# The Healthcare Pulse: April 24 – May 1, 2026

> Healthcare podcast intelligence brief for April 24 – May 1, 2026. Eli Lilly's Q1 blowout and M&A spree reframe the obesity narrative while sector-wide dealmaking, an FDA AI-trial pilot, and an Amgen Tavneos regulatory cloud dominate the tape.


# The Healthcare Pulse: Weekly Podcast Intelligence Brief

**Week of April 24 – May 1, 2026**

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## 1. This Week at a Glance

Healthcare's center of gravity tilted decisively toward **Eli Lilly** this week, as the company's Q1 blowout (revenue +56% YoY to $19.8B, FY guidance raised by $2B) and a four-deal M&A spree reframed the obesity narrative from "saturation risk" to "platform expansion." The other dominant threads: a sector-wide **M&A acceleration** anchored by Sun Pharma's ~$12B takeout of Organon; an FDA push into **AI-driven "real-time" clinical trials** with Amgen and AstraZeneca as first adopters; managed care quietly rebounding behind a **2.48% finalized 2027 Medicare Advantage rate**; and a brewing **regulatory cloud over Amgen's Tavneos** after the FDA escalated its withdrawal request. Tone across podcasts, sell-side notes, and earnings calls was the most constructive on biopharma since the IRA overhang began clearing late last year.

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## 2. The People Driving the Conversation

**Evan Seegerman, BMO Capital Markets, Senior Pharma Analyst & Head of Healthcare Research.** Bullish across-the-board this week, especially LLY, VRTX (~40% implied upside) and REGN (~27% implied upside). On Lilly post-print: *"I have a buy rating on the stock, so I would recommend buying Lilly at these levels. Even with the move today, I see more upside. The stock is down 13% or so year to date, so there is still more room to grow."* He framed pharma's broader rerating: *"I think pharma's been back since we started giving the MFN deals late last year… these are relatively cheap to some of the AI names."* (Power Lunch, Apr 30)

**Asad Hader, Goldman Sachs, Head of Healthcare Business Unit & Lead U.S. Pharma Analyst.** The pre-earnings cautionary voice on Lilly (LLY had been down ~18% YTD entering the week, with a *"recalibration and repricing of expectations… around the obesity market, broadly speaking, and the TAM in the context of pricing debates"*). Bull on Merck: *"The story has really changed over the last, call it, eight months or so… it was very much seen as a pure play on Keytruda… But it's also their biggest LOE."* On AbbVie: *"The execution around SkyRisi and Winvoke… has been excellent. But now it's about sort of a fatigue narrative… investors are looking for a new revenue generator from that company, which really is probably likely going to come from BD."* On industry M&A firepower: *"almost $650 billion if you lever up about 2.5 times EBITDA. And these companies need to do deals."* (Closing Bell, Apr 27)

**David Ricks, CEO, Eli Lilly.** Set the tone for the entire sector this week. *"Obviously, we had a really strong start to the year… 56% revenue growth year over year."* On international demand: *"It turns out people like to lose weight all around the world."* On retatrutide: *"The sign so far is this is going to be really maybe as much as 50 percent better than terzepatide. That could be incredible."* On TAM: *"There are a billion people on the planet who could benefit from these medications. Will we ever reach a billion? I don't know. But right now we're reaching about 20 million. So there's a big runway in front of us."* On capital allocation: *"You can expect a continuous cadence of acquisitions."* (Squawk Pod, Apr 30)

**Dave Knapp, Founder, On The Pen (the dedicated GLP-1 podcast).** The most granular voice on Foundayo's launch and Lilly's tiered obesity strategy. On cash-pay dynamics: *"Nearly half of the patients who are on Zepbound are paying cash. Half. That means the old system of payers, insurance companies, that's not driving this market. Patients are driving this market."* On the Foundayo vs. Wegovy-pill comparison: *"Wagovi did have the market name recognition going into this where Foundao did not… Lily's point with Foundio is that they're attempting to build access to the drug first."* On the future of obesity care: *"That's really the future of these drugs… you'll have a future where patients may be on multiples of these targeting different receptor sites because different patients have different needs."* (On The Pen, Apr 30)

