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Stock Futures Little Changed as Traders Enter December

Expectations are running high for a strong December after a volatile November.

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South Korea’s Export Growth Picked Up in November

South Korea’s exports rose at a stronger-than-expected pace in November, backed by brisk demand for semiconductors and a trade deal between Seoul and Washington.

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China Manufacturing Gauge Shows Slightly Firmer Growth Momentum

China’s official factory gauge edged up on stronger production and demand in November, but remained in contraction for an eighth straight month.

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Is America Heading for a Debt Crisis? Look Abroad for Answers

Politics and debt don’t mix well. Americans would be wise to look across the Atlantic to see how tough things can get.

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Since Trump’s Return, Bets on His Brand Have Soured

Stocks and cryptocurrencies tied to the president and his family have tumbled amid a broader rout of riskier assets.

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Why Jewelry Is Outperforming the Rest of the Luxury World

Expensive jewels are the choice of superwealthy households getting even richer from the stock market.

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The Score: Campbell’s, Kohl’s, Alphabet and More Stocks That Defined the Week

Here are some of the major companies whose stocks moved on the week’s news.

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Week Ahead for FX, Bonds: U.S. ISM, ADP Data in Focus as Fed Rate Cut Looks Likely

U.S. ISM surveys on manufacturing and services activity, plus the latest ADP private payrolls, will be watched closely for confirmation that the Federal Reserve could cut interest rates at its next meeting.

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Salesforce, Marvell Technology, Dollar General, Ulta Beauty, and More Stocks to Watch This Week

The first week of the year has a full slate of earnings reports and economic data.

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A Chicago Data Center Overheated-and Shut Down Trade in Key Markets Across the Globe

The outage, which lasted for 10 hours, hit CME’s equity, bond and commodity futures. It also offered a warning.

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Canadian Economy Rebounds by More Than Expected

Canada’s economy recovered far more strongly than anticipated in the latest quarter, pulled out of its decline by a bounce-back in net trade and a surge in defense spending that helped mask weak domestic demand.

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The Fed Is Turning the Corner on Profits. It’s Good for the Treasury.

Higher interest rates have brought a tide of red ink to the bank.

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Japan Plans Extra Bond Issuance That May Fuel Fiscal Fears

Prime Minister Sanae Takaichi’s cabinet on Friday approved a draft supplementary budget for the fiscal year ending March 2026 that is worth 18.303 trillion yen, or about $117.10 billion.

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Silver Shift: How China’s Older Consumers Are Becoming Reliable Spenders

Seniors in China aren’t simply buying the basics. They are demanding high-quality food, health services, and travel.

  (END) Dow Jones Newswires

  November 30, 2025 21:15 ET (02:15 GMT)
Copyright (c) 2025 Dow Jones & Company, Inc.

Real-world data on usage of the tyrosine kinase inhibitor nintedanib (Ofev; Boehringer Ingelheim) suggest there is significant dissonance between how the therapy is being used to treat non–idiopathic pulmonary fibrosis that has progressed to progressive pulmonary fibrosis (non-IPF PPF) in clinical practice and how it was used in clinical trials.¹

The report, published in BMJ Open, suggests additional research is needed to better understand how the therapy performs in real-world practice.

Nintedanib is approved to treat IPF, chronic progressive interstitial lung diseases (ILDs) with a progressive phenotype, and systemic sclerosis-associated ILD. The study authors noted that it is the only antifibrotic approved for the treatment of non-IPF progressive pulmonary fibrosis (PPF). Yet, they explained that significant evidentiary gaps remain related to its usage in non-IPF PPF.

“To our knowledge, there is no real-life data on the use of nintedanib in non-IPF PPF,” they explained. “Additionally, there is a lack of information regarding the combined use of antifibrotic and immunomodulatory drugs, particularly in patients with PPF in CTD-ILD (connective tissue disease-ILD).”

The investigators examined real-world data for nintedanib usage to see how closely it aligned with usage patterns in clinical trials. They analyzed all patients who were treated for non-IPF PFF at the Hospital District of Helsinki and Uusimaa in Finland in 2022 and 2023. A total of 31 patients were identified who met inclusion criteria.

Of those, 13 patients were diagnosed with CTD-ILD, and 10 patients were diagnosed with fibrotic idiopathic non-specific interstitial pneumonia (iNSIP). Patients in the real-world data set had forced vital capacities (FVCs) and diffusion capacities for carbon monoxide (DLCO) scores that were similar to the patients in the INBUILD clinical trial of nintedanib.

