{
  "report_id": "theme_healthcare_technology_and_aging_demand_node_chronic_disease_therapeutics_drug_access",
  "report_type": "theme_value_chain_node",
  "site_path": "themes/healthcare-technology-and-aging-demand/nodes/chronic-disease-therapeutics-and-drug-access/index.html",
  "title": "Chronic Disease Therapeutics And Drug Access",
  "as_of": "2026-06-12",
  "generated_at": "2026-06-12T00:00:00-07:00",
  "freshness": {
    "price_data_as_of": "2026-06-12",
    "daily_ohlc_latest": "2026-06-12",
    "chart_interval": "weekly",
    "knowledge_reviewed_as_of": "2026-06-12",
    "web_policy_reviewed_as_of": "2026-06-12",
    "earnings_date_checked_as_of": "2026-06-13",
    "market_cap_checked_as_of": "2026-06-13",
    "api_required": true
  },
  "revision": {
    "version": 2,
    "updated_label": "Latest node-page format refresh with setup visual, basket cards, evidence board, and source-gap caveats",
    "metadata_path": "themes/healthcare-technology-and-aging-demand/nodes/chronic-disease-therapeutics-and-drug-access/report.json",
    "curation_source": "themes/healthcare-technology-and-aging-demand/report.json",
    "updated_by": "implementation worker",
    "updated_at": "2026-06-13T00:00:00-07:00",
    "shared_file_updates_deferred": [
      "themes/healthcare-technology-and-aging-demand/report.json still has parent-level freshness through 2026-06-11 and inherited ticker order; coordinator should decide whether to align parent metadata with this node's 2026-06-12 node refresh.",
      "sitemap.json entry exists and routing is valid, but its discovery source still references the 2026-06-11 node query ref; coordinator should refresh the shared sitemap metadata if aggregate freshness consistency is required."
    ]
  },
  "node": {
    "slug": "chronic-disease-therapeutics-and-drug-access",
    "level": "L2 pharma-access node",
    "role": "Maps chronic disease, obesity, oncology, immunology, cardiometabolic, and aging-brain demand into drug volume and franchise replacement.",
    "description": "Branded drug makers and profitable biotechs convert aging-linked chronic disease into prescriptions, net product sales, margin, and cash flow only when starts, persistence, supply, formulary access, gross-to-net discipline, Medicare and Part D price mechanics, and replacement assets hold together."
  },
  "ticker_baskets": {
    "core": [
      "LLY",
      "ABBV",
      "JNJ",
      "MRK",
      "AMGN",
      "GILD",
      "REGN",
      "PFE",
      "VRTX",
      "BMY"
    ],
    "option": [],
    "watch": []
  },
  "ranking_method": [
    "source-backed chronic disease and access economics",
    "net revenue conversion through supply, starts, persistence, formulary access, rebates, and gross-to-net",
    "franchise replacement after LOE, generic, or biosimilar erosion",
    "financial quality, cash conversion, leverage, and capital allocation",
    "technical setup from weekly daily_ohlc aggregation"
  ],
  "chart_artifacts": [
    {
      "chart_id": "chart-lly",
      "ticker": "LLY",
      "source_table": "daily_ohlc",
      "chart_interval": "weekly",
      "aggregation": "weekly bars grouped from daily rows by calendar week; open is first row, high is weekly max, low is weekly min, close is final row, volume is summed",
      "indicators": [
        "20w_ema",
        "100w_ema",
        "weekly_volume"
      ],
      "price_data_as_of": "2026-06-12",
      "visible_years": 3,
      "rendering": "api_right_rail"
    },
    {
      "chart_id": "chart-abbv",
      "ticker": "ABBV",
      "source_table": "daily_ohlc",
      "chart_interval": "weekly",
      "aggregation": "weekly bars grouped from daily rows by calendar week; open is first row, high is weekly max, low is weekly min, close is final row, volume is summed",
      "indicators": [
        "20w_ema",
        "100w_ema",
        "weekly_volume"
      ],
      "price_data_as_of": "2026-06-12",
      "visible_years": 3,
      "rendering": "api_right_rail"
    },
    {
      "chart_id": "chart-jnj",
      "ticker": "JNJ",
      "source_table": "daily_ohlc",
      "chart_interval": "weekly",
      "aggregation": "weekly bars grouped from daily rows by calendar week; open is first row, high is weekly max, low is weekly min, close is final row, volume is summed",
      "indicators": [
        "20w_ema",
        "100w_ema",
