6 people, 33 statements
Prasad argues AI tools and private markets, not government, will best solve access to medical advice, with information quality exceeding most doctors.
The solution here is likely to be private markets and AI driven. These tools dramatically lower the barrier to ask medical questions, and the quality of the information surpasses most doctors. Technology and not government is best poised to address this.
Prasad says many new drugs and devices don't work or do more harm than good, and the ACA worsened this by letting lobbyists add unproven products to public spending.
Many novel drugs, devices and procedures debuted don’t work/ have harms exceeding benefits. The ACA has only exacerbated this problem by allowing lobbyists to add more and more unproven remedies, tactics, strategies and products to the public tab.
Prasad doubts government cost control will be value-driven, predicting indiscriminate cuts that discourage both transformative and marginal products.
I have little confidence it will be value driven. In other words, I doubt that government will reduce spending on marginal goods and service and incentivize innovation and valuable services. Instead, very likely it will be done haphazardly and indiscriminately resulting in disincentives to make transformative products and marginal products alike.
Prasad warns that cost control will rely on tiers and arbitrary delays, frustrating American consumers' access to new therapies.
Again, because we are unable to differentiate good vs marginal products, cost control will rely on tiered structures, arbitrary delays, etc. This will likely result in further frustration from the American consumer.
Prasad argues overall survival is the only meaningful endpoint in smoldering myeloma trials because early treatment adds toxicity and cost without proven benefit.
With smoldering myeloma, the only endpoint that matters is overall survival. After all, if you treat a pre-cancer with a temporizing regimen, you add toxicity and cost, by definition. Your tumor will still eventually grow, and it will still eventually kill you.
Prasad says trials like Aquila can manufacture an OS benefit by comparing against substandard control-arm care in global trials rather than true US standard of care.
So the only appropriate study would be to randomize to early treatment vs current standard of care, and measure survival. But that would be difficult, and make it hard to increase uptake for your product, so the easy cheat code is to randomize to early treatment vs poor care— if you run your trial globally the control arm will tank— then you can easily show a OS benefit.
Prasad contends Aquila is inconsistent: either use PFS with a lenalidomide control, or use OS against genuine US standard of care.
If PFS is a suitable endpoint for smoldering, the control arm should be Len. If Len isn’t standard of care for smoldering because it never shown an OS benefit (in a clean trial), then OS should be the endpoint of Aquila. But OS should be measured against actual US standard of care, not substandard care.
Prasad remarks that AI will be extremely disruptive for cognitive work, noting he used AI tools to fact-check curves.
AI is going to be so, so disruptive for cognitive work
Oyler says BeOne is the only company with potentially best-in-class drugs across all three key mechanisms in B-cell malignancies, giving it a unique competitive position.
With BRUKINSA, BEQALZI, and tacabrutideg, we are the only company with potentially best-in-class medicines across the three key mechanisms of action in B-cell malignancies. So whether a patient wants continuous or fixed-duration therapy, or requires an option after progression, we will be able to meet the need with the right medicine, alone or in combination. No other company is positioned to do that.
Oyler argues BeOne's solid tumor pipeline is unusually productive, with five late-stage programs advancing toward registration at about the same time.
Most companies have just one exciting asset. Some have two. From just the first wave of our solid tumor pipeline, we have five, all advancing towards registration-enabling development in roughly the same time.
Oyler says the CDK4 inhibitor and B7-H4 ADC went from first-in-human to pivotal in 2.5 years, showing the speed of BeOne's global development model.
Both moved from first in human to pivotal development in just two and a half years, allowing us to rapidly close the gap with the competition. Now we are seeing that pipeline advance into registrational trials, which puts BeOne in an exceptionally select group of oncology innovators.
Oyler says BeOne's four competitive advantages form a compounding loop and the company will keep investing behind it to build the world's leading oncology company.
These advantages create a self-reinforcing feedback loop. Together, they enable us to drive industry-leading R&D returns at scale, turn that innovation into profitable growth, and to fund a growing level of investment in next-generation medicines. Each turn of the cycle strengthens the next.
Ricks argues that AI structure prediction solves only about one-thousandth of the problems in drug discovery, tempering hype around AI-designed drugs.
A machine can “predict things pretty well, like predicting the structure of a protein,” Ricks said according to Fortune, “but that is one maybe 1,000th of the kind of problems we face in drug discovery.”
Ricks says language models are not particularly good at biology and chemistry because they are trained on human language rather than the languages of science, and favors many narrow models.
language models are “not particularly good” at biology and chemistry because “they’re trained on the human language, not on the language of chemistry, physics, and biology.”
Ricks said now is the right time to merge Lilly's U.S. and international commercial units to build on momentum, and named Ilya Yuffa, who has run both, to lead global customer-facing operations.
To build on our momentum, now is the right time to consolidate our geographies for greater impact. Ilya has run both our international and U.S. businesses, and his range of experience and commitment to excellence make him uniquely qualified to lead our customer-facing operations worldwide.