**Jeff Axe & Heather McKenzie, BioSpace.** The most useful voices this week on FDA / regulatory drama (Tavneos, CBER transition, psychedelic vouchers) and on Regeneron's gene therapy milestone. McKenzie on Otarmeni: *"This is less about Regeneron having a major product. This is more about saying, listen, these gene therapies work… this is really big for gene therapy, the modality in general."* Axe on the Tavneos withdrawal escalation: *"This is a really rare situation, actually. The FDA can absolutely force a company to withdraw a drug. They just don't typically have to do that."* (BioSpace, Apr 29)

**Stephen Hanson, Lauren Martz & Simone Fishburne, BioCentury.** Carrying the M&A and AACR-pipeline conversation. Hanson on Lilly: *"Lilly's definitely been on a shopping spree… they essentially are an ATM now that's just throwing off cash."* Fishburne pushing back on extrapolating Q1 deal pace: *"There are a lot of people who are like, well, if the pace carries on, then this will obviously be one of the greatest all-time ever for M&A. But people don't make deals normally at a specific pace throughout the year."* Martz on AACR: 175 new oncology targets, *"not a lot of checkpoint targets that we're seeing proposed at this conference."* (BioCentury This Week, Apr 28)

**Sell-side actions worth flagging this week.** BofA's Tim Anderson upgraded **AbbVie to Buy from Neutral, PT $234**, arguing immunology competition fears are *"overdone"* and that ABBV offers *"one of the best ex-pipeline growth profiles in large cap pharma with room for upside"* (thefly, Apr 30). Goldman added **UnitedHealth to its US Conviction List** with a Buy rating and **$435 PT** on May 1, citing the bottoming of the MA underwriting cycle. Erste upgraded **UNH to Buy from Hold** Apr 27, JPMorgan raised UNH to **$420** Apr 28. Morgan Stanley nudged **AbbVie to $278** (thefly, Apr 30). Morgan Stanley's commentary on the **Pfizer/Vyndamax settlement** (extending exclusivity to June 1, 2031) noted the outcome was *"at the lower end of investors' expectations of 2031/2032."*

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## 3. The Key Debates

### Debate #1, Has Lilly's blowout Q1 "ended" the GLP-1 saturation/pricing debate, or just delayed it?

- **Bull (Seegerman, BMO, Apr 30):** Q1 effectively put the saturation thesis to bed. Tirzepatide is annualizing at ~$50B and growing +70% YoY for Zepbound; international volume +95%; Lilly is now the *"low-cost manufacturer"* of incretins and *"will be able to compete with generics when those eventually happen."* (Power Lunch, Apr 30)
- **Bear (Hader, Goldman, Apr 27 + sell-side bears):** Even after the print, Lilly's growth is partially offset by *"lower realized prices"* (IRA pull-through), and the long-term TAM is being recalibrated as cash-pay tiering compresses ARPU. Redburn is at Neutral with an **$880 PT** vs. Morgan Stanley's $1,327; the gap reflects unresolved questions about steady-state pricing. Andrew Ross Sorkin pushed Ricks on the innovation-cycle problem: in two-to-four years, *"you're going to have so many more advanced versions"* potentially shortening today's product lifecycles.

### Debate #2, Is Foundayo's launch "lagging" or "deliberately staged"?

- **Bear:** Initial scripts have visibly trailed Novo's Wegovy pill. Reuters (Apr 29) reported analysts saying Foundayo is *"lagging behind Wegovy."* Web sources cite ~3,700 scripts in the second week vs. >18,000 for the Novo oral counterpart. Compounding crackdown also adds shortage/gray-market risk.
- **Bull (Knapp, On The Pen, Apr 30 + Ricks):** The Wegovy pill had pre-existing brand recognition; Lilly is intentionally building prescriber relationships and is *"not yet on TV and advertising."* First-month Foundayo data from Lilly: 8,000+ unique prescribers, ~20,000 scripts, **80% of patients new to GLP-1 entirely**, daily new starts >1,000 and rising. Ricks: *"It's not analogous to when we launched ZepBound, which was already available in a medicine called Manjaro."* Importantly, Knapp argues both oral pills *"are not necessarily cannibalizing the injectable market… It means more people are getting treatment."*

