周末医疗脉搏：药物预测市场……离反乌托邦更近一步了吗？

Justin Smith+442077625899 justin.smith@bernsteinsg.comCourtney Breen+19173448407 courtney.breen@bernsteinsg.comLee Hambright+19173448429 lee.hambright@bernsteinsg.comDelphine Le Louet+331421392 93 delphine.le-louet@bernsteinsg.comRebecca Liang,Ph.D.+85221232656 rebecca.liang@bernsteinsg.comSusannahLudwig+41582723127 susannah.ludwig@bernsteinsg.comMiki Sogi, Ph.D.+81367776991mikisogi@bernsteinsg.comLanceWilkes+1917344 8501 lance.wilkes@bernsteinsg.comSpecialist Sales Christian Moore+19173448555christian.moore@bernsteinsg.com ResolvedYES foralloptions,vs.market expectation of~25% chance by April 10 evenbeginningtoseecontractsrelatedtoFDA regulatorydecisions.This is hardly surprising given the binary nature of the biotechindustry.But is it good or bad? Setting aside volume and liquidityconstraints,biotechinvestorsmightactuallypreferpredictionmarketcontracts relativeto equity exposuregiven the ability to strip out alltheadditionaldrivers of sharepricemoves (expectation offinancing,positioning intothenext catalyst, etc.).On theotherhand, insidertradingconcernsthathaveweighedonpredictionmarketsasawholearelikelytobeespeciallyacuteforbiopharma contracts.Andexistenceofthesecontractscouldevennegativelyimpactthedrugdevelopmentecosystem.Considera clinicaltrialthat'scurrentlyenrollingandwhosePolymarketcontractpegsPOSat1o%...wouldyou want to enrollin that trial? This HC Pulsetakes a closerlookatthestatusquoforbiopharmapredictionmarketsandassessesthestrengthofargumentsforandagainsttheirexistence.Ourownview is thattheyareunnecessaryandare likelytodomoreharmthan good.Forthose interested in learning more aboutthe broaderpredictionmarketlandscape,wehighlyrecommendthispiecebyourcolleagueGautamChhugani:TheLongView:PredictionMarkets-$1Tnmarketby2030 When willthe FDA approve Orforglipron? WHATKALSHIANDPOLYMARKETCURRENTLYOFFER There are numerous contracts related to FDA regulatorymilestones as well as broader HHS policy (e.g,vaccine rec). Inalmostall cases,the contractsrelatedtoregulatorymilestones arefor drugs that have already had a readout; they are not proxies fortrialoutcomes. Source: Kalshi for?"Resolved No across theboard.Whichvaccineswill RFK endrecommendations ·"When will theFDAapprove orforglipron?" ResolvedYESfor all options,vs.marketexpectationof~25%chancebyApril10"When will Intellia Therapeutics submit a BLAfor Lonvo-z?" Onlyexamplewefoundofaregulatorymilestoneforatrial thathasnot read out yet, effectively allowing users to short the trial.."Whichvaccineswill RFKend recommendationsfor?"ResolvedNOacrosstheboard."Retatrutideapproval thisyear?"Active,higher-volumemarket."FDArevokes polio vaccine in Trump's first 100 days?"ResolvedNO.“FDAapprovesa psychadelicformedicinalusein2026?" outcome of clinical trials.We believe this ismore likely due toperceived resolution challenges as opposed to lack of interest.Trialoutcomes are nuanced; a trial can meet its primary endpointbutwith weak effectsizeandthe sponsor's stock will sell off.Butthesame is true of regulatorydecisions:the approve/reject decisionis binary,but disappointments in the label can cloud an otherwisefavorable outcome.For contracts tiedto somethingveryblackandwhite (does the study achieve stat-sig on its primary endpoint), weseeno reason these would present greaterresolution challengesthan an FDA approval decision. volume market.小口 Volumes today arequite low relative to prediction marketsas a whole and relativetotrading volume in therapeuticsnames.Thelargest contractwefoundwas the one on RFK vaccinerecommendations,and it was only $1.4M.Given thelow volume,we would expectmanyofthesemarketsto be inefficient, butwithlimited opportunityto makemuchmoney in absolute $ terms. EXHIBIT 2:“When will Intellia Therapeutics submit a BLAforLonvo-z?"This example is interesting because thetrial hasnot read out yet, effectively allowing users to short the trial. Source: Polymarket against one anotherin a mockprediction market to seewhosetrial forecasts are most accurateMichael @endpointarena·1dX market will resolve to *No*IfFDA approval is withdrawn or suspended for any specific populotion group (e.g, infonts, toddlers, children) t wilcount toward α "Yes" resolution... BIOPHARMA weakPurerinformationsignalthan equityprices.Biotechstock 2026?" prices embed non-trial information:cash runway,portfoliodiversification,sectorrotation,shortinterest,andmacro.Whileanalysts can geta rough idea of whatthe share price implies aboutbuyside POS, it's admittedly an imperfect science. A dedicatedevent contract tied to a trial outcome-or aregulatoryfilingmilestone as a proxy -strips out much of this noise and couldsupport improveddecisionmakingbymarketparticipants andevenbybiotechcompaniesthemselves.Forexample,asponsormaydecideto expand enrollmentto increase studypower inresponsetoa prediction marketcontractthatimplies low POS.Bernstein:Wethink the informational value is quite low, particularly when it comesto industry decision-making (Exhibit 8). Counterbalancetosell-sideopti