“However, in our study, the predominant radiological pattern was fibrotic NSIP in more than half (58%) of the patients, and only 19% had a usual interstitial pneumonia (UIP) pattern,” the investigators said. “This differs markedly from the INBUILD trial, in which most patients (62.1%) had a UIP pattern.”²

The authors also found significant differences in dosage patterns in their real-world data.¹ Of the 30 patients who received nintedanib, 6 permanently stopped taking the drug due to side effects. And only half (47%) of the patients who were still taking the therapy at the end of follow-up and for whom dosage was known were taking the full dose of 150 mg twice daily. The other 10 patients for whom dosage was known were taking a reduced dose of 100 mg twice daily.

The discontinuation rate in the study was similar to the INBUILD trial. However, the high rate of patients taking a reduced dose is notable because of the relative lack of data on the efficacy of reduced doses. The topic has not been extensively studied in randomized controlled trials, the authors noted, though there is some real-world evidence supporting its efficacy at lower doses.³

The authors said, however, that the biggest difference between their patient cohort and the patients in the INBUILD trial has to do with the use of immunomodulatory treatments.¹ In the INBUILD trial, patients who were treated with one of several immunomodulatory therapies were excluded. In the real-world data set, 87% of patients were taking immunomodulatory drugs.

The investigators added that the relatively high rate of discontinuation they saw underscores the need for additional treatment options for patients with non-IPF PPF. They noted that in patients with IPF, the availability of pirfenidone gives clinicians and patients an alternative in cases where side effects or progression occur.

The findings were limited by the small sample size and the fact that all of the patients were treated in the same health care system, the authors noted, and therefore they may not be generalizable to all populations. They said the significant differences they saw between real-world usage and clinical trials show that more studies are warranted.

References

1. Renner A, Vertanen E, Sutinen E, Ainola M, Myllärniemi M, Hollmén M. Characterisation of patients with antifibrotic-treated non-idiopathic pulmonary fibrosis progressive pulmonary fibrosis: a retrospective real-life study. BMJ Open. 2025;15(11):e097246. doi:10.1136/bmjopen-2024-097246
2. Flaherty KR, Cottin V, Devaraj A, et al. Nintedanib in progressive fibrosing interstitial lung diseases. N Engl J Med. 2019;381(18):1718-1727. doi:10.1056/NEJMoa1908681.
3. Porse S, Hoyer N, Shaker SB. Impact of reduction in antifibrotic treatment on mortality in idiopathic pulmonary fibrosis. Respir Med. 2022;204:107015. doi:10.1016/j.rmed.2022.107015

KUALA LUMPUR, Dec 1 — A senior oncologist has advised patients to get lawyers to send letters to insurance companies that deny their medical claims, without necessarily going to court.

Dr Mohamed Ibrahim A. Wahid, a senior consultant clinical oncologist who has been in practice for more than three decades, said he has suggested to some patients to consult lawyers when coverage was denied over what he believed to be a “gray area”.

“I have seen patients who go to a lawyer and all the lawyer has to do – no need to take them to court – is to write a letter to the insurance,” Dr Ibrahim told the Do More – Today financial podcast hosted by Khoo Hsu Chuang that aired last November 18.

“‘Why did you deny? On what account did you deny? Where in your policy says you will not pay for this?’

“The whole thing flips.”

“Oh, so they’re deathly afraid of lawsuits?” Khoo remarked. “Fantastic.”

Dr Ibrahim, who is former president of the Malaysian Oncological Society, pointed out that even if insurance companies decided to go to court to defend claims denials, the industry might have difficulty recruiting specialist doctors as expert witnesses.

“I think none of the specialists will sit down and represent them. Certainly my own oncology society, we’re not going to help defend. They will defend the patients; they will not defend the insurance industry.”

The senior oncologist advised the general public to discuss claims denials with lawyers, who would be able to interpret their health insurance policies and decide whether denials should be challenged.

“And when it comes to a challenge, most of the specialists, certainly the oncologists, will be protecting their backs – they will help patients.”

Raja Eileen Soraya Raja Aman, a management partner at Raja, Darryl & Loh, previously said patients could take insurers and takaful operators (ITOs) or third-party administrators (TPAs) to court for health insurance denials or delays.

RM1 Million Policy, RM130 Monthly Oral Cancer Therapy Denied

During the Do More – Today podcast, Khoo noted that some people take up medical plans with RM1 million coverage limits, expecting to be covered for any contingency.

“But when the crunch time comes and they go through the process with the hospital, they’re then denied coverage,” said Khoo. “Is that what you’re saying?”

Dr Ibrahim affirmed it. “When it comes to claims, there are a lot of little hidden phrases in the insurance clause that you signed. You’re not aware of the limits to the RM1 million [policy] that you can claim, how much, and what they will pay or what they will not pay.”

