Dear clients and friends: Given your interest in health and medicine, we would like to share with you our collection of the most interesting perspectives on our industry's trends and developments. We are happy to share them with you — and hope you share your thoughts with us.

1. The $20 Billion Bargain?

What’s harder to decipher than the handwriting of doctors? Their speech.

At least that’s why Microsoft made a $20 billion bet with its purchase of Nuance, a speech-recognition company focused on transcribing doctor’s visits. WIRED thinks the price tag is right:

Nuance’s voice transcription technology is used by more than 300,000 clinicians and 10,000 health care organizations worldwide…Microsoft said in a statement that the acquisition would double the value of the health care market it accesses to $500 billion.

Siri and Alexa may understand your grocery list, but [analyst Greg] Pessin says Nuance has spent time and effort developing technology that grasps the specialized language of medicine; that won’t be easy for other companies to replicate. “That process of getting the system, the AI engine, to understand the medical jargon that’s important and difficult—I think that's the real gem.”

2. “If You Make an Ad, I’ll Tax the Screen”

In 2020, healthcare companies spent a dizzying $9.53 billion on digital advertising. Now, Maryland has become the first US state to pass a tax on all digital ads. Bloomberg Tax breaks down the basics of the law and what it could mean nationwide:

Although many say the outcome of Maryland’s case will be a bellwether for other states, digital tax bills will continue to be proposed even if the Maryland law fails. In fact, states will likely rethink their nascent plans to avoid the same pitfalls.

Will digital taxes – along with growing cries for privacy – threaten DTC as pharma’s BFF in the US of A?

3. Come Together?

In the past five years, the pharmaceutical industry made nearly 1,000 M&A deals valued at nearly $1 trillion. But newly-proposedFTC regulations in the US could end the party. The recent statement from the FTC’s acting chair, Rebecca Slaughter, builds on anti-pharma sentiment emerging in the Biden administration:

“We intend to take an aggressive approach to tackling anticompetitive pharmaceutical mergers,” Ms. Slaughter said.

“Given the high volume of pharmaceutical mergers in recent years, amid skyrocketing drug prices and ongoing concerns about anticompetitive conduct in the industry, it is imperative that we rethink our approach,” she said.

4. Is Pharma’s Honeymoon Over?

The arrival of the COVID vaccines kicked off a brief respite for pharma’s PR woes. One study even found that views of Big Pharma flipped from 58% negative to 56% positive. But the “big bad pharma” headlines have returned. Incredibly, COVID vaccines are the smoking gun:

The most profitable course for pharmaceutical companies is to delay worldwide production for as long as possible, and sell their own vaccines for as long as they can—the opposite of what the world needs, morally, economically and epidemiologically.

Will this narrative stick? Or will the public health miracle of the vaccine relegate such rhetoric to a post-pandemic footnote?

5. High Hopes for ASOs

Nature explores an emerging class of genetic therapies—antisense oligonucleotides (ASOs)—that could treat many of the most vexing rare diseases. A treatment for spinal muscle atrophy (SMA) shows what’s possible:

The drug has drastically altered the course of the disease: infants with SMA who receive it shortly after birth are no longer dying within the first years of life. Nowadays, “conversations [with families] don’t just end with, ‘We’re going to do everything we can, but your baby’s going to die’,” says Russell Butterfield, a pediatric neurologist at the University of Utah in Salt Lake City (Butterfield has received consulting payments from Biogen). “Instead, that conversation switches to, ‘We have this new drug, it’s absolutely amazing. We need to get it in as soon as possible’.”

Next up on the ASO hit list: Huntington’s disease and ALS.