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 Clarity Is the Problem

Clinical and scientific publications aren’t exactly page-turners. An exception is the widely maligned DSM-5. This 1,000-page tome is written, according to Awais Aftab, a clinical professor of psychiatry, with “apparent clarity, readable prose, and an approachable format.” Is this style part of what makes the DSM-5 psychiatry’s lighting rod?

[The DSM-5] is not a guidebook for laypeople navigating their inner worlds. Yet the DSM’s design seems to invite this kind of lay appropriation…In contrast to the DSM, the International Classification of Diseases by the World Health Organization rarely becomes the butt of jokes or fodder for op-eds. That may be because the ICD wears its technocratic nature on its sleeve: dry, dense, and unmistakably aimed at professionals. The DSM, with its deliberately “user-friendly” format and preference for everyday language, appears vulnerable to misinterpretation by the public.

2. A Better WIFM for Clinical Trials

The Eli Lilly CEO joined a podcast and discussed why it’s so expensive to run clinical trials in the US. Alex Tabarrok’s summary of the conversation is spot on:

Sponsors must provide high-end care to trial participants–thus because U.S. health care is expensive, US clinical trials are expensive. Clinical trial costs are lower in other countries because health care costs are lower in other countries but a surprising consequence is that it’s also easier to recruit patients in other countries because sponsors can offer them care that’s clearly better than what they normally receive. In the US, baseline care is already so good, at least at major hospital centers where you want to run clinical trials, that it’s more difficult to recruit patients.

3. The Skinny on 2026

The surge in new products will enrich pharmaceutical firms.  But competition could also drive down the costs of treatment, as first-generation drugs, or those that offer slightly poorer top-line results, command lower prices. Some government-funded health systems are likely to make population-scale deals in the coming years, which could broaden access. And as the patent for semaglutide expires in many markets (but not America and Europe) in 2026, generic manufacturers will be able to make cheap copies and expand availability in countries such as Brazil, China and India.

4. When Less Is More

Public health bodies have long struggled to stretch vaccine supply. Often, there simply isn’t enough medicine to go around. A new paper suggests a better way to think about supply and demand. Instead of more jabs in each arm, give fewer jabs in more arms:

Take the human papillomavirus (HPV) vaccine. For years after its introduction, countries administered it as a three-dose series. Then additional evidence emerged; eventually, a single dose proved to be non-inferior. This policy shift has been a game-changer—massively reducing delivery costs while expanding coverage in low- and middle-income countries (LMICs). But it took 16 years from regulatory approval to WHO recommendation.

The problem? “A lack of incentives to generate the required evidence.”

5. Shrug and Bear It

What happens, on the ground, after USAID cuts funds and pulls out? In some places, devastation. In others, a shrug. Mara Kardas-Nelson reports in The Guardian on the as-yet non-event in Sierra Leone:

Mustapha Kabba, the deputy chief medical officer at Sierra Leone’s ministry of health and sanitation, told me that he couldn’t be too worried about the cuts because he didn’t actually know how much money the US government gave to Sierra Leone: the funding was so byzantine, funnelled through so many different NGOs, each with their own budget and timeline and priorities, that he didn’t have a comprehensive picture of what would be affected and therefore which gaps he’d have to fill.