Newsletter · · Ashutosh Agarwal

Eli Lilly's Foundayo Launch and Strong Heart Data Drive a Managed Care Rally on the New Medicare Advantage Rate - Healthcare Podcast Weekly Digest - Week of April 10–17, 2026

Healthcare podcast and news synthesis for April 10–17, 2026. Eli Lilly's Foundayo launch and ACHIEVE-4 data, a managed care rally on the finalized CMS Medicare Advantage rate, and a record-pace M&A environment frame the sector.

Healthcare Podcast Weekly Digest

Week of April 10–17, 2026: Eli Lilly's Foundayo Launch and Strong Heart Data Drive a Managed Care Rally on the New Medicare Advantage Rate

Opening Summary

The healthcare sector this week was dominated by Eli Lilly's Foundayo launch rollout and blockbuster ACHIEVE-4 cardiovascular data, a continued managed care rally on the back of CMS finalizing a 2.48% Medicare Advantage rate increase for 2027, and an active M&A environment on pace for a record year. Meanwhile, tariff confusion persists as pharma companies negotiate MFN pricing deals with the White House, and Trump nominated Dr. Erica Schwartz as CDC Director, adding to the regulatory reshuffling underway across healthcare agencies.

👥 Key People This Week

Speaker Affiliation Key Quote / Takeaway
Thomas Seck, M.D. Eli Lilly, SVP Product Development On ACHIEVE-4: "The risk of all-cause death was 57% lower with Foundayo vs. insulin glargine."
Dave Ricks Eli Lilly, CEO Lilly captures 70-75% of new GLP-1 patients; building "the biggest biologically focused supercomputer" with Nvidia.
Jim Cramer CNBC On Novo: "I don't see a path to own [Novo]. I still see a path to own Lilly." Price target ~$1,300 range for LLY.
Steve Eisman The Real Eisman Playbook Bearish on entire managed care sector: "P.E. multiples on medical insurance stocks have collapsed, but so have the business models."
Raul Shah DocShaw Financial Most bullish voice on UNH ($550 PT), sees margin recovery by 2027-2028. HIMS is his largest position (~$100 PT).
Adam Feuerstein STAT News Q1 2026 M&A at $44-49B, "If it continues at this pace, it would be the best year for M&A since 2019."
Andrew Summers Summers Value Fund Shifted from 5% to 40% biotech/pharma allocation: "On a relative basis, the sector looks very attractive."
Jim Rossman Barclays Healthcare is the second-most attractive sector for activist campaigns, driven by policy uncertainty creating valuation dislocations.
Rod Wong RTW Investments Capital invested in rare disease dropped from $9.5B to $6.5B, 70% attributed to regulatory unpredictability at CBER.
Annalee Armstrong BioSpace On pharma tariffs: "The headline was kind of jarring, but there's so many exemptions that it's really unclear how much of a big deal this is going to be."

🔥 Hot Topics

1. Eli Lilly's Foundayo: Back-to-Back Catalysts

Lilly's oral GLP-1 Foundayo (orforglipron) dominated the week:

  • FDA-approved April 1, shipping immediately. Pricing: $25/month with insurance, $149-$349/month cash pay, $50/month for Medicare seniors starting July 2026. (CNBC Money Movers, Apr 2026)
  • Distribution partnerships announced with Amazon Pharmacy (same-day delivery), GoodRx, LifeMD, and Walmart (expanding Better Care Services platform with GLP-1 support).
  • ACHIEVE-4 Phase 3 data released April 16: In 2,700+ patients with T2D and elevated CV risk, Foundayo showed non-inferior MACE vs. insulin glargine, with 57% lower risk of all-cause death and 16% lower MACE risk. No hepatic safety signal.
  • BRUIN CLL-322 trial (Jaypirca + venetoclax/rituximab) also met its primary endpoint in relapsed/refractory CLL, label expansion submission planned this year.
  • Morgan Stanley raised LLY PT to $1,327 from $1,313 (Overweight maintained).
  • Key competitive edge: No food or water restrictions for Foundayo vs. Novo's oral Wegovy which requires empty stomach, large glass of water, and 30-minute fast. (BioSpace, Apr 2026)

2. Managed Care Rally on CMS Rate Finalization

CMS finalized a 2.48% net payment increase for 2027 Medicare Advantage rates, dramatically better than the initial 0.09% proposal from January that had tanked the sector. Health insurers rallied on the news, with the Fly calling it a "positive surprise."