        "weekly_volume"
      ],
      "price_data_as_of": "2026-06-12",
      "visible_years": 3,
      "rendering": "api_right_rail"
    },
    {
      "chart_id": "chart-mrk",
      "ticker": "MRK",
      "source_table": "daily_ohlc",
      "chart_interval": "weekly",
      "aggregation": "weekly bars grouped from daily rows by calendar week; open is first row, high is weekly max, low is weekly min, close is final row, volume is summed",
      "indicators": [
        "20w_ema",
        "100w_ema",
        "weekly_volume"
      ],
      "price_data_as_of": "2026-06-12",
      "visible_years": 3,
      "rendering": "api_right_rail"
    },
    {
      "chart_id": "chart-amgn",
      "ticker": "AMGN",
      "source_table": "daily_ohlc",
      "chart_interval": "weekly",
      "aggregation": "weekly bars grouped from daily rows by calendar week; open is first row, high is weekly max, low is weekly min, close is final row, volume is summed",
      "indicators": [
        "20w_ema",
        "100w_ema",
        "weekly_volume"
      ],
      "price_data_as_of": "2026-06-12",
      "visible_years": 3,
      "rendering": "api_right_rail"
    },
    {
      "chart_id": "chart-gild",
      "ticker": "GILD",
      "source_table": "daily_ohlc",
      "chart_interval": "weekly",
      "aggregation": "weekly bars grouped from daily rows by calendar week; open is first row, high is weekly max, low is weekly min, close is final row, volume is summed",
      "indicators": [
        "20w_ema",
        "100w_ema",
        "weekly_volume"
      ],
      "price_data_as_of": "2026-06-12",
      "visible_years": 3,
      "rendering": "api_right_rail"
    },
    {
      "chart_id": "chart-regn",
      "ticker": "REGN",
      "source_table": "daily_ohlc",
      "chart_interval": "weekly",
      "aggregation": "weekly bars grouped from daily rows by calendar week; open is first row, high is weekly max, low is weekly min, close is final row, volume is summed",
      "indicators": [
        "20w_ema",
        "100w_ema",
        "weekly_volume"
      ],
      "price_data_as_of": "2026-06-12",
      "visible_years": 3,
      "rendering": "api_right_rail"
    },
    {
      "chart_id": "chart-pfe",
      "ticker": "PFE",
      "source_table": "daily_ohlc",
      "chart_interval": "weekly",
      "aggregation": "weekly bars grouped from daily rows by calendar week; open is first row, high is weekly max, low is weekly min, close is final row, volume is summed",
      "indicators": [
        "20w_ema",
        "100w_ema",
        "weekly_volume"
      ],
      "price_data_as_of": "2026-06-12",
      "visible_years": 3,
      "rendering": "api_right_rail"
    },
    {
      "chart_id": "chart-vrtx",
      "ticker": "VRTX",
      "source_table": "daily_ohlc",
      "chart_interval": "weekly",
      "aggregation": "weekly bars grouped from daily rows by calendar week; open is first row, high is weekly max, low is weekly min, close is final row, volume is summed",
      "indicators": [
        "20w_ema",
        "100w_ema",
        "weekly_volume"
      ],
      "price_data_as_of": "2026-06-12",
      "visible_years": 3,
      "rendering": "api_right_rail",
      "source_gap": "no filed local security lane"
    },
    {
      "chart_id": "chart-bmy",
      "ticker": "BMY",
      "source_table": "daily_ohlc",
      "chart_interval": "weekly",
      "aggregation": "weekly bars grouped from daily rows by calendar week; open is first row, high is weekly max, low is weekly min, close is final row, volume is summed",
      "indicators": [
        "20w_ema",
        "100w_ema",
        "weekly_volume"
      ],
      "price_data_as_of": "2026-06-12",
      "visible_years": 3,
      "rendering": "api_right_rail",
      "source_gap": "no filed local security lane"
    }
  ],
  "links_out": [
    "theme_healthcare_technology_and_aging_demand",
    "sector_health_care",
    "theme_health_care_policy_reimbursement_dispersion",
    "theme_funding_dependency_and_duration_tolerance"
  ],
  "knowledge_sources": [
    "../../../../../knowledge/wiki/lanes/sector/health-care.md",
    "../../../../../knowledge/wiki/concepts/themes/health-care-policy-reimbursement-dispersion.md",
    "../../../../../knowledge/wiki/concepts/themes/funding-dependency-and-duration-tolerance.md",
    "../../../../../knowledge/wiki/lanes/security/lly.md",
