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Tamron 12-20mm f/2.8 Review: A Whole New Direction
Tamron bring a fresh new look to its professional lenses. They may have brought fierce competition as well.
Sanofi suspends chronic lung disease phase 2 study, tied to ‘strategic business reasons’
Sanofi halted a phase 2 trial testing a monoclonal antibody, SAR445399, in non-cystic fibrosis bronchiectasis, Fierce Biotech has learned. The trial, which began only back in April, was a randomized, double-blind, placebo-controlled study to measure the reduction in mucus plug score following treatment with SAR445399 compared with placebo in adults aged 18 to 80 years with NCFB, a chronic lung disease. The trial was officially reported as halted on July 29, the day before Sanofi’s second-quarter earnings call. The decision to pause the trial was made “as part of a company-wide portfolio review for strategic business reasons,” and not due to safety concerns, a Sanofi spokesperson told Fierce. The move to pause the NCFB trial comes during a trying time for Sanofi following a year filled with a series of trial fails. In February, the French pharma ousted CEO Paul Hudson and appointed Merck KGaA leader Belén Garijo, M.D., Ph.D., to steer the ship. Since then, Garijo has been doing a deep dive on correcting the company’s strewn R&D and clinical strategies. On July 24, Sanofi scrapped amlitelimab for atopic dermatitis, despite its lore as being a potential $5 billion blockbuster. During its second-quarter report, the company abandoned two more assets, balinatunfib and itepekimab, following failed trial results in psoriasis and chronic obstructive pulmonary disease, respectively. SAR445399, only first revealed by Sanofi in 2023, is an anti-interleukin-1 receptor 3 monoclonal antibody developed to block the interleukin 1, 33, and 36 cytokine pathways. These pathways can be important in chronic immune-related dermatologic diseases, such as atopic dermatitis and hidradenitis suppurativa, as well as respiratory conditions, such as NCFB. Related Sanofi’s new CEO ‘looking deeply’ at late-stage pipeline as clinical clearout continues NCFB affects roughly half a million people in the U.S., with a global incidence of greater than one million cases. In August 2025, Insmed received FDA approval for Brinsupri, a DPP1 inhibitor targeting neutrophil activation, for treatment of NCFB in adults and kids ages 12 and older. The British biotech Infex Therapeutics showed promising NCFB phase 2a data using their monoclonal antibody, INFEX702, which acts by disabling Pseudomonas aeruginosa, a bacteria known to be a major pathogen of NCFB. Sanofi is currently running a separate phase 2 study testing SAR445399 as a potential treatment for the inflammatory skin condition hidradenitis suppurativa.
Wellstar Health System lays off 761 corporate, administrative staff
Wellstar Health System laid off 761 workers yesterday “following a comprehensive review of our organization,” the Georgia nonprofit confirmed to Fierce Healthcare. | The cuts translate to about 2% of the nonprofit system's headcount, and do not include frontline care roles.
Andrew Garfield got ‘so scared’ playing basketball with Woody Harrelson: ‘He’s fiercely competitive’
The erstwhile Spider-Man actor “fully froze and folded” going up against the “White Men Can’t Jump” star.
FIFA scraps highly-criticized proposal to sell minority stake
When FIFA announced a proposal to sell a minority stake of its organization, it was met with fierce criticism from CONCACAF and UEFA.
Takeaways from Michigan Senate debate between Abdul El-Sayed, Mike Rogers
Even mothers were not exempt in a fierce debate in the race for a critical U.S. Senate seat.
An Israeli documentary on the war in Gaza sets off a firestorm at home after Venice award
An Israeli documentary about the civilian death toll from the war in Gaza has sparked a fierce backlash in Israel after being awarded the special jury prize at the Venice International Film Festival.
Berkeley’s Nabolom Bakery blames political backlash for closure
Nabolom’s owners say an Instagram removal and backlash over its political positions hurt sales, but they also point to rising costs, staffing problems and fierce competition.
Independent Kansas health systems launch shared services organization
Five Kansas health systems have launched a regional collaboration, called Astra Health, to pool resources and coordinate services while retaining their independence. | Astra Health's five founding members, who serve more than half a million patients annually, hope to improve quality and trim costs at scale while maintaining their independence.
Pentagon plan to livestream execution of Fort Hood shooter prompts fierce political backlash
The move has been branded as ‘disturbing’ and compared to the actions of terror groups by US lawmakers
Michigan, Missouri primaries will again lay bare the Democratic divide over Israel
Fiercely fought primaries on August 4 in Michigan and Missouri will provide the next crucial tests in the debate over American policy toward Israel that has convulsed the Democratic Party this year.
Team’s Up – Derek McInnes names Rangers XI to face Celtic
Rangers manager Derek McInnes has named his team for this afternoon’s Premier Sports Cup clash against Celtic. The Scottish Champions arrive at the home of their fierce rivals as both teams look to ...
Pioneer of China NewCo model sued in US over trade secret misuse, double-dealing
A legal feud unfolding in New York is putting a spotlight on the work of a business development veteran who is credited for pioneering one of biopharma’s hottest dealmaking mechanism: the China “NewCo” model. In a lawsuit originally filed in New York state court and recently moved to federal court, China’s Lepu Medical Technology has alleged that biopharma business development consultant Su Zhang, who was hired to help shop its GLP-1 weight-loss candidates to Western partners, engaged in corporate double-dealing and trade secret leaks. According to the complaint, while acting as Lepu’s primary dealmaking liaison for a group of obesity and metabolic disease drug candidates, Zhang was secretly double-dipping as the acting chief business officer for a direct competitor, BrightGene Pharmaceutical. “She never adequately disclosed the role, never sought Lepu’s consent, and never proposed any safeguard,” Lepu alleged in its complaint, which was filed in July after Zhang’s consulting firm, CoDevCo, sought certain transaction-based success fees from its angry customer through an arbitration process in Singapore. Lepu, the parent company of Lepu Biopharma, has asked Zhang to pay back its $500,000 retainer and disgorge all benefits she received during the alleged breaches of fiduciary duty, plus other damages and relief. The company has also requested the court grant injunctions to protect Lepu’s trade secrets. The ill-fated partnership officially kicked off in December 2024, when Lepu tapped CoDevCo as its “exclusive business development mechanism” to identify collaborators for the company’s drug candidates. According to Lepu’s complaint, Zhang personally negotiated and signed the agreement as managing director for CoDevCo, which used her home address. Before the Lepu deal, Zhang made a name following a short stint as the global head of business development for Hengrui Pharmaceuticals. It was during her tenure that Hengrui signed a landmark deal granting exclusive rights for a portfolio of GLP-1 assets to Hercules, which was at that time newly established by a group of private equity and venture capital firms. In addition to the regular upfront and milestone payments, Hengrui also gained an equity stake in Hercules, which later became Kailera Therapeutics. The Hengrui-Hercules deal opened a new paradigm, where a Chinese biopharma company spins off certain early-stage assets to investors for further development through the creation of a new company abroad. The “NewCo” model quickly came into vogue as it allows Western investors to access high-potential assets originating from China at an early stage while giving the Chinese licensors an opportunity to reap long-term benefits through equity stakes in the new firms. The NewCo model proved its value when Kailera staged a record-breaking $625 million IPO on Nasdaq this April, merely two years into the Hengrui deal. Related Kailera CEO 'knew we were in a good spot' before obesity biotech's record-breaking $625M IPO On her LinkedIn page, Zhang described her work at Hengrui as “[b]uilding team and capability from the ground up,” forming NewCo and major pharma partnerships worth billions of dollars. Lepu clearly wanted that kind of track record to help boost its own cardiometabolic portfolio, which includes a range of assets for obesity, Type 2 diabetes, fatty liver disease and muscle preservation during weight loss treatment. “Lepu’s pipeline is very valuable, but only if Lepu could secure the right international partner to expand into the overseas market during the available commercial window,” the company argued in its complaint. The Chinese biotech said it had little knowledge of U.S. laws, customs or business practices in the business development field, and therefore “needed to rely entirely” on the expertise of Zhang and her team as the firm’s first engagement of a U.S.-based BD consultant. “Zhang’s dominating influence on the business development strategy is further evidenced by the fact that she personally controlled the business-development communications on behalf of Lepu with potential partners,” Lepu said in its complaint. After entering the deal, Zhang introduced Lepu to her four associates. According to Lepu’s version of events, all of them were allegedly employed at different time points to perform similar jobs at other Chinese companies that Lepu described as its competitors, while having access to Lepu’s confidential information. As such, Lepu described Zhang’s team as “a roster of individuals whose primary professional loyalty, by virtue of their concurrent full-time employment, ran to Lepu’s competitors.” As well as the specific examples set out in the case, a look at Lepu’s deals over the period suggests Zhang may have been involved in at least one transaction. During their partnership, Lepu, through its subsidiary Shanghai Minwei Biotechnology, also out-licensed its GLP-1/GIP/FGF21 agonist MWN105 to a NewCo called Sidera Bio in the fall of 2025. The deal included an upfront and near-term payment of $35 million, up to $1.01 billion in milestones, and a 9.99% stake in the Danish startup. It seems likely that Zhang facilitated the Minwei deal given that Lepu is on record as having used CoDevCo as its “exclusive business development mechanism.” The big shock for Lepu came in the form of a news article on June 25, 2025. The article, reporting on phase 2 data for BrightGene’s GLP-1/GIP receptor agonist BGM0504, identified Zhang as acting chief business officer of the Lepu rival. Blindsided by her association with BrightGene, Lepu confronted Zhang in July 2025. “Lepu was given assurances that there was nothing to be concerned about and told that Zhang would explain the matter to Lepu,” Lepu alleged in its complaint. “Zhang never did.” Lepu claimed that Zhang had the motive and opportunity to steer potential prospective partners toward BrightGene or other competitors. Later, in February 2026, one of Zhang’s associates joined BrightGene as the vice president for global business development, according to the complaint. Around the same time, Lepu sent written demand letters asking Zhang to account for her BrightGene role, identify what confidential data were shared with the rival firm, and provide any conflict-of-interest or firewall policies during the engagement. According to Lepu, neither CoDevCo nor Zhang answered the questions in their responses. Related Novo vs. KBP: How a $1.3B deal turned into a fraud accusation and an international legal fight In a motion to dismiss filed with the U.S. District Court in the Eastern District of New York on Sept. 4, Zhang’s legal team argued that Lepu’s agreement was signed with CoDevCo, and that an employee of the contractor does not owe fiduciary duties to the client. In its complaint, Lepu said: “That CoDevCo was the contracting entity does not insulate Zhang from personal liability for duties she personally undertook and personally breached.” Taking the argument one step further, the defending party argued that the consulting agreement “does not create a fiduciary relationship even between CoDevCo and Lepu; instead, it identifies CoDevCo as an independent contractor retained to market Lepu’s business to potential western partners.” Although CoDevCo was Lepu’s exclusive business-development contractor, there were no terms stipulating that the consulting firm should serve only Lepu, Zhang’s lawyer noted. As to Lepu’s claims that Zhang misappropriated trade secrets, the defendant argued that Lepu authorized the use of the information so Zhang’s team could perform their service per the agreement. In a rebuttal filed on Sept. 11, Lepu’s lawyer set out why they believe the Chinese biotech satisfied New York law’s misappropriation definition by alleging that the defendant used a trade secret “in breach of a duty or through improper means.” As an alternative to dismissing the suit, the defendant suggested the action should be stayed pending outcomes from the arbitration of a separate case in Singapore. While NewCo pioneer Zhang is defending her business arrangements, momentum behind the NewCo trend has continued unabated into 2026. Through August, Chinese biotech assets have spurred 15 NewCo deals this year, according to local trade publication PharmaDJ.
