A newly published cost-minimization analysis from Argentina offers one of the clearest economic assessments to date on how immunization budgets should be evaluated [1]. The study, conducted by the CINVE research group, compares two hypothetical hexavalent vaccination strategies, one containing whole-cell pertussis (wP) antigens, the other acellular pertussis (aP) antigens, and reaches a seemingly counterintuitive conclusion: the vaccine with the higher purchase price can result in lower total costs to the health system. These wP vaccines are known to have higher rates of side effects (adverse events), placing a significant additional burden on the healthcare system and society [2].

The findings of the study add to a growing body of evidence from previously published cost-minimization studies and go further than most, modelling wP and aP hexavalent strategies and highlighting the monetary benefits of lower reactogenicity.

A long-held assumption is now being challenged

Where the effectiveness of two strategies (or options) aiming to protect against the same pathogen is assumed to be similar, immunization budget holders will typically focus on acquisition cost alone. But a vaccination program’s costs extend well beyond the product: logistics, cold chain, additional appointments, staff time, adverse event management, and the productivity lost when parents take time off work or travel for care.

The evidence from Argentina suggests that this approach risks overlooking where the greatest costs actually occur: in adverse events and their subsequent consequences.

A global randomized controlled trial by Decker et al. assessed the risk of adverse events between wP and aP [3]. Many adverse events, such as pain, redness, and fever, are far more common among those who receive wP vaccines. Fever rates were between two and nearly five times higher among wP recipients [4]. Primary-series recipients are infants, many of these adverse events lead to primary care visits, generating direct costs to the system and households, along with distress that other studies link to reduced willingness among families to accept vaccination more broadly [2]. The impacts of these adverse events are often overlooked and not factored into budget considerations.

The long-held assumption that whole-cell vaccines are the economical choice is becoming increasingly difficult to defend. Assessed against total health care and societal costs rather than acquisition price alone, acellular hexavalent vaccination increasingly presents as the more favorable option.

The current vaccination situation in Argentina

Argentina’s public schedule currently uses three doses, and a single booster dose of a pentavalent wP-containing vaccine (combined with diphtheria, tetanus, Hib (Haemophilus influenzae type B), and hepatitis B antigens), alongside three IPV (Inactivated Poliovirus Vaccine) doses. This option is available through the public healthcare system; however, Argentina’s immunization program already recognizes the more favorable tolerability profile of acellular (aP) hexavalent vaccines by providing them to certain premature infants through Pan American Health Organization (PAHO) supported programs [5].

Those with the means to purchase the acellular vaccine, with its more favorable tolerability profile, can opt for it through the private market [5]. For most Argentinian infants, however, the wP vaccine remains the default option, as it is offered in the National Immunization Program. Families with private insurance have access to the better-tolerated aP formulation as a matter of course. The burden of adverse events and their associated costs falls disproportionately on the public system and the households it serves.

Can the ‘more expensive’ vaccine be the cheaper option?

The answer, according to the analysis of Argentina, is an unambiguous yes. The upfront acquisition cost of an aP hexavalent vaccine is substantially higher than its wP equivalent. In Argentina’s public sector, the PAHO Revolving Fund price is $21.54 per dose for the aP formulation, versus $4.90 per dose for the wP formulation. On a per-vial basis, the case for wP looks straightforward [1].

But the Argentina study exposes the flaw in this reasoning. The vaccine acquisition cost is only one line item in the budget. Modelling Argentina’s annual birth cohort of roughly 495,000 infants across the public sector (representing 94% of the birth cohort), the wP program’s total societal cost was $70 million: $7 million in acquisition costs, $5 million in programmatic costs, and $58 million in adverse event management. The aP program’s acquisition cost was higher at $32 million, with similar programmatic costs ($5 million), but adverse event management fell to $24 million — enough to bring total societal cost down to $61 million [1].

Total public sector costs fell by $9.1 million (~13.0%) under the aP scheme, driven by a $33.6 million reduction in adverse event management costs. In practical terms, this translated to 533,110 fewer primary care visits, 308,687 fewer emergency department visits, 2,868 fewer hospitalizations, and 1,654,129 fewer missed working days for parents [1].

