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. Go Big or Go Home

Even in a period of economic growth, mid-sized firms are hurting. Harvard Business Review floats a few ideas on why – and suggests the challenges may be here to stay. Mid-size pharma beware?

One plausible reason is that businesses that could scale their virtual operations without the need for physical assets benefitted most from the technological progress and economic conditions…In contrast, midsize companies lacked not only the dynamism of small companies but also the R&D investment and scaling capabilities of large companies. Furthermore, the last decade was a winner takes-all-economy, with large companies like Amazon and Apple getting even bigger.

2. Be More Like Cocoa Krispies

Is there a better way to share prescription drug side-effect information with patients? Many advocates believe so. Steven Woloshin, professor of medicine at the Dartmouth Institute, has a proposal. The Atlantic reports:

Woloshin developed what he calls a “drug-facts box”—a one-page sheet that doctors would give to patients or pull up via a website or app. In clear, simple language, the box describes exactly what the drug is for, how much it helps people, what the side effects are, and how often they occur. A sample box he sent me, for the insomnia drug Lunesta, shows that Lunesta helps people fall asleep about 15 minutes faster, but its users are about four times as likely to experience an aftertaste than those who took a placebo. Woloshin envisioned it as a nutrition label, but for prescription drugs. “If they can do that for Cocoa Krispies, why can’t you do it for Lipitor?” Woloshin said. The way Woloshin sees it, a doctor would show a patient the drug-facts box before prescribing a drug, so the doctor and patient together could decide whether the benefit of taking the medication outweighs the possible harms.

3. Global Health Goes Local

Need a break from COVID doomscrolling? Have a look at the Bill and Melinda Gates Foundation’s latest annual letter. It posits that the pandemic will usher in a better approach to global health:

If there’s a reason we’re optimistic about life on the other side of the pandemic, it’s this: While the pandemic has forced many people to learn a new vocabulary, it’s also brought new meaning to old terms like “global health.”

In the past, “global health” was rarely used to mean the health of everyone, everywhere. In practice, people in rich countries used this term to refer to the health of people in non-rich countries. A more accurate term probably would have been “developing country health.”

This past year, though, that changed. In 2020, global health went local. The artificial distinctions between rich countries and poor countries collapsed in the face of a virus that had no regard for borders or geography.

4. R&DIY

A growing group of DIY scientists have taken their at-home gene editing and synthetic biology skills to make up for COVID vaccine shortages. One basement scientist details his experience both making and taking his own COVID-19 vaccine:

All of the materials and equipment to make the vaccine cost us about $1000. We did not need any special licenses or anything like that. I do have a little wetlab experience from my undergrad days, but the skills required were pretty minimal… Why am I doing this? I imagine, a year or two from now, looking back and grading my COVID response. When I imagine an A+ response, it’s something like “make my own fast tests, and my own vaccine, test that they actually work, and do all that in spring 2020”.

Like all things internet, the comments section looks unkindly at the experiment: “Do you have any thoughts on the risks/hazards involved here? Some thoughts / priors: Snorting chemicals I got from the Internet / mixed up myself without really knowing what I was doing: Superficially, seems potentially pretty risky.”

5. All the Ooze That's Fit to Print

It’s not just social media. Legitimate news outlets have botched public health messaging on COVID with their nonstop, often contradictory headlines. In an interview for NPR’s On the Media, a sociologist offers her assessment:

Let's not put six-fold decrease in net neutralizing antibodies in a headline, as if that's something the public should be expected to understand. And that's going to make people not want to take the vaccine when they should jump at it.

The media has to examine how it switches, like there's this herding effect, where they dismissed the pandemic risk. They dismissed masks. They did this for a long time, and then when it flipped, there's a lot of doom-saying now. I'm seeing articles saying vaccinations are not going to get us out of it. Yes, it will. The problem is we don't have enough.