Germany pushes through healthcare reform package despite pharma's drug discount resistance
Even as the effort has met with fierce pushback from drugmakers, trade groups and opposition parties in the country’s own government, German lawmakers late Friday voted to pass health insurance ref | Even as the effort has met with fierce pushback, German lawmakers late Friday voted to pass health insurance reforms aiming to cut healthcare costs, in part by hiking up mandatory rebates that pharmas must pay on branded medicines.
Ryan Murphy has had ‘arguments’ with Sarah Paulson over her hatred of ‘AHS: Roanoke’
Ryan Murphy is fiercely defending ‘American Horror Story: Roanoke’ after series star Sarah Paulson admitted that she ‘doesn’t give a s---‘ about that season.
Increases in healthcare spending the largest driver behind premium growth: Yale study
As insurance premiums continue to rise, a new study finds that escalating healthcare spending is the leading factor behind the trend. | As insurance premiums continue to rise, a new study finds that escalating healthcare spending is the leading factor behind the trend.
NJ Business, Labor Groups Maintain Fierce Opposition to Climate Superfund Act
In separate op-eds posted in the recent days, both New Jersey business and labor groups said they remain staunchly opposed to the Climate Superfund/ Polluters Pay Act and offered dire warnings of their impact on affordability, jobs and the state’s business climate. In an op-ed published by the USA TODAY/Gannett NJ Network, NJBIA Deputy Chief Government Affairs Officer Ray Cantor said many New Jersey[...]
AI as the next political divide
We have a guest post today from our friends at Focaldata, with whom we have done polling before. They have been doing a lot of work on attitudes towards AI and how this is affecting politics on both sides of the Atlantic. In this post, they explore exclusive new polling – with a whole set of fascinating charts on how voters’ views are developing and why. In particular, the authors explore why the debate is currently so much more polarised by party in the US than in the UK, to the benefit of the Democrats. Subscribe Focaldata HQ is located in Shoreditch, east London. To access the office from the Shoreditch High Street Overground station, you have to walk under the bridge at Braithwaite Street. We mention this not as a navigational aid, but because the posters above caught our eye over the summer. Since June, the area has been the centre of a fiercely contested debate around the construction of a data centre on the Truman Brewery estate on Brick Lane, less than 200 metres from our office. It was one of the first ‘US-style’ protest movements around AI data centres the country has seen, and may not be the last. These protests served as the catalyst for our forthcoming report, examining whether AI could become the next political divide on both sides of the Atlantic. We wanted to understand what was driving the emerging politics of AI and whether the dynamics at play in the US offer clues as to how the British debate will evolve. Over the last month, we polled 3,851 people across the UK and US about their views on AI. Our research found striking similarities between the two countries: for instance, both electorates are evenly split on their views towards AI development, with just over a third in favour (37% in each country), a similar number opposed, and the remainder somewhere in the middle or unsure. Statistically speaking, there is no difference in overall sentiment towards AI between the UK and US. Under the hood, demographic patterns also look largely the same in the two countries, with millennials, degree holders, full-time workers and those who describe themselves as financially comfortable more pro-AI than the rest of the country. Despite this convergence in overall attitudes, there is a striking divergence in how much of a politicised issue AI has become. In the US, attitudes are increasingly split by political affiliation and the issue has become the latest front in the seemingly interminable culture war, playing a role in the upcoming midterms. This stark political polarisation of AI has not happened in the UK – at least not yet. In what follows, we test several hypotheses for why the two countries are so far apart on a political basis. Understanding which hypothesis is correct will give us an indication of where the British dynamics go next.
Andy Biggs wins Republican nomination to challenge Democrat for Arizona governor
Biggs is a fierce ally of President Donald Trump and former head of the House Freedom Caucus
Orlando Magic's Surrounding Cast Around Paolo Banchero Key to Improvement
Jalen Suggs anchors a fierce defense while Anthony Black faces a critical prove-it season, determining if Orlando’s supporting cast can transform potential into a deep playoff run.
Boston Scientific hit by cyberattack causing ‘disruptions’ to parts of its business
This year has seen a growing number of medtechs hit by cyberattacks, and now Boston Scientific has become the latest victim. In an SEC filing posted Aug. 26, the medtech giant said it had detected a “cybersecurity incident” the day before. The incident has affected certain parts of its information technology systems, something that “has resulted in a global disruption to the company’s operations.” The incident has hit not just its information systems but also its business applications, which “support aspects of the Company’s operations,” it said in the filing. This includes its ability to process and ship customer orders. Boston Scientific said it is working to restore the systems, but the timeline remains unknown. Related Baylor Genetics hit by cybersecurity attack targeting patient, staff information As the company investigates the incident, it remains unclear how significantly its business will be affected. “Accordingly, the Company has not yet determined whether the incident is reasonably likely to have a material impact.” The company’s shares were down 3.5% in premarket trading as the news broke. This adds another layer of pressure for the medtech, which last month revealed a new global restructuring program that starts this year and is slated to be completed by 2029. The company said at the time that it “does expect some headcount reductions to result from these restructuring activities,” but did not provide any numbers or specify areas where the cuts may be made. It added, however, that new jobs are also set to be “created in areas of growth.” It was also forced to cut its sales guidance in Q2, saying in late July that it now expects full-year 2026 organic revenue growth of 5% to 6%, down from its previous guidance of 6.5% to 8%. Boston Scientific is one of a growing number of life sciences companies, notably medtechs, that have been hit by cyberattacks this year. These include Abbott, iRhythm, Medtronic and Stryker, as well as Big Pharmas Amgen and Novo Nordisk.
Boost to business makes Oxford, MS the real winner in football matchup
OXFORD, Miss. — Things are really heating up as the fierce rivalry between the University of Mississippi Rebels and the LSU Tigers is set to kick off Saturday night. The matchup is expected to brin…
Portland Trail Blazers' Season Opens With a Gauntlet
The Blazers will be on the road for a majority of the first two months of the season, and the competition is fierce.
The Trailblazing Business Savvy That Built Dolly Inc. Into an Empire
Dolly Parton was fiercely protective of her songwriting catalog when even the Beatles and the Rolling Stones failed to maintain control. That conviction became the powering force as she expanded beyond music.
