Prediction markets have moved into medical research, allowing people to put money on whether experimental treatments will succeed or receive government approval. The new betting options from Kalshi and Polymarket are creating debate among researchers, patients’ families and others involved in drug development.
Kalshi recently introduced a pilot program with about a dozen contracts connected to late-stage drug trials. Users can make predictions involving treatments from pharmaceutical companies such as Eli Lilly, Intellia Therapeutics and Takeda Pharmaceutical. Some contracts focus on when the Food and Drug Administration might approve a treatment, while others involve regulatory filings or results from trials. Polymarket also offers wagers connected to cancer treatments and other medical decisions.
Kalshi says these markets could make information about developing drugs easier to understand and access. The company argues that predictions from people putting real money at risk may provide useful information about which treatments have better chances of moving forward. That information, it says, could also influence where investors decide to put funding.
People who work with clinical trials have raised a different concern. Trials can involve hundreds of workers with different levels of access to information. Researchers, pharmacists, coordinators and employees of pharmaceutical companies may know details about a study before the public does. That creates a complicated situation when money can be made by correctly predicting the outcome.
David Tsai, who works with clinical trials at a biotechnology company in the San Francisco Bay Area, has started a petition seeking a ban on this type of wagering. His concern goes beyond someone simply knowing results early. A person working directly on a study could potentially influence how it is conducted while also having money riding on the result.
Nicholas Zaorsky, a Mayo Clinic radiation oncology professor who has experience with clinical trials, has raised similar questions. Prediction markets normally collect people’s expectations about events, but medical studies are different because some of the people with the most information may also have a role in producing the final outcome.
Kalshi says it has measures designed to detect insider activity. These include checking users’ employment information and watching for unusual betting behavior. The company also says its current markets involve later-stage studies in which patients have already been selected. It does not allow wagering when every participant in a trial is a minor.
The debate feels much less abstract for families participating in experimental treatments. Boston University professor Joshua Pederson has a 12-year-old son who is currently in a clinical trial after his cancer returned following chemotherapy and radiation. His son’s name has been kept private because of his medical situation.
Outside of treatment, the boy is preparing for seventh grade. He enjoys making his own art, especially pictures involving robots and frightening characters, and says lunch is what he is most looking forward to at school.
For Pederson, those ordinary details are part of what can disappear when a medical study becomes something strangers can wager on. He worries that prediction platforms can make people focus on winning a bet rather than the patients whose health depends on what happens in the trial.
Kalshi has defended the markets as another way to distribute information about developing treatments. Pederson wants the platforms to stop offering wagers in which users can make money by predicting that experimental treatments will fail.
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