Health insurance premiums are on the rise, and it’s brought a frightening term back into conversation: death spiral.

Exact definitions vary, but this often refers to a “spiral” of rising premiums and falling enrollment that ends in the market’s collapse.

Experts told Healthcare Brew this isn’t likely to happen without drastic policy changes. But one way it could happen is if out-of-pocket increases motivated a significant amount of healthy people—the ones who pay more into the system than they cost—to leave the Affordable Care Act (ACA) marketplace.

Those who still enroll would likely be people who really need coverage: the sickest with the costliest medical care. This would spike insurers’ expenses, prompting them to further raise premiums and potentially scaring even more healthy people away in a self-propelling cycle of doom.

Right now, though, the market has fail-safes to stop that from happening.

Which is why experts say they don’t expect a spiral to occur.—CC

There’s no shortage of AI models aimed at discovering new drugs these days. Researchers have introduced more than 200 of these foundation models in the last three years, with 40% growth per quarter, according to a new paper published this month in the journal Drug Discovery Today.

Pharmaceutical giant Merck and Nvidia recently rolled out a new entry in this growing body with a small-molecule drug model called KERMT. The model is pretrained on more than 11 million molecules, then fine-tuned for various tasks specific to industrial drug discovery workflows, according to Merck.

Alan Cheng, Merck’s senior director of data science, told us the model could help scientists better predict how a given molecule will behave in the body, potentially catching problems before researchers invest in months of testing.

“Traditionally, scientists spend months running physical and biological tests to understand ADMET properties: absorption, distribution, metabolism, excretion, and toxicity,” Cheng said in an email interview. “These steps are essential because a promising compound can fail late in development if it is toxic or has poor exposure at the therapeutic target.”

Here’s more on what Merck and Nvidia have in store.—PK

As the end of the year rolls around, Healthcare Brew has compiled a list of the largest capital raises of 2025—just for the fund of it.

Silicon Valley Bank reported midyear that venture capital funding in healthcare had a “steep drop” in 2025 compared to 2024, with projections showing $9 billion expected in investment overall this year compared to $23 billion last year. But by Q3, market analysis firm PitchBook reported the year had bounced back some, hitting $12.2 billion compared to $12.1 in 2024. Jury’s still out on final numbers, as the year isn’t over yet.

We worked with venture fund and advisory firm Rock Health and reviewed public notices to create a list of the 20 largest US funding rounds of the year as of Nov. 30.

See Rock Health’s list of top fundraising rounds here.—CM

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