### Debate #3, Tavneos: regulatory tail risk or buyable Sarepta-style overreaction?

- **Bear (BioSpace, Apr 29):** FDA escalated its call for Amgen to withdraw Tavneos on April 28, alleging *"unblinded study personnel may have manipulated results of the pivotal clinical trial."* Eight deaths reported; liver-tox concerns. Amgen paid **$3.7B** for ChemoCentrics in 2022; the questioned data predates Amgen ownership.
- **Bull (Axe, BioSpace):** *"This is a really rare situation… The FDA can absolutely force a company to withdraw a drug. They just don't typically have to do that."* The 2025 Sarepta/Elevidys precedent, where FDA initially sought to halt shipments and ultimately reversed, provides a path for Amgen to negotiate. Bernstein's *"waiting year"* downgrade ahead of MariTide Phase 3 data is the bigger, broader bear lens on AMGN; Tavneos is incremental noise to that thesis.

### Debate #4, Is AbbVie's "post-Humira pivot" derisked, or are the competitive concerns just deferred?

- **Bull (BofA, Apr 30 + Canaccord, Apr 30):** Q1 beat across all key franchises; Skyrizi +30.9% YoY, Rinvoq +23.3% YoY. BofA: *"forward indicators for Skyrizi remain strong and new competitors appear 'category expanding.'"* Morgan Stanley raised PT to $278, citing positive Phase 2 update on next-gen immunology combo.
- **Bear (Hader, Goldman, Apr 27):** *"Now it's about sort of a fatigue narrative."* The market wants a new revenue generator that has to come from BD. A $744M IPR&D charge clipped Q1 EPS by $0.41, and trenibotulinumtoxinE received a CRL.

### Debate #5, Sanofi's Dupixent: is the patent cliff being telegraphed too early, or is this a CEO-transition signal?

- **Bear (Annalee Armstrong, BioSpace, Apr 29 + TD Cowen's Steve Scala):** *"Analysts were kind of taken aback. They were like, why are you all of a sudden talking about the patent issues with this drug?"* Scala questioned whether the timing was related to CEO Paul Hudson's February departure. Dupixent generated $4.9B in Q1 (no other Sanofi drug above $1B); single-asset concentration risk is acute.
- **Bull:** Sanofi has visible pipeline depth via the Regeneron partnership; new leadership may simply be resetting expectations to clear the deck.

### Debate #6, Will the 2026 M&A pace hold?

- **Bull (Hader, Goldman, Apr 27):** Industry has *"almost $650 billion"* of firepower at 2.5x EBITDA leverage. *"If you look at the stock reactions after deals get announced, these stocks go higher. So this is the market telling you go out and spend the money."* Sun/Organon ($12B), Merck/Terns (~$6.7B), and four Lilly deals in ~10 days reinforce the signal. Janus Henderson's Luyi Guo and Agustin Mohedas note this M&A wave is mitigating the IRA overhang.
- **Bear (Fishburne, BioCentury, Apr 28):** *"People don't make deals normally at a specific pace throughout the year."* Q1 enthusiasm shouldn't be linearly extrapolated.

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## 4. Hot Topics Under Debate