Soriot cautions that biology and disease are too complex, so claims that AI will cure cancer are overstated.
If we remain active in the industry long enough, we quickly learn to be humble. Diseases are complicated, biology is complicated. Claiming that AI will cure cancer may be going a little too far,
Narasimhan recalled that being named Novartis CEO at around age 40 had seemed implausible to him at the time.
It didn’t seem plausible, at the time I was only 40.
Pfizer CEO Albert Bourla said the most-favored-nation drug pricing agreements are signed and will remain in place through the end of the current administration's term.
I think the agreements are signed and are going until the end of the term of this government,
Bourla said Pfizer is pausing big dealmaking for now and will focus on the cancer and obesity drugs it has already acquired.
CEO Albert Bourla said the company is instead focusing on the cancer and obesity drugs it acquired through the ...
Bourla expects a split government after the elections to limit legislative change and does not anticipate any changes to MFN drug pricing agreements.
But I think that in any case, looks like we will have a split government So I do not think that many things can move legislation wise. I do not expect any changes in MFN. I think the agreements are signed and are going until the end. Of the term of this government.
Bourla says the industry has moved from fear over tariffs and MFN in 2025 to a stable policy environment that should last.
it is a very big contrast vis a vis what I was telling you a year ago in 2025, I was really scared. About the implications that either tariffs or MFN could have. I think through the successful navigation, of those issues, we brought the stability that it is now projected to last.
Bourla likens the obesity drug commercial model to the Viagra launch, with out-of-pocket payment and e-commerce driving much larger international markets.
People are willing to pay out of pocket for products that they value irrelevant if they are reimbursed or not. That creates dramatically different size in the international markets. The second was that because of the consumer nature of these launch, the ecommerce and the Internet as it happened with Viagra.
Bourla says AI is changing pharma promotion, especially at the patient level.
And to add another dimension, AI is changing the way that promotions are happening right now. And not only at the physician's level, actually, even more importantly at the patient's level.
Bourla says Pfizer will advance 10 Phase 3 obesity trials in 2026, including a switch study to monthly berobenatide.
We plan to advance 10 active and planned Phase 3 trials in 2026. Including 1 evaluating a switch from approved weekly therapies to our investigational monthly GLP-1 peptide berobenatide.
Bourla says Pfizer has line of sight to a risk-adjusted high single-digit revenue CAGR from 2028 to 2033.
We have line of sight to our aim of delivering a risk adjusted high single digit revenue CAGR from year-end 2028 through year-end 2033.
Bourla argues the Street underestimates Pfizer's launched products such as Nurtec, which is already near $2 billion annualized.
I will mention 2 as just examples that I think people need to reevaluate their assessment. 1, it is regarding Nurtec. That we are already close to $2 billion this.the way if you annualize it. And the street has us almost $2.5 billion by year 2020.
Bourla says the Street's $600M forecast for Elrexfio versus $5B for a competitor is unjustified given similar efficacy and better tolerability.
I will also mention another example of Elrexfio. Where for a competing product, the street is forecasting $5 billion, and for us $600 million. We aspire to present the profile that is very similar in efficacy and better in tolerability and in side effects.
Bourla stresses that mevrometostat gives Pfizer full global rights unlike Xtandi, where it had only half the US market.
Sometimes people forget that Xtandi, which is 1 of our very big and strong product, we basically had half of the Xtandi in the U.S., and that is it. Here, we are going to have the whole US and the whole global international market.
Bourla says Pfizer aims to fully offset patent expirations, expecting a return to growth after 2028 with high single-digit growth through 2033.
I think uh our aim was to cover the whole thing. So post 28 uh we expect to turn into growth the company and to have made uh our projections that from 28 to 33 the 5year uh projections are high singledigit growth.
Bourla says Pfizer invested nearly $80 billion since COVID, about double the next-largest pharma investor, and the acquired products are growing 37%.
We invested almost $80 billion. the second one probably around 40 and uh as you you've said uh the performance of this portfolio is doing extremely well actually the acquire products 80% of them were in uh three companies they are growing uh 37% right now
Bourla calls the obesity market huge and says Pfizer will enter in two years with a highly differentiated portfolio.
I think it's huge. The market is as you know one of the largest markets. This is the market that created the first $1 trillion company which is Lily with exceptional performance on the obesity. We are coming to this market now in two years and uh we are coming with a portfolio but it is highly differentiated very different.
Bourla believes monthly dosing will be strongly preferred, letting Pfizer win new GLP-1 patients and switch maintenance-phase patients from weekly products.
We believe that uh for products that they are monthly there will be a huge preference from people and that will allow us not only to gain good market share of every new patient that is going into the GLP1s but also we can switch patients that they are already on their maintenance phase in the weekly products into our monthly.
Bourla said late-stage pipeline progress and numerous near-term pivotal readouts strengthen Pfizer's chance to extend leadership in key areas.
Our late-stage pipeline progress, with a significant number of pivotal readouts expected near term, is strengthening our opportunity to extend our leadership in key areas.