Connect with us

Published

on

The new drug looked so promising except for that one warning sign.

This story also ran on Fortune. It can be republished for free.

At the American College of Rheumatologys annual meeting in 2008, Duke Universitys Dr. John Sundy proudly announced that pegloticase, a drug hed helped develop, was astoundingly effective at treating severe gout, which affects perhaps 50,000 Americans. In about half of those who had taken it, the drug melted away the crystalline uric acid deposits that encrusted their joints to cause years of pain, immobility, or disfigurement.

But Sundy also disclosed an unsettling detail: In one clinical trial, patients who got the drug were more likely to develop heart problems than those who didnt. The day after Sundys talk, the stock price of Savient Pharmaceuticals, which developed the drug with Duke scientists, plunged 75%.

That danger signal would disappear in later studies, and the FDA approved pegloticase, under the trade name Krystexxa, two years later. But the small biotech company never recovered. In 2013, Savient was sold at auction to Crealta, a private equity venture created for the purpose, for $120 million.

Two years later, a young company now called Horizon Therapeutics bought Crealta and its drug portfolio for $510 million.

Even at that price, it proved a good deal. Krystexxa brought in $716 million in 2022 and was expected to earn $1 billion annually in coming years.

Although Horizon says it now has 20 drugs under development, in its 15 years of existence it has yet to license a product it invented. Yet the company has managed to assemble a war chest of lucrative drugs, in the process writing a playbook for how to build a modern pharmaceutical colossus.

As the White House and both parties in Congress grapple with reining in prescription drug prices, Horizons approach reveals just how difficult this may be.

Horizons strategy has paid off handsomely. Krystexxa was just one of the many shiny objects that attracted Amgen, a pharmaceutical giant. Amgen announced in December that it intends to buy Horizon for $27.8 billion, in the biggest pharmaceutical industry deal announced in 2022.

Horizons CEO, Tim Walbert, who will reportedly get around $135 million when the deal closes, has mastered a particular kind of industry expertise: taking drugs invented and tested by other people, wrapping them expertly in hard-nosed marketing and warm-hued patient relations, raising their prices, and enjoying astounding revenues.

Hes done this with unusual finesse courting patients with concierge-like attention and engaging specialist clinicians with lunches, conferences, and research projects, all while touting his own experience as a patient with a rare inflammatory disease. Walberts company has been particularly adept at ensuring that insurers, rather than patients, bear the costly burdens of his drugs.

A federal prosecutor in 2015 began examining allegations that Horizons patient assistance program had worked with specialty pharmacies to evade insurers efforts to shun Horizons expensive drugs. A separate probe opened in 2019 over alleged kickbacks to pharmacy benefit managers, companies that negotiate to get Horizons drugs covered by insurers. Those investigations appear to be no longer active, Horizon spokesperson Catherine Riedel said. The company this year disclosed a third probe, concerning methods the company allegedly used to get prior authorization of its drugs. Justice officials did not respond to requests for comment on the investigations. Email Sign-Up

Subscribe to KFF Health News' free Morning Briefing. Your Email Address Sign Up

An Injection of Marketing

To help sell its drugs, Horizon blankets specialist physicians with marketing and peer-to-peer appeals. Its payments to physicians for things like consulting, speeches, and meals totaled $8.7 million in 2021, compared with the $10 million it paid them for research, federal records show. By contrast, Seagen, a biotech company of roughly the same size, paid doctors a total of $116 million, with nearly $112 million of that pegged for research. Riedel said Horizons marketing and educational approaches were necessarily unique because of the challenges of treating rare and neglected diseases.

Walbert launched Horizon in 2008 in the Chicago area by combining and refashioning generic drugs into single pills. Duexis, Horizons first drug, is a mixture of generic Motrin and Pepcid. Its Vimovo combines generic Aleve and Nexium. In a 2017 article, a ProPublica reporter described being prescribed Vimovo for a shoulder injury. It cost him nothing, but his insurer was billed $3,252 for pills that together cost about $40 for a months supply in generic form. Horizon sold more than $57 million worth of Vimovo that year.

In 2014 and 2015, respectively, Horizon picked up two relatively new drugs that had no generic versions: the immunosuppressant Actimmune and Ravicti, which treats a rare genetic disorder. Soon Horizon was charging more than $50,000 a month for each, placing Actimmmune fourth and Ravicti second on GoodRxs 2020 list of the most expensive U.S. drugs.

Horizons net sales soared from $20 million in 2012 to $981 million in 2016; Walberts pay package followed suit, topping an astronomical $93.4 million in 2015 in salary and stock. Stock analysts questioned the long-term soundness of a strategy of simply selling old drugs for mind-boggling prices, but Walbert was using the cash to refashion the company as a rare-diseases franchise.

