Betting on sports playoffs is one thing. Betting on whether a cancer drug will work is another — and it's now possible.
Prediction-market company Kalshi, in partnership with data firm AppliedXL, has launched markets on clinical trial outcomes and FDA decisions. The pilot opened with about a dozen contracts tied to late-stage trials, letting people wager on whether a drug will hit its primary endpoint, win approval, or when a company will file its application.
What you can bet on
Early contracts cover closely watched programs including Takeda's oveporexton, Intellia Therapeutics' lonvo-z, Eli Lilly's retatrutide and VERVE-102, and Compass Pathways' psilocybin therapy COMP360.
Why the industry is uneasy
Pharma and health-tech leaders warn the markets could invite abuse. Clinical trials involve hundreds of people with potential access to unblinded data.
“At best it incentivizes predictably bad behavior from folks with insider access,” said Shashi Shankar, CEO of Novellia, pointing to insider-trading risk.
Amy Bucher, chief behavioral officer at Lirio, raised a subtler worry: public predictions could nudge how researchers interpret results or how funding flows, through cognitive bias and social influence. The concerns aren't hypothetical — prediction markets have already produced eye-catching payouts, including a reported six-figure win on Kalshi and a $400,000-plus haul on a rival platform tied to non-public information.
Why it matters
Clinical trials are meant to protect patients and produce trustworthy science. Turning their outcomes into tradable contracts tests whether that integrity can survive a profit motive — a debate regulators and drugmakers are only beginning to have.