugmaker is expecting a return to company sales growth next year, from increased sales of drugs that still have patent protection and from launches of new treatments for cancer and diabetes. It hopes to launch three new drugs this year: ramucirumab for stomach cancer, and dulaglutide and empagliflozin for type 2 diabetes - the most common form of the disease, which is closely linked to obesity. Although analysts have forecast annual sales of more than $650 million for ramucirumab, they are concerned the new diabetes drugs may have a hard time competing with similar drugs already on the market. The company has introduced no new products in recent years. In a recent interview, Lechleiter said it was time for Lilly “to go back on offense”, helped by a pipeline of nearly 40 medicines in mid- and late-stage studies, compared with only seven in those stages of development a decade ago. Claim: Lilly's quarterly sales largely offset Cymbalta slide.
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Drugmaker Eli Lilly and Co’s quarterly revenue fell far less than expected, it reported on Thursday, as plunging sales of its Cymbalta depression treatment were largely offset by higher revenues for most of its other prescription drugs.


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Paragraph: The story makes no mention of costs. With an estimated cost of $150,000 to 200,000, the cost of a allogenic bone marrow transplant is significant enough to be mentioned. We’re giving this one a pass here. The story makes quite clear that it is a report on the experience of only one patient and that while the researchers say there are now no signs of HIV infection in this individual, the tests don’t completely rule out the possibility that the virus is lurking somewhere. In particular, the comments of Dr. Gallo to place the apparent benefit in this single patient into context. The story notes that bone marrow transplants are risky and in fact , “…can kill people.” But it should have told readers that for some types of leukemia, up to 40 percent of patients die have receiving a bone marrow transplant from a donor. What’s more the list of serious complications is harrowing. According to the National Cancer Institute, leukemia patients treated with a bone marrow transplant may have less than a 50-50 chance of successful treatment and even when the treatment works, it is often very painful and may cause serious to kidneys, liver, heart and lungs. So even though this story does tell readers that transplants are risky, it fails to provide numbers that would make clear just how perilous this course of treatment is. The story does a great job on this point, emphasizing the almost unique circumstances of this case and that the results could not be replicated in most people with HIV. By making good use of the right experts, it is able to show what a long shot this treatment really would be for most patients. “AIDS researchers have rejected the approach on any kind of scale for patients with HIV. A bone marrow transplant is a last-ditch treatment for cancers such as leukemia. It requires destruction of a patient’s own bone marrow — itself a harrowing process — and then a transplant from a donor who has a near-exact blood and immune system type. Months of recovery are needed while the transplant grows and reconstitutes the patient’s immune system.” The story does not engage in disease-mongering. The story does point out the staggering number of people worldwide (33 million) infected with the AIDS virus. We would have liked to have seen some mention of the number of people who more closely resemble this patient, having both HIV infection and a type of leukemia that might be treated with a bone marrow transplant. The story’s main expert source was Dr. Robert Gallo of the Institute of Human Virology at the University of Maryland, who helped discover the human immunodeficiency virus that causes AIDS. His comments offered context and appropriate cautions. While the story does not discuss potential conflicts of interest, the researchers declared in their journal article that they had no competing financial interests and the work was supported by non-commercial institutions. The last sentence in the story reads “Cocktails of strong drugs can suppress the virus, keeping patients healthy and reducing the chance they will infect others, but there is no vaccine.” We would have liked to have seen a little more on this point. The fact is, HIV infection is becoming more and more like a chronic disease because of the success of antiretroviral (ARV) therapies. The death rate from AIDS has plummeted, even in developing countries, over the past two decades. This means that, while a vaccine or another therapy that eliminated the virus post-infection would be a boon for humankind, it is not the only approach worth hailing. We would like to see more ink devoted to innovative attempts to stop the spread of HIV and to broadly apply ARVs in countries that already have a high concentration of infected adults and less attention given to one offs like this study. We would have rated this as satisfactory if the story did not mention the vaccine issue. That expands the criterion into prevention and therefore into public health measures as comparators. The story makes it clear that it is based on the findings in one patient and that it couldn’t be applied broadly. The story shows that bone marrow transplants are available and points out the unique aspects of the procedure in this single patient; that is, while bone marrow transplants are available, marrow from recipients with the CCR5 mutation is not. The story apppropriately points out the uniqueness of the report. The patient presented with leukemia and HIV and a donor was available who happened to have te CCR5 mutation. The story did not rely on a news release. Claim: German doctors declare “cure” in HIV patient
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The quote marks around the word “cure” in the headline were a sign of the cautious approach of this story. Instead of allowing a sense of hyperbole to permeate, as we saw in other coverage of the same study, we were glad to see many of the appropriate caveats included. The story should have been more specific about the enormous hazards of bone marrow transplants and told readers of their high cost. The word cure, even when surrounded by quote marks certainly gets one’s attention. Applied to a story about HIV and AIDS, it is an attention-grabber. Despite the arguable hyperbole on the part of the German researchers, the story is interesting because it adds to the suggestion that the CCR5 mutation may represent an approach to eradication of the virus. This story, like others on the topic, spent a fair amount of time explaining the difficulty in broadly applying stem cell transplants to AIDS patients and leukemia patients and talked with the appropriate experts. It serves as a good lesson, in many ways, for reporters covering studies with limited results and stacked odds of long term success.