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In recent years, the FDA has approved dozens of gene and cell therapies that can potentially cure rare diseases like sickle cell disease and spinal muscular atrophy. But many patients still can’t access these treatments because insurers have refused to cover them. That reluctance is understandable, unfortunately. Widespread use of these multimillion-dollar therapies would bankrupt many health insurers. But the solution isn’t to deny lifesaving drugs to patients. Rather, it is to deploy creative financing solutions that deliver these therapies to sick Americans without collapsing the insurance system. The sickle cell dilemma Consider, for instance, the dilemma posed by sickle cell disease. About 100,000 Americans suffer from the condition, in which a genetic defect causes red blood cells to become crescent-shaped and impede circulation, leading to severe pain and shortened lifespans. Two therapies approved by the FDA show great promise, but are each priced above $2 million, reflecting the decades of research and development costs required to bring them to market and the relatively small patient population. Shockingly, $2 million may not be out of line, given the number of lives to be saved and the years of suffering to be averted, not to mention the improvements in workforce productivity for patients and their caregivers, and cost-avoidance of chronic disease management for sickle cell disease in the future. Curing the condition once and for all could actually save money in the long run, compared to managing the disease year after year and only slowing, not stopping, the patient’s decline. Even the Institute for Clinical and Economic Review, which argues that many pharmaceuticals are wildly overpriced, has concluded that these treatments would “achieve common thresholds for cost-effectiveness” at a price exceeding $2 million. Yet few insurers can afford the up-front cost of these cutting-edge therapies. Commercial insurance companies would similarly struggle to afford the treatments for dozens or hundreds of patients in their risk pools state by state. Simply put, the health insurance system was designed to pay for statins and surgeries, not miracle cures with seven-figure price tags. The mortgage model Giving patients widespread access to these cures will require going outside the traditional insurance system, and facilitating partnerships between manufacturers, payers, and financial institutions, including banks and private equity. For example, right now, sickle cell chronic disease-and pain-management for just one patient can cost upwards of $50,000 per year. For Medicaid, which covers about 50% of U.S. sickle cell patients, these costs could add up to $2.5 billion annually. But if banks partnered with Medicaid, they could finance sickle cell gene therapies in bulk for a discount, say $1.7 million, then Medicaid would amortize the loan over several decades, the same as mortgaging a multimillion-dollar house. At a federally subsidized interest rate of 1%, Medicaid would pay $50,000 per patient per year over 40 years. In other words, the government would effectively pay the same annual price for gene therapies that cure patients up-front as it currently spends just to manage the condition in perpetuity. But after 40 years, Medicaid would have paid off the loan. Banks get a safe, government-backed investment; manufacturers are paid quickly and can scale production; and patients enjoy decades of good health. Outcomes-based contracts The Centers for Medicare & Medicaid Services is embarking on a voluntary program between the makers of sickle cell gene therapies and state Medicaid offices to expand access, but it is limited to contracts that take the states off the hook if a treatment doesn’t work as intended. So-called outcomes-based contracts are rife with complexities and are unlikely to lead to widespread access for sickle cell patients. Similarly, employer-sponsored health plans’ coverage of gene therapies is erratic. If private equity partnered with these health plans at publicly traded companies, the up-front cost of paying for treatment in working-age populations could be amortized over time, predictably increasing the value of the company’s shares. Consider that healthier employees lead to gains in top-line productivity and fewer chronic conditions in a company’s risk pool that could potentially lower premiums. This means a greater return for private equity, one that makes their large up-front investment worthwhile. Everyone wins Traditional insurance simply wasn’t designed for a 21st-century world where we have the tools to completely cure diseases by altering patients’ genetic code. But with regulators’ permission, financial institutions could introduce tools that reduce the long-term costs of chronic conditions, improve public health, and generate predictable financial gains.