Pfizer makes ‘business decision’ to end phase 2 trial of autoimmune drug as program’s future uncertain
Pfizer has called time on a phase 2 trial of its CXCR5 antibody in an autoimmune blood disorder, with the company tight-lipped on whether this marks the end of the road for the asset. The Big Pharma had been evaluating the therapy, dubbed PF-06835375, in a phase 2 study of 61 patients with primary immune thrombocytopenia (ITP) that kicked off in 2022, according to the federal trials register. However, Pfizer confirmed to Fierce on Monday that this study had been terminated “due to a business decision.” “The decision to terminate the trial was not based on any safety concerns,” a spokesperson pointed out. At time of publication, PF-06835375 remained listed on Pfizer’s website for both ITP and lupus. A phase 1 study in lupus wrapped up in 2022, according to the trials database. ITP is an autoimmune disorder characterized by a low platelet count. Novartis was at one point evaluating its B-cell-depleting antibody ianalumab—recently approved as Fabhalta to treat immunoglobulin A nephropathy—as a potential treatment ITP. But the therapy struggled to demonstrate a benefit in the clinic for this indication. When contacted by Fierce, Pfizer wouldn’t confirm whether all work on PF-06835375 has been halted, and whether the company has any other plans to explore C-X-C chemokine receptor type 5 (CXCR5) as a mechanism. CXCR5 is found in blood cancers such as diffuse large B-cell lymphoma and mantle cell lymphoma chemokine receptor. However, there is little expression in normal tissue, which has led some drug developers to explore its potential. Vincerx Pharma had at one point been planning to take an anti-CXCR5 ADC into the clinic to treat B-cell malignancies, but that ambition was scrapped due to cash constraints. Where Big Pharma is placing its bets is one of the hot topics being discussed at Fierce Biotech's high-impact event in London next month. Find out more information and register by clicking on the banner below: [ ](https://qtxasset.com/quartz/qcloud5/media/image/where_big_pharma_is_placing_its_bets.png?VersionId=B8JrRbJ.pFUSK1pJgjeWHLGm_18RdLAy)
America owes black women 'everything,' Rep. Jasmine Crockett rants over July 4 weekend
Rep. Jasmine Crockett told the Essence Festival that America owes Black women "everything," sparking fierce online backlash over the Fourth of July holiday weekend.
Maxx Crosby reveals what stands out when tackling Patrick Mahomes
Image Press Agency/Depositphotos Crosby shares a surprising detail about Mahomes’ reaction Maxx Crosby and Patrick Mahomes may be fierce rivals on the field, but their latest encounter has revealed a funny detail about their battles. The Las Vegas Raiders defensive end shared what he notices when he gets close enough to hit the Kansas City…
Clinton’s eyebrow-raising socialism take sparks brutal mockery: ‘Definition of insanity’
Hillary Clinton called the Democratic Party's embrace of socialism a "healthy" experiment to reach young voters, sparking fierce backlash on X.
Enzo Maresca defends Man City’s wild Anfield celebrations
Enzo Maresca and Manchester City players have fiercely defended their wild celebrations at Anfield as they prepare for the first match at the Etihad Stadium since the Premier League cheating scandal.
Colorado can help lead data center construction
Across Colorado, proposals for new data centers are running into fierce opposition. Residents are worried about noise, water use, health risks and high electricity costs. Six municipalities, including Denver, have imposed bans, caps or moratoriums while they figure out how these massive facilities could affect their communities. Local officials cannot ignore voters’ concerns. But the […]
Politics chat: Lindsey Graham dies at 71, Congress back in session, U.S. strikes Iran
South Carolina Senator Lindsey Graham's sudden death at 71 has shocked Washington. Once a fierce critic of then-candidate Donald Trump, he became one of the president's most consistent defenders.
From dockers to hooligans: the Millwall-West Ham rivalry returns
A fresh chapter in one of English football's fiercest rivalries begins this weekend when Millwall and West Ham United meet for the first time in 14 years.The Hammers' relegation from the Premier Leagu...
India's 2036 Games bid fuels sporting superpower dreams but hurdles, heavyweight rivals remain
India's bid for the 2036 Olympics sits at the heart of a wider effort to transform the country into a sporting superpower and the Indian Olympic Association is convinced it can come out on top in a fiercely competitive process, its chief executive officer Raghuram Iyer told Reuters on Wednesday.
Caring for my 88-year-old mom means being her tech support
My fiercely independent mom managed mostly on her own into her 80s. Now two-factor authentication has taken away her autonomy.
From staunch critic to fierce ally: Graham's long, strange and consequential friendship with Trump
After the Capitol riot on Jan. 6, 2021, Sen. Lindsey Graham said he had finally had enough of the man who was championed by the mob that stormed the pillar of American democracy: President Donald Trump.
China’s thorium-229 nuclear clock beats Vienna’s on stability, studies show
Chinese and European teams in ‘fierce but friendly’ competition to develop the next-generation timepieces.
AZ's R&D chief Barr touts internal 'science success story' after IL-33 antibody's stellar showing in COPD
With a detailed data drop that AstraZeneca’s R&D chief described as an internal “science success story,” the British Big Pharma has secured an FDA priority review for what it believes could become a flagship biologic in chronic obstructive pulmonary disease (COPD). In detailed results from the late-stage Oberon and Titania trials—first teased in March and detailed in full at the European Respiratory Society Congress in Barcelona this week—the drugmaker laid out the extent of its IL-33 inhibitor’s potential to reduce moderate and severe exacerbations in a wide range of COPD patients still struggling with those “lung attacks,” as AstraZeneca’s Sharon Barr, Ph.D., called them, despite using standard-care inhaled therapy. In the headline results, a 300 mg dose of tozorakimab given once every four weeks curbed those moderate and severe exacerbations in the studies’ primary population of former smokers by 29% in the Oberon study and 34% in Titania. In the overall population of both current and former smokers, these reductions were 30% and 29%, respectively, versus placebo and inhaled standard of care. The benefits also extended to clinically meaningful exacerbation reductions in all prespecified patient subgroups and specifically turned up promising signals in patients across a range of blood eosinophil counts, with Barr telling Fierce that “it’s the details that make this even more exciting than the high-level results that we’ve already shared.” In fact, during AZ’s tozorakimab poster presentation at the ERS 2026 Congress this past weekend, attendees were so enamored by the data that event organizers had to encourage people to clear the room and look at the other presentations on offer, Barr said in an interview. “I think it really speaks to the fact that there is a lot of buzz around these data because the entire respiratory community has been so desperate for new therapies for these patients,” she explained. The respiratory disease continues to represent a “staggering unmet medical need,” Barr said, highlighting the COPD exacerbations that the Oberon and Titania studies homed in on, which she added carry a greater mortality risk than a heart attack. “When a patient has a severe exacerbation, only about half of them are still alive within three and a half years,” she pointed out. As for tozorakimab specifically, Barr christened the molecule “an AstraZeneca science success story,” harkening several years back to the point at which researchers began to explore IL-33 as a driver of respiratory disease, and COPD in particular. At the same time, “there was still so much that wasn’t understood,” she admitted, highlighting the insight that IL-33 signals through both ST2 and EGFR through the RAGE pathway, a discovery Barr attributed to AstraZeneca's own scientists. Understanding the need to tackle both pathways in COPD—and aware of competitor candidates in the hopper, including one that bound ST2—the company ultimately had to make some “courageous decisions,” Barr said. These included taking a prior COPD molecule offline and going back to the drawing board to reinvent its potential IL-33 label “to make sure that we had a molecule that could block signaling through both arms of the pathway, through both the reduced form and the oxidized form, knowing that we wouldn’t be first, but striving to be best.” “When we put [tozorakimab] into the clinic, we firmly believed that we had a differentiated molecule, and we saw the other molecules blocking just ST2 or partially blocking IL-33, unable to deliver two positive pivotal studies in COPD,” Barr explained. “We kept marching forward because we believed our molecule was differentiated, and now I think we have the clinical validation that supports that.” Ultimately, AstraZeneca finds itself on much better footing these days when it comes to potential biologic rivals to tozorakimab in COPD. Sanofi and Regeneron’s Dupixent, for instance, is approved to treat COPD exacerbations in patients with high eosinophil counts, but not low ones. Meanwhile, the future has become cloudier for other next-gen IL-33 candidates from Sanofi and Regeneron, as well as Roche, which have suffered trial flops in recent years. One other potential ingredient for AstraZeneca’s success in its duo of studies was that the company was “ambitious in the trial design, willing to look at an all-comers population,” Barr said, “and willing to enroll the most severe patients.” Prior studies for would-be biologics rivals in COPD “avoided enrolling” those patients, she pointed out. She also highlighted the Big Pharma’s painstaking design of exacerbations in its trial, which “gave us a very rigorous readout,” and pointed to “the extra effort and investment” the company put in to understand the effect of mucus plugs in patients. Barr described mucus production as a “key feature in disease diversity,” noting that mucus plugs—obstructing clumps of mucus that block patients’ airways—are associated with worse outcomes in COPD. In its data announcement, AstraZeneca noted that an integrated analysis of Oberon and Titania found tozorakimab “demonstrated a reduction in patients’ mucus plug score,” with the pharma claiming its biologic is the first to deliver such results in a broad COPD population. “So being able to reduce those mucus plugs, we expect, is an important part of driving benefit for patients who are living with COPD,” Barr said. Again touching on the breadth of the study populations, Barr added that tozorakimab “worked across all eosinophil levels in both current and former smokers across all levels of lung function,” which she suggested “really simplifies decision-making for clinicians, and it allows them to offer therapy to the broadest possible patient population.” In the highest patient eosinophil count group, tozorakimab helped chart a 43% reduction in exacerbation risk, which Barr stressed were “unprecedented data.” In the mid-level group, AZ’s drug delivered a 23% reduction and, in the lowest group, a 34% reduction in eosinophils, which Barr said suggests efficacy “in all patient subgroups.” As for AZ’s recent guidance upgrade on the medicine’s sales opportunity, the lift from a $3 billion to $5 billion range to $5 billion plus was informed by multiple factors, Barr said, including the fact that “in 2024, there were multiple competitors, and there aren’t anymore.” Additionally, “we know that this is a massive unmet medical need, and this is a really incredible set of data that we think will be very convincing to the clinical community,” Barr said. Looking ahead to a potential evolution of the COPD treatment landscape, Barr noted that most patients start treatment in the community with an option like a triple therapy, and for them, having an option like AstraZeneca’s inhaler Breztri will remain a “really important part” of that journey. But of the patients uncontrolled on triple therapy, which Barr described as “about half of them today,” just a “small fraction” are currently eligible for biologic therapy, which she emphasized AstraZeneca is working to change. Understanding that COPD is not a “one-size-fits-all” disease, AstraZeneca is also looking at its antibody drug Tezspire for patients with T2-driven disease, and the company continues to think about new mechanisms for tackling COPD through both systemic and inhaled drugs, Barr said.