The oncologist cited, as an example, hormone tablets that breast cancer patients need to take, sometimes up to 10 years, which he said was part of the standard of care.

However, he noted that insurers often refuse to cover such oral therapy that costs RM130 per month, paying only for surgery or chemotherapy for breast cancer. RM130 monthly over 10 years is equivalent to RM15,600, just a fraction of RM1 million.

“But the problem is, if you don’t pay for that, there’s a high chance that your cancer might come back,” said Dr Ibrahim. “It’s not maintenance treatment; it is part and parcel of ongoing cancer treatment.”

He likened it to taking medication for diabetes. “When you stop taking your tablets, your diabetes will come back and your blood sugar will shoot up.”

Dr Ibrahim said he has had patients complaining to him about how their insurers deny RM130 claims, despite having an RM1 million medical plan. These patients are then forced to be referred to government hospitals because they can’t afford to pay out of pocket.

“The responsibility shifts from insurance who are supposed to provide that cover, and you still have that amount of coverage, but that cost now has to be borne by the Ministry of Health.

“Ministry of Health hospitals are already burdened with lots and lots of patients,” he noted. “Why should the government take the responsibility that belongs to the insurance company?”

Khoo said his sources have told him that most claims denials come from “big players” that control about 20 per cent of the insurance industry.

The financial journalist added that he personally raised his medical insurance cover to over RM1 million earlier this year to reach a certain comfort level. “Clearly, that peace of mind is not really a real peace.”

Patients Allegedly Reimbursed 50% After Tribunal Determines Wrongful Claims Denial

Dr Ibrahim and Khoo also discussed regulatory gray zones in health insurance. Khoo noted that Bank Negara Malaysia (BNM) is a financial regulator that regulates banks and the financial services industry, which the insurance industry falls under.

“But Bank Negara doesn’t know about medical issues,” Khoo said. “So if you’re an aggrieved customer or an aggrieved patient, where are your points of resolution?”

Dr Ibrahim similarly said the central bank doesn’t know much about health care, whereas the MOH lacks regulatory authority over ITOs.

“So I think there’s a huge grey area in Malaysia in terms of governance. Because of that, insurance companies are taking advantage of this grey area and they’re making their own rules and doing their own thing.”

In a statement last October, Health director-general Dr Mahathar Abd Wahab warned ITOs and TPAs against interfering with doctors’ clinical decisions that he said might be in breach of the Private Healthcare Facilities and Services Act 1998 (Act 586).

“They’re contravening the private health care Act if they deny patients standard-of-care treatment,” said Dr Ibrahim. “Despite coming up with such a circular, nothing has changed.”

Citing public disclosures by insurance companies, Khoo noted that some of the biggest houses are “literally making billions of ringgit”.

“I’ve done the research, I’ve spoken to many insurers, and they’re literally making at least a few hundred million, if not a few billion ringgit,” said the financial journalist.

BNM recently reactivated its Grievance Mechanism Committee (GMC) to resolve disputes between health care providers and ITOs, with the GMC holding its first meeting last November 10. There is also an existing Financial Markets Ombudsman Service (FMOS) that manages disputes involving insurance, among other financial services or products.

Dr Ibrahim, however, noted that even if the tribunal found that a health insurance claim was wrongly denied, the ITO would merely be instructed to reimburse the claim, which he described as a “slap on the wrist”. Even then, some of his patients allegedly received only 50 per cent reimbursement instead of the full amount.

“I would like to see them [ITOs] get penalised – pay a summons of maybe 10 times the value to the government as a penalty,” said the oncologist. “Once you start penalising these people, this nonsense will stop.”

Malaysia Among Cheapest For Health Care In Southeast Asia

Dr Ibrahim said despite the rise in private health care costs over the past few decades, Malaysia remained one of the cheapest countries in Southeast Asia for health care, illustrated by Malaysia’s medical tourism.

“We’re a lot cheaper than our neighbouring countries,” said the oncologist.

“To do a PET scan in Indonesia costs RM5,000 to RM6,000, but in Malaysia, it costs RM2,300.”

Comparing his experience working in the United Kingdom and the United States, Dr Ibrahim said, “I’m proud to say the Malaysian health care system is one of the best in the world.”

Medical equipment and treatment in Malaysia are at par, if not better than other countries.

“I don’t want the health care industry to be destroyed by false accusations of, you know, private hospitals charging so much,” said Dr Ibrahim, stressing that treatment costs have gone up, in line with the rising prices of food and other goods.

The oncologist maintained that the problem was with health insurance denials, despite companies promising protection with RM1 million annual coverage.

“But when the claim comes, you cannot claim for this, you cannot claim for that.”