His approach would make Walbert a darling of pharmaceutical investors and his board, which lavished him with over $20 million in compensation each of the past three years. While most biotechs and startups borrow heavily from venture capital to do science and have no idea how to develop and market a drug, Walbert got cash coming in quickly. He did it backwards, said Annabel Samimy, an analyst at Stifel Financial Corp. Horizon built commercial platforms before they got into drug development.

Generating robust sales of what sounded like not very interesting drugs allowed Walbert to start a company on not very much, said Oppenheimer analyst Leland Gershell. All the while, Horizon funded and cultivated the patient advocacy groups that can help lobby for a drug to be approved by the FDA and placed on insurers formularies, the lists of drugs health plans cover for patients.

Capitalizing on His Own Illness?

As Walbert and his spokespeople often point out, Walbert and his youngest son suffer from a rare disease, and Walbert also has an autoimmune disease. Walbert wont name the diseases, but has said hes taken the anti-inflammatory injectable Humira since 2003 the year he led that drugs commercial launch as a vice president at Abbott Laboratories. Humira has become the bestselling drug in history, with about $200 billion in all-time global sales.

In 2014, Walbert moved Horizons headquarters to Ireland, which nearly halved its tax rate. A year later it gained control of Krystexxa, and in 2017 it bought, for $145 million, a failing company that produced Tepezza, a drug for thyroid eye disease, which causes unsightly eye bulging and pain.

Tepezza quickly became a blockbuster, with $3.6 billion in total sales in 2021 and 2022. The company conducted additional clinical research on both Tepezza and Krystexxa, but it also spent heavily promoting these and other drugs to specialists who could prescribe them.

All the while it steadily raised prices. Savient put Krystexxa on the market in 2011 at $2,300 per injection. Horizon charges roughly 10 times as much. Six months of Tepezza treatment can run more than $400,000.

Horizons publicity emphasized the companys sensitivity to patients, and its constant contact with disease advocates.

Our scientists are attuned to the unmet needs of patients, their diagnostic and therapeutic journey, Bill Rees, Horizons vice president for translational sciences, told KFF Health News. Its the marrying of the basic clinical science with a focus on the needs of the patient that differetiates us.

To make sure patients keep using its drugs, clinicians say, Horizon staffers negotiate with insurance carriers, and the company offers drug discounts to lower-income patients while swaddling them with attention from its medical staff.

Horizon has a nurse talk to each and every patient before every appointment, said Dr. Brigid Freyne, who treats around half a dozen patients each year with Krystexxa at her Murrieta, California, rheumatology clinic. The patients who come in here are highly motivated to get their IV. They get the message that its very important and they are fortunate to get the medicine.

None of the manufacturers of her other infusion drugs shower patients with this kind of attention, she said.

While at Abbott, Walbert pioneered direct-to-consumer advertising for specialty drugs like Humira, a trend that aggravated insurers, who anticipated, correctly, that they would soon be shelling out billions for expensive drugs.

Horizons marketing plan for Krystexxa includes direct-to-consumer ads aimed at driving patients to specialists. The drug is designed for recalcitrant gout patients, who often have large lumps on their fingers, feet, and kidneys. Many, though not all, are heavy drinkers of beer or soda sweetened with high-fructose corn syrup, which can increase the buildup of uric acid, the cause of gout, said Dr. Robert McLean of Yale University.

While Krystexxa can help patients with advanced gout, the American College of Rheumatology views it as a drug of last resort, with plenty of cheaper, early intervention alternatives available.

I prescribe it maybe once a year, McLean said. From a cost-effectiveness standpoint, it warrants questioning.

Horizon recently started a publicity campaign addressed to all gout sufferers, urging them to see a rheumatologist or a nephrologist the specialists it has targeted with Krystexxa educational materials before the disease does too much harm.

Horizon would like you to say, Everyone with serious gout should be started on Krystexxa, said Dr. James ODell, a rheumatologist at the University of Nebraska Medical Center. The Horizon pitchmen he deals with are nice guys, but we dont believe thats the best way.

The company defends its marketing practices. We learn what matters most to patient communities and act. This approach has been validated by independent third-party research, said Riedel.

The Federal Trade Commission said in January it was seeking more information on the Amgen-Horizon merger. Sen. Elizabeth Warren (D-Mass.), citing high prices for Horizon and Amgen drugs, urged the agency to nix the deal.

Arthur Allen: ArthurA@kff.org, @ArthurAllen202 Related Topics Health Care Costs Health Industry Pharmaceuticals Drug Costs Prescription Drugs Contact Us Submit a Story Tip

Continue Reading

UK

Man ‘seen with weapons’ detained in Leeds after three injured

Published

on

By

Man 'seen with weapons' detained in Leeds after three injured

A man has been detained in Leeds after being “seen with weapons” and three people were left injured.

