# The Healthcare Pulse: May 15–22, 2026 > Healthcare investor newsletter for May 15–22, 2026. Eli Lilly's Phase 3 retatrutide readout anchors the GLP-1 debate while the tape rotates into legacy pharma, and a policy stack from SCOTUS to TrumpRx resets the structural backdrop. ## The Healthcare Pulse ### Weekly Podcast Intelligence Brief, May 15–22, 2026 --- ```request-access variant: ghost heading: Want this kind of synthesis on your own coverage? buttonText: Request access ``` ## 1. This Week at a Glance Healthcare's center of gravity this week sat at the ASCO / European Congress on Obesity preview window, with the May 21 Phase 3 retatrutide ("Triple G") readout from **Eli Lilly** anchoring the GLP-1 conversation and a sharp single-day rotation out of GLP-1 names into legacy pharma (MRK / JNJ / BMY up double digits while LLY -3% / NVO -13%). Layered on top: a Supreme Court denial of certiorari on May 18 that cements the IRA Medicare drug negotiation program as permanent, the FDA's May 22 hard deadline ending compounded semaglutide production, an FDA leadership shake-up with Tracy Beth Hoeg's departure from CDER, and a Trump "dramatic expansion" of TrumpRx announced May 18. The biotech tape skewed bullish into ASCO, with small-cap names (RVMD up 93% YTD as the #1 XBI holding) outperforming. --- ## 2. The People Driving the Conversation - **Jared Holz, Healthcare Specialist at Mizuho** (CNBC Fast Money, May 21), the most prominent voice this week. On retatrutide: *"We were all sort of expecting 25 to 30% weight loss for this drug, which is obviously very powerful and that's sort of what we got. So I wasn't shocked by the results."* Pushed back hard on a Bernstein note arguing Lilly will "cream Novo Nordisk" in oral GLP-1: *"To just come out and say that Lilly is going to be victorious there as well, I think sort of negates a lot of the success that Novo has had early on with the Wegovy pill... You have over a million patients now on the Wegovy pill and it's being completely overlooked."* - **Steve Grasso** (Fast Money desk) framed the week's most important macro: *"The market is sort of moving away from the GLP story,"* with MRK / JNJ / BMY rotation as the new trade and a string-of-pearls patent-cliff approach where *"Merck's doing it better than most."* On biotech: *"Go with small-cap biotech over the names that you all know and hear about every day."* - **Guy Adami** (Fast Money desk) on Merck post-ASCO: *"When you start to use Keytruda with other drugs, that might extend it or give them sort of a new lease on life, so I think Merck is a buy here."* - **Julie Beal** (Fast Money desk), the counter-voice on SMID biotech: *"I do like owning health care. I don't like owning this kind of pharma, especially when we're talking about small and mid-cap. You're dependent on one drug and you're dependent on FDA submissions."* Preferred West Pharmaceutical (WST) as a "drug delivery mechanism" proxy. - **Thomas Fuchs, Chief AI Officer at Eli Lilly** (The AI in Business Podcast, May 19) described LLY's NVIDIA DGX SuperPOD B300 deployment with 1,000 GPUs as *"the most powerful supercomputer in our industry"* and argued the company's competitive moat is proprietary negative experimental data: *"For every molecule that worked, we had millions that failed... that's also one reason why language models will never be able to be actually a good scientist or solve these problems."* - **Tom Miller, CEO of Iambic Therapeutics** (CNBC Fast Money, May 21) said his AI drug discovery platform got *"to clinic in less [than], in a third of the industry average pace."