Biotech, in brief

Experts advising the World Health Organization (WHO) want 2 new vaccines added to an Ebola trial in Congo. [1] Both were built for Bundibugyo, the kind of Ebola now spreading there. [1]

The outbreak has killed more than 5,300 people, most of them in Congo. [3] No vaccine is approved against Bundibugyo. [4]

This will be the first time vaccines made for this virus are tested during an outbreak of it. [1]

Africa's disease agency counts 10,444 confirmed cases. [3] It says more than half of those infected have died. [3]

WHO's chief, Tedros Adhanom Ghebreyesus, says vaccines cannot replace early care, contact tracing, isolation and safe burials. [3]

He also asked countries such as the US and Ghana to lift travel limits. [4] He says they punish countries for doing right and discourage openness. [4]

Epidemiologists, who study how disease spreads, call Tumaini's design ring vaccination: it enrols the contacts of each confirmed patient. [1]

Tumaini has 4 rings so far, including contacts of people who fell ill or died. [1] The same approach proved Ervebo in Guinea a decade ago. [1]

It tests several vaccines inside one trial, which is how Oxford's and Moderna's shots can join it. [1]

A firefighter wets the houses next to a fire, not every house in town.

So far, tests in people have measured safety and immune response, not protection from Ebola. [2]

Oxford's and Moderna's Covid vaccines were linked to rare blood clots and heart inflammation. [2] The advisers said nobody knows if those risks apply here. [2]

WHO expects results from the vaccine trial in early 2027. [1]

WHO's advisers have chosen 2 vaccines built for Bundibugyo, but more than 5,300 people have died and the trial's results are not due until early 2027.

Elsewhere, the work of finding and selling medicines moved between companies: Boehringer and AbbVie bought early drugs, Ultragenyx cut its own research, and CVS is splitting its shops from its insurer. [1][3][10][13][14][17]

They work in a conflict zone without a proven vaccine, and a nurse was killed responding to an alert. [6]

Travel limits by countries such as the US and Ghana fall on them, against WHO's advice. [4]

Whether either new vaccine protects people from Bundibugyo.

Tests in people so far have measured safety and immune response, and WHO expects trial results only in early 2027. [1][2]

How many people have died in Congo.

Africa's disease agency counted 5,372 deaths in Congo on Monday, while Congo's own data to 31 October shows 5,103. Neither report explains the gap. [5][4]

How deadly this outbreak really is.

The BBC reported a death rate of 48.6% at the end of October, while Euronews and Africanews say more than 50%. [7][3][5]

When Congo will approve the 2 new vaccines.

WHO says they join the trial after national approvals and names no date. [1]

Two vaccines built for the Bundibugyo kind of Ebola will be tested during an outbreak of it for the first time, and WHO's advisers were unanimous in backing them.

A British health worker with Ebola is being flown from Congo to Britain, a document seen by Reuters shows. [8]

The UK government confirmed that a British citizen in Congo has tested positive. [7] It says "the risk to the UK public from Ebola remains low". [7]

A humanitarian group had sent the person to help fight the outbreak. [8] The patient's condition is stable. [8]

A specialist ambulance will take the patient to a unit for high-risk infections. [8]

It is the first British case in this outbreak. [7] Britain has had only 4 confirmed cases since 1976, and none of them died. [7]

Switzerland flew out a patient from Nigeria last month, and France reported a case in June. [8]

The people sent to help are among those catching it. [8] France's first case was a doctor back from a humanitarian mission. [8]

Epidemiologists call this contact tracing: people with Ebola infect others only once they have symptoms, so contacts can be found. [9]

Ebola passes through body fluids, with no evidence of spreading by coughing. [9] Covid could spread before people knew they were ill. [9]

A wet paint sign works because you can see the paint and avoid touching it.