Police were called to Otley Road at 2.47pm on Saturday to reports of a “serious incident involving a man seen with weapons”, West Yorkshire Police said.

Officers arrived at the scene to find three people injured and a man was detained at the scene, the force said. The injuries are not believed to be life-threatening.

Officers inside the cordon in Leeds
Image:
Officers inside the cordon in Leeds

Officers guard one of the crime scenes in Leeds
Image:
Officers guard one of the crime scenes

An ambulance inside one of the cordons in Leeds
Image:
An ambulance inside one of the cordons

Inquiries are under way to establish the “wider circumstances” and a “number” of crime scenes remain in place, they added.

This breaking news story is being updated and more details will be published shortly.

Please refresh the page for the fullest version.

You can receive breaking news alerts on a smartphone or tablet via the Sky News app. You can also follow us on WhatsApp and subscribe to our YouTube channel to keep up with the latest news.

Continue Reading

UK

Wrexham promoted for third season in a row under Ryan Reynolds and Rob McElhenney

Published

on

By

Wrexham promoted for third season in a row under Ryan Reynolds and Rob McElhenney

Wrexham AFC have been promoted for the third season in a row.

The North Wales-based side has gone from the National League to the Championship in just three seasons, under its Hollywood owners Ryan Reynolds and Rob McElhenney.

Wrexham were second in the table and had a run of eight games unbeaten ahead of their match against Charlton Athletic on Saturday, which they won 3-0.

Wrexham's James McClean lifts the trophy after the Sky Bet League One match at SToK Racecourse, Wrexham. Picture date: Saturday April 26, 2025.
Image:
Wrexham’s James McClean lifts the League One trophy. Pic: PA

Wrexham's Dan Scarr celebrates with the fans on the pitch after Wrexham won promotion to the Sky Bet Championship after the Sky Bet League One match at SToK Racecourse, Wrexham. Picture date: Saturday April 26, 2025. PA Photo. See PA story SOCCER Wrexham. Photo credit should read: Martin Rickett/PA Wire...RESTRICTIONS: EDITORIAL USE ONLY No use with unauthorised audio, video, data, fixture lists, club/league logos or "live" services. Online in-match use limited to 120 images, no video emulation. No use in betting, games or single club/league/player publications.
Image:
Wrexham’s Dan Scarr celebrates with the fans on the pitch after Wrexham won promotion to the Championship. Pic: PA

It is the first time any club has been promoted for three consecutive seasons within the top five tiers of English football.

The third oldest association football club in the world, Wrexham AFC was bought by Reynolds and McElhenney in 2020, and has since been the subject of a Disney+ documentary, Welcome To Wrexham.

Reynolds, wearing a Wrexham sweatshirt, and McElhenney were pictured celebrating each goal, and after the game, as the fans came onto the pitch at the SToK Cae Ras (Racecourse Ground) to celebrate the victory with the players.

Wrexham co-owners Rob McElhenney (left) and Ryan Reynolds (right) and Ryan's wife Blake Lively before the Sky Bet League One match at SToK Racecourse, Wrexham. Picture date: Saturday April 26, 2025.
Image:
Wrexham co-owners Rob McElhenney (L) and Ryan Reynolds and Ryan’s wife Blake Lively, before the match. Pic: PA

Both stars came onto the pitch after the supporters returned to the stands.

More on Ryan Reynolds

Speaking to Sky Sports, McElhenney praised those behind the scenes, referring to “so many that don’t get the credit they deserve, people who aren’t talked about”.

Reynolds said bringing success back to the club “seemed like an impossible dream” when they arrived in North Wales in 2020.

Wrexham's Sam Smith celebrates in front of the fans on the pitch after Wrexham won promotion to the Sky Bet Championship after the Sky Bet League One match at SToK Racecourse, Wrexham. Picture date: Saturday April 26, 2025. PA Photo. See PA story SOCCER Wrexham. Photo credit should read: Martin Rickett/PA Wire...RESTRICTIONS: EDITORIAL USE ONLY No use with unauthorised audio, video, data, fixture lists, club/league logos or "live" services. Online in-match use limited to 120 images, no video emulation. No use in betting, games or single club/league/player publications.
Image:
Wrexham’s Sam Smith celebrates in front of the fans after Wrexham won promotion to the Championship. Pic: PA

He put the three promotions down to “the coaching staff, the greatest dressing room” and an “all for one, one for all” attitude throughout the club, adding he was “speechless with their commitment and their emotion”.

As for the mouth-watering prospect of another promotion to the promised land of the Premier League, the pair agreed it was “for tomorrow”, before ending the interview with a joint mic-drop.