HHS awards nearly $250M in addiction treatment, overdose prevention grants
The U.S. | Projects supported include those to strengthen mental health support in schools, expand trauma treatment for families and children and more.
Fierce Healthcare Regulatory Recap: HHS presses medical groups on gender-affirming care for minors; CMS distributes RHTP funding to 5 states
Stay up to date on the latest across Washington, D.C. with this weekly brief. Read below for news from Oct. 12 to Oct. 16. | The latest news from CMS and HHS this week: HHS demands info on ‘sex-rejecting procedures’ for minors, CMS releases more RHTP funds and more.
8 fierce animals show just how metal nature is
‘Nature is Metal: It’s A Life-Eats-Life World’ shows Earth’s flora and fauna in all of their hungry glory.
Hackensack Meridian Health signs definitive agreement to acquire Hunterdon Health, commits $230M
Hackensack Meridian Health has signed a definitive agreement to pick up Central New Jersey’s Hunterdon Health, a $230 million deal that would grow the state’s largest health system to 19 total hosp | The announcement did not outline a potential timeline for the merger, which would add a nineteenth hospital to New Jersey's largest health system.
Measles outbreak hangs heavy over Trump administration health nominees' Senate HELP appearance
Three key Trump administration leadership nominees
MultiCare Health System to launch new health plan
Tacoma, Wash.-based MultiCare Health System is set to launch its own health plan next year, the organization
Olympiacos Eyeing OFI Goalkeeper as Panathinaikos Complicates Move
Olympiacos face a strategic battle for OFI Crete's Nikolaos Christogeorgos, as a complex resale clause grants fierce rivals Panathinaikos the power to hijack the deal.
Trump to Nominate Heidi Overton, a Top Domestic Policy Aide, for F.D.A. Commissioner
Dr. Overton is a fierce opponent of abortion rights and a supporter of Health Secretary Robert F. Kennedy Jr.’s Make America Healthy Again agenda.
Seminoles MBB Schedule Highlighted By SEC Showdowns
Coach Leonard Hamilton’s squad navigates a grueling non-conference slate featuring a fierce rivalry renewal with Florida and high-stakes road tests against powerhouse Tennessee and Houston programs.
Where to watch El Clásico de México live?
The time has come to support Guadalajara, Chivahermanos! This Saturday, El Rebaño will visit its fiercest rival in another edition of El Clásico de México, where it will look to make the most of it...
Feminist icon Gloria Steinem dies at 92
Steinem was a celebrated author and activist who became one of the most visible symbols and potent voices of the U.S. women’s movement and a fierce advocate for feminist causes throughout her life.
Judge rejects NC State Health Plan's request to block Atrium affordability program
Atrium Health scored an early courtroom win on Tuesday when a judge rejected the state of North Carolina’s request for a temporary restraining order on an affordability program the health system pl | The state's treasurer has said the large health system's Affordability Protection Program, a response to being left out of a preferred provider program, would bankrupt the public health plan.
Luma locks down 15-year, $410M fund for life science investments
Luma Group today announced the final close of its inaugural life sciences venture capital fund, totaling $410 million. The New York-based investment firm has had a grip on life sciences since its founding in 2023. The funds unveiled today, dubbed LumaBio Fund I, include investments that have already been made into more than 10 biotechs. They include the likes of eye disease-focused Character Biosciences, rebranded Belgian biotech Coultreon Biopharma and cellular rejuvenation company Altos Labs. The fund saw early success when one of the companies it co-founded, called Vaccine Company, was picked up by Eli Lilly earlier this year for up to $1.55 billion. The acquisition of the in vivo nanoparticle technology-focused biotech formed part of a trio of vaccine buys for the Big Pharma, which has itself been on a prolonged spending spree in 2026. Luma's fund is structured as a 15-year investment with plans to support groundbreaking science and support companies through key milestones from discovery to commercialization, Luma explained in the release. "We founded Luma Group on the belief that extraordinary science, supported by patient, long-term capital, has the power to improve millions of lives," Joshua Fink, founder and managing member of Luma Group, said in the release. "This fund represents more than capital—it is a commitment to partnering with extraordinary innovators as they translate visionary science into life-changing medicines."
Friday, July 24th: Fit4Life Health Clubs, Capital Financial Advisory Group, Entertainment with Erica
From fitness wins to financial advice, we’ve got it all on your fierce Friday show.
Rivalries renewed: The derby clashes back this season
West Ham visit Millwall and Wolves host West Bromwich Albion in the first derby weekend of the Championship season as fierce rivalries are renewed in 2026-27.
Bengals’ Dominant Defense Disappears in Loss to Steelers
Aaron Rodgers dismantled Cincinnati’s elite unit as injuries to key starters left the secondary vulnerable, stalling a fierce pass rush and forcing a late Joe Burrow turnover.
Mutant Sperm Are Waging a Fierce Survival-of-the-Fittest Battle Inside Men's Testicles
Darwin would be so proud.
ICE confusion ignites MAGA backlash: ‘I would have called for impeachment’
Verbal guidance telling some ICE offices to stop arresting illegal immigrants without criminal histories was rescinded within hours amid fierce backlash.
Downtown Bend Business Association leader resigns
Rachel O’Rourke, the leader of a prominent downtown Bend business group, announced plans this month to step away from her role amid a period of major upheaval for the organization. Days before the resignation went public, the Downtown Bend Business Association also announced it would redo the process for a recent board of directors election. The turmoil comes after discussions over the prospect of paid parking were met with fierce pushback from […]
Hochul, Blakeman talk debate performance after clash on Spectrum News
Just hours earlier on Tuesday evening, Hochul was in a fierce debate on Spectrum News with her Republican challenger.
I’ve already picked my National Television Awards winners - here’s who I think will be bringing home the trophies
The competition is fierce, but I know who I want to come away from the ceremony with a gong
Man Utd in 'good place' despite imperfect squad, says Carrick
Manchester United manager Michael Carrick said he is delighted with the additions to his squad despite being outspent by Premier League rivals in the transfer window and short on depth in some areas.The Red Devils' fiercest rivals spent almost that budget on a single player as Manchester City broke the British transfer record for Enzo Fernandez, while Liverpool splashed up to £123 million on French winger Bradley Barcola.
HHS launches 4 new vaccine injury research, reporting initiatives
The U.S. | The U.S. Department of Health and Human Services (HHS) on Thursday announced a series of actions aimed at strengthening the federal government's response to vaccine-related health concerns.
Forge’s Fierce Life Sciences Announces 2026 Fierce Innovation Awards Finalists and Unveils the Fierce Vanguard Gala
The new celebration brings together the Fierce 50, Fierce 15 and Fierce Life Science and Healthcare Innovation Awards, with Innovation Awards winners to be...
Florida Loses 4-Star Defender to Bitter SEC Rival
Elite safety Adryan Cole chooses home-state Georgia over Gainesville, testing the Florida Gators' top-10 recruiting class as the fierce SEC battle for secondary dominance intensifies for 2027.
Can MRVL's Data Center Business Sustain Its Growth in 2027?
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Dr. Olu Jegede Honored for Leading Efforts Making Healthcare More Accessible to All
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USMNT youngsters pass Mexico test with flying colors
By Charles BoehmYou’ve probably heard of the ‘Dos a Cero’ mythology within the US men’s national team’s fierce rivalry with Mexico, a nod to the 2-0 scoreline by which they’ve defeated El ...
