Arizona Plague, Amazon Pharmacy, and Drinking Health Effect

Greetings, readers! This is Sy.

There’s some troubling public health news out of Arizona this week. The Navajo and Coconino counties of the state have warned that fleas in the area tested positive for bubonic plague.

To be clear, no deaths or illnesses have been reported in the region so far. But the highly infectious and deadly pathogen—which claimed millions of lives in the Middle Ages and is caused by the bacterium Yersinia pestis—is concerning enough that health officials have issued public warnings over the fleas, urging residents to stay away from animals that might contract the infection.

“Navajo County Health Department is urging the public to take precautions to reduce their risk of exposure to this serious disease, which can be present in fleas, rodents, rabbits and predators that feed upon these animals,” the officials wrote. “The disease can be transmitted to humans and other animals by the bite of an infected flea or by direct contact with an infected animal.”

There have been isolated plague cases in the U.S., including in recent years, according to the Centers for Disease Control (CDC). Between 2001 and 2012, there was a median of three plague cases per year (with a high of 17); in 2015, the rate spiked. Nearly all of the infections occurred in the American West (including California, Arizona, New Mexico, Colorado, and Oregon).

Luckily, the plague is no longer the death sentence it once was thanks to modern medicine. A course of antibiotics can kill it off—but only if it’s caught early enough. In 2015, four people died of the plague.

Read on for the day’s news.

Sy Mukherjee

@the_sy_guy

sayak.mukherjee@fortune.com

DIGITAL HEALTH

Goldman Sachs on how Amazon can break into pharmaceuticals. CNBC reports that Goldman Sachs is out with a 30-page research note on how Amazon can break into health care, specifically the pharmaceutical sector. The note suggests that Amazon could take an incremental approach by partnering with pharmacy benefits managers, which serve as the middlemen between insurance companies, health care providers, and patients. And the firm may focus at first on one of its biggest strengths—delivery. Your prescriptions could come straight to your doorstep. (CNBC)

INDICATIONS

Novartis heart failure drug Entresto finally starts to pick up some steam. Swiss pharma giant Novartis was near-unanimously lauded by heart health experts for Entresto, a heart failure treatment that's shown significant promise in clinical trials. But the drug's high list price has been a barrier to its market share. Now, the tide may be turning for the therapy as Novartis pursues an aggressive strategy to convince insurance companies to cover the drug. Novartis CEO Joe Jimenez believes the therapy's sales will soar to $500 million this year. (FiercePharma)

THE BIG PICTURE

Moderate drinking: Good or bad? My colleague Laura Entis delves into the hotly-debated world of drinking-related studies. Is it actually good for you in moderation? Or are the claims overblown? Here's what you need to know about the existing research. (Fortune)

CBO set to release report on effect of cutting off Obamacare insurance payments. The Congressional Budget Office will release an analysis of how ending Obamacare payments to insurers (the "cost-sharing subsidies" which help cover low-income Americans' out-of-pocket medical costs) would affect the markets. Health policy experts largely expect that cutting off the payments, as President Trump has repeatedly threatened, will lead to premium increases and insurer exits from Obamacare markets. (The Hill)