Veteran striker Steven Fletcher said, “as soon as I came to this club, I knew it was something special. We want to go again. We’ll reset in the summer, take a break and go again”.

Continue Reading

Environment

Whisper Aero ultralight aircraft scores $500K for “UltraQuiet” electric jet motor tests

Published

on

By

Whisper Aero ultralight aircraft scores 0K for

Along with Tennessee Tech, Tennessee-based ultralight aircraft company Whisper Aero has secured a $500,000 grant to help advance the company’s innovative electric jet motor concept off the drawing board and onto the testing phase.

Earlier this month, the Tennessee Department of Economic and Community Development (TNECD) announced plans to award $500,000 to Tennessee Tech and Whisper Aero through the Transportation Network Growth Opportunity (TNGO) initiative.

“We look forward to using these award dollars to place students in internships working directly with Whisper Aero leaders,” said Tennessee Tech President Phil Oldham. “By learning from an electric propulsion innovator like Whisper Aero, our students will gain invaluable perspective and can take what they have learned in the classroom and apply it right here in Tennessee.”

The grant will see a Whisper Aero glider fitted with a pair of the company’s eQ250 electric-powered jet “propulsors” for UltraQuiet flight. Tennessee Tech faculty and students will carry out copper-bird ground testing to ensure the safe integration of engines, batteries, and controllers, and kickstart Tennessee Tech’s new Crossville Mobility Incubator.

Advertisement – scroll for more content

Those propulsors, by the way, are super cool.

UnltraQuiet WhisperDrive; via Whisper Aero.

Whisper Aero’s main claim to fame is its innovative UltraQuiet WhisperDrive (above). It’s effectively an electrically spun ducted fan jet engine that uses a large number of stiff composite fan blades inside a lightweight, acoustically treated duct. With so many blades, the Whisper Aero propulsor can push more air than a conventional prop while spinning much more slowly. As such, the “blade passage frequency” moves up to more than 16,000 Hz – outside the range of most human hearing but not, supposedly, high enough to freak out the beagles.

The Whisper Aero ultralight is effectively an Aériane Swift3 glider fitted with a pair of Whisper’s eQ250 propulsors, each capable of up to 80 lbs. of thrust. The Ultralight has a wingspan of over 40 ft with a maximum L/D of 35:1 and can be stressed to a design loading of +6/-4g, making it capable of some pretty impressive acrobatic feats.

The Swift3 glider is designed for a low speed, low power cruising speed of 45–55 knots with “just” 6.5 hp. Power-off glides from a few hundred feet showed a low sink rate, and a climb rate of 1,250 ft/min with full self-launching power (in other words: the Whisper glider doesn’t have to be towed by a launch vehicle, like a conventional ultralight glider).

Quiet cool

Dual WhisperDrive fans deliver ~160 lbf of thrust; via Whisper Aero.

Range under full power is about 109 miles with current battery tech, but it’s expected that range under the latest EPiC 2.0 energy batteries would rise to nearly 170 miles.

Nathan Millecam, CEO of Electric Power System, said, “EPiC 2.0’s leap in energy density and thermal performance has enabled a significant increase in range, a clear validation of our next-gen cell technology. We are impressed by what the Whisper team continues to achieve in advancing electric aviation.”

The press release concludes explaining that flight tests are expected to show that the Whisper Aero glider can be flown, “a few hundred feet away from neighborhoods without any disturbances, while carrying a 220 lbs. payload with full range,” which is all kind of ominous in today’s political climate, but still pretty neat from a purely tech perspective.

The TNGO grant follows a separate grant from NASA awarded last year, though that grant aims to develop the eQ250s – not as a propulsion system, but as a key component in future spacecraft ventilation systems.

Tennessee Tech announces TNGO grant

With support from TNECD’s Transportation Network Growth Opportunity (TNGO) initiative, Tennessee Tech University and Whisper Aero are partnering to advance next-generation propulsion technology in the aerospace industry. This collaboration will enhance aerospace research and workforce development, ensuring Tennessee remains a leader in cutting-edge mobility solutions.

TNECD

SOURCE | IMAGES: TNECD; via eVTOL Insights, New Atlas.


If you’re considering going solar, it’s always a good idea to get quotes from a few installers. To make sure you find a trusted, reliable solar installer near you that offers competitive pricing, check out EnergySage, a free service that makes it easy for you to go solar. It has hundreds of pre-vetted solar installers competing for your business, ensuring you get high-quality solutions and save 20-30% compared to going it alone. Plus, it’s free to use, and you won’t get sales calls until you select an installer and share your phone number with them. 

Your personalized solar quotes are easy to compare online and you’ll get access to unbiased Energy Advisors to help you every step of the way. Get started here.

FTC: We use income earning auto affiliate links. More.

Continue Reading

Trending