As elective surgical volumes drag in 2026, health system execs say solid demand is still in sight
Though surgical volumes were a sore spot for major for-profit health systems in the opening half of 2026, executives said this week they are optimistic those service lines will stay afloat for the | In fireside chats this week, leaders of the country's largest for-profit systems acknowledged a slowdown in demand that will generally continue through 2026. They also affirmed continued investments to meet future anticipated demand, particularly in ambulatory settings.
Fiorentina vs Pisa: Preview
The Viola get a rare midweek game against a fierce rival that’s proven plenty troublesome.
York County tax deals spark fierce debate. What will officials do to fix it?
Public officials need a route forward with business incentives, discussing options from going after massive projects to nixing tax breaks.
Sidney Crosby sparks controversy with surprising take on Mike Babcock
The Penguins captain's surprising assessment comes as Edmonton faces fierce backlash over its decision to hire the veteran coach.
Judge isn’t swayed by government’s claims that plans for an ‘anti-weaponization fund’ are dead
The fund for compensating Trump’s political allies encountered a fierce bipartisan backlash and threatened to derail Attorney General Todd Blanche’s Senate confirmation.
Ayble Health banks $16M series A to expand AI-driven precision digestive, autoimmune healthcare
Ayble Health secured a $16 million oversubscribed series A funding round to accelerate its expansion into artificial intelligence-driven precision digestive and autoimmune healthcare. | Ayble Health says it is currently in-network with most commercial health plans, covering more than 80 million patients through its various partnerships.
Rising yields are wreaking havoc on stocks outside the AI trade
After the 10-year Treasury yield rose as high as 5.34% for the first time since 2002, stock traders are fiercely debating when the selloff in bonds will start to trigger
Cardinal Health to buy Strive Medical, AdaptHealth's diabetes health business for $360M
Cardinal Health is pursuing two tuck-in acquisitions to expand its home care business. | The pharmaceuticals and specialty products distributor plans to buy AdaptHealth's diabetes health business unit and medical supply provider Strive Medical in separate deals worth $360 million.
Michigan State Women’s Basketball Schedule Announced: High Expectations
Robyn Fralick’s squad eyes a deep postseason run as stars Kennedy Blair and Theryn Hallock reunite to navigate a daunting Big Ten slate and a fierce rivalry.
Slotkin wants GOP prosecutions to deter young people from Trump administration jobs
Elissa Slotkin said she wants young people to fear legal problems before joining the Trump administration, sparking fierce online backlash..
August Monthly Review: ChatGPT In Epic
Death, taxes, another frontier lab healthcare launch inspiring truly insane LinkedIn takes. As much as I want to stay away, I repeatedly am the crewman unplugging his ears whenever we pass these sirens. So it’s not the first and probably not the last time we dial up the typewriter rather than tie ourselves to the mast. The full blow-by-blow timeline: Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe The End of the Standalone PHR (Jan 8): ChatGPT Health arrives for consumers, at the time powered by b.well. I was bullish on the approach in that the best way for the PHR to finally solve distribution was to meet consumers were they already are (i.e. When Horizontal Meets Healthcare (Jan 9): OpenAI for Healthcare puts out the shingle for enterprises, with SharePoint ingestion standing in for the EHR integration the product actually needed. Another One: Anthropic’s Healthcare Debut (Jan 16): Claude's version, on HealthEx rails instead of b.well, with Agent Skills for FHIR development as the one true vertical-specific investment. ChatGPT for Clinicians: The Trap Sprung (Apr 24): OpenAI filled in the missing GTM middle with a free product for verified clinicians, effectively peeling the enterprise wrapper off ChatGPT for Healthcare and taking the PLG fight directly to OpenEvidence. OpenAI’s Second Attempt at Health (Jul 31): a relaunch of their patient specific app, now branded Health in ChatGPT, where the privacy partition came out, the connectors thinned, and b.well disappeared in favor of first-party FHIR work against a smaller network Beyond a Shingle So what was announced now? Today, we’re introducing a new electronic health record integration that brings authorized patient context from Epic into ChatGPT for Healthcare, along with the Healthcare Public Data plugin for direct, structured access to official healthcare datasets like PubMed, DailyMed, and CMS Coverage. Together, these capabilities bring ChatGPT closer to the systems and sources healthcare teams trust, while supporting the controls and compliance healthcare work requires. The core portfolio is unchanged from prior announcements we delineated and discussed (aside from the relaunch of patient-facing). Since trade publications still seem to be confusing them by using the wrong names: Enterprise sales motion: ChatGPT for Healthcare Protecting their core product / PLG: ChatGPT for Clinicians Consumer/patient-facing product: Health in ChatGPT So really, this is a feature release (specifically for ChatGPT for Healthcare when it comes to EHR integration). What’s cool about it, though, is that we are moving beyond just putting out a shingle. Everything in the January enterprise launch was horizontalizable: Horizontal tech companies thus generally start verticalization with their “putting out a shingle phase”. Telling the world you’re open for business as a horizontal tech company reliably attracts early inbound interest from buyers who are already trying to force-fit horizontal tools into domain-specific workflows and are eager for any signal that the vendor intends to support their use case more directly. Nothing was really vertical specific, which is exactly what you'd expect from the ultimate hypergrowth horizontal company dipping their toes into specific industries. But eventually you have to stop changing the sign on the door and start changing the product. Can you guess where the horizontal product was going to run out of road? This is the core dilemma writ large: verticalization requires differentiation, while scale economics of consumer and horizontal push toward unification. I’ve buried the lede so deep here it will be painful to some readers, but what should be shocking to no one is that my perspective is that EHR integration is the only path that meaningfully resolves this tension for ChatGPT for Healthcare. Integration with Microsoft Sharepoint is fine, but it is categorically insufficient for any product that hopes to influence clinical decision-making. SMART Money Well here we are, eight months later! Real vertical investment has begun, which surprised a few people. One friend in the industry messaged me: “Absolutely no way Epic gave ChatGPT API access.” Looking forensically at the announcements, the integration is notably read-only across appointment notes, laboratory results, medications, and specialist documentation. So while I’m not a betting man, I'd wager the house this is a SMART on FHIR launch: That sounds a lot like USCDI! The recommended path for the workflow they outline would be SMART on FHIR Their Health AI lead’s post is evocative of both standalone and EHR launch SMART, which another termed “ChartGPT” and “EHR Plugin” The implementation burden for SMART on FHIR is the lowest of the available integrative paths This is the team who literally did patient-facing SMART on FHIR with Epic last month Most importantly, if you’re a horizontal company, you generally still haven’t taken the full plunge and thus (overly) value reusability. SMART on FHIR is the logical compromise: healthcare-specific enough to matter, but standardized enough to reuse. Nobody Asked Judy Another friend asked “I thought they had to go to each health system, or did they go direct to Epic and now health systems opt in?” Given the trust paradigms in healthcare, this functionally cannot be Epic hoovering up all the data for OpenAI and shoving ChatGPT in their customers’ faces (or they would revolt). However, I do believe the aforementioned terrible coverage by TechCrunch and other outlets is probably responsible for that question, given the 325 million reference. When using FHIR as a business associate to an Epic customer, there is no EHR gatekeeping to speak of, as that isn’t how fhir.epic.com works: You register an app You pick your APIs You test against the sandbox APIs You list as “Ready for Production” Hospitals pick your app You test and go live with them Bluntly, nobody had to say yes or no in Verona (nor were they given the chance). Vendor Services (their next developer tier up that I doubt OpenAI is using quite yet in this initial release) certainly has contractual paperwork that some resent, but even there, the twin pressures of mounting antitrust and information blocking make outright gatekeeping increasingly fraught. My friend’s sentiment is, to me, representative of a broader industry neurosis, perhaps a sort of scar tissue of prior eras: people assume the gate is still there and never actually try the door. There are certainly other ways Epic (and any EHR) can put its thumb on the scale, but they are not so dumb as to stand in front of a federally mandated API and play bouncer at this exact moment in time. So I think they can and probably should go deeper, as this release is at best parity and at worst behind vertical-specific competition. OpenEvidence did a basic SMART launch with Sutter Health in February, allowing for more convenient evidence search by providers. They then add patient-context (the equivalent SMART on FHIR flow to what we see here) when Cedars-Sinai went enterprise-wide in May. UpToDate has four distinct applications across deeper workflows like patient engagement listed in Epic Showroom and announced a partnership with Epic to power Art at UGM Abridge and other ambient scribes have invested deeply into the deepest bidirectional clinical copilot workflow with integrations well beyond SMART on FHIR. In that light, the “Who is OpenAI primarily targeting here?” is clear. This release brings them into striking distance of OpenEvidence, but not the others quite yet. They are the only one of the three you can reach without building something truly Epic-specific. When will they go further? Competition is a great motivator to overcome the horizontal demons and start building things that can’t be reused: not across industries, not across EHRs, maybe not past the customer you built them for. That’s the price of actually verticalizing. The question is if and when OpenAI will be willing to pay it. Month in Review Here is the monthly review. As a reminder, this is a regular round-up of the month’s posts and other content to surface things you may have missed across regulation, litigation, interoperability, and beyond. AI assistance is used in these bullet summaries so I can focus on articles. Articles Published: None this month Video Content: The Information Exchange: Standards-based Thruple Edition (Aug 14): Back to school for us too, with Brad reporting in from the CMS Health Tech Ecosystem’s one year anniversary in DC. We get into the January CMS-0057 deadline, the fall rulemaking reading list, and why enrollment still keeps most apps off FHIR. The Information Exchange: Epic Dúnadan Edition (Aug 25): A UGM roundup with Ryan Brickner joining for the first time to check our takes against what the building actually thinks. Rangers, Ergo sitting on top of EHI, and a down-market lineup that needs some cuts. Regulatory: Stacked Deck, Bad Hand (Aug 05): ONC’s website refresh took the entire HIT Policy Committee record with it, so I rebuilt the archive and went looking for the regulatory capture story everyone assumes is buried in there. Stacking the deck and winning the hand turn out to be very different things. The Sixth Generation of Patient Access (Aug 19): A quick catalog of the five generations of patient access we’ve layered on since HIPAA, and the two candidates now competing to be the sixth. One is planned. The other is the market routing around the plan entirely. Court cases: Three Cases Walk Into a Docket (Aug 06): Two surprise settlements cleared the board in a single week, and then Judge Maddox dropped ninety-four pages on Vyne v. Henry Schein. The sleeper is a DMCA holding that makes direct-to-database a considerably riskier business model. Epic v. Health Gorilla: Into the MDL (Aug 10): Nine class actions are headed to Miami, and the Panel signaled it wants to bring the case that spawned them along too. That would leave Epic arguing the requests were obviously fraudulent in one courtroom and unknowable in the other. Amazon v. Perplexity: Agents Are Legalized! (Aug 11): The Ninth Circuit vacated the injunction against Comet, holding that the user is the one accessing the servers rather than the company that built the agent. A real win for agentic access, and a much narrower one than the headline suggests. Veeva v. Epic: Come At Me, Bro (Aug 26): Epic’s response brief wants the dismissal affirmed and, unusually, wants the opinion published as precedent. Buried in it is Epic’s own description of what its non-competes actually prohibit, which current and former employees should read closely. EHRs: The Contract Epic Would Never Sign Today (Aug 04): A 1999 SEC exhibit catches Epic licensing nearly its entire product line, Tapestry included, to the company that became TriZetto. The marketing services menu attached to it is the part that will make you blink. Forecast from Verona (Aug 07): The Epic Almanac makes one argument six different ways: the AI is only as good as the networks behind it. Emmie headlines, Art’s context stack is the most ambitious part, and Penny finally gets an autonomous coding date on the calendar. Works With Epic MyChart (Aug 17): Epic’s first new Showroom category since the death of Workshop certifies hardware instead of software, badge on the box and all. Made for iPhone, but for blood pressure cuffs, and rough news for anyone selling the RPM stack sitting in between. UGM Hot Takes 2026 (Aug 20): Everyone else covered the AI announcements, so I went after Savvy deleting the payment gateway, Rangers as Boost with the timer removed, and a down-market lineup with too many entries. Plus the Health Grid tidbits I cannot help myself on. MyChart Central Grows Up (Aug 24): Device data and Emmie turn Epic’s identity hub into a full consumer platform, which is both a logical answer to ChatGPT and a bit of a mistake. It also happens to be the best scraping target Epic has ever shipped. Industry Analysis: The Wrong Yardstick (Aug 12): Vertical software keeps getting judged against Superhuman and Notion, which is the wrong bar entirely. Your user is comparing your product to a whiteboard and forty phone calls before lunch. Primitives vs. Abstractions (Aug 27): Developers want building blocks, systems of record prefer to hand out business logic, and both sides have a real case. There’s no test from the outside that separates the engineering reason from the competitive one, which is why this keeps ending up in court. Cross-industry Comparisons: The Two Kinds of Platform Power (Aug 18): Attention power and record power are different problems that keep getting handed the same regulatory toolkit. Congress’s latest swing at Big Tech shows both what’s possible and where it falls apart. The Dogs of (Platform) War (Aug 21): A CourtListener alert turned up a property management fight with healthcare’s exact shape and none of the Cures Act. Shell prospects, ghost accounts, a notetaker bot that came back to haunt someone, and a lawyer arguing both sides of the same theory in two states. Fractals All the Way Down (Aug 31): Yardi dominates property management right up until you zoom into one segment, where AppFolio owns it outright and Yardi doesn’t appear at all. Where you draw the line around a B2B software market is about to decide an awful lot of cases. Other News: If Judy Had the Courage (Aug 13): A short eulogy for the era when software was allowed to look insane: WinAMP, bold colors, and everything the grey chatbot era has taken from us. External Media: Portland Monthly Health Tech Meetup: Erin O’Brien channeled my own feelings - maybe it’s just because it’s August and beautiful, but the monthly edition of the PDX Health community meetup was a ripper. Make sure to reach out if interested to join for the next one. STAT’s Coverage of Epic This Month: Brittany Trang of STAT did a fantastic job of breaking the FTC investigation that’s been lurking, as well as UGM related coverage, so I had to give her her wish of a meme. Fall Conferences: I’m pumped to be kicking off my fall conference season in NYC at Nabla Accelerate next month, which Chrissy provided the link to apply for. Here’s the rest of my schedule in case you want to meet up: Commonwell (Redwood Shores, CA): Oct 13-14 Open@Epic (Madison, WI): Oct 21-22 eHealthExchange (Austin, TX): Oct 27 Sequoia Project (Austin, TX): Oct 28-29 HLTH (Vegas): Nov 15-18 RSNA (Chicago): Nov 29-Dec 3 Posts I Liked: HTI-6 Should Unbundle API Certification: Josh Mandel makes the case that HTI-6 should split (g)(10) into separate authorization and data certifications, so a PACS or a genomics platform can certify only the role it actually performs. Imaging is the urgent example, but the structure solves a much bigger problem. On implementing ePrior Auth with Epic: Scott Rossignol’s field notes from a live ePrior Auth build on Epic, including the two app registrations nobody warns you about and the CPT mapping problem waiting at the end. CMS-0057 implementations are going to be such a beast. Healthcare point solutions are starting to look a lot like streaming services: Spencer Dorn runs the cable-to-streaming arc against health IT and lands squarely on the bundling half of the cycle. Bundling can be good! It can also be bad! Life is nuanced. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
The Not-So-Secret Winner in Netflix and YouTube’s Streaming Wars Battle
(Welcome to the “Most Important Story of the Week”, my bi-weekly strategy column analyzing the most important (but often not buzziest) news story of the last two weeks. I’m the Entertainment Strategy Guy, a former streaming executive who now analyzes business strategy in the entertainment industry. Please subscribe.) Here’s a good piece of advice: when someone tells you a company has “won” the streaming wars, just assume they haven’t. Remember the narratives about the streaming media over the last few years: 2024 - Netflix has won the streaming wars! 2025 - YouTube has won the streaming wars! Yet…in 2026, I’d categorize it as… 2026 - Netflix and YouTube are battling for talent! Netflix and YouTube are aggressively fighting for top creators, marking a fierce new battle in the streaming wars. For two companies that “won”, that certainly doesn’t seem like winning behavior. If you win, you don’t have to fight for talent, because talent has to come to you. This is a good reminder that, if the streaming wars are a war—and I think they are—we should know what type of war they are. So it’s worth revisiting one of my big theories of the streaming wars, that the war these battles most represent is… The Thirty Years’ War1 I prefer this war to other, simpler wars, because, while it featured two “sides”—based on religion—and the current war has two main sides—tech versus entertainment—it also featured a lot of smaller players battling it out, sometimes switching sides. And that’s still the case for entertainment and media, despite the above headlines. I’d recommend this truism: if someone has to tell you they won the streaming wars, they probably haven’t. To wit, if someone told you they were fighting in the Thirty Years’ War—and no, they didn’t call it that at the time—and in year five, they told you they won, well, obviously they had 25 more years to go. That’s a lot of preamble to say, the story of the week is the latest battles between YouTube and Netflix. Their battle for talent says a lot about how hard this war will be to win. All that, plus The Curse of the Mogul in action, Netflix providing more (theatrical) data, whether Apple TV is in trouble, AMC getting in on distribution, and a whole lot more. Subscribe Today’s article is sponsored by… Substack is hosting a live Emmys watch party, starting at 5PM on the East Coast (2PM on the West Coast) on Monday, 14-Sep. Check it out! Tune In Most Important Story of the Week - Who’s the Big Winner in the Netflix vs YouTube Showdown? Netflix spent a lot in 2025, and then even more in 2026 adding a host of “creators”—both podcasters and YouTube stars—to their TV lineup. Frankly, for years, I’ve thought that more major studios/streamers/channels should look to YouTube as the launching pad for future stars and IP. Either by poaching proven talent—albeit at good prices—or by treating YouTube as an arena for your “A&R” reps to scout new talent and emerging voices. Netflix started executing the former strategy—which I thought was smart—while Focus Features did the latter with Obsession. So what changed? YouTube finally responded! Yikes. That’s a strong response, and stronger than I’d argue most narratives about YouTube suggest. People often describe YouTube as a self-reinforcing flywheel of success. Get on YouTube or perish. So why did YouTube have to respond? Because other folks poaching their top talent could really damage their business, implying their flywheel is a pinch more rickety than most analysis suggests. Clearly, creators can envision a life off YouTube and potentially a much more lucrative one. The Curse of the Media Mogul is Playing Out In Real Time We’re just getting started with this issue, but the rest is for paid subscribers of the Entertainment Strategy Guy, so if you’d like to find out… Who is the big winner in the Netflix versus YouTube battle… The biggest question about YouTube… Plus why YouTube’s saber rattling should worry talent… Why I’m skeptical that a U.S. federal tax credit for film will happen… What key change could pull Apple from the streaming business. AMC getting in on distribution… Some great reads on the Warner Bros.-Paramount merger... And a whole lot more... ...please subscribe! We can only keep doing this great work with your support.
In 1990, the northern spotted owl became a symbol of America’s logging wars; 36 years later, scientists say it is already functionally extinct across large swaths of its range
In 1990, a small bird became an unlikely symbol of one of America’s fiercest environmental battles. The northern spotted owl was listed as threatened under the Endangered Species Act, putting the future of vast stretches of old-growth forest in the Pacific Northwest at the centre of a bitter fight between environmentalists and the logging industry.
‘Fiercely independent’ South Carolina votes on Lindsey Graham’s Senate successor
Republicans, including Graham’s sister Darline, expedite campaigns to replace late senator in special primary race
Cincinnati nuisance business rules for late-night bars face fierce opposition
A proposed crackdown on Cincinnati’s so-called nuisance businesses has put City Hall at odds with some late-night bar and nightclub owners.
Erlanger Health System signs letter of intent to join Prisma Health
Erlanger Health System plans to join Prisma Health, creating a 27-hospital system in exchange for a $2 billion strategic capital commitment toward care in the Chattanooga, Tennessee area. | The tentative deal includes a $2 billion strategic capital commitment from Prisma, and would yield a 27-hospital, $9 billion operating revenue nonprofit in the southeast.
Redistricting scrambles Florida primary as Alaska awaits Dan Sullivan v Dan Sullivan
Today’s contests will help shape the fiercely contested midterms this fall to determine control of Congress
Old friends, fierce rivals play at 95th New York State horseshoe championship in Camden
Nestled beneath the trees in southern Camden, the game of horseshoes is alive and well at the Pine Grove Horseshoe Club on Route 13. The club hosted the 95th annual New York State Horseshoe Pitcher's State Championship Tournament this past weekend, where pitchers from all across the state gathered to find the best of the best.
Berkeley's Nabolom Bakery blames political backlash for decline ahead of closure
Nabolom's owners say an Instagram removal and backlash over its political positions hurt sales, but they also point to rising costs, staffing problems and fierce competition.
Zodoc acquires health tech company Sohar Health for automated benefits eligibility checks
Zocdoc acquired insurance technology co | Zocdoc acquired insurance technology company Sohar Health as it pushes to evolve beyond an appointment-booking marketplace into broader healthcare access infrastructure.
When “DEI” research is cut, what happens to community health?
“I’m just going to run to the grocery store!” How many times have we said this without thinking about it? For most of us, it's usually an easy walk or a short drive to get the cheese we forgot. In reality, though, 13% of the U.S. population (about 39 million people) live in “food deserts,” which means living more than a mile from a grocery store in urban areas and more than 10 miles in rural areas. This was the case for people in Pittsburgh’s Hill District, where a quick run to buy food wasn’t an option. In the 1930s, federal maps marked the Hill as "hazardous" for lending, a practice known as redlining that steered investment away from Black neighborhoods. Decades of disinvestment followed, and residents went about 30 years without a nearby grocery store. This made it hard to keep healthy eating habits and contributed to chronic disease. When a grocery store finally opened in the area in 2013, researchers saw the opportunity and launched the PHRESH study, which initially compared the health of participants from the Hill district to those in the Homewood district. Over time, the study expanded to other factors such as brain health and Alzheimer's risk. Residents like Roderick Blair overcame initial hesitation to share their health data, trusting it would benefit their neighborhood. Then, in August 2026, the NIH abruptly canceled the study’s grant, citing that it was “subjective” and fell outside their scientific scope—an effect of the administration’s interpretation of diversity, equity and inclusion (DEI). Research like PHRESH can help determine what changes in a neighborhood actually improve health, so cutting it has left that question unanswered. Other canceled studies have examined health issues like maternal health, preterm birth rates, or sickle cell disease. Courts have reversed some of these grant cancellations, but not all of them. If we really want America to be healthier, research into why some communities get sicker than others is absolutely critical. The law that created the federal minority health research institute passed with bipartisan support in 2000. But these days, as evidenced by grant cancellations, the political shift in attitudes toward DEI means we often lose access to the health information we need to help all communities thrive. DEI vs. health equity vs. equality and the overlap (or lack thereof) The letters “DEI” evoke very different reactions depending on who you are in the U.S. DEI programs can address gender, disability, age, and other factors, but the fiercest debate centers on race. For some people, hearing DEI brings to mind policies that may have cost them a job or a college seat because they are white. Others see DEI as a matter of justice: a way to expand representation and opportunity for groups that have been historically marginalized. Both perspectives are rooted in lived experience, and both center on the same question: whether hiring and admissions practices are fair. Hiring and admission practices, though related, are not the same as health equity. Health equity is “the attainment of the highest level of health for all people.” It’s the recognition that some groups of people consistently experience worse health outcomes than others. For instance, black mothers die from pregnancy-related complications at three times the rate of white mothers, and rural Americans are more likely to die from issues such as heart disease and cancer. Equity is also often conflated with “equality,” which leads to misunderstanding of how to actually best support communities. Equality ignores the fact that we aren’t all starting life with the same resources or circumstances, whereas equity is about helping people get what they specifically need based on their situation so they have the chance to achieve the same outcome as anyone else. For example, if every household in Pittsburgh got a $30 grocery gift card, that would be equal. But during the decades the Hill District went without a grocery store, that card wouldn’t have helped much. Equity means making sure everyone can actually access a store in the first place. DEI policies can overlap with health equity in many ways. For example, they may help expand access to quality education and stable, well-paying jobs, which in turn can provide health insurance, safer housing, and improved finances—all of which can reduce health disparities. But to make that happen, we first need data to identify disparities in communities and to develop solutions that effectively address them. What we lose when the research stops Community data is important to health equity because: You can’t fix what you don’t see: Data show which communities are most affected by health factors such as infection, heart disease, and cancer. If we don’t know what is happening and where, then we can’t develop interventions to help. Poor health costs everyone: Chronic disease is expensive—both to the individual person and to the overall economy. Understanding what groups of people are most at risk allows us to develop interventions that can save everyone money. Disparities exist for many communities: Health equity includes disparities that exist due to a whole host of factors, such as family background, race and ethnicity, rural vs. suburban residence, gender and sexual orientation, veteran status, disability, and lower income. This means many Americans can benefit from research into differences in health outcomes and how to improve them. Trust is easy to lose: Some participants in the PHRESH study were initially vocal about their concerns about participating. But that trust was earned because the researchers kept their promises and centered their work on the community. When projects are canceled mid-cycle, researchers have no choice but to leave behind communities they had promised to help. This hurts trust in the long run. It’s also a very inefficient use of resources, and it will take significant time and effort to redo the work when the government realizes this work is important again. How should we talk about health equity? This is hard because the words “equity” and “DEI” are currently very politically charged. So whether you’re a public health professional, teacher, or friend, how we talk about this topic matters. The right framing can help people who might otherwise be skeptical see why health equity research is important and deserves funding. Here are some suggestions to help your conversations: Choose your words strategically: Who are you trying to reach with your message? Are they likely to be resistant to terms like “diversity” and “equity”? If so, find alternative words to use to still get the message across. It is frustrating to be in that position, but the goal of improving health is too important not to try to make inroads. Sometimes simply reframing can help the message reach those who need to hear it. Focus on the problem: The terms “health equity” and “DEI” are abstract. Make it more specific. For example, discuss differences in maternal death or ways to improve health outcomes in rural communities. These still have equity at their core but will likely be better understood by those you’re talking with. Focus on systems: Disparities exist, but if they are communicated poorly, people can mistakenly think the issue is the individual’s fault. Disparities are largely driven by failures of the system—such as lack of access to health care and a long legacy of racism. When discussing the disparities, frame them around these systemic issues to ensure blame isn’t placed on the individuals impacted. Tell stories: Personalize these policies by using stories from those impacted that connect to the data you’re trying to convey. This helps make the policies and outcomes more concrete and meaningful. Bottom line Some communities end up sicker than others. That’s just the facts. We can argue about the best way to do that research, but canceling it simply because it may be linked to DEI doesn’t make anyone healthier. It just leaves communities like the Hill district behind. And in the end, it causes us all to move backward in our efforts to improve health in this country. Love, EM Big thanks to MacKenzie Isaac & Legairre Radden, who reviewed this piece and generously shared their expertise and lived experience to help improve it. Dr. Liz Marnik, PhD, is Executive Director of The Evidence Collective and a science communicator and immunologist working at the intersection of public trust, science, and public health. To discuss communication training on topics like health equity and storytelling, email Liz at liz@yle.health or learn more on our website. Your Local Epidemiologist (YLE) comprises a team of experts, ranging from physicians to immunologists to epidemiologists to nutritionists, working together with one goal: to “translate” ever-evolving public health science so that people are well-equipped to make evidence-based decisions. The YLE suite of newsletters reaches over 475,000 people across more than 132 countries. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below: Your Local Epidemiologist is a reader-supported publication. 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The Fierce Battle For Kids’ Eyeballs...Plus Two “Devils” Face Off