The cost of adverse events is higher than many assume

The study’s most important methodological contribution may be its rigorous quantification of the costs of adverse events. The paper effectively demonstrates that adverse events are not simply clinical inconveniences. They consume healthcare resources at a scale that is seriously underestimated.

Adverse events management costs accounted for 64% of total costs under the wP hexavalent scheme [1]. It reflects the real-world consequences of administering a more reactogenic vaccine to hundreds of thousands of infants. Pain, redness, fever, prolonged crying, and, in rare but serious cases, seizures and hypotonic-hyporesponsive episodes each generate healthcare resource use: medications, outpatient visits, emergency visits, hospitalizations, and the parental time and travel that accompany them.

Notably, the economic model used adverse event data from Decker et al. 1995 [3]. The estimates from this study report smaller differences between wP and aP vaccines compared with more recent analyses, such as Zhang et al. 2014 [2] and Patterson et al. 2018 [6], which suggest a higher risk in the adverse event profiles of wP vaccination. Consequently, the estimates of savings related to adverse events presented for aP vaccination may be rather conservative.

Argentina is unlikely to be an exception

Comparable findings are emerging across different health systems, procurement models, and income settings. A previous whitepaper from Algeria, discussed in Medika Life [7], demonstrated that acellular hexavalent vaccination has improved vaccination coverage and simplified the vaccination schedule by reducing the number of appointments from 10 to 6. Overall, the higher upfront cost of adopting the new vaccine was offset by around 73% through savings generated by managing adverse events, improved logistics and transportation, and increased parental productivity.

Peru and South Africa saw similar patterns after adopting hexavalent vaccines: higher initial costs were substantially offset by reduced adverse events, lower programmatic expenses, and logistical efficiencies. Peru reported a reduction in logistical costs of nearly 60%, with roughly 44% of the initial cost increase recovered [8]. South Africa achieved overall savings of about $10 per child [9]. Projections from Paraguay and Uruguay estimate overall system savings of $2 million and $16.1 million, respectively, when comparing wP vs aP hexavalent vaccination [10,11].

A potential, and very rare, “double-win” for the health system

Evidence indicates that vaccination should be viewed as an investment, rather than an upfront cost, yielding up to 54 times the initial investment according to the WHO [12]. Much of this return on investment is calculated over a very long period, taking into account costs incurred by the medical system after vaccination, not just acquisition costs. The figure demonstrates the power of vaccines, leading to better health outcomes throughout childhood, fewer missed school days, and, in turn, better prospects later in life.

For a policymaker, on the other hand, the initial cost of a new vaccination program must be justified against a host of other healthcare interventions competing for health system resources. Long-term benefits calculated over many years are often insufficient to justify the expenditure. Because most of the savings in this case come from reducing the direct impacts of adverse events, they are realized in the short term. In addition, the societal costs of adverse events are reduced, with fewer children hospitalized and fewer parents taking time off work to care for sick children.

Healthcare decision-makers are often asked to choose between better outcomes and lower costs. The emerging evidence surrounding acellular hexavalent vaccination increasingly suggests that this may be one of the very rare situations in which both objectives can be achieved simultaneously.

[This consensus paper is based on the findings of a white paper discussing the findings of a group of vaccination experts focusing on pediatric immunization, supported by Sanofi. Intended for professional use.]