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E-Commerce
For the first time in more than 20 years, Amazons logo got a touch-up. In fact, all of its logos got a touch-up. The small but subtle changes are part of a company-wide brand system refinement, bringing together more than 50 Amazon sub-brands across categories like pharmacy, groceries, and on-demand streaming under a single brand umbrella. Typography was key to making it all work.A pair of bespoke fonts, Amazon Logo Sans and Ember Modern, tie Amazon products and services together with a unified brand voice that has flexibility for different contexts. This is a brand thats everywhere, from cardboard boxes to music to prescriptions, and needed to adapt to convey boldness and excitement in use cases like entertainment, but trustworthiness in its healthcare divisions.[Image: Amazon]Koto Studio, the creative agency that worked on the brand system and refresh, started the endeavor by thinking of Amazons master brand logo as a type specimen, not just a mark. (Though they did plump up its arrow to give it a deeper smile.) The team refined the letterforms in the logo, which eventually became the foundation for a font.The biggest challenge was the sheer scale, Koto New York executive creative director Arthur Foliard tells Fast Company of the Amazon brand refresh. Amazons brand had become visually fragmented. Every product or service seemed to have its own logo. It was a sea of arrows with no clear system or structure.Under the new brand system, the Amazon family of sub-brands, house brands, and core services, from Amazon Basics to Amazon Kids, now have a unified logo system set in the new proprietary Amazon Logo Sans.[Image: Amazon]Ember Modern is a new version of the typeface Amazon originally designed for Kindle screen. Koto updated it with characters for 366 languages and seven weights so it can be used globally in instances like high-impact headlines or for text-heavy, long-form reading. Its a typeface designed for versatility.They also updated the companys color palette to standardize its main brand color, Smile Orange; tweak its blue to a more saturated, digital-friendly shade; and give each sub-brand its own bright, expressive color scheme. Amazon Fresh, its grocery delivery business, uses shades of green to communicate freshness, while Amazon One Medical, its primary care provider, uses a turquoise green reminiscent of scrubs.Historically, Amazon teams moved fast, spinning up businesses and logos on the fly to meet customer demand, Foliard says. That agility was great, but it sometimes led to brand fragmentation. [Image: Amazon]Going forward, the agency left the company with an automated [amazon]:name command to generate future consistent logos instantly, plus a full logo architecture to define what needs a logo and what doesnt.With its new brand system and font book, Amazon is better positioned to express its brand and sub-brands across a growing number of categories. If Alexa is the audible voice of Amazon the brand, Amazon Logo Sans and Ember Modern are the brands voice in print.
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E-Commerce
During his campaign, President Trump made a lot of promises about what he would do during a second term. One of those promises was to roll back the civil and social rights of transgender people. And in his first 100 days in office, Trump has been delivering on expelling transgender rights from the U.S., unlike with other promises like improving the economy. Starting from his first day in office, Trump has attacked the trans community from all anglesin rhetoric and in policy. He has removed workplace protections for trans people and disallowed gender-affirming medical care. In just a few months, here’s what Trump has done to turn back the clock for the trans community and transgender rights. An executive order to recognize only two genders On Trump’s first day, he signed a flurry of executive orders. Among them was an order declaring that the U.S. government will now only recognize a persons gender assigned at birth. It also set forth that the U.S. would recognize only two genders, male and female. The order states: Gender ideology replaces the biological category of sex with an ever-shifting concept of self-assessed gender identity, permitting the false claim that males can identify as and thus become women and vice versa, and requiring all institutions of society to regard this false claim as true.” The executive order meant that the U.S. would not recognize transgender, nonbinary, or intersex people, or even the idea that gender can be fluid. With the order, the State Department has ceased to issue passports with an “X” in the gender category, forcing trans individuals to return to using a gender category that doesn’t align with their identity. Banning trans Americans from military service Trump banned transgender Americans from serving openly in the military, rolling back Biden-era protections. The move didn’t come as a surprise, given that Trump had spoken frequently about the plan during his campaign. “If you want to have a sex change or a social justice seminar, then you can do it somewhere else, but you’re not going to do it in the Army, Navy, Coast Guard, Air Force, Space Force, or the United States Marinessorry,” Trump said at a preelection rally. An estimated 15,000 transgender individuals are currently serving in the U.S. military. Lawsuits against Trump’s order have already been filed by transgender active-duty members of the military, as well as those attempting to join. Last week, Trump asked the Supreme Court to allow the enforcement of a ban on transgender people in the military as those legal challenges continue. Gutting DEI and allowing for workplace discrimination The Trump administration quickly gutted DEI (diversity, equity, and inclusion) policies from federal organizations. The move is likely to hit the transgender community hard, as hiring discrimination is rampant for the group. But the administration also made specific moves to target trans individuals in the workplace. On January 29, the Office of Personnel Management sent a memo to federal organizations explaining that agency heads should place any workers whose jobs entail promoting gender ideology on leave. It called for the closing of all programs that support the concept that gender exists on a spectrum. It also banned all workers from using pronouns in email signatures, and media that may “inculcate or promote gender ideology.” Banning gender-affirming medical care In a January 28 executive order, Trump banned gender-affirming medical care for individuals under the age of 19. It is the policy of the United States that it will not fund, sponsor, promote, assist, or support the so-called transition of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures, the order says. Not only did the order attack trans children, but it also targeted care providers, asserting that federal funds would be restricted from doctors who provide gender-affirming care. A federal judge temporarily blocked the enforcement of the order aiming to shut down access to gender-affirming care. Banning trans individuals from using their preferred bathrooms Trump’s January 29 order also attacked transgender individuals using the bathroom that aligns with their gender identity. It directed agencies to designate bathrooms “by biological sex and not gender identity. In an interview with Time magazine, which named Trump 2024’s Person of the Year, the then-president-elect said, I dont want to get into the bathroom issue. Because its a very small number of people were talking about, and its ripped apart our country, so theyll have to settle whatever the law finally agrees.
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E-Commerce
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