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. Crispy Takes

Fast Company and MIT Technology Review hail recent milestones for CRISPR, suggesting it may “guide the drugs coming out in the 2020s” and “stop the biggest killer on earth”:

Fast Company: [In a recent CRISPR trial] all 75 patients with either beta thalassemia or sickle cell disease given the gene-editing therapy showed zero or a greatly reduced need for blood transfusions (in the case of beta thalassemia) or incidences of life-threatening blockages (in the case of SCD).

MIT Technology Review: A volunteer in New Zealand has become the first person to undergo DNA editing in order to lower their blood cholesterol, a step that may foreshadow wide use of the technology to prevent heart attacks. “If this works and is safe, this is the answer to heart attack—this is the cure,” says Sekar Kathiresan, [Verve Therapeutics CEO].

…but not so fast, say Israeli researchers, writing in Nature Biotechnology:

Altogether, our findings indicate that over nine percent of the T-cells genetically edited with the CRISPR technique had lost a significant amount of genetic material. Such loss can lead to destabilization of the genome, which might promote cancer.

2. Doc Hollywood

Writing in the New Yorker, a doctor-turned-writer emphasizes the importance of storytelling in medicine. And he suggests why HCPs are often bad at it:

After writing and revising three chapters of what I envisioned as my first book, I showed a draft to my wife, an endocrinologist. “They’re awful,” she said.

I reread my words and concluded that she was right. What’s more, I realized that many of the problems with my draft reflected the conditioning that occurs during medical training. I had used technical jargon [and] removed myself from the stories, a result of the psychological distancing needed to remain steady while helping a patient coping with a life-threatening disease. Finally, I’d focused on the clinical details of the cases, instead of exploring patients’ emotional and spiritual dilemmas—the very thing that had moved me to write in the first place.

What I needed was a new kind of training, analogous to my medical training but very different.

3. Golden State Insulin

Is pharma’s next heavyweight player California? Wired covers the state’s unconventional $100-million plan to crank out generic insulin:

Initially, California will spend $50 million to acquire insulin from a manufacturing partner to get a product to the market as quickly as possible. [State communications deputy Alex Stack] expects that to happen by the beginning of 2024. Eventually, the state will spend another $50 million to build a California-based manufacturing facility that will create a “stronger supply chain.” While the state hasn't worked out distribution details yet, Stack says the insulin it makes would be to anyone in the US, not just California residents.

4. Some Don’t Like It Hot

Is climate change a healthcare crisis? After heat waves suffocated Europe, a researcher at the University of Oxford discusses the mental health consequences of extreme heat:

For those with underlying psychiatric illnesses, there are a host of problems. Mortality rates go up by a couple of percentage points during a heat wave, levels of hospital presentation and/or admission go up, levels of suicide go up. There’s a possibility of exacerbation of symptoms or switching into a certain phase of a condition, for instance, relapsing into a manic or hypomanic state in bipolar disorder or a depressive episode in depression. Multiple studies have shown a significant correlation between high temperature and severity of symptoms in schizophrenia.

Further, a recent study finds “climate change has aggravated 218, or 58%, of the 375 infectious diseases listed in the Global Infectious Diseases and Epidemiology Network (GIDEON), and the CDC’s National Notifiable Diseases Surveillance System.”

5. Nudge

Two recent trials at the University of Pennsylvania suggest the untapped potential of a powerful healthcare tool – simplicity:

Researchers mailed fecal immunochemical test (FIT) kits directly to patients instead of making them proactively sign up for them or come in for more involved colonoscopies. They [expected] a relative improvement of 60 percent. They found a giant one. The rate of patients whose kits were mailed home improved over the standard texting group by 1,000 percent.

[A study of Hepatitis C screening] replaced a system that needed physicians to click once to opt-in to a screening for overdue patients [with a system where physicians did not have to click at all]. This resulted in a near-doubling of screening rates.