* - **Dr. Louis J. Aronne**, founder / Chair Emeritus of the American Board of Obesity Medicine (Lilly consultant, disclosed): *"Weight regain remains one of the biggest challenges in obesity care, and is often the result of treatment interruptions that cause biology to work against patients, undoing the progress they've made"* (Diabetes Connections, May 19). - **Jake Leach, CEO of Dexcom**, unveiled G8 next-gen CGM details: 50% smaller form factor, 15-day wear, a multi-analyte (ketones + potassium) version to follow, with FDA submission targeted for 2027 (Diabetes Connections, May 19). - **Biotech Hangout** co-hosts Sam Fazeli, Josh Schimmer, Eric Schmidt, and Tess Cameron (May 15 episode) dissected the FDA Commissioner Marty Makary departure, the $15.2B Hengrui-BMS partnership as evidence of accelerating China outsourcing, and Moderna's swift initiation of Hantavirus vaccine research after the cruise-ship outbreak. - **STAT's Adam Feuerstein, Allison DeAngelis, and Elaine Chen** (The Readout LOUD, Episode 402, May 21) covered Damian Garde's reporting on China and biotech, BridgeBio CEO Neil Kumar's candid admission that the company has been publishing "not the right structures" to protect proprietary assets, and an interview with Retro Biosciences CEO Joe Betts-LaCroix. --- ```request-access variant: inline heading: Want this kind of synthesis on your own coverage? buttonText: Request access ``` ## 3. The Key Debates ### Debate 1, LLY vs. NVO in Oral GLP-1 **Bull LLY** (Bernstein, via Fast Money): *"Lilly is a marketing machine and its oral pill will eventually overcome the Wegovy pill,"* will "cream Novo Nordisk." Citi's Geoff Meacham sits at the most bullish end of the sell-side spectrum with a $1,500 PT, arguing Lilly's oral GLP-1 orforglipron will outflank injectables on accessibility and price. **Bull NVO** (Jared Holz, Mizuho; Hedgeye): Holz: *"The execution piece of the Lilly versus Novo debate or discussion has sort of already played out... going forward, it seems like... Novo is gaining a lot of momentum in the oral market."* Hedgeye initiated NVO as a long with up to 117% upside on undervalued oral Wegovy. **Bear NVO** (Bernstein) anchors with a 175 DKK Underperform target citing US realized-price erosion and a 15% conglomerate discount. ### Debate 2, GLP-1 vs. Traditional Pharma Rotation **Bull rotation** (Grasso): *"The market is sort of moving away from the GLP story,"* pointing to MRK / JNJ / BMY all +10% on May 21 vs. LLY -3% / NVO -13%; *"Merck's doing it better than most"* on the patent-cliff approach. **Cautious on MRK durability** (Holz): *"I still need to figure out whether this PD-1 VEGF combination is really the real deal."* ### Debate 3, Small-Cap Biotech vs. Large-Cap Pharma **Bull SMID biotech** (Grasso, Holz): Revolution Medicines (RVMD) up 93% as #1 XBI holding; Holz: *"The one that the street's really looking forward to the most, and I am as well in part, is Revolution. Just given the fact that Pancreatic [cancer] has really taken center stage."* **Bear SMID** (Julie Beal): *"I don't like owning this kind of pharma, especially when we're talking about small and mid-cap. You're dependent on one drug and you're dependent on FDA submissions,"* preferring WST as the diversified play. ### Debate 4, UNH MLR Cycle: Has It Bottomed? **Bull** (Mizuho, Goldman Sachs): Mizuho raised UNH PT to $440 from $410 on May 20 citing "reduced likelihood of negative medical loss ratio shifts through the end of 2026." Goldman lifted to $435 from $400 and added UNH to its Conviction List. **Bear**: bears continue to model margin pressure from Medicaid funding cuts through year-end. UNH stock was trading around $385 on May 18, well below most price targets, partly weighed down by ongoing Mangione murder trial headlines. ### Debate 5, TransMedics (TMDX): Capitulation or Compounder? The most detailed single-stock bull/bear of the week on Equity Mates (May 17). Stock at ~$64, down ~64% from its August 2024 ATH; revenue growth decelerating from +159% (2023) to +83% (2024) to +37% (2025) to +21% YoY in Q1 2026. **Bull** (Simon) built explicit math: 10,000 cases by 2028 leading to ~$320M net income, ~$9 EPS, 25–30x PE, a $225–$270 price target discounted to ~$190–$220. **Bull hold** (Bryce): *"My thesis hasn't broken... Nothing in here has sort of broken the original reason I went into it."* **Bear/cautious** (Ren): *"The Europe thing has rattled me a little bit... Just feels like they don't need to go to Europe."* Tail risks: Scorpion Capital's 342-page short report alleging billing fraud (early 2025, $0 PT), class action settlement risk of $30–$50M, and Precision Cold Storage competing at $10–20K per case vs. TMDX OCS at $80–100K. --- ## 4. Hot Topics Under Debate **Retatrutide Phase 3 readout (May 21)** At the top 12 mg dose: 70.3 lbs / 28.3% mean weight loss at 80 weeks, with 45.3% achieving ≥30% loss (a level "typically seen with bariatric surgery"); the extension cohort to 104 weeks averaged up to 85 lbs. RBC called it a "clean win" and modeled launch in 2027 with 2030 sales of $4.9B and 2034 sales of $11.0B at a 70% probability of success. Wolfe raised its PT to $1,350 (from $1,325); Truist reaffirmed $1,281; Jefferies lifted to $1,330. Holz characterized it as in-line, *"I wasn't shocked by the results,"* which is what drove the sell-the-news 3% LLY drawdown. **Merck Keytruda combo lung cancer data** 65% reduction in disease progression/death vs. Keytruda alone in advanced lung cancer; MRK +3% on the day. Negative read-through to Summit Therapeutics (SMMT) flagged by Holz, *"This Merck is maybe a small negative for Summit,"* but hedged: *"It's really tough to look at these trials in a vacuum."* Separately, Merck's sacituzumab tirumotecan met primary endpoints in Phase 3 advanced/recurrent endometrial cancer. **FDA compounded semaglutide deadline (May 22)** The hard cessation of outsourcing facility production collapses the gray market and drives prescription volume back to NVO and LLY incumbents (Becker's Hospital Review). **Trump's TrumpRx expansion (May 18)** An afternoon healthcare affordability event announced a "dramatic expansion" of discounted Rx offerings, with AZN, BMY, LLY, GSK, JNJ, MRK, NVS, PFE, RHHBY, and SNY all named as exposure. **Supreme Court IRA denial (May 18)** SCOTUS denied certiorari on petitions from AstraZeneca, Novo Nordisk, Novartis, and Johnson & Johnson, cementing the Medicare Drug Price Negotiation Program as a permanent structural reality (Duane Morris). **GLP-1 cancer signal (WSJ, May 22)** Observational studies showed GLP-1 users had reduced cancer spread, with lung and breast cancer progression "cut by half," 25% lower breast cancer incidence, and higher 5-year survival. **FDA leadership turnover** Tracy Beth Hoeg, acting director of CDER and a Makary ally, departed May 15. Michael Davis becomes acting director. **Gilead's Tubulis close + Maxim upgrade** GILD closed its $3.15B Tubulis ADC acquisition on May 21 (up to $1.85B in milestones). Maxim's Michael Okunewitch upgraded to Buy from Hold with a $165 PT, citing Yeztugo PrEP growth, Trodelvy 1L breast, and HIV dominance. RBC stayed conservative at $122 Sector Perform. --- ```request-access variant: inline heading: Want this kind of synthesis on your own coverage? buttonText: Request access ``` ## 5. Emerging Themes to Watch - **GLP-1 to cancer read-through:** The WSJ-reported observational data adds yet another vertical to the obesity-drug TAM expansion narrative, and follows the JAMA Network Open study (>840,000 patients) showing breast cancer mortality and recurrence benefits. - **GLP-1 maintenance dosing:** SURMOUNT-MAINTAIN and ATTAIN-MAINTAIN showed patients can maintain weight loss long-term