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Brainstorm Health Daily: May 19, 2017

Alzheimer’s. Brain cancer. Creutzfeldt–Jakob disease. Diabetes. One could sweep through the alphabet naming diseases that we don’t yet know how to cure.

But doctors do know how to cure, prevent, or successfully manage (at least for a while) a much longer list of ailments. Even the deadly Ebola virus kills roughly only half of the people it infects. (During the recent outbreak, case-fatality rates—a rare piece of medical jargon that actually means what it sounds like—ranged from a low of 37% to a high of 74%, depending on when and where people were treated.)

And yet, having the knowledge to cure, prevent, or manage the most common human illnesses often does not translate into actually curing, preventing, or managing them.

How often, you wonder?

That’s what a group calling itself the “GBD 2015 Healthcare Access and Quality Collaborators” set out to answer in a thoughtful, if very dense, research study published in The Lancet last night. The study assessed death rates around the world from “causes that should not be fatal in the presence of effective medical care”—or what’s known to epidemiologists as “amenable mortality.”

The researchers examined 32 common ailments—from measles to diarrheal disease to appendicitis—that ought to be treatable by reasonably qualified doctors in a relatively modern healthcare system. Then, based on 2015 mortality rates from those preventable causes of death, the team gave each of 195 countries and territories, what it called a “Healthcare Access and Quality” index score, ranging from a low of 0 to a high of 100.

The United States earned a score of 81—a B-minus, if you will—right on par with Estonia and Montenegro, but unfortunately much lower than most of the rich nations in America’s peer group. Sweden, Norway, and Australia received a score of 90, for instance; Iceland—that brown-nosing snot—got a 94.

But what’s most scary is how poorly the U.S.—which spends about 17% of its GDP on healthcare, and more per capita than pretty much every country in the world—did in preventing death from things like lower respiratory infections (the tiny nation of Bosnia and Herzegovina performs better than we do in this regard), neonatal disorders (Lithuania kicks our butt), Hodgkin’s lymphoma (we’re bested by Armenia, Jordan, the Northern Mariana Islands, South Korea, and Saudi Arabia), and diabetes (more deaths from this brutal disease are prevented in Cuba, Russia, and Moldova).

The findings are ego-bruising, to be sure, though our HAQ has come up substantially since 1990, say the authors of the Lancet paper—who number so many, by the way, that they could be split into 50 research groups the size of the Wu Tang Clan and still have dozens of scientists left over to serve as roadies.

Worth noting as well is that these findings are consistent with lots of previous research. And the stark message that they convey has much to do with “access” to care—a key component in the HAQ score, you’ll recall. (That’s what the “A” in that little acronym stands for.) After all, it really doesn’t matter how good the care is if people don’t have access to it.

Which brings up some other news from yesterday: Bloomberg reports that the House of Representatives may have to vote again on their controversial Trumpcare bill—after its budgetary and overall financial impact is re-scored by the Congressional Budget Office.

If the CBO does conclude, as expected, that even more Americans will lose their healthcare coverage under the revised AHCA bill, then voting for it anew is only likely to bring America’s B-minus healthcare average down.

Happily, something tells me that our nation is more ambitious than that.

More news below from my colleague Laura Entis. (Sy is on vacation.)

Clifton Leaf, Editor in Chief, FORTUNE
@CliftonLeaf
clifton.leaf@fortune.com

DIGITAL HEALTH

MindMaze gets FDA clearance for a VR-based rehabilitation platform. Called MindMotion Pro, the VR program is designed to help stroke victims regain mobility. By having patients complete a series tasks of tasks using a virtual representation of their impaired limbs (controlled by their working arms or hands), the goal is to trigger the brain into restoring functionality. The company recently raised $100 million in funding and is also working on a VR headset that detects a wearer’s facial expressions and maps them on an avatar inside the game. Per MobiHealth, the company is hoping to treat multiple neurological disorders using augmented and virtual reality. (MobiHealthNews)

Using CRISPR to build better tomato plants. Modern crops are shaped by years of plant-breeding. Today’s tomato plants have been bred to eliminate the swollen part of the stem called the joint. (The change keeps fruit from falling off the vine.) But this tweak included an inadvertent disadvantage: it caused plants to produce multiple flower-bearing stems, which drained the plant’s tomato-growing resources. Geneticist Zachary Lippman has found one workaround to this conundrum. By identifying variants of the genes that cause extreme branching and flowering, he used CRISPR to alter their activity—eventually producing plants with better yields. (Nature)

INDICATIONS

The world’s best-selling drug just lost an important patent battle. Last year, AbbVie's Humira, which is used to treat rheumatoid arthritis and psoriasis, generated $14 billion in sales. But its lucrative monopoly could be in jeopardy. On Tuesday, the U.S. Patent Trial and Appeal Board invalidated one of AbbVie’s key patents, greatly increasing the likelihood that rivals, including Coherus, will launch generic Humira copycats. (Fortune)

A $65 million bet. That’s the amount biotech company Iterum Therapeutics just raised in Series B funding. The investment is notable, as the company is helmed by Corey Fishman and Michael Dunne. Two years earlier, the duo helped win approval for the antibiotic Dalvance, which was acquired from Pfizer. Now, they’re trying to turn sulopenem, another shelved Pfizer antibiotic, into a second success story. Iterum Therapeutics plans start a phase 3 program for sulopenem, which it hopes could be used to treat urinary tract infections, later this year. (FierceBiotech)

THE BIG PICTURE

Calorie counts hit chain food outlets in the Big Apple. Beginning next week in New York City, chain food outlets with 15 or more locations must list calorie information on prepared foods. The move is an expansion of the city’s health code, which has required restaurants chains to list calories on menu items since 2008 in a bid to help consumers make healthier choices. Whether these measures actually work, however, is unclear. A detailed study from NYU found that adding calorie counts to menus did not have an impact on what patrons ordered, or how frequently they visited restaurants. (Fortune)

Can you be clinically addicted to the Internet? While researchers continue to debate the question, a fascinating and heartbreaking piece in NPR illustrates how technology addiction can lead to feelings of depression and isolation, particularly among teens. The article tells the story of Naomi who, in middle-school, begins to retreat from her family and friends, instead spending hours alone in her room, hooked to her iPhone screen. After sliding into a clinical depression that culminates in a suicide attempt, she is sent to an addiction recovery center for teens. This characterization remains controversial, but appears to be gaining steam. (NPR)

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