    "../../../../../knowledge/wiki/lanes/security/abbv.md",
    "../../../../../knowledge/wiki/lanes/security/jnj.md",
    "../../../../../knowledge/wiki/lanes/security/mrk.md",
    "../../../../../knowledge/wiki/lanes/security/amgn.md",
    "../../../../../knowledge/wiki/lanes/security/gild.md",
    "../../../../../knowledge/wiki/lanes/security/regn.md",
    "../../../../../knowledge/wiki/lanes/security/pfe.md",
    "../../../../../knowledge/wiki/lanes/security/azn.md",
    "../../../../../knowledge/wiki/lanes/security/incy.md",
    "../../../../../knowledge/wiki/lanes/security/cor.md",
    "../../../../../knowledge/wiki/lanes/security/cvs.md",
    "../../../../../knowledge/wiki/lanes/security/ci.md"
  ],
  "external_sources": [
    {
      "title": "CMS National Health Expenditure Fact Sheet",
      "url": "https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet",
      "reviewed_as_of": "2026-06-12"
    },
    {
      "title": "CMS Selected Drugs and Negotiated Prices",
      "url": "https://www.cms.gov/initiatives/medicare-prescription-drug-affordability/overview/medicare-drug-price-negotiation-program/selected-drugs-negotiated-prices",
      "reviewed_as_of": "2026-06-12"
    },
    {
      "title": "CMS Medicare Drug Price Negotiation Program negotiated prices for initial price applicability year 2026",
      "url": "https://www.cms.gov/newsroom/fact-sheets/medicare-drug-price-negotiation-program-negotiated-prices-initial-price-applicability-year-2026",
      "reviewed_as_of": "2026-06-12"
    },
    {
      "title": "FTC interim staff report on prescription drug middlemen press release",
      "url": "https://www.ftc.gov/news-events/news/press-releases/2024/07/ftc-releases-interim-staff-report-prescription-drug-middlemen",
      "reviewed_as_of": "2026-06-12"
    },
    {
      "title": "Nasdaq earnings pages for LLY, ABBV, JNJ, MRK, AMGN, GILD, REGN, PFE, VRTX, and BMY",
      "url": "https://www.nasdaq.com/market-activity/stocks/lly/earnings",
      "reviewed_as_of": "2026-06-13",
      "used_for": "Bounded next-earnings-date check; no basket date was confirmed in the worker pass."
    },
    {
      "title": "CompaniesMarketCap market capitalization pages for basket tickers",
      "url": "https://companiesmarketcap.com/",
      "reviewed_as_of": "2026-06-13",
      "used_for": "Market-cap metric tiles."
    },
    {
      "title": "Vertex Reports First Quarter 2026 Financial Results",
      "url": "https://investors.vrtx.com/news-releases/news-release-details/vertex-reports-first-quarter-2026-financial-results",
      "reviewed_as_of": "2026-06-13",
      "used_for": "VRTX Q1 2026 total revenue and product-revenue mix."
    },
    {
      "title": "Bristol Myers Squibb Reports First Quarter Financial Results for 2026",
      "url": "https://www.bms.com/assets/bms/us/en-us/pdf/investor-info/doc_financials/quarterly_reports/2026/BMY-Q1-2026-Earnings-Press-Release.pdf",
      "reviewed_as_of": "2026-06-13",
      "used_for": "BMY Q1 2026 total revenue and portfolio revenue mix."
    }
  ],
  "basket_metrics": {
    "market_cap_source": "CompaniesMarketCap pages accessed 2026-06-13; delayed market data.",
    "earnings_date_source": "Nasdaq earnings pages accessed 2026-06-13; dates not confirmed, so cards use Not confirmed.",
    "latest_quarter_revenue_source": {
      "LLY": "Q1 2026 company release/10-Q via local LLY security lane; total revenue $19.799B.",
      "ABBV": "Q1 2026 company release via local ABBV security lane; net revenue $15.002B.",
      "JNJ": "Q1 2026 company release via local JNJ security lane; sales $24.062B.",
      "MRK": "Q1 2026 company release via local MRK security lane; sales $16.286B.",
      "AMGN": "Q1 2026 company release via local AMGN security lane; revenue $8.618B.",
      "GILD": "Q1 2026 company release via local GILD security lane; revenue $6.960B.",
      "REGN": "Q1 2026 company release via local REGN security lane; revenue $3.605B.",
      "PFE": "Q1 2026 company release via local PFE security lane; revenue $14.451B.",
      "VRTX": "Q1 2026 official Vertex release; total revenue $2.9869B, total CF product revenue $2.915B. No filed local security lane exists.",
      "BMY": "Q1 2026 official Bristol Myers Squibb release; total revenue $11.489B, Growth Portfolio revenue $6.227B, Legacy Portfolio revenue $5.277B. No filed local security lane exists."