- **Foundayo (orforglipron) launch trajectory.** Cash-pay $149/month; ~20K scripts in month one with 80% GLP-1-naive patients per Lilly. Bears note the gap to Wegovy pill's ~160K month-one. Bulls say the comparison is apples-to-oranges (existing brand vs. new molecule, no DTC yet). (On The Pen, Apr 30; Squawk Pod, Apr 30)
- **Retatrutide as the next "step-up" molecule.** First obesity Phase 3 readout *"in a few weeks or a month."* Ricks framed weight-loss tiers as Foundayo (20–30 lbs) → tirzepatide (~50 lbs) → retatrutide (potentially 70+ lbs). Knapp flagged biologic-classification debate as a watch-item for compounding/exclusivity. (Squawk Pod, Apr 30)
- **Amgen's Tavneos withdrawal standoff.** Material event because of the data-integrity allegations. Watch for FDA's next move; precedent (Elevidys) suggests negotiation is possible. (BioSpace, Apr 29)
- **Regeneron offering Otarmeni (gene therapy for OTOF hearing loss) free in the U.S.** Symbolic; small population (~50 eligible patients), but the first FDA-approved gene therapy for hearing loss. McKenzie's framing: *"This is really big for gene therapy, the modality in general, rather than… a big market play for Regeneron."* Open question per BioSpace: who is absorbing the cost, the government or Regeneron? (BioSpace, Apr 29)
- **Sun Pharma / Organon, $12B all-cash deal.** Vaults Sun into the top 25 global pharma and top 10 biosimilars. Largest India-pharma deal on record. (Closing Bell, Apr 27; BioCentury, Apr 28)
- **Novartis Q1 weakness.** Revenue −5%; Entresto −46% on generics; Lutathera generic entry June 2026; LP(a) trial delayed ~1 year. Bullish counter from Goldman: Novartis remains the *"first one to prove or disprove the hypothesis"* on the LP(a) class. (Closing Bell, Apr 27; BioSpace, Apr 29)
- **Pfizer Vyndamax settlement.** All three generic filers settled, extending U.S. exclusivity to **June 1, 2031**. Morgan Stanley described the outcome as *"at the lower end of investors' expectations,"* noting the polymorph patent expiring in 2035 *"is likely not very strong."* Citi PT to $27 from $26.
- **UnitedHealth on the comeback path.** Q1 beat ($7.23 EPS vs. $6.57 consensus per web reporting), MCR improving, FY guidance raised. Goldman added to **US Conviction List** with **$435 PT** on May 1, calling the bottom of the MA underwriting cycle. Erste upgraded to Buy from Hold Apr 27. JPMorgan PT to $420.

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## 5. Emerging Themes to Watch

- **Combination obesity therapy as the next architecture.** Knapp's framing, *"patients may be on multiples of these targeting different receptor sites,"* and Lilly's lauralintide (eloranlitide) amylin program (~20% weight loss with minimal side effects) point to stacking molecules as the next era after monotherapy maximization. (On The Pen, Apr 30; Power Lunch, Apr 30)
- **GLP-1 indication creep beyond weight loss.** Sinai/Drucker liver mechanism work shows semaglutide acts directly on liver cells (LSEC + T cells) independent of weight loss, strengthening MASH economics for a population *"projected to affect nearly 2 billion people worldwide by 2050."* Heart Rhythm 2026 data showed GLP-1s lower atrial fibrillation risk independently of weight loss. Ricks separately cited a 22% reduction in CV events and >50% reduction in all-cause death in diabetics on Lilly's incretin. (DDW Podcast, Apr 28; Squawk Pod, Apr 30)
- **FDA "Real-Time Clinical Trials" pilot.** AI extracts data from EHRs and submits to both FDA and sponsor in real time. AstraZeneca (TRAVERSE, MCL) and Amgen (STREAM-SCLC) are first proof-of-concept partners; Paradigm Health providing the AI layer. Could be a structural tailwind for trial-tech infrastructure names. (WSJ via thefly, Apr 28)
- **Cash-pay distribution as a structural shift in pharma.** Knapp: *"The old system of payers, insurance companies, that's not driving this market. Patients are driving this market."* The Hims/LillyDirect distribution arrangement (Apr 24), Hims now offering Zepbound vials, KwikPen, and Foundayo, signals a continued consumerization of branded specialty pharma even without a formal partnership.
- **Vertical-integration regulatory pushback.** Bipartisan "Break Up Big Medicine Act" (Warren/Hawley) and "Profits Over Patients" PBM hearings reframe the policy risk for UNH-style integrated models even as MA payment dynamics turn favorable. Worth modeling as a downside scenario despite the constructive near-term tape. (ajmc.com)
- **Psychedelics gaining institutional sanction.** Three FDA Commissioner's National Priority Vouchers granted in late April (Compass Pathways/COMP360, Otsuka/Transcend for PTSD, Usona for MDD per Psychedelic Alpha). FDA didn't name recipients, raising transparency questions. (BioSpace, Apr 29)
- **AACR 2026: oncology-target diversification.** 175 new targets, dominated by breast/lung but with high activity in ovarian, colorectal, prostate. Mechanism focus on **tumor microenvironment modulation and ferroptosis**. Notably *"not a lot of checkpoint targets,"* and four companies pursuing **pan-RAS inhibitors via ADC platforms** to solve Revolution Medicine's toxicity problem. (BioCentury This Week, Apr 28)

