Brainstorm Health: STDs and Drug Overdoses, Biotech Boom and Wall Street, Surprise Billing

August 29, 2018, 4:40 PM UTC

Americans contracted a record number of sexually transmitted diseases in 2017, beating the 2016 tally—which was then an all-time high—by more than 200,000 cases, according to preliminary data revealed yesterday by the CDC. An estimated 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the U.S. last year, capping a multiyear period of “steep and sustained increases in STDs,” said the U.S. health agency. Gonorrhea cases alone jumped a shocking 67 percent from the number in 2013, according to the analysis presented at the CDC’s 2018 STD Prevention Conference in Washington.

Clifton Leaf, Editor in Chief, FORTUNE

The news follows a report earlier this month that an estimated 72,000 Americans had died from drug overdoses in 2017, according to a provisional count by the CDC’s National Center for Health Statistics—a figure that would mark not only a dismal milestone, but also a nearly 7% increase from the year before.

To put it bluntly, as Jonathan Mermin, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, did in a CDC press release: “We are sliding backward.”

This double-barreled data shot from our friends in the U.S. government is yet one more reminder of how critical social determinants are in human health. Yes, “social determinants” is one of those academic terms that makes the eyes of all but academics gloss over. But such factors—drug and alcohol use, sexual and reproductive health, smoking status, nutrition and weight, oral health, our homes and environment, violence, wealth, social exclusion, zip code—have more of a collective impact on our wellbeing, population-wide, than every pharmaceutical drug and medical device put together. It’s not even close.

And yet we all but ignore these critical health components when we talk about, plan for, and pay for health.

Luckily, I think that conversation is just beginning to change—as Fortune’s conversation with Kaiser Permanente CEO Bernard Tyson two weeks ago reflects. (See Sy’s wonderful write-up here.) Aetna CEO Mark Bertolini, likewise, emphasized the importance of social determinants in his discussion with me at this year’s Fortune Brainstorm Health conference.

But for us to have a real and lasting hope of a healthier America, we have to rethink our entire health system to align with such improvements in social health indicators. The CDC just gave us two scary reminders of the cost of business as usual.


The quest to make a 3D map of the human genome. A new study published in the Journal of Cell Biology says that University of Illinois-Urbana Champaign researchers have developed a technique that could one day lead to three-dimensional maps of the human genome. The advance involves the creation of a "cytological ruler" which could be used to pinpoint the location of genes inside a cell's nucleus—and there could be important medical implications, as gene location may well affect their activity. (Journal of Cell Biology)


Biotech boom fuels big paydays for analysts. The Wall Street Journal is out with an excellent report the big money that investment banks are paying to snag top-of-the-shelf biotech analysts amid a boom in the industry. The sheer amount of VC funding and consolidation in the sector has upped the demand for experts; but, as the Journal notes, there may be unintended consequences, such as pushing analysts to be more bullish than market realities might warrant. (Wall Street Journal)

Ketamine may treat depression by acting like an opioid. A small new Stanford study published in the American Journal of Psychiatry suggests that ketamine—used legitimately as a powerful tranquilizer/anesthetic and not-so-legitimately as a party drug—may help treat depression by behaving like an opioid. If the results hold, that could raise a dilemma, since patients being treated for depression may also be developing an offshoot of opioid dependence (or at least a vulnerability to addiction). (TIME)

How do you get docs to prescribe cheaper biologics? Biosimilars, the generic copycats of expensive and popular biologic drugs, are still relatively new to the United States. And, overall, their uptake hasn't been all that impressive. A new PricewaterhouseCoopers survey suggests some of the reasons why: 55% of surveyed individuals said they were unfamiliar with biosimilars (and 35% had never prescribed them). But, the survey finds, increasing physicians' familiarity with the products and confidence in their efficacy, as well patient comfort with the treatments, would make them more likely to prescribe biosimilars. (PwC)


America's broken health system distilled into one bill. NPR has a must-read report in its "Bill of the Month" series that shows how broken even the relatively-lauded employer-based health insurance system is in the U.S. A Texas teacher who had a heart attack received a staggering $108,951 bill for his treatment—even though he had health insurance. The reason? The closest hospital for his emergency situation wasn't within his insurers' network, resulting in a surprise bill. Another phenomenon at work here is the practice of "balance billing," wherein hospitals demand patients to pay the balance of their total cost of care and whatever it is their insurer agreed to pay. (NPR)


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