In this week’s edition of InnovationRx, we look at BillionToOne’s IPO, China’s biotech power couple and Lilly’s eye drug deal. To get it in your inbox, subscribe here.
A deal between defecting Democrats and the Republicans may end the government shutdown, but it punted on subsidies for health insurance coverage under the Affordable Care Act, the key demand of Democrats in the shutdown fight. These tax credits are designed to keep ACA plans affordable and are slated to expire at the end of the year.
The agreement was reached after eight Democratic Senators broke ranks on Sunday to reopen the government after the longest shutdown in history. The Senate passed its bill Monday, and the House may vote as early as this afternoon.
About 22 million people, or 92% of those enrolled in ACA marketplace plans, receive these enhanced subsidies. These recipients would see their monthly premium payments more than double on average—increasing by about 114%—according to a KFF analysis of ACA Marketplace premium data. Among those expected to be hit especially hard: People who live in red states that did not expand Medicaid coverage.
If more people drop their health insurance due to cost, that would lead to more people using the nation’s emergency rooms, a trend that would be both bad for care and more expensive for the healthcare system. If younger, healthier people were to drop their coverage, rates would rise even faster for those who remain.
The Democratic splinter group received a commitment to allow a vote in December on extending the tax credits for a year, but such a bill seems virtually assured of dying in a Republican-led Congress. Speaker of the House Mike Johnson has not committed to such a vote, and President Trump has talked about replacing Obamacare for more than a decade; during the 2024 campaign said that he had “concepts of a plan” for doing so.
More recently, Trump has proposed cutting out insurance companies–which rely on shared risk to cover the costs of expensive care, such as cancer treatment or heart surgery–and sending some cash directly to people, through personal health savings or flexible spending accounts. That proposal has gained steam among Republicans in Congress, though policy experts warn it could cause Obamacare to collapse.
How A Turkish Immigrant Engineered A Successful Diagnostics Startup IPO
BillionToOne’s Oguzhan Atay
Duy Ho Photography
Oguzhan Atay, a Turkish immigrant with a Ph.D. in systems biology from Stanford University, started BillionToOne in 2016 with the idea of creating noninvasive prenatal genetic tests for common diseases, like sickle cell anemia and cystic fibrosis. On Thursday, the Menlo Park, California-based company went public on the Nasdaq stock exchange, raising $273 million, in an offering that was upsized to meet investor demand. By the end of trading, its shares were up more than 80%, at $109 from the offering price of $60, giving it a market cap of $5.8 billion. (The stock closed at $102 on Tuesday.)
That makes BilliontoOne the rare medical diagnostics company to have a successful IPO this year, even more unusual given the federal government shutdown.
But BillionToOne, which started with prenatal blood tests and expanded to cancer testing, has built a significant, fast-growing business. It booked $209 million in latest 12-month revenue (through June 30) from 508,000 genetic tests, according to its offering document. That compares with last year’s revenue of $153 million, itself up 19-fold from $8 million in 2021. While the company is losing money, those losses have been shrinking, to just $4 million in the first half of 2025.
“We have blown past every projection we had at the time,” Atay, the company’s cofounder and CEO, told Forbes. “We are not trying to change the market or convince Congress to change reimbursement. We are taking risk on the technical [side], to do something that is not just 5% better.”
China’s Richest Self-Made Woman Amassed A $20 Billion Fortune From Biotech
Increasing numbers of drugs are coming from China, as that country gets more innovative with its clinical research. Last week, Forbes wrote about Zhong Huijan, chairman and CEO of Hansoh Pharmaceuticals and China’s richest self-made woman with a net worth of $19.8 billion. Her wealth has risen rapidly as shares of Hansoh have more than doubled over the past year. Behind the rise: significant licensing deals with American and European pharmaceutical giants like Roche, GSK and Merck. In October, for example, Hansoh struck a deal worth up to $1.5 billion with Roche to jointly develop a colon cancer drug.
Zhong, 64, graduated from Jiangsu Normal University with a degree in chemistry and started her career as a middle-school teacher, moving on to work for China’s drug regulation agency before founding Hansoh in 1995. She is one half of China’s biotech power couple: Her husband Sun Piaoyang, who is 67, is chairman of Jiangsu Hengrui Pharmaceuticals and has a net worth of $13 billion. The two companies are run independently with separate boards of directors, but are both backed by billionaire investor Cen Junda, whose fortune of $8.2 billion comes largely from his stakes in those two drugmakers.
Deal of the Week
Eli Lilly agreed to license a gene therapy from New York-based biotech MeiraGTx for up to $475 million. The treatment, for a rare genetic condition that causes children to be born legally blind, restored vision to all 11 patients in a clinical trial. MeiraGTx, which is publicly traded with a market cap just above $700 million, will receive $75 million upfront for the exclusive license with additional payments tied to regulatory and development milestones. Lilly will also gain exclusive access to MeiraGTx’s technology for other potential vision disorders. (Forbes profiled MeiraGTx earlier this year.)
WHAT WE’RE READING
Pfizer wins the fight for Metsera, and will acquire the obesity drug startup in a $10 billion deal.
Richard Padzur, a longtime FDA staffer who founded its cancer therapy division, has been tapped for the agency’s top drug regulator job.
Immigrants with common health conditions, including diabetes or obesity, may be denied visas under new Trump Administration guidance.
Mark Cuban will offer a low-price, biosimilar version of J&J’s popular Stelara drug for chronic inflammatory and autoimmune conditions.
Tech titans like Sam Altman are backing startups that are gene-editing embryos to prevent disease and improve chances for a high IQ baby–even though doing so is illegal in most countries.
The FDA reversed a two-decade-old “black box” warning on hormone replacement therapies for menopause, a decision completed without going through a typical regulatory process.
RFK Jr., top HHS deputies and healthcare executives are slated to speak at a day-long MAHA Summit today that has not been disclosed by administration officials.
Canada lost its measles elimination status after failing to control outbreaks for more than 12 months. The U.S. might be next.