(Welcome to my weekly streaming ratings report, the single best guide to what’s popular in streaming TV and what isn’t. I’m the Entertainment Strategy Guy, a former streaming executive who now analyzes business strategy in the entertainment industry. If you were forwarded this email, please subscribe to get these insights each week.) During the week of this report, Spider-Man: Brand New Day hit theaters and went on to become one of the biggest films of all time. So, you know what that means! It’s time for a poll! Recently, Project Hail Mary came to Prime Video and became a top five film for them, but didn’t smash streaming records, a feat I cautiously thought it could accomplish. Can Spider-Man 4 do better? To set the stakes, some of the biggest films of all time do just okay on streaming. Wicked, Top Gun: Maverick, and Barbie come to mind... But unlike those films, Spider-Man: Brand New Day is a Sony film which means it’s headed to Netflix, the world’s largest streamer. Now, per friend of the newsletter and my go-to Netflix expert, Kasey Moore of What’s on Netflix, Sony films usually appear on Netflix 120 days after they premiere, which means Spidey 4 would land on Netflix on, checks notes, 28-November, one of the two biggest streaming weekends of the year! But Sony occasionally delays its biggest hits for a bit longer, to give them more time to make money on PVOD, so Spider-Man: Brand New Day might not swing onto Netflix until late December or even February 2027. Loading... Okay, on to this week’s issue. Since The Super Mario Galaxy Movie made its way to Peacock, I’m looking at the true workhorse of streaming viewership: kids films. And the surprising film that bested most Netflix animated movies. All that, plus Hulu has a new show that might be a hit (for them…?), two “Devils” square off on streaming, Zendaya tries to find some streaming magic, Netflix’s I Will Find You continues to do well, House of the Dragon tries to break into the season three top ten, some big NBC sports and summer programs, what friendly neighborhood Spider-Man character actually generates the most viewership on streaming, all the flops, bombs and misses, and a whole lot more. Let’s dive right in! (Reminder: The streaming ratings report focuses on the U.S. market and compiles data from Nielsen’s weekly top ten viewership ranks, Luminate’s Top Ten Data, JustWatch and Reelgood interest data, Samba TV household viewership, company datecdotes, Netflix hours viewed data, Google Trends, and IMDb to determine the most popular content. While most data points are current, Nielsen’s data covers the weeks of July 27th to August 2nd, 2026. You can find a link to my terminology here.) Subscribe Film - As The Super Mario Galaxy Movie Hits Peacock, How Have Kids Films Fared in 2026? Like Mario hopping on a Koopa, The Super Mario Galaxy Movie landed on Peacock on 30-July. (Yeah, I kinda forced that Mario reference.) How did it do? Great, just like the first film. It got 13.0 million hours on its opening, and that’s good enough to take second place among Peacock films on the Nielsen charts all time: As I mention all the time, Peacock just isn’t the world’s biggest streamer—in fact, nowhere close—so its films struggle to put up numbers like Netflix (or even Prime Video and Disney+). So this is a solid debut for that streamer. And as we saw last time, The Super Mario Bros. Movie had a HUGE second life on Netflix when it moved streamers. This chart doesn’t even show how long the first Mario lasted on Netflix: a whopping, KPop-esque 31 weeks. For NBCUniversal, though, the big win was the second Mario movie grossing $429 million in America and over $1 billion globally. But yeah, to add a very strong streaming performance only makes its success even greater. Illumination pretty clearly has another hit franchise on their hands. This is a good time, though, to check in on kids films so far in 2026. We’ve had a few big, big titles, a rare Netflix success, and some disappointments. Let’s start with the top animated films since November of 2025, over their first four weeks on the charts, along with a few of the “best all time” animated films: (As a reminder, if a film doesn’t make the Nielsen top ten lists, I don’t have data for it, so it gets a “zero” in terms of viewership. Now, it had some viewership, but I don’t know what it is, so it gets a zero.) I added a few titles to get an idea of what the best of the best looks like in terms of animation. And you can see, through four weeks, Zootopia 2 can now claim “one of the biggest streaming films of all time” titles. GOAT too did surprisingly well, besting Netflix’s biggest films (Swapped and In Your Dreams) through four weeks. When I’ve talked about how films can have varying performances on streaming compared to their box office, this is what I mean. Goat just managed to gross even $103 million at the box office—so it’s popular, but just barely—but did very well on streaming. Of course, what set Encanto and KPop Demon Hunters apart from the rest was their absolutely insane longevity. Here are the kids film charts through eight weeks to show that: And really KPop Demon Hunters just kept going, and no 2025 or 2026 kids films have had that sort of longevity. I can’t wait to see the sequel in theaters. Film - Two Devils and a Drama As I wrote last week, in the past, theatrical-first film flops weren’t eligible for “Miss of the Week” or “Miss of the Year” honors/dishonors, but since so many more films go to theaters first these days, I’ve made them eligible now! But it’s complicated. You see, this is a Streaming Ratings Report, emphasis on streaming, which makes analyzing this week’s two biggest streaming misses—The Drama on HBO Max (A24’s dramedy starring Zendaya and Robert Pattinson) and Prime Video’s The Devil Mouth (a killer shark movie starring young attractive people)—somewhat tricky. The Drama isn’t eligible for Luminate, but The Devil’s Mouth only had 1.5 million hours in its first week: The Devil’s Mouth notched 5.2 million hours according to Nielsen. Meanwhile, The Drama missed the charts entirely. Not great! But Prime Video is a much bigger streamer than HBO Max. That said, HBO Max titles are on Prime Video, but I think Prime Video prioritizes their original/exclusive titles, which helps boost their viewership. Complicating this further, The Drama made $48 million in the US—while A24 sells foreign distribution; the $57 million of overseas grosses helps A24 sell overseas rights for money in the future—off of a $28 million budget (which seems low for Zendaya and Pattinson, so they might have backend). The Devil’s Mouth, though, had zero dollars at the box office. The other stats for The Devil’s Mouth are bleak, and by “bleak”, I mean horrendous: a 4.7 on 15K reviews on IMDb (yikes) and a 46 on Metacritic (double yikes). The Drama, though buzzy online, only has a solid (but far from elite) 7.1 IMDb score on 121K reviews and a 59 on Metacritic (which is far, far lower than I’d have guessed). So which film is the “Miss of the Week”? I’m giving it to The Devil’s Mouth for one simple reason: it’s a horror film. And almost all horror films, even poorly reviewed horror films, should get a shot in theaters to at least try to recoup some of their budgets. The Drama made money at the box office and The Devil’s Mouth didn’t. It’s just like the situation last issue with Obsession and Masters of the Universe. Sure, Obsession didn’t pop on the streaming charts, but at least it already made it money at the box office. And as we’ve been seeing for years now and we’ll see all fall, theatrical films just do better on streaming. After all, the big “devil” winner this week was actually The Devil Wears Prada 2 with 14.8 million hours according to Nielsen. That’s right, The Devil Wears Prada 2—one of the box office success stories of May—came to streaming and parlayed its $220 million box office into 14.8 million Nielsen hours. Disney also put out a datecdote that it had 15.2 million “views” globally in five days, but again we don’t have a lot of great context for what that means. Here’s how it stacks up to other Hulu films, since I’m categorizing this mainly as a Hulu title (though it was also on Disney+): Share Quick Notes on Film We’re just getting started with this issue, but the rest is for paid subscribers of the Entertainment Strategy Guy, so if you’d like to find out… Whether Hulu has a new hit show on its hands... The top first and third seasons of all time and which shows are climbing those charts… What version of Spidey is the most popular... What sport and TV show are performing better on NBC than the NBA... All the flops, bombs and misses... ...please subscribe! We can only keep doing this great work with your support. Coming Soon! Next week, wow, things stay so busy. One of streaming’s biggest shows of all time, Ted Lasso, returns along with new YA-ish shows from Hulu (The Shards, from Ryan Murphy) and Prime Video (Sterling Point). The Challenge moves to Paramount+, plus My Life with the Walter Boys returns to Netflix and Futurama returns to Hulu. And Netflix has a new horror film, The Last House. Lots to talk about! All month, things stay busy. We’re talking Reacher on Prime Video! Outer Banks and Tires on Netflix! Lanterns on HBO Max! UFC 330 on Paramount+ and the MLB Field of Dreams game on Netflix. And a ton of smaller films come to streaming. Long term, the VMAs are back on 27-Sep! I feel like I haven’t heard much about this show in past years, but I’m seeing more news coverage and buzz for this show than in past years. I’m curious to see how it does.
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