References

1. Ignacio Olivera, Eduardo Lopez, Carlos Grau Pérez et al. A cost-minimisation analysis: comparison of acellular versus whole-cell hexavalent paediatric vaccination strategies in Argentina, 16 September 2026, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-11039921/v1]
2. Zhang L, Prietsch SOM, Axelsson I, Halperin SA. Acellular vaccines for preventing whooping cough in children. Cochrane Database of Systematic Reviews 2014, Issue 9. Art. No.: CD001478. DOI: 10.1002/14651858.CD001478.pub6.
3. Decker MD, Edwards KM, Steinhoff MC, Rennels MB, Pichichero ME, Englund JA, Anderson EL, Deloria MA, Reed GF. Comparison of 13 acellular pertussis vaccines: adverse reactions. Pediatrics. 1995 Sep;96(3 Pt 2):557-66. PMID: 7659476.
4. Casabona, G., Shah, N., Choudhury, J., & Shah, U. (2026). Whole cell and acellular pertussis vaccines – rethinking the evidence. Expert Review of Vaccines, 25(1). https://doi.org/10.1080/14760584.2026.2689606
5. Olivera, I., Pérez, C.G., Lazarov, L. et al. Cost minimization analysis of a hexavalent vaccine in Argentina. BMC Health Serv Res 23, 1067 (2023). https://doi.org/10.1186/s12913-023-10038-0
6. Patterson, J., Kagina, B. M., Gold, M., Hussey, G. D., & Muloiwa, R. (2018). Comparison of adverse events following immunisation with acellular and whole-cell pertussis vaccines: A systematic review. Vaccine, 36(40), 6007-6016. https://doi.org/10.1016/j.vaccine.2018.08.022
7. Medika Life, An Expert Perspective from Algeria on Hexavalent Vaccine Adoption. https://medika.life/an-expert-perspective-from-algeria-on-hexavalent-vaccine-adoption/
8. Seinfeld J, Rosales ML, Sobrevilla A, López Yescas JG. Economic assessment of incorporating the hexavalent vaccine as part of the National Immunization Program of Peru. BMC Health Serv Res. 2022 May 16;22(1):651. doi: 10.1186/s12913-022-08006-1. PMID: 35570278; PMCID: PMC9109284.
9. Batson A, Glassman A, Federgruen A, et al. The world needs to prepare now to prevent polio resurgence post eradication. BMJ Global Health. 2022;7(12):e011485. doi: https://doi.org/10.1136/bmjgh-2022-011485
10. ID-308 – COST MINIMIZATION ANALYSIS OF THE HEXAVALENT VACCINE WITH ACELLULAR PERTUSSIS COMPONENT (HEXA PAC) VERSUS HEXAVALENT VACCINE WITH THE WHOLE CELL PERTUSSIS COMPONENT (HEXA PC). PARAGUAY 2025.Olivera Ignacio (1); Martínez Celia (2); Grau Carlos (1); Lazarov Luis (1); Dibarboure Hugo(1). Center for Economic Research, CINVE-Health, Montevideo, Uruguay; (2). Hospital de Clínicas, Asunción, Paraguay.
11. ID-307 – COST-MINIMIZATION ANALYSIS OF THE HEXAVALENT ACELLULAR PERTUSSIS COMPONENT VACCINE (HEXA PAC) VERSUS HEXAVALENT WHOLE-CELL PERTUSSIS COMPONENT (HEXA PC). URUGUAY 2025.Olivera Ignacio (1); Grau Carlos (1); Lazarov Luis (1); Dibarboure Hugo (1). Center for Economic Research, CINVE-Health, Montevideo, Uruguay.
12. WHO, Fully-funded Gavi, the Vaccine Alliance, is a lifeline for child survival, says WHO. https://www.who.int/news/item/28-03-2025-fully-funded-gavi–the-vaccine-alliance–is-a-lifeline-for-child-survival–says-who

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KYLE, Texas — Kenney Blewett was diagnosed with lung disease more than a decade ago but started experiencing flare-ups this year that made him feel like he couldn’t breathe.

Blewett described those flare-ups as “the scariest thing in the world,” said his wife, Cindy, adding that while the episodes typically lasted no more than a few minutes, they had become more frequent.

On top of that, simple tasks, like taking out the trash, left Blewett winded. He rarely left the house and had recently lost 45 pounds. “That sounds like cancer,” Cindy remembered one of his doctors said. It was clear, she said, that her husband’s poor health, tied to decades of smoking, was getting worse.

