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 Wrong “Disruption” for Biotech

The collapse of Silicon Valley Bank “provides a painful irony,” argues biotech investor Steve Brozak in Forbes. The problem isn’t just that SVB’s demise may hurt future biotech funding, but that the entire investment model is under strain:

Biotech has never been a sure investment. With an average failure rate of 90% for biotech startups, investors are asked to take certain risk and to put their faith and their money in ideas…If the lifeblood of biotech is in its people and their ideas, the fuel needed to sustain them is investment capital. This provides painful irony to the SVB collapse. Its demise was not caused by its business with excessively risky startups, rather the problem was as simple as SVB’s asset strategy.

2. Fat Chance

 It’s a sudden truism that new diabetes medications can shed pounds and create hefty profits. The Economist takes a look at what “could become the biggest-selling class of pharmaceuticals ever.” It offers a few weighty lessons:

Analysts have long complained that Novo’s focus on diabetes-related illnesses make it the least diversified big pharma firm in Europe. But that is orthodoxy gone mad. One of the beauties of the firm, whose founders first made insulin in Denmark in the 1920s, is specialisation. That industrial focus gave Novo a head start on obesity. For decades it toiled in the wilderness, while its rivals concluded obesity drugs were neither effective nor safe. But once it discovered that the glp-1 medicines it used for diabetes, if made longer acting, could lead to at least 15% weight loss, it doubled down. Besides obesity, it hopes to use glp-1-related drugs to help treat heart disease and other related illnesses. Its success is testimony to the virtue of innovating in adjacent, highly specialised businesses, rather than creating something from scratch.

3. Fiction, Based on a True Story

The New Yorker’s most recent piece on health inequity reads like a scene ripped from House. A young doctor sees a patient with mysterious symptoms and theorizes that she has early-onset Alzheimer’s. His boss, the steely medical guru, is not impressed:

Graham’s blue eyes lasered in on me. “This woman has untreated diabetes,” he said. “It’s caused her to have thousands of small strokes that have killed all these parts of her brain. That’s what’s causing her dementia.”

“I didn’t know it could do that,” I said—a response that revealed my ignorance. I’d never even looked up the symptoms of untreated diabetes; I had assumed that a patient would never grow this sick from a common and manageable disease. “Pocket Medicine” didn’t mention poverty, or a lack of health insurance as a cause of any illnesses. I was starting to realize that its perfect world, in which medicine straightforwardly confronted disease, was a fiction.

4. Schizophrenic and Proud

It’s not just Teams meetings. Calendars are flooded with awareness days. One website we found lists over 300! But is awareness enough? Writing in State of Mind, one advocate argues we don’t need to raise awareness of schizophrenia, but take pride in it:

Schizophrenia is not just a disease I live with—it’s also an inextricable part of my identity. Like many of my peers, I tried to run from the label at first, only to learn that denying it amplifies the shame and difficulty of living with one of the most stigmatized mental health conditions.

My schizophrenia is and will always be a fundamental part of who I am. Loving myself means loving my schizophrenia. It’s time the healthcare system acknowledges the need for a movement to convince people with this condition of their worth, schizophrenia and all.

5. CRISPR vs. Cholesterol

 MIT Technology Review is back with its annual list of 10 Breakthrough Technologies for the year ahead. Coming in at number one for 2023 is “CRISPR for high cholesterol.” The article reports on a study in New Zealand – and suggests why cholesterol may be only the beginning of this next phase of CRISPR:

The trial is a potential turning point for CRISPR, the editing tool they used. Since the technology was first programmed to edit genomes about a decade ago, we’ve seen CRISPR move from scientific labs to clinics. But the first experimental treatments have focused on rare genetic disorders. A high-cholesterol treatment has wider potential…These newer forms of CRISPR could broaden the scope of gene editing to take on many conditions—not all of them genetic. Someday, people may have the option to add genes thought to protect against high blood pressure, or certain diseases, to their genetic code.