The patient's name was not given. [8] WHO sent Reuters' questions about the case to British authorities. [8]

CVS Health, a US health giant, said on Wednesday it will split into two companies. [10] It expects the split to finish in the first half of 2028. [10]

One company keeps the name CVS Health, with its insurer Aetna and its drug middleman, Caremark. [10] The other, CVS Pharmacy, takes the 9,000 shops. [10]

Caremark is a pharmacy benefit manager, or PBM: a middleman on drug prices between drugmakers and health plans. [10]

CVS bought Caremark in 2007 and Aetna in 2018, the second in a $78 billion merger. [10]

It made a $2.2 billion profit last quarter, after a $4 billion loss a year earlier. [10] Its chief says it is acting "from a position of strength". [10]

Arkansas and Tennessee have laws that would stop one owner holding both pharmacies and PBMs, and CVS is challenging them. [10]

CVS Pharmacy will have to stand alone in a trade where some chains have gone private or bankrupt. [10]

Economists call owning several steps of a chain vertical integration, and CVS built it by buying Caremark and Aetna. [10]

CVS's chief says what the shops and the insurer share can be kept through contracts. [10] So, he says, they need no single owner. [10]

A cafe that sells off its bakery can still buy the same bread from it each morning.

CVS's chief says regulators are not the reason for the split. [10] A Leerink analyst says avoiding state scrutiny could be part of it. [10]

Why a company does some jobs itself and buys the rest

Ronald Coase, an economist, asked in 1937 why companies exist, when every job could be bought from outside

Buying has costs: finding a seller, agreeing a price, checking the work

Doing it inside has costs too: bosses, staff and work that may fail

The company picks whichever costs less for that one job

When those costs change, the line moves: firms buy in, or split up

A company is a line drawn around the jobs that cost less to do inside than to buy. Today that line moved at CVS, Boehringer, AbbVie and Ultragenyx.

Each way of getting a job done has its own bill. A company compares the two, one job at a time.

CVS's chief says what the shops and the insurer share can be kept by contract, so the company no longer needs to own both.

Boehringer pays Sino to run the early work on 6 projects, then decides which to license, instead of doing that work itself.

Nxera's chief called IBD too complex and expensive to develop, so the work moved to a firm that already sells IBD drugs.

Ultragenyx is halving its research spending and will fill its pipeline partly with small deals, moving some of the job outside.

Real firms rarely do these sums cleanly: they misjudge their own costs, and laws can move the line as much as prices do, as Arkansas and Tennessee are trying to do with CVS.

A person collecting a prescription sees one shop and one pill.

It loses a parent with an insurer behind it, in a trade where other chains went bankrupt. [10]

Novo Nordisk, the Danish maker of the weight-loss drug Wegovy, raised its yearly forecast on Wednesday. [11] Adjusted for currency swings, sales and profit may now grow as much as 2%. [11]

In May, the best case the company gave was a 4% drop. [11]

Its Wegovy pill, on sale since January, brought in 5.39 billion Danish kroner, about $811 million, last quarter. [11] Analysts had expected 4.96 billion. [11]

Foundayo, the rival pill from Eli Lilly, reached $184 million, which was $44 million short of estimates. [11]

Novo has lost about two-thirds of its value since June 2024. [11] Its next shot, CagriSema, failed a trial against Lilly's Zepbound. [11]

Finance chief Karsten Munk Knudsen is leaving, and Luigi La Corte of Galderma, a skin-care drug company, will replace him. [11]

Patents on Wegovy's main ingredient end several years before those on Lilly's rival drugs. [11] Lilly already claims 63% of the US market for these medicines. [11]

Business schools call this a first-mover advantage: Novo's January pill is outselling Lilly's April pill so far. [11]

The first ice cream van on the street gets the queue, until a better one turns up.

An early lead in pills gives it income while its older patents run down. [11]

Boehringer Ingelheim, a German drugmaker, agreed on Wednesday to $358 million in early payments to China's Sino Biopharmaceutical. [12][13]

The money covers 6 cancer projects, all still at the preclinical stage, before any human trial. [12]

Sino could earn up to $7 billion more if the drugs keep advancing, plus a share of any sales. [13]

Sino runs the early work up to agreed points. [13] Boehringer then chooses whether to pay more for a licence. [13]

Boehringer could buy worldwide rights to 2 of the drugs and rights outside China to the other 4. [13]

Sino's LaNova Medicines unit made 5 of the projects, and its Beijing Tide Pharmaceutical unit made 1. [13] This is the second partnership between the two companies. [12]

US lawmakers may look harder at the surge in drug deals with China, BioPharma Dive reports. [20] RBC's analysts do not expect a ban on company deals. [20]

Lawyers call this an option: Boehringer pays now for the right to license each drug later. [13]

Boehringer keeps that choice until the early tests report, so it pays licence fees only for drugs it picks. [13]

A small deposit holds a flat while you decide, and walking away costs only the deposit.

Boehringer pays Sino to run the early work on 6 projects, then decides which to license, instead of doing that work itself.

It can wait for Sino's early tests before paying licence fees, so projects it does not pick cost it no fee. [13]

It takes in money now while keeping the running of early work, and keeps China rights on 4 of the 6 projects. [12][13]

Kamau Therapeutics, a California biotech, released its first results from repairing the gene fault behind sickle cell disease. [15]

In sickle cell disease, a faulty gene makes bad haemoglobin, the blood protein that delivers oxygen. [15]

Doctors repaired the fault in 3 patients' own stem cells outside the body, then gave the cells back. [15]

All 3 no longer need blood transfusions and have had no pain crises since, Kamau reports. [15]

After 12 and 8 months, sickle haemoglobin in the 2 longest-followed patients was 17.6% and 19.1%, both below 20%. [15]

The treatment, nula-cel, began at Graphite Bio, which halted its trial in late 2022 and later disbanded. [15]

Few people with the disease have had the approved gene treatments so far, Kamau's co-founder says. [15]

Geneticists call this homology-directed repair: the cell swaps its faulty DNA for a healthy copy, as nula-cel does. [15]

Casgevy, already approved, works differently: it switches on baby haemoglobin instead of replacing the fault. [15]

Correcting a typo in the master copy beats sticking a note beside it.

This is an early-stage trial with 3 patients so far, of some 15 planned. [15] Some serious side effects fit the strong chemotherapy and transplant given first. [15]

No serious side effects were tied to the repaired cells themselves. [15]

The results will be presented on 14 December in New Orleans, at a meeting of blood specialists called ASH. [15]

Whether repairing the sickle cell gene beats Casgevy, the approved treatment.

Kamau's co-founder believes it may. The journal GEN calls that a major question, and only 3 patients are reported. [15]

Three sickle cell patients who had the gene fault repaired in their own stem cells no longer need blood transfusions and have had no pain crises since.

Democrats won both chambers of the US Congress on Tuesday, which changes who can question US health officials. [19]

Ron Wyden, a Democratic senator who leads on health, posted one word that night: "Subpoenas". [19] A subpoena is a legal order to appear or hand over papers. [19]

Annie Andrews, a children's doctor, won a South Carolina seat in the US Senate. [19] Democrats have not had a senator with a medical degree since 1969. [19]

Roger Marshall, a Kansas senator who helped found the Make America Healthy Again caucus, lost his seat. [19]

Analysts expect closer questions for US health secretary Robert Kennedy Jr, whose moves weakened vaccine recommendations. [20]

One Leerink analyst says Democrats have "bigger fish to fry" than drug prices for now. [20]

Science advocates want answers for cuts to research grants. [21] "It's a new day in Washington," says Gretchen Goldman, head of the Union of Concerned Scientists. [21]

Political scientists call this oversight: the party holding Congress can investigate officials, which is what Wyden's word points to. [19]

A new club treasurer can ask to see the old treasurer's receipts.

Heidi Overton, President Trump's pick to run the FDA, the US drug regulator, still needs a US Senate vote. [20] Her nomination might expire if none comes this year. [20]

Winning Congress gives Democrats powerful new tools to investigate US health decisions. [19]

Whether Democrats will change US drug or vaccine rules.

Analysts expect closer questions on vaccine policy, and one says drug prices can wait. No law or subpoena has yet been reported. [20][19]

Ultragenyx, a US drugmaker for rare diseases, is laying off 20% of its staff. [17] About 1,000 people will remain. [17]

It wants yearly research spending at half of what it spent in 2025, with $350 million proposed for 2027. [17]

It is ending UX701, a gene therapy for Wilson disease, an inherited illness, because too few patients did well enough. [17]

It is also winding down GTX-102 after a final trial failed in September in Angelman syndrome, a rare brain disorder. [17]

Ultragenyx already cut 10% of its staff, about 130 people, in February. [17] It wants to make a profit in 2027. [17]

Most of the money left will support 6 drugs it already sells. [17] Its chief plans about 5 projects a year, from modest lab work and small deals. [17]

Statisticians call it noise: Ultragenyx's chief says scores in the untreated group varied too much to show an effect. [17]

In a noisy classroom you cannot hear whether one person has started whispering.

Ultragenyx has not yet shared the data from that failed trial. [17]

Ultragenyx is halving its research spending and will fill its pipeline partly with small deals, moving some of the job outside.

Their jobs go so that the company can reach profit in 2027. [17]

Two projects aimed at them are ending, and families lose those options. [17]

A former top executive is suing Madrigal Pharmaceuticals in a US federal court. [18] He says he was forced to resign after raising safety concerns about its approved drug. [18]

Michael Charlton, a doctor, led clinical development at Madrigal from October 2024 until January 2026. [18]

The drug treats MASH, a liver disease. [18]

The suit was filed on 9 October in northern Illinois. [18] It seeks his job back or money. [18]

"Madrigal punished him for it," the lawsuit says. [18]

Charlton's job was to safeguard the safety and accuracy of the drug's trials, the suit says. [18]

Employment lawyers call this retaliation: punishing a worker for raising a problem, which US whistleblower laws forbid and Charlton alleges. [18]

A pupil who reports a broken fire door should not get detention for it.

These are one side's claims in a lawsuit. [18] We could read only the opening of this report, and saw no reply from Madrigal. [18]

Whether Madrigal's drug has the safety problem the suit describes.

The claim comes from a former executive's lawsuit, untested in court, and we could read only the opening of the report. [18]

Sanofi, the big drugmaker behind the eczema drug Dupixent, has stopped work on a pill from Nurix, a biotech. [16]

Nurix revealed the decision on Tuesday. [16] Its shares fell more than 40% in early trading on Wednesday. [16]

Sanofi told analysts that "emerging nonclinical findings" did not justify more work in eczema. [16] Nonclinical means lab and animal tests, not patients. [16]

The partnership began in 2020, with $55 million up front and possibly $2.5 billion overall. [16] Nurix got $10 million in August, when a first human trial began. [16]

People with eczema lose one possible pill. [16] Sanofi still has a second STAT6 project, with Recludix Pharma. [16]

Chemists call a drug like this a protein degrader: it destroys a protein rather than blocking it. [16]

The target, STAT6, plays a part in a misdirected immune response, and small drugs have struggled to block it. [16] So companies tried destroying it instead. [16]

You can hold down a noisy toy's button, or you can take the toy away.

RBC's analyst called the decision disappointing. [16] Leerink's says it does not count against other drugs aimed at STAT6. [16]

Kymera, another protein-degrader company, reports a mid-stage trial of a similar drug later this year. [16]

They carry the fall, since Sanofi's next payments will not come. [16]

What Sanofi found in its eczema pill.

Nurix gave no reason, and Sanofi told analysts only of emerging nonclinical findings. [16]

AbbVie, the drug giant behind Humira and Skyrizi, will pay $100 million up front for a gut drug from Nxera. [14]

It may pay up to $1.37 billion more as the drug advances and sells, plus a share of sales. [14]

The drug, NXE0033744, is a pill for inflammatory bowel disease, or IBD, in which the gut stays inflamed. [14] It has finished only a first human trial. [14]

Nxera, a drug company once called Sosei, pulled back from this project late last year while cutting staff. [14]

Its chief called IBD a "very, very complex and expensive" area in which to develop a drug. [14]

AbbVie already sells Humira, Skyrizi and Rinvoq for IBD. [14] Nxera pitches the new drug at people whose disease is not well controlled. [14]

Pharmacologists call such a drug gut-restricted, and Nxera says its first trial found this one stays in the gut. [14]

It switches on a receptor called EP4 in the gut, hoping to calm swelling and heal the lining. [14]

A hose aimed at one plant leaves the rest of the garden dry.

Nxera's chief says AbbVie must now find out whether this biology really helps people with IBD. [14]

Nxera's chief called IBD too complex and expensive to develop, so the work moved to a firm that already sells IBD drugs.

It turns a project it had stepped back from into cash, and it no longer pays to develop it. [14]

The FDA, the US drug regulator, gave a fast review to BeOne Medicines' blood cancer pill, Brukinsa. [23]

BeOne is a cancer drug company. [23] It wants Brukinsa with an antibody drug, rituximab, as first treatment for mantle cell lymphoma, a blood cancer. [23]