That’s why, on June 2, Blewett’s pulmonologist wrote him a prescription for a new medication to improve the terrifying breathing issues caused by chronic obstructive pulmonary disease, or COPD. But the prescription wasn’t immediately filled. Two days after that doctor appointment, Blewett received an email from Walgreens explaining that, “due to an insurance issue that we’re working to resolve,” the medication was delayed.

“He was hopeful that it would work,” Cindy said of the drug, two months after her husband’s death. “I wish we had the chance to find out.”

Insurance delays and denials have become an infamous feature of the American healthcare system, with nearly 7 in 10 adults calling them “a major problem,” in a January KFF Health Tracking Poll.

In June 2025, six months after UnitedHealthcare’s CEO was shot in New York, the Trump administration announced a highly publicized industry pledge, signed by dozens of major health insurers, to remove some of the barriers that block or delay patients from accessing doctor-recommended care. And yet that pledge was voluntary, and it carries no penalties if companies fail to comply. Indeed, a report published by KFF Health News in July found that some insurers that signed the pledge would not implement all the promised initiatives as originally outlined.

Insurers Hedge on Trump-Backed Pledge To Improve Denials Process

Last year, the Trump administration announced a voluntary pledge by dozens of insurers to improve prior authorization, which often requires patients to seek approval before treatments. But prior authorization remains commonplace, and there’s no evidence the government is trying to hold insurers to account.

In recent years, lawmakers in most states, including Texas, have attempted to address delays and denials by regulating the insurance industry in the absence of substantial federal reform. But most health insurance plans, including traditional Medicare policies and employer-sponsored offerings, which together cover more than half of all Americans, typically aren’t under state jurisdiction.

Even some medical office staff and pharmacy employees find the patchwork of state and federal insurance rules and regulations confusing, a problem that is poised to become more complicated as artificial intelligence plays a larger role in approving and processing claims.

“It’s just gotten completely out of hand,” said Matt Toresco, CEO of Archō, a patient advocacy and consulting company. He argued that patients need more assistance facing insurance hurdles.

The Blewetts’ story illustrates how navigating these complexities remains a herculean task for patients and their caregivers.

Cindy has sought answers from Medicare; Kenney’s private Part D drug plan; his pulmonologist’s office; and Walgreens. She still has questions about who was responsible for the medication delay and how the holdup could have been prevented.

If the COPD flare-up Blewett experienced on the afternoon of Sunday, June 7, could have been avoided, she wondered, would he still have chosen to die by suicide that night?

‘Complex and Convoluted’

During that first week of June, Cindy said her husband repeatedly asked if his prescription — a liquid medication meant to be inhaled through the nebulizer machine Kenney owned — was ready to be picked up from Walgreens.

Cindy said she wasn’t initially surprised or worried by the delay. Since its acquisition by a private equity firm last year, Walgreens has cut thousands of jobs across the country, according to the Private Equity Stakeholder Project. Cindy said in August that their Walgreens pharmacy in Kyle seemed to her to have been understaffed for months, and that prescriptions were being filled more slowly.

When Cindy called the pharmacy a few days after Kenney’s appointment to find out more about the insurance delay, she said, a Walgreens employee told her the prescription required prior authorization. Also called preapproval or precertification, prior authorization is a practice widely used by health insurers that requires medical providers to seek permission before their patients may receive covered treatment.

But Cindy didn’t know which of Kenney’s insurers required prior authorization for this medication.

For years, she had helped manage multiple policies on behalf of her husband. Kenney was insured by Medicare parts A and B, the federal health insurance program for people 65 and older or with disabilities. But he also had a private Part D plan to cover drug costs through Wellcare Value Script, as well as a Medicare supplement plan through Blue Cross and Blue Shield of Texas — also called a “Medigap” plan — that paid for other out-of-pocket costs.

Initially, Cindy assumed that Kenney’s Part D plan had invoked prior authorization for his new medication. But because it was a liquid that is inhaled through a nebulizer machine, this drug was one of relatively few covered by Medicare Part B’s durable medical equipment benefit, not Part D.

The federal government had no record showing that this prescription had been billed to Kenney’s Part B policy, the Medicare agency told Cindy over the phone, she said.