    },
    "market_caps": {
      "LLY": "$1.010T",
      "ABBV": "$402.35B",
      "JNJ": "$579.82B",
      "MRK": "$294.03B",
      "AMGN": "$191.70B",
      "GILD": "$155.92B",
      "REGN": "$64.17B",
      "PFE": "$149.38B",
      "VRTX": "$112.92B",
      "BMY": "$116.66B"
    }
  },
  "discovery_sources": [
    {
      "kind": "duckdb_readonly_query",
      "label": "Chronic Disease Therapeutics And Drug Access weekly OHLC and EMA setup inputs",
      "query_ref": "discovery:duckdb:daily_ohlc_weekly_aggregation_20w_100w_ema:chronic-disease-therapeutics-and-drug-access:2026-06-12"
    },
    {
      "kind": "report_api_route",
      "label": "Selected-security right-rail chart route",
      "route": "/api/securities/{ticker}/chart?frequency=weekly&window=3y&as_of=latest"
    },
    {
      "kind": "discovery_cli_status",
      "label": "LLY status and daily_ohlc lineage",
      "query_ref": "discovery:status:LLY; discovery:lineage-status:LLY:daily_ohlc:limit_10"
    },
    {
      "kind": "discovery_cli_status",
      "label": "VRTX status and provider filing-index lookup",
      "query_ref": "discovery:status:VRTX; discovery:lookup-filings-index:VRTX:10-Q:limit_5"
    },
    {
      "kind": "discovery_cli_lookup",
      "label": "BMY provider filing-index lookup",
      "query_ref": "discovery:lookup-filings-index:BMY:10-Q:limit_5"
    }
  ],
  "known_gaps": [
    "BMY and VRTX are chartable but have no filed local security lanes.",
    "VRTX and BMY now use official Q1 2026 revenue releases in this report, but local security-lane work is still needed before this page can make company-specific product, payer, margin, or valuation claims with the same confidence as maintained rows.",
    "Nasdaq earnings pages did not confirm next earnings dates for the basket on 2026-06-13.",
    "NVO is economically important for GLP-1 access but has no local OHLC and no filed local security lane.",
    "Access intermediaries are treated as gates and routed to the pharmacy-distribution and reimbursement nodes rather than ranked in the manufacturer-led basket.",
    "Current-week volume is partial through 2026-06-12 and should be refreshed after the next completed market week.",
    "Static setup thresholds from the prior article-body table were removed because live API chart data is newer than those levels; setup labels should be refreshed before use as current trading evidence."
  ],
  "validation": {
    "structural_contract": [
      "lead plus detailed stack explanation",
      "Current Setup visual with hidden source fields",
      "Basket cards with rank buttons and metrics-strip chart triggers",
      "basket detail sections: Role in stack, Revenue mix, Latest qtr revenue",
      "neutral evidence-board with Area, What confirms, What weakens or invalidates, Watch next",
      "no article-body setup table",
      "no embedded OHLC chart payloads"
    ],
    "api_smoke_check": "Focused API unit tests passed: python -m unittest tests.test_api_securities tests.test_api_charts. A live HTTP probe was attempted after python -m api.run logged startup on 127.0.0.1:8765, but a separate curl to /api/securities/VRTX/chart?frequency=weekly&window=3y&as_of=latest returned connection refused in this environment; static API attributes and chart route metadata were verified instead.",
    "shared_files": {
      "parent_report_json": "not updated due review-worker scope; routing and counts did not change, but parent freshness and inherited ticker order are older than this node sidecar",
      "parent_html": "not updated; routing and counts did not change",
      "sitemap_json": "not updated due review-worker scope; existing sitemap entry routes correctly but still carries the older 2026-06-11 discovery query ref",
      "node_data_json": "not present for this theme"
    }
  }
}