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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

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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

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Science

A Planet with a Death Wish: How HIP 67522 b Is Forcing Its Star to Explode

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A Planet with a Death Wish: How HIP 67522 b Is Forcing Its Star to Explode

Scientists have caught a planet with a death wish, which is an alien world, orbiting very near to its star, and so speedy that it is causing the star to go to its death with bursting explosions. HIP 67522 b is the planet, and it is of the same size as Jupiter with a seven-day orbit around its host star. These orbits are disturbing the magnetic field of the star and causing enormous blasting eruptions to blow back the planet and make it wrinkled. This is the first time that a planet is influencing the host star, as the astronomers reported in a study published on July 2, 2025, in the Journal Nature.

A Planet with a Death Wish: HIP 67522 b’s Fiery Orbit

As per the study by NASA, Ekaterina Ilin, the first author of the study and an astrophysicist at the Netherlands Institute for Radio Astronomy, said that the planet was observed to trigger the energetic flares. It has been predicted by the scientists that the waves are setting off explosions that are going to happen.

Magnetic Chaos: Planet Triggering Star’s Explosions

Stars are burning plasma, gigantic balls with charged particles or ions that move on their surface to form strong magnetic fields. Since the magnetic fields cannot cross each other, sometimes these field knots suddenly snap to launch flares of radiation known as solar flares, which are often accompanied by coronal mass ejections, also known as surface plasma.

As many planets have a magnetic field, scientists have long wondered whether the planets, having close orbits near their stars, might disturb these strong magnetic fields and trigger the explosions. For years, scientists have observed whether the planets can influence the magnetic behaviour of their host stars, especially the ones that are close to their orbits.

A New Era of Star-Planet Relationship Studies

A planet with a strong magnetic field orbits around a star which has a delicate magnetic field, then it might be bombarded with solar radiation. These interactions helps int he study of star and planet bond and further the evolution of atmospher and magnetic field.

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Vladimir Putin tells Donald Trump he will not back down from goals in Ukraine, Kremlin says

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Vladimir Putin tells Donald Trump he will not back down from goals in Ukraine, Kremlin says

Vladimir Putin told Donald Trump he “will not back down” from Russia’s goals in Ukraine during a phone call today, the Kremlin has said.

The Russian president spoke to his US counterpart for almost an hour, and Mr Trump “again raised the issue of an early end to military action” in Ukraine, Kremlin aide Yuri Ushakov told reporters.

In response, Mr Putin said “Russia will not back down” from its aims there, which include “the elimination of the well-known root causes that led to the current state of affairs,” Mr Ushakov said.

The phrase “root causes” is shorthand for Moscow’s argument that it was compelled to invade Ukraine in order to prevent the country from joining NATO.

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Trump and Putin’s latest call on Ukraine

Ukraine and its European allies say this is a pretext to justify what they call an imperial-style war, but Mr Trump has previously shown sympathy with Russia.

At the same time, Mr Putin told the US president that Russia is ready to continue negotiating, the aide said.

The Russian president said any prospective peace deal must see Ukraine give up its NATO bid and recognise his country’s territorial gains.

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Donald Trump and Volodymyr Zelenskyy NATO summit in The Hague, Netherlands June 25, 2025. Pic: Reuters
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Volodymyr Zelenskyy, seen with Mr Trump in June, is pushing for Ukraine to join NATO. Pic: Reuters

He also briefed Mr Trump on agreements made last month, which saw Russia and Ukraine exchange prisoners of war and dead soldiers.

Specific dates for the third round of peace talks in Istanbul were not discussed – nor was the US decision to halt some shipments of critical weapons to Ukraine.

Mr Putin and Mr Trump’s call came after the Pentagon confirmed some weapons due to be sent to Ukraine have been held as it reviews military stockpiles.

The paused shipments include air defence missiles and precision-guided artillery, two people familiar with the situation have said.

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The decision led to Ukraine calling in the acting US envoy to Kyiv on Wednesday to underline the importance of military aid from Washington.

Kyiv also cautioned that the move would weaken Ukraine’s ability to defend itself against intensifying Russian airstrikes and battlefield advances.

Mr Putin and Mr Trump’s phone call was the sixth they have publicly disclosed since the US president returned to the White House in January.

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UK

Diogo Jota’s joyous final weeks make his death even more devastating to comprehend

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Diogo Jota's joyous final weeks make his death even more devastating to comprehend

The joy that filled the final weeks of Diogo Jota’s life makes his death even more devastating to comprehend for his family and millions of fans worldwide.

The most illustrious title of his career was won in May, when he paraded through Liverpool with his teammates and the Premier League trophy.

More success came with Portugal as he won the Nations League for a second time alongside Cristiano Ronaldo in June.

And then came the bliss at marrying his childhood love Rute Cardoso, watched by their three children.

Latest: Liverpool players pay tribute to Jota

Just yesterday Jota posted a video from the ceremony on social media alongside the message “a day we will never forget”.

The happiest of days was remembered before the tragedy that killed Jota and his brother Andre Felipe in northwest Spain.

Diogo Jota and wife Rute
Pic: rutecfcardoso14/Instagram
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Diogo Jota and wife Rute. Pic: rutecfcardoso14/Instagram

Brothers – whose careers both developed at their hometown club, Porto – so tragically dying together.

“Football has lost two great men,” Porto president Andre Villas-Boas said, as fans descended on the club’s stadium to mourn.

At Anfield, Liverpool fans are grieving the versatile forward who was so often in the shadow of Mohamed Salah, as he was under Ronaldo at Portugal.

But he knew how to sacrifice stardom to contribute to the squad.

Liverpool's Diogo Jota holds the  Premier League trophy with Wataru Endo and teammates.
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Diogo Jota holds the Premier League trophy with Wataru Endo and teammates. PIc: Reuters

The last of his 65 Liverpool goals was the winner in the Merseyside derby against neighbours Everton in April – helping the club become the record 20-time champions of England.

A Premier League winners’ medal joining those from the FA Cup and League Cup, won by the 28-year-old after he joined the Reds in 2020.

It was Wolverhampton Wanderers who gave Jota a platform to shine in England after he joined from Atletico Madrid.

Promotion was gained to the Premier League in 2018, and they more than just avoided relegation, but secured back-to-back top-seven finishes.

Jota was a reason why.

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Fans react to Jota death

He was also why Wolves could embark on such a memorable European campaign, and scored two hat-tricks in the run-up to the Europa League quarter-finals in 2020.

“The memories he created will never be forgotten,” Wolves said.

For the football world, the loss of such a talent so young will be hard to comprehend.

And so many are reflecting on the fragility of life as football grieves from Liverpool to Portugal – and beyond.

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