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. Vote ‘Yes’ to High Drug Prices! 

Writing on EconLog, a Hoover Institution fellow and a life-sciences consultant make a case for why Americans should be happier to pay more than anyone else for drugs. The authors hinge their argument on the well-established truth that the U.S. market funds pharmaceutical R&D and, without this cash, innovation would stall. Fair enough.  

But it’s in the back-and-forth in the comments where the most illuminating idea emerges:

One thing I think many people don’t understand is that there are old drugs, current drugs, and future drugs.

Old drugs are generic and generally inexpensive, although sometimes not available.

Current drugs are patent-protected and generally expensive. However, in a few short years (1-10) those current drugs will become old drugs.

Future drugs won’t ever exist unless current drugs are successful. The characteristics of current drugs drive the investment in future drugs.

If you think that current drugs are too expensive, don’t complain, just wait a few years and they will be inexpensive.

2. What Ozempic Does to Our Brains

“Marco Leyton, PhD, assures me the cocaine he purchased was legal.” So begins this Vox article exploring how Ozempic and GLP-1 drugs work on the brain. In short, no one knows. But scientists hypothesize that these body-slimming treatments can separate what you like from what you want. The implications may go far beyond just saying no to Oreos: 

 A curious piece of the puzzle resides in the brain. GLP-1 drugs appear to work directly in the brain as a neurotransmitter, influencing neurons in the brain’s reward system, and in the hypothalamus, which regulates the body’s metabolism. The drugs are “probably not acting primarily on dopamine neurons per se…But they’re acting on the neurons that dopamine neurons are talking to.”

So, it’s complicated. But however the drugs are working, they seem to pull off a neat trick. They seem to tap into the wanting system, dialing it down while leaving liking intact.

3. Now Hiring: Mental Health Screenwriters 

Hollywood, never known for its authentic portrayal of anything, may be breaking from tradition with mental health. The American Psychological Association speaks with a PsyD who, in addition to clinical care, now helps TV and movie producers write “more full-bodied stories” of people living with mental illness. The battle is uphill:

Of the 3,815 characters in 100 top films from 2023, just over 2% experienced a mental health condition… [and] 72% of 2022 film characters with a mental health condition were perpetrators of violence, even though psychological research has long shown that few people with mental illness are violent.

4. The Broken Promise of EHRs

A history of Electronic Health Records, stemming from the early days of Obamacare. Dr. Muthulingam, an infectious disease doctor who read more than the Cliff’s Notes to Das Kapital, argues the problems aren’t technological, but economic:   

EHR vendors rushed to claim stimulus money and market share. Economists call this rational, but also perverse. It has paid off: despite lawsuits, fraud accusations and prosecutions for rushed, error-prone products, EHR is now a $28 billion industry and growing. Financial incentives also shape hospitals and private practices, who lose revenue when patients go to other institutions; there is no financial reward to sharing medical charts, nor the proprietary data entangled in it.

5. Are Rates of Depression Really Increasing?

The always-interesting Scott Alexander is interviewed by NewNarrative, a headier blog. Topics include AI, newborns, and Judaism. The conversation about depression, and its prevalence, questions the conventional wisdom about the “mental health crisis” we hear so much about:

Depression diagnoses have gone up, but this could be because people are more likely to go to the doctor for mild cases. I got a strong sense of this when I did my training in Ireland, which at the time was about 25 years "behind" the US culturally. People there thought of depression as something that would probably land you in the psychiatric hospital - an extreme, life-ruining condition that made you totally different from normal people. As time goes on, opinions change, and pharma companies produce better commercials, we shift our diagnostic line closer and closer to ordinary unhappiness. We've seen something similar with autism.