Sarah Tanner and Myriea Amaya, spokespeople for Centene, Wellcare Value Script’s parent company, would not answer questions for this article.

After Kenney’s death, when Blewett sought clarification at the Walgreens pharmacy, she said the employee “kept saying different things.” She recalled his explaining that the prescription was submitted to Medicare Part B but without a necessary diagnostic code that the doctor should have included.

Carmen Lopez, a spokesperson for Walgreens, told KFF Health News in late September that the company “cannot comment on matters involving specific individuals.”

Subsequently, Cindy said, a district pharmacy supervisor for Walgreens reached out by phone, and told her the pharmacy tried to process the prescription through Part B on June 2, the same day as the pulmonologist appointment, but that the prescription was missing a diagnostic code from the physician. The supervisor said Walgreens sent a request for that code to the pulmonologist’s office later that day, Cindy recalled.

Kenney’s pulmonologist — Rajesh Shetty of LungDocs — did not respond to phone or email messages from KFF Health News. But Cindy said an employee at the practice told her they did not see a fax from Walgreens asking for a diagnostic code for the prescription.

Meanwhile, it couldn’t have been an issue with Kenney’s Medigap plan, since those policies don’t require prior authorization.

“Short of getting attorneys involved,” Cindy said, “I’m not sure how to find out what really happened.”

More Red Tape Ahead

Confusion surrounding these Part B and Part D distinctions is common, said Mike Hess, senior director of advocacy and regulatory affairs at the nonprofit COPD Foundation. “Medicare has gotten to be so complex and convoluted over the years,” he said, that even medical office staff and pharmacy employees often misunderstand the nuances.

And with the introduction of AI to the preapproval process, navigating insurance hurdles will likely get more complex for Medicare beneficiaries, doctors say.

Historically, traditional Medicare, unlike Medicare Advantage, used prior authorization sparingly. But in January, Medicare launched a pilot program in six states — Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington — testing the use of AI to preapprove some healthcare services.

It is intended to “root out waste in Original Medicare,” CMS Administrator Mehmet Oz has said, but physicians and patients say the program is creating more red tape for Medicare beneficiaries and leading to inappropriate denials. The pilot program does not currently impose prior authorization requirements on COPD medications, but industry experts expect the scope of the initiative will grow to include more services and states.

On the night of June 7, hours after her husband’s last COPD flare-up, Cindy Blewett was sitting on their back porch when she heard a loud noise. She assumed a picture had fallen off the wall in the living room. In fact, it was a gunshot. She discovered Kenney’s body in their bedroom.

“I can’t tell you how horrible it was,” Cindy said.

She said her husband had struggled with his mental health for a long time and had attempted suicide once before, years ago. His deteriorating health only made things worse, she said.

Kenney confirmed that much in a note he left. He told Cindy that she was a wonderful wife, mother, and grandmother but that his health was too poor to continue living.

A second COPD medication, which his pulmonologist ordered directly from the drug manufacturer during the June 2 appointment, arrived several weeks after Kenney’s suicide, she said.

“Perhaps, just perhaps,” Cindy said, “if he had received both medications in a timely manner, he would be here today, and we would have had many more years together.”

Do you have an experience with prior authorization you’d like to share? Click here to tell KFF Health News your story.

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She asked: “If they got all the cancer out, why do I still need radiation?” It should have been easy to explain. Instead, I found myself saying things like “to be safe” and “to reduce recurrence risk” without actually telling her what her risk was without treatment, how much radiation might reduce it, or what that difference meant for her. I was describing what we did, not why it mattered for the person in the room. That question has stayed with me. It is the question that changed how I practice.

The question has changed

For most of my early career, breast radiation meant a fairly predictable course: five days a week, often for five or six weeks, treating the entire breast. The discussion was not nuanced. What I spend time asking now is completely different: How much treatment does this particular woman actually need?

That shift has moved through all of cancer medicine. We are getting better at identifying cancers that carry completely different risks even when they look similar under a microscope and arise in the same place. Breast cancer is not one disease. A small, estrogen-sensitive cancer in a woