Last Week Tonight in BioPharma: Week of May 25th, 2026
Lilly' PCSK9 gene editing data, HBV functional cure, GLP-1 formulary update, Pfizer looks to China to reinvigorate its pipeline, and more!
Welcome back to Last Week Tonight in BioPharma (LWTB). What a week!
Lilly buys three vaccine platforms in a single day and drops some interesting gene-editing data, Pfizer locks in a China collab and subtly signals some retreat on their Seagen assets, and GLP-1s are finally on equal footing with US private insurers.
All that and more below. Let’s get into it!
A little programming note: I didn’t include any ASCO updates in this edition. I will be covering ASCO separately in future posts.
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I recently mapped out all the Big Pharma x Big AI partnerships and dug into who is winning the early rounds in that race, how each Big AI company is positioning themselves slightly differently, and what success factors may be for these tie-ups.
📡 PRESS RELEASE DECODER
What the press releases actually mean
Lilly/Verve’s VERVE-102 Cuts LDL Up to 62% With a Single Infusion — But the Real Question Is Whether Gene Editing Can Compete With Cheap Statins and Forthcoming Oral PCSK9s
📅 May 25-26, 2026 | 🏥 Eli Lilly ( LLY 0.00%↑ ) / Verve Therapeutics | 💊 VERVE-102 (in vivo PCSK9 base editor) | 📄 Phase 1b Heart-2 Interim Data — EAS Congress Late-Breaker + NEJM Publication
Lilly reported positive interim Phase 1b Heart-2 data for VERVE-102, the in vivo adenine base editor designed to permanently turn off PCSK9 in the liver via a single IV infusion. In 35 patients with heterozygous familial hypercholesterolemia (HeFH) or premature coronary artery disease, a single dose produced dose-dependent mean PCSK9 reductions of 51–88% and LDL-C reductions of 9–62% across six dose cohorts (0.3–1.0 mg/kg), with effects sustained out to 18 months. No treatment-related serious adverse events, no dose-limiting toxicities, no withdrawals; the main AEs were low-grade infusion reactions and fatigue. '
The data were presented as a late-breaker at the European Atherosclerosis Society Congress and simultaneously published in NEJM.
The asset came to Lilly via its $1B acquisition of Verve, and Lilly plans to start Phase 2 by year-end 2026. VERVE-102 has FDA Fast Track designation for hyperlipidemia with high lifetime CV risk.
🧠 BPS Take: 60%+ LDL drop without background statins is impressive, but the real question for VERVE-102 is the competitive landscape it has to win against. The available PCSK9 mAbs (Repatha, Praluent) and forthcoming oral PCSK9 inhibitors achieve roughly the same LDL reduction on top of background statins, and statins are so cheap and so deeply entrenched in US prescribing that displacing them is structurally near-impossible. The PCSK9 mAbs underperformed initial expectations because of cost, prior auth friction, and injectable burden — issues that have improved with CV outcomes data, primary prevention indications, and price reductions, but that history is the cautionary template here.
Oral PCSK9s arriving over the next few years can tailwind off that mAb improvement and offer the same efficacy in pill form; dollar-for-dollar, oral remains the most likely class winner. Gene editing clearly works for LDL reduction, but the appetite from patients, prescribers, and payers for one-time treatment that delivers comparable efficacy to small molecules is “guilty until proven innocent”.
One aspect of in vivo base editing I did not fully appreciate though was the cost. Typically we think of in vivo gene therapies and gene editing drugs as being quite expensive, but the cost to make these therapies has come down quite a bit as a result of the massive scale up of mRNA and LNP supply chains during the pandemic.
Here’s Sek Kathiresan, CEO of Verve and noted dosa monger giving some insight into the manufacturing costs:
So at $5 per 100 microgram, that marks the the 1mg/kg dose in the study at roughly $4K for a 80KG adult. Now I don’t know if that number is just raw materials or if it includes labor, licensing, platform fees, royalties, etc. You always need to be a little cautious of COGS figures being floated out for programs that are still early-clinical stage. However, even at a $4K baseline, the cost is still starting lower than I would have expected.
I kind of buy this $5 number though because Lilly actually went in and cleaned up (to wit, bought out) a large chunk of the the licensing and royalties Verve would have owed to Beam BEAM 0.00%↑ (who they got the base editing tech from). Plus Verve is also using their own proprietary LNP for this program. The royalties and licensing is where the largest chunk of COGS stem from for mRNA-LNP based therapies. So the biggest piece of the COGS puzzle is likely pretty minimal for Verve/Lilly now, maybe still owing some small royalties to the original academic institution(s) the base editing tech comes from.
Not every company can really pull that off, so to me, it is still unclear if this COGS number is a Lilly-specific thing or far more uniform across other in vivo gene editing treatments. Either way, it feels like progress.
Sek has also subtly indicated that they are thinking about pricing this closer to common procedures a heart patient would get: things like stenting, coronary angioplasty, and catheter ablation. This means, you could see Lilly pricing their one-time gene-editing treatment at the $25-$50K range, which is way lower than what we typically associate with cell and gene therapies.
At that price point you start to really force payers and patients to think a little bit. It becomes a bit easier to pay for a $25K one-time treatment that can minimize your risk of getting a heart attack or stroke. That price tag starts to look a lot better than the roughly $6.5K per year you would pay for PCSK9 mAbs or siRNA.
Ultimately, I think the PCKS9 orals will be the initial commercial winner in this space. They get the same level of LDL suppression, with oral convenience, and map better to the formulary games insurance/PBMs like to play. Even those will need to sequence behind generic statins and ezetimibe. I would expect most patients and physicians to be initially slow to adopt a one-time gene-therapy in this setting and want to wait for long-term safety data to rule out any unexpected editing-driven toxicity. But after that, assuming all goes well, these one-time edits may make a better argument than any other competitors in the injectable class.
GSK's Bepirovirsen Hits 19% Functional Cure in Chronic Hep B Phase 3 — A 20x Improvement Over Standard of Care, and the First Real Shot at Replacing Lifelong Antivirals
📅 May 28, 2026 | 🏥 GSK ($GSK), licensed from Ionis Pharmaceuticals (IONS 0.00%↑ ) | 💊 Bepirovirsen (antisense oligonucleotide targeting HBV RNA) | 📄 B-Well 1 & B-Well 2 Phase 3 Results — NEJM Publication + EASL Late-Breaker
GSK reported positive pivotal data from the B-Well 1 and B-Well 2 Phase 3 trials of bepirovirsen, simultaneously published in NEJM and presented as a late-breaker at EASL. Pooled across both trials, a 6-month course of bepirovirsen achieved a 19% functional cure rate (233/1,220) vs. 0% on placebo plus standard of care (p<0.001 in both trials) in the overall population — adults with baseline HBsAg ≥3,000 IU/mL on nucleos(t)ide analogue therapy. In the pre-specified key secondary endpoint of patients with baseline HBsAg ≤1,000 IU/mL (~45% of diagnosed CHB cases globally), functional cure rose to 26% (200/768).
Functional cure is defined as undetectable HBsAg and HBV DNA in blood for at least 24 weeks after stopping all treatment. For context, current standard of care — lifelong nucleos(t)ide analogues — achieves functional cure in <1% of patients.
In exploratory analysis, 49% of bepirovirsen recipients reached qHBsAg ≤100 IU/mL one year after end of treatment, a level associated with improved long-term immune control. Safety profile was acceptable: the three most common AEs were injection site erythema, local pain, and transient liver enzyme elevations.
Bepirovirsen has FDA Priority Review with Breakthrough and Fast Track Designation; first regulatory decisions are expected Q3 2026. GSK announced a Sino Biopharmaceutical collaboration in May to accelerate China launch.
🧠 BPS Take: 19% functional cure may not sound like much, but it is a big moment in the HBV world, which has been a disease where cure rates have remained elusive. A 20x improvement over placebo is nothing to shrug your shoulders too in any disease.
Chronic Hep B affects 240M+ people globally (1.7M in the US, 75M in China) and accounts for ~56% of global liver cancer cases. The current paradigm is lifelong tenofovir or entecavir, which are effective at viral suppression but rarely curative, with the patient committed to indefinite therapy. Bepirovirsen offers a 6-month finite course that converts roughly one in five patients to off-treatment immune control.
It’s not the same was what we’ve seen in HIV or HCV, but it is still incredibly meaningful, and could be a first step towards renewed investment interest in this space that leads to more significant breakthroughs.
🌐 CONNECTING THE DOTS
When the outside world meets biopharma
CVS Caremark Re-Adds Zepbound and Unblocks Foundayo — All Three Major PBMs Now Cover Both Novo and Lilly Obesity Portfolios, Setting Up the First Real Oral GLP-1 Competition
📅 May 28, 2026 | 🏥 CVS Health / Caremark (CVS), Eli Lilly ( LLY 0.00%↑ ), Novo Nordisk ( NVO 0.00%↑ ) | 💊 Zepbound (tirzepatide), Foundayo (orforglipron), Wegovy (semaglutide) | 📄 Commercial Formulary Update
CVS Caremark announced two formulary changes that, taken together, reshape the GLP-1 obesity access landscape. Effective October 1, 2026, Zepbound (tirzepatide) returns to Caremark’s commercial template formularies as an additional preferred option alongside Wegovy — reversing the May 2025 exclusion that had handed Novo a single-payer advantage at the largest PBM in the country. Effective June 1, 2026, Caremark also removes the new-to-market block on Foundayo (orforglipron), Lilly’s oral GLP-1 approved on April 1, 2026.
With this move, all three major PBMs — Caremark (~88M lives), Express Scripts, and OptumRx — now cover both Novo and Lilly’s obesity franchises. LLY shares traded up as much as 6% on the news; this got remarkably little commentary across biopharma media given the scale of the access expansion.
🧠 BPS Take: For the past year, Caremark’s exclusion of Zepbound was the most consequential single payer decision in the GLP-1 class — it forced employer plans toward Wegovy by default and capped Lilly’s commercial upside. Reversing it sets up the first real head-to-head formulary competition in the obesity class on both injectables (Zepbound vs. Wegovy) and, more importantly, orals (Foundayo vs. an eventual oral semaglutide expansion).
Oral GLP-1 competition is the more interesting commercial battleground because orals are far more frictionless. CVS’s own framing , “delivering affordability and optionality”, after manufacturer negotiation is the polite way of saying both Novo and Lilly conceded net price to get on (or stay on) the formulary.
💰 FOLLOW THE MONEY
Deals, dollars, and what they signal
Pfizer Pays $650M to Option Into 12 Chinese ADC and Bispecific Programs
📅 May 28 | 🏢 Pfizer ( PFE 0.00%↑ ), Innovent Biologics ( $IVBXF ) | 💊 12 ADC and multi-specific antibody programs | 🏷 Strategic Partnership | Up to $10.5B
Pfizer ($PFE) and Innovent Biologics announced a strategic collaboration covering 12 oncology assets, including eight Innovent-originated programs and four programs from Pfizer’s discovery pipeline. The deal terms provide for $650 million in upfront payments, with total potential value of up to $10.5 billion including development and commercial milestones. Under the structure, Innovent leads clinical development through Phase 1. Pfizer then holds rights to advance the programs globally outside of China, with tiered co-development and co-commercialization arrangements depending on the asset. Innovent shares rose approximately 10% on the announcement.
🧠 BPS Take: A few curious details in the press release worth highlighting. Pfizer gets global rights to 4 programs, ex-China rights to 4 other programs, and a global Co/Co on 4 other programs. The programs span multi-specific antibodies, but notably also ADCs. It’s a strange deal considering Pfizer spent $40B+ on an ADC company (Seagen) in 2023, with little to show for it. Implicitly, they are conceding that a lot of the pipeline Seagen assets were not good enough or will be deprioritized.
True co-commercialization arrangements between Big Pharma and Chinese biotechs remain rare — Legend Biotech / J&J on Carvykti (50/50 global cost-and-profit split outside Greater China; 70/30 in Greater China favoring Legend) is the canonical reference, and the comparable structures are few. Most recent US-China oncology deals have been structured as licensing or option deals with cleaner economic separation. I’m not sure how this is going to play with the current White House. However, amidst all the struggles Pfizer has had post-COVID, the one thing they have seemed to do a good job of is maintaining a friendly relationship with the Trump administration.
Eli Lilly Buys Three Vaccine Developers for $3.8B in a Single Day
📅 May 26 | 🏢 Eli Lilly ($LLY) | 💊 Shingles vaccine (Curevo), staph vaccine (LimmaTech), EBV vaccine (Vaccine Company) | 🏷 Triple M&A: Vaccine Acquisitions | $3.8B combined
Eli Lilly ($LLY) announced the acquisition of three private vaccine developers on May 26 in a combined deal valued at up to $3.8 billion. The three companies are Curevo, a shingles vaccine developer acquired for $1.55 billion, LimmaTech Biologics, a Swiss company developing a vaccine for staph infections, and a company referred to in press reports as Vaccine Company developing an EBV and mononucleosis vaccine.
The three acquisitions push Lilly’s 2026 total M&A spending past $20 billion. Earlier deals this year include the acquisition of Centessa Pharmaceuticals for $7.8 billion (orexin receptor agonist in sleep disorders, March 31), Kelonia for $7 billion (in vivo CAR-T platform, April 20), Ajax Therapeutics for $2.3 billion (JAK2 inhibitor in myeloproliferative neoplasms, April 27), and a deal for Profluent (gene editing, up to $2.25 billion in milestones, undisclosed upfront).
Curevo’s lead shingles vaccine would compete with GSK’s ($GSK) SHINGRIX, which generates more than $4 billion in annual revenue and is the dominant shingles vaccine franchise globally.
🧠 BPS Take: The hat trick of vaccine company deals are almost secondary to the meta-story, which is that Eli Lilly has spent what for most companies would be a decade’s worth of business development budget in a single calendar year, and every single acquisition is in a therapeutic area with no meaningful overlap with GLP-1 obesity and diabetes. This is Lilly trying to intentionally diversify for the long-term and set them selves up to be less dependent on GLP-1 revenues over the long-term, especially after they inevitably go generic.
You’re never going to plug that GLP-1 sized revenue hole with one product (at least that is unlikely), so spending the dollars while you have them to build into orthogonal opportunities is prudent risk-management and strategy.
Digging into the vaccine story a bit, it is a bit odd that Lilly went down this route, given they aren’t considered a typical vaccine company or a player in infectious disease. Still, this could be an area their corporate strategy team has identified as winnable (the hiring of former FDA vaccine chief Peter Marks says as much) and investing in three core platforms would allow Lilly to slowly build into being a player in this therapeutic area, which has largely been dominated by the likes of Merck, Pfizer, Sanofi, and GSK.
Kardigan Files S-1 With Three Mid-to-Late-Stage Cardiovascular Assets — MyoKardia 2.0
📅 May 27, 2026 | 🏥 Kardigan (pre-IPO) | 💊 Danicamtiv (cardiac myosin activator), tonlamarsen (ASO targeting hepatic angiotensinogen, licensed from Ionis), ataciguat (sGC activator, licensed from Sanofi/Mayo Clinic) | 📄 IPO S-1 Filing
Kardigan filed its S-1 on May 26, capping a remarkably fast 18-month arc from launch to public markets. The Bay Area cardiovascular company is led by CEO Tassos Gianakakos — who ran MyoKardia for seven years before its $13.1B sale to Bristol Myers Squibb in 2020. The company has raised approximately $570M to date across a $300M Series A (January 2025) and a $254M Series B (last fall). Cash position was $287.1M at the end of March.
The lead asset, danicamtiv, is a cardiac myosin activator (mechanistically the inverse of MyoKardia/BMS’s Camzyos, a myosin inhibitor) in Phase 2b/3 for genetic dilated cardiomyopathy, originally a BMS asset. Tonlamarsen is an Ionis-licensed antisense oligonucleotide targeting hepatic angiotensinogen for treatment-resistant hypertension; its prior Phase 2 readout hit a biomarker endpoint but missed the primary blood pressure endpoint. Ataciguat is a soluble guanylate cyclase activator licensed from Sanofi and Mayo Clinic, in Phase 2b for calcific aortic valve stenosis — an indication with no approved disease-modifying therapy.
🧠 BPS Take: The investment pitch here is pretty simple. Here is a company flush with cash that has collected three under-appreciated assets from (mostly) Big Pharma and are looking to remix the MyoKardia album, only this time with three hit songs instead of one. It also helps that you have a management team that has done it before, specifically in cardiovascular disease.
On the IPO market read: Kardigan joins Seaport, Hemab, Avalyn, Odyssey, Generate, and Kailera in a window that has clearly reopened, with the common thread being Phase 2+ assets and $250M+ raise targets. Investors are paying for de-risked clinical data (not platforms).
Back next week with more BioPharma strategy takes! Share this with a friend or colleague if you found it helpful.