However, UNH remains under pressure from the ongoing DOJ antitrust probe into Optum. UNH also announced a $250K maternal health collaboration in Missouri, a small community investment.

3. GLP-1 Market Approaching $190B TAM

Global weight loss drug market projected to reach $190B by 2035 per 7investing. (The 7investing Podcast)

U.S. adoption doubled from 3% to 6% of eligible patients in 2024-2025; only ~2% of the obese population currently treated. Lilly's retatrutide (triple agonist) delivered 28.7% weight loss in Phase 3, highest ever in a clinical trial. FDA submission planned 2026, potential launch early 2027.

4. AC Immune / Lilly Tau Collaboration Amendment

AC Immune receives CHF 10M upfront for continued Tau aggregation inhibitor work targeting Alzheimer's. Eligible for CHF 1.7B+ in milestones. Leerink called it "great news", shows Lilly hasn't given up on intracellular Tau despite prior setbacks.

⚖️ Key Debates

Bull vs. Bear: Can Novo Nordisk Recover?

Bears (Cramer, Carter Worth, Holtz): Clinical inferiority after Cagrisema missed non-inferiority in REDEFINE-4 (23% vs. Lilly's 25.5% weight loss). Stock down ~50% from mid-2024 peak. 9,000 layoffs. "I don't see a path to own the stock." (Squawk on the Street, Feb 2026)

Contrarian Bulls (Erickson, Major): Novo is "an inexpensive stock" with oral Wegovy first-mover (200K patients in month one), UBT-251 triple agonist (19.7% weight loss at 24 weeks, no plateau), and dominant emerging market brand built over 100+ years of insulin. (The 7investing Podcast, Mar 2026)

Bull vs. Bear: UNH, Value Trap or Recovery Play?

Value Trap (Eisman, Klein): "Business models have collapsed." 69% quarterly earnings decline. Structural populist/political risk. "Old business model is gone." (The Real Eisman Playbook, Feb 2026)

Recovery (Shah, $550 PT): Actuarial miscalculation, not structural collapse. Three catalysts: AI cost reduction, shedding unprofitable plans, 10-20% premium increases. Margin recovery expected 2027-2028. CMS 2.48% rate increase validates thesis. (Investing Experts, Mar 2026)

Bull vs. Bear: GLP-1 Pricing, Destructive Race or Volume Play?

Destructive (Ann Berry, Brew Markets): "Once those price cuts are there, they tend not to be reversed, and often the whole sector loses." (Brew Markets, Feb 2026)

Volume-accretive (Lilly & Novo mgmt): Lower prices drive volume that more than compensates. GLP-1s now "wildly cost-effective" per ICER. The real issue becomes budget impact. (Business Daily, Mar 2026)

Bull vs. Bear: Lilly Valuation, Justified or Stretched?

At ~50x trailing P/E vs. 12x pharma average, bulls cite 40% revenue growth, 80%+ gross margins, $190B TAM, and pipeline optionality (retatrutide, brinipatide in addiction/mental health).

Bears (Paul Major, Bellevue) don't own it despite being healthcare specialists: "A lot of hope in that share price... a lot of duration assumed." (The Business, Dec 2025)

🌱 Emerging Themes

  1. Oral GLP-1s as Market Expanders: Foundayo's no-restriction dosing and $25/month insured pricing could meaningfully expand the treatable population beyond injection-tolerant patients. William Blair expects Foundayo to "blunt the uptake of oral Wegovy" since most oral Wegovy users were new GLP-1 users, not switches.

  2. GLP-1 Indication Expansion Beyond Obesity: Lilly running trials in chronic pain, PCOS/fertility, psoriasis, Crohn's/colitis, rheumatoid arthritis, early Alzheimer's prevention. Also Phase 3 for brinipatide in alcohol use disorder, tobacco use disorder, bipolar disorder, and major depressive disorder. CRP drops 60-70% within weeks on tirzepatide, suggesting broad anti-inflammatory mechanism.

