In this week’s edition of InnovationRx, we look at the medical community’s response to Trump’s Tylenol claims, a startup working to fix drug pricing, Pfizer’s obesity bet and more. To get it in your inbox, subscribe here.
In a press conference on Monday, President Donald Trump claimed that the active ingredient in Tylenol, acetaminophen, can cause autism in children if taken during pregnancy. He also falsely claimed that the current childhood vaccine schedule can also lead to autism. The Department of Health and Human Services said the FDA will accordingly begin the process of changing acetaminophen’s safety label.
Tylenol manufacturer Kenvue said in a statement that “We believe independent, sound science clearly shows that taking acetaminophen does not cause autism.”
Medical groups issued statements with similar sentiments: The American Academy of Pediatricians said the “White House event on autism was filled with dangerous claims and misleading information.” The World Health Organization noted that multiple studies over the past decade have found “no consistent association” between the painkiller and autism. The American College of Obstetricians and Gynecologists also affirmed the drug’s safety and warned that “the conditions people use acetaminophen to treat during pregnancy are far more dangerous than any theoretical risks.”
Despite this pushback, a Forbes investigation found that Trump’s claims are going viral on Tiktok. Analytics firm Zelf found that videos about acetaminophen, vaccines and autism garnered more than 100 million views in the hours after the event. Videos of Trump’s allegations were the most popular, even though the platform’s policies prohibit “health information that could cause significant harm.”
Quatiba Davis, chief clinical officer of autism care provider ABA Centers, said this discussion ignores the most urgent concern for people with autism: access to care. “Autism is a lifelong condition that can be effectively supported with a compassionate and comprehensive therapy plan,” she said, going on to say that “our true focus right now should be on finding ways to eliminate the wait lists and red tape that those seeking an autism diagnosis or services face every day here in the United States.”
This Startup Hit A $3.25 Billion Valuation Building Software To Fix Drug Pricing
Judi Health founders Ryan Kelly (left) and AJ Loiacono
Judi Health
AJ Loiacono knew he truly had something after dogfooding his medical benefits administration software on his own company. Not only did he see year-over-year cost savings of 11% for the 1,800 members of the health plan, including employees and their families, but claims processing time dropped from more than six months to a maximum of 18 days. Better still, he got those cost savings even as he offered improved benefits to his workers.
“We were able to see a reduction per member per month on all costs because we are stripping out these fees and additional fees that are encumbering the plan,” Loiacono told Forbes.
With the test done, Loiacono’s firm, which started in the messy world of pharmacy benefits under the name Capital Rx, is now rolling out medical claims administration to businesses and third-party administrators. To do so, the newly renamed Judi Health has raised $252 million in equity funding led by Wellington Management and General Catalyst. The deal brings total funding to $607 million and values the company at $3.25 billion, more than double the $1.5 billion it was worth at its previous funding in March 2024. Firms that include Goldman Sachs Asset Management and Generation Investment Management, which is chaired by former vice president Al Gore, also invested. The funding was so oversubscribed that eager investors also purchased a more than $150 million stake from the company’s early backers.
Medical benefits and prescription ones go through completely separate channels, despite the fact that this often creates duplication, higher costs and enormous frustration for doctors and patients. The way drugs are priced is a particular morass of rebates, clawbacks, financial wizardry and fees on top of fees. Loiacono had built Capital Rx to develop modular, cloud-based software, called Judi (short for “adjudicate,” which is what it does to claims) that could cut through this swamp with a more transparent, cheaper way of doing things. With employers trying to get control of spiraling drug costs, he built a substantial pharmacy benefit management business with revenue expected to reach $3.7 billion this year, up more than 75% from last year’s $2.1 billion. Its technology handles the administrative work of claims, but the company does not take on the risk of paying for them, a role akin to Fidelity’s recordkeeping business in administering 401(k) plans.
“AJ is somebody who has been trying to tackle this problem for a very long time,” said Jonah Surkes, an investor at Generation. “This is an industry that is complicated, where there are many loud voices and players that have fought dirty to accrue market power and AJ has shown incredible staying power through all of this.”
Read the whole story at Forbes.
BIOTECH AND PHARMA
Pharma giant Pfizer will acquire biotech company Metsera in a deal valued up to $7.3 billion. Metsera is developing multiple drugs against obesity, including one that would compete with Wegovy or Zepbound, but might only need to be injected once a month. It’s also developing oral versions of those drugs. These treatments are currently in clinical trials. Earlier this year, Pfizer discontinued development of its own obesity pill, danuglipron, after it caused a liver injury in a clinical trial.
Plus: The FDA has approved an injectable version of Merck’s blockbuster cancer drug Keytruda, which previously could only be administered by I.V. The company said this will broaden treatment options for doctors and make the medicine more accessible to patients.
DIGITAL HEALTH AND AI
Massachusetts-based Pi Health announced that it is working with pharma giant GSK on a global phase 2 clinical trial for an experimental cancer drug. The startup will use its AI-powered software to identify and recruit patients for the trial, and will also manage site selection, regulatory submissions and other aspects of the process on GSK’s behalf. Forbes profiled Pi Health’s founders earlier this year.
PUBLIC HEALTH AND HOSPITALS
More than 40% of healthcare providers say that over 10% of their insurance claims are denied, according to a new report from Experian. The main reason for these denials, the providers say, is missing or inaccurate data. More than two thirds (68%) of respondents say that it’s more challenging to submit data-free claims than it was a year ago. One major challenge is the fragmented nature of getting patient data: 81% of providers are using two or more different systems to check patients in and collect their information. Another challenge is staffing: 43% of providers said they are understaffed when it comes to claim submissions.
Plus: Health officials say that measles is spreading in Utah and Arizona, primarily impacting unvaccinated children.
WHAT WE’RE READING
Since 2023, RSV vaccines for pregnant moms and antibodies for babies have reduced hospitalizations of infants for the respiratory disease by half.
A ProPublica investigation found that over the past 15 years, more than 90 psychiatric facilities have violated federal law in caring for patients–but have faced few consequences for doing so.
Lilly announced Tuesday that it will be building a $6.5 billion facility in Houston to manufacture its oral GLP-1 drug orforglipron. The company said it’s applying for FDA approval of the pill by the end of the year.
Federal and state budget cuts are threatening programs aimed at training and keeping doctors in rural areas in California.
The Democratic Republic of Congo is facing a particularly deadly Ebola outbreak, with 47 cases and 25 confirmed deaths so far.
A federal district court ruled that the National Institutes of Health must restore unlawfully terminated research grants to scientists in the University of California system.