on either oral Foundayo or lower-dose Zepbound, which changes the LTV math on GLP-1 patients and could shift mix away from peak-dose injectables. - **AI-native drug discovery scaling up:** Isomorphic Labs raised a $2.1B Series B; Iambic Therapeutics' CEO Tom Miller claims clinical timelines a third of the industry average; Lilly's 1,000-GPU DGX SuperPOD; BridgeBio CEO Neil Kumar acknowledging the company has been publishing "not the right structures" to protect proprietary assets. - **China decoupling in early-stage biotech:** The Hengrui-BMS $15.2B partnership debate and Damian Garde's reporting on China highlight a structural risk-vs-cost trade-off that buy-side healthcare PMs are now actively underwriting. - **Medical-device tariff repricing:** Section 301 tariffs on Chinese imports stepped up to 25% (rubber gloves) and a 50% level on syringes/needles is now fully in force, a structural tailwind for North American domestic manufacturers. - **Medicare Advantage retrenchment:** 2026 will mark the first aggregate MA enrollment decline in ~two decades (projected 34.9M to 34M), with Humana cutting county footprint 6.8% and exiting ND, SD, and Puerto Rico; UNH retreating 4% and exiting Vermont. - **Regenxbio DMD Phase 3 success, but skepticism:** Met its primary endpoint, but Biotech Hangout flagged investor concerns on the safety profile, limited data, and an unclear FDA path. - **Hantavirus and pandemic preparedness re-entering portfolios:** 18 Americans evacuated to specialized quarantine after a cruise-ship outbreak; Moderna spinning up mRNA Hantavirus research. --- ## 6. Stocks on the Radar | Ticker | Direction | Rationale | | --- | --- | --- | | LLY | Mixed (analyst-bullish, tape-cautious) | Retatrutide Phase 3 "clean win" (RBC, Wolfe $1,350, Truist $1,281, Jefferies $1,330) but Holz called the readout in-line and Grasso flagged GLP-1 rotation; stock -3% on data | | NVO | Mixed | Hedgeye new long up to 117% upside; Holz bullish on oral Wegovy momentum (>1M patients); Bernstein bear at 175 DKK; stock -13% on May 21 rotation | | MRK | Bullish | Keytruda + targeted drug combo cut disease progression risk 65% in lung cancer; sacituzumab tirumotecan Phase 3 win in endometrial; Grasso/Adami called it a buy; +10% on May 21 | | JNJ | Bullish | Caught the legacy-pharma rotation bid (+10% May 21); Leerink upgraded to Buy with $265 PT citing Tremfya IBD uptake, Rybrevant, Inlexzo; 2.3% dividend yield | | BMY | Bullish | +10% on rotation day; Citi raised PT to $66 (Neutral); BofA's Gerberry at $67 (Buy); $2B cost-savings program offsets patent expirations | | ABBV | Bullish | Piper Sandler $298 (OW) on IBD pipeline; BofA's Gerberry Buy at $234; Evercore $235 OW; Allergan Aesthetics got positive CHMP opinion for Boey | | AMGN | Bearish/Caution | Tavneos under scrutiny in Japan (20 deaths reported); Piper trimmed to $427; Argus cut to $375; IRS tax litigation overhang; CFO Peter Griffith retiring | | PFE | Bearish/Caution | 25-valent pneumococcal data positive but offset by rivals (Goldman Hold $26); consensus PT clustered at $28.61; Daiwa $28 Neutral | | GILD | Bullish | Maxim upgrade to Buy ($165) on Yeztugo PrEP momentum (Q1 $166M, $1B FY26 forecast); Tubulis ADC acquisition closed $3.15B + $1.85B milestones; RBC more conservative at $122 | | UNH | Bullish (analyst) | Mizuho $440, Goldman $435 + Conviction List; reduced MLR risk through 2026; but stock weighed down by Mangione trial headlines (~$385) | | RVMD | Bullish | +93% YTD, #1 XBI holding; Holz and Grasso both flagged as top ASCO name on pancreatic cancer focus | | TMDX | Mixed (high-conviction bull/bear) | $190–$220 bull PT (Simon) vs. ~$64 current; cautious-watch (Ren) on Europe expansion and Precision Cold Storage competition | | DXCM | Bullish (LT product cycle) | G8 next-gen CGM unveiled, 50% smaller, 15-day wear, multi-analyte path (ketones + potassium); FDA submission 2027 | | WST | Bullish | Julie Beal's preferred way to play healthcare diversified, "those I'm all for" | | BNTX | Bullish | +6% on mid-stage ASCO bispecific antibody + chemo data | | SMMT | Mixed/Negative | Holz: MRK Keytruda combo "maybe a small negative for Summit" but hedged | | CSL (ASX) | Bearish | No CEO, falling margins, poor guidance, $5B Vifor write-down; ICE enforcement risk to plasma donation supply | | MRNA | Watch | Hantavirus mRNA research initiation; platform adaptability test | | REGN | Watch | Otarmeni accelerated approval (61 days from BLA filing), first dual AAV vector in vivo gene therapy | --- ```request-access variant: inline heading: Want this kind of synthesis on your own coverage? buttonText: Request access ``` ## 7. Upcoming Catalysts (Next 2 Weeks) - **ASCO Annual Meeting (late May / early June):** Holz's top ASCO names to watch are Revolution Medicines (pancreatic), Roche, Corpus, and Bicara (ADCs). - **FDA NGS off-target editing draft guidance:** public comment window open through mid-July; meaningful for the in vivo genome editing pipeline. - **TrumpRx implementation details:** follow-up after the May 18 expansion announcement; watch for which manufacturers and which drugs land on the platform. - **TMDX kidney transplant FDA filing:** in progress; TAM of 23,000–25,000 procedures/year is the single largest market expansion. - **PFE 25-valent pneumococcal Phase 3 pediatric:** pivotal trial in up to 2,400 children now underway. - **Retro Biosciences first clinical data readout:** Joe Betts-LaCroix flagged preparation underway in his STAT interview. - **2028 IRA negotiation cycle prep:** buy-side now modeling the next 15 high-spend drug list. --- ## 8. The Bottom Line Three things matter for healthcare investors heading into next week. First, the GLP-1 trade has matured. Retatrutide data was strong but in-line with expectations, and the Street is starting to question whether peak enthusiasm has been priced. Holz's NVO oral pushback against Bernstein's "cream" call is the most important debate to watch because it signals NVO is now the contrarian long. Second, the rotation into legacy pharma is real and Merck is the highest-conviction expression. The +65% disease progression reduction with the Keytruda combo plus the positive endometrial cancer data give the patent-cliff bears something to work around. Third, the policy stack just shifted permanently. SCOTUS sealing the IRA, the compounded semaglutide deadline, the TrumpRx expansion, and FDA leadership turnover are all stacked into a single week, and the buy-side is repricing both the negotiation glide-path for 2028 and the GLP-1 incumbent share recapture. On the SMID side, the biotech tape into ASCO is bullish but heavily concentrated in RVMD-style high-conviction names. Beal's critique that "you're dependent on one drug and you're dependent on FDA submissions" remains the right risk frame, and West Pharmaceutical / Dexcom are the cleaner secular plays for PMs who don't want binary readout risk. --- ## Sources - CNBC Fast Money, May 21, 2026 - The AI in Business Podcast, May 19, 2026 - Diabetes Connections, May 19, 2026 - Equity Mates, May 17, 2026 - Biotech Hangout, May 15, 2026 - STAT, The Readout LOUD, Episode 402, May 21, 2026 - WSJ, May 22, 2026 - Becker's Hospital Review (compounded semaglutide deadline) - Duane Morris (Supreme Court IRA certiorari denial) - Fierce Healthcare (medical-device tariffs) ```request-access variant: banner heading: Run your own corpus. description: matterfact is deployed with select institutional partners. Request access to run it on your own coverage. buttonText: Request access ```