  3. Healthcare as Activist Target: Barclays' Jim Rossman identified healthcare as the #2 sector for activist campaigns, policy uncertainty creating valuation dislocations. "There are a lot of undervalued health care companies." (CNBC Money Movers, Apr 2026)

  4. Rare Disease Investment Pullback: RTW's Rod Wong reports capital invested in rare disease fell from $9.5B to $6.5B, a one-third decline, with 70% attributed to regulatory unpredictability under Vinay Prasad at CBER. (The Readout Loud, Apr 2026)

  5. Pharma Manufacturing Reshoring Wave: Abbott ($500M), BD ($2.5B), Regeneron ($2B), CSL ($1.5B) committing to U.S. manufacturing expansions amid tariff pressure and MFN deal requirements.

💼 Deals and M&A Tracker

Q1 2026 deal volume: ~$44-49B. BMO predicts ~$172B for full year, potential record. (BioSpace, Apr 2026)

Deal Value Status/Date
Abbott / Exact Sciences $21B Q1 2026
BD / Waters Corp $17.5B Q1 2026
Merck / Sedara Therapeutics $9.2B Nov 2025
Gilead / Arcelix ~$8B Feb 2026
Pfizer / Metsera (GLP-1) ~$7.3-10B Oct 2025
Eli Lilly / Centessa (orexin/sleep) $6.3B Apr 2026
Biogen / Apellis (immunology) $5.6B Apr 2026
Gilead / Tubulis (ADC) $3.5B Apr 2026
Neurocrine / Soleno (rare disease) $2.9B (51% premium) Apr 2026

Active acquirers with capacity: Amgen, AbbVie, Bristol-Myers Squibb, Novartis. Lilly has cash but expected to be "more selective." Gilead has made three acquisitions in three months despite saying they were "in no rush."

🏛️ Regulatory Watch

  • CMS finalized 2.48% Medicare Advantage rate increase for 2027 (vs. 0.09% initially proposed), sector-wide positive.
  • Trump nominated Dr. Erica Schwartz as CDC Director (former Deputy Surgeon General, Brown University MD). Sean Slovenski named CDC Deputy Director/COO.
  • Pharma tariffs: 100% tariffs on 17 large pharma companies announced, but with extensive exemptions (orphan drugs, cell/gene therapy, ADCs). Effective in 120-180 days. Multiple companies negotiating MFN pricing deals for reprieves, creating confusion as some companies (Pfizer, J&J, GSK) have deals but remain on the tariff list.
  • MFN spillover concern: Some pharma companies reportedly considering delaying European launches to avoid setting reference prices, "the idea that European patients would be actually denied new medicines just so that Americans can be charged more." (BioSpace, Apr 2026)
  • CMS launched ACCESS Model for chronic care management.
  • FDA PDUFA decisions this week for Travere Therapeutics (Filspari) and Geron (Rytelo).
  • Lilly to submit Foundayo for T2D to FDA by end of Q2 under Commissioner's National Priority Review Voucher.
  • Bipartisan PBM reform pressure continuing to build in Congress.

🔭 Week Ahead

  • Q1 2026 Earnings Season kicks off, J&J among first large pharma reporters. Watch for tariff impact guidance, GLP-1 competitive commentary, and M&A appetite.
  • AACR Annual Meeting (San Diego), dense oncology catalyst calendar with multiple clinical data presentations.
  • FDA PDUFA dates: Travere Therapeutics (Filspari), Geron (Rytelo).
  • Allogene Therapeutics ALPHA3 trial readout, key for allogeneic CAR-T space.
  • IDEAYA Biosciences, trial data expected.
  • Novo Nordisk, first oral Wegovy revenue figures anticipated in upcoming quarterly report.
  • Managed care guidance updates, will UNH, CVS, Centene upgrade 2026 guidance on CMS tailwind?
  • Lilly Foundayo T2D submission, expected by end of Q2 2026.
  • Retatrutide additional Phase 3 readouts, six trials completing throughout 2026.
  • Medicare GLP-1 access, Lilly's $50/month Medicare pricing begins July 1.

Sources