The world is flat, make that flatter, compared to just a couple of decades ago. That has both positive and negative implications when it comes to managing disease and care on a global level.

It began in December, with CVS’s proposed $69bn buyout of insurer Aetna. In January, three more corporate behemoths — Amazon, JPMorgan Chase and Berkshire Hathaway — said they were forming a joint venture aimed at reducing health care costs and improving outcomes for their combined 1 million or so employees.

Over 20 years, Brian Komoto built a thriving pharmacy in California’s Central Valley. Each day, his nurses would travel the vast agricultural region’s roads to help hepatitis C patients take a grueling regimen of shots.

When Teva Pharmaceuticals announced recently that it would begin selling a copycat version of Syprine — an expensive drug invented in the 1960s — the news seemed like a welcome development for people taking old drugs that have skyrocketed in price.

A historically bad flu season has sent Americans to the doctor in droves -- and given a boost to companies across the health-care business.