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## 6. Stocks on the Radar

| Ticker | Direction | Rationale |
| --- | --- | --- |
| **LLY** | Bullish | Q1 +56% YoY revenue, FY guidance raised by $2B; Foundayo launching, retatrutide readout imminent; four M&A deals in ~10 days; Seegerman maintaining Buy with upside even after +10% pop. Bear pushback: stock still –13% YTD after print; some Foundayo script-pace concerns; Redburn Neutral PT $880 vs. MS $1,327. |
| **MRK** | Bullish | Hader (Goldman) Buy: diversification beyond Keytruda LOE working; oral PCSK9 launching 2026; ASCO data pending. Q1 revenue $16.28B (web). Long-term Keytruda LOE remains the main concern. |
| **ABBV** | Mixed → Bullish | Q1 across-the-board beat; Skyrizi +30.9%, Rinvoq +23.3%; BofA upgrade to Buy ($234), Morgan Stanley to $278. *"Fatigue narrative"* (Hader) waiting on BD; trenibotulinumtoxinE CRL. |
| **AMGN** | Mixed → Bearish near-term | Tavneos FDA-withdrawal escalation; LP(a) trial delayed to 2027; Bernstein downgrade to Market Perform; Phase 3 MariTide trials still ongoing (web suggests Phase 2 showed up to 20% weight loss with monthly/quarterly dosing, bullish if confirmed). |
| **PFE** | Mixed | Vyndamax exclusivity to June 2031, *"lower end of expectations"* per MS. RBC Underperform PT $25. Argus upgrade to Buy ($35). Strong dividend, IP visibility into 2030s (Seegerman). Q1 4% revenue miss vs. consensus per RBC. |
| **JNJ** | Bullish | Web: Q1 pharma beat by $356M; MS upgrade to Overweight, PT $200→$262; Icotyde approval (peak ~$14.9B); Darzalex/Tremfya driving growth. Stelara biosimilar erosion + talc overhang as offsets. |
| **BMY** | Mixed → Bullish | Q1 adj. EPS $1.58 vs. $1.42 consensus; revenue $11.49B vs. $10.92B consensus; FY26 guidance reaffirmed ($46–$47.5B revenue, $6.05–$6.35 adj. EPS). Growth Portfolio +12% to $6.2B. Eliquis 10–15% growth guidance maintained, but Cost Plus Drugs price-cut weighs on bull case. |
| **GILD** | Bullish | Q1 revenue +4.7% YoY; $16B deployed in 60 days rebuilding pipeline; Biktarvy patent extended to 2036; four major drug launches in 2026 incl. anito-cel; MS PT $171→$175; Cantor PT $135→$155. RBC cautious on execution risk; Yeztugo 2025 actuals ($150M) below extreme bull case. |
| **VRTX** | Bullish | Seegerman: ~40% implied upside; CF franchise, kidney pipeline. Generalist underowned because of GLP-1 mania. |
| **REGN** | Bullish | Seegerman: ~27% implied upside; Otarmeni gene therapy approval; signed MFN deal April 23; Praluent at lower price + Otarmeni free in U.S.; melanoma readout mid-2026. |
| **NVS** | Bearish near-term | Q1 revenue −5%; Entresto −46%; Lutathera generic entry June 2026; LP(a) trial delayed ~1 year. Still the pivotal first-mover for the LP(a) class per Goldman. |
| **NVO** | Bearish | 2026 adj. sales guided –5% to –13%; CagriSema Phase 3 setback; Deutsche Bank downgrade to Hold (PT cut 31% to ~275 DKK). Bull case is depressed valuation (~11x 2026E) and Wegovy HD launch. |
| **SNY (Sanofi)** | Mixed → Bearish | Unexpected Dupixent patent-cliff commentary + CEO transition; tolibrutinib FDA failure; single-asset concentration. |
| **UNH** | Bullish | Goldman to US Conviction List with $435 PT on May 1; Erste upgrade Apr 27; JPM PT $420; MCR improved to ~84%; finalized 2.48% 2027 MA rate; Optum Rx onboarded 800 new clients. Medicaid margin pressure remains the offset. |
| **HUM/ELV/CNC** | Bullish | 2.48% MA rate finalized; Centene raised 2026 guidance, stock surged ~39% per web. ELV temporarily hit by $935M CMS RA accrual. |
| **TERN** | Take-out | Merck/Terns deal at **$53/share, ~$6.7B**; closing in Q2 (post-HSR). |

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## 7. Upcoming Catalysts (Next ~2 Weeks)

- **Retatrutide**, first major obesity Phase 3 readout *"in a few weeks or a month"* per Ricks (most likely mid-May). Highest single-event sensitivity for LLY.
- **Lilly Foundayo Week 2–4 launch metrics**, daily prescribing run-rate trajectory, payer mix, ad spend ramp.
- **Amgen Tavneos / FDA next move**, material event-risk after the April 28 escalation.
- **CBER chief announcement**, promised by end of April / early May post-Vinay Prasad's leave end-date.
- **Novartis & Lilly LP(a) updates** (Novartis pivotal first readout was already cited as ~1 year delayed; watch for any recalibration).
- **AACR 2026 follow-on data flow**, pan-RAS ADC readouts, ferroptosis-targeted programs, oncology TME platforms.
- **AstraZeneca / Amgen RTCT pilot updates**, early signals on the FDA's AI real-time-trial program.
- **Continuing healthcare Q1 earnings calendar**, large managed care names already cleared; remaining mid-cap biotech and device prints over the next two weeks.
- **PDUFA / FDA decisions and ODAC meetings**, no specific PDUFA dates were surfaced in this week's podcast or news pulls; **flag as a coverage gap** that should be filled in next week's brief from a calendar source.

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## 8. The Bottom Line

The dominant signal this week: **the GLP-1 saturation/pricing scare is fading as the prevailing narrative**, replaced by a more durable "platform expansion" thesis, one in which Lilly has a four-tier obesity portfolio, the indication map keeps widening (MASH, AFib, sleep apnea, OA, CV mortality), and patients are paying cash at scale. If retatrutide reads out as Ricks teased (*"50 percent better than terzepatide"*), Lilly's upper-bound TAM gets meaningfully revised again. If Tavneos is forced off the market, Amgen's "waiting year" thesis becomes a "lost year" thesis. M&A momentum is real but probably not linear; Hader's $650B firepower number plus Hanson's "ATM" comment vs. Fishburne's pacing pushback is the right frame. Managed care quietly entered a more constructive setup this week with Goldman's UNH conviction-list addition, the finalized 2.48% MA rate, and Centene's guidance raise, but the bipartisan vertical-integration backlash deserves to be modeled as a real downside scenario, not an academic one.

**Coverage gaps to be honest about:** medical devices (ISRG, BSX, SYK, MDT, EW, DXCM, ABT) had **essentially no podcast coverage this week**; managed-care discussion came primarily from the financial press / sell-side notes rather than podcasts; tariff impacts on pharma were referenced only obliquely (MFN deal commentary); and JNJ, BMY, and GILD specific podcast coverage was thin, most of the bull/bear color for those names came from sell-side actions and financial press.

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## Sources

- Power Lunch, Apr 30, 2026 (matterfact podcast archive)
- Closing Bell, Apr 27, 2026 (matterfact podcast archive)
- Squawk Pod, Apr 30, 2026 (matterfact podcast archive)
- On The Pen, Apr 30, 2026 (matterfact podcast archive)
- BioSpace, Apr 29, 2026 (matterfact podcast archive)
- BioCentury This Week, Apr 28, 2026 (matterfact podcast archive)
- DDW Podcast, Apr 28, 2026 (matterfact podcast archive)
- thefly.com news flow, Apr 24 – May 1, 2026
- [Break Up Big Medicine and PBM policy coverage, AJMC](https://www.ajmc.com)

*Sources include podcast transcripts archived at app.matterfact.com (Squawk Pod, Power Lunch, On The Pen, BioSpace, BioCentury This Week, DDW Podcast, Closing Bell, The Rundown), thefly.com news flow for the period Apr 24 – May 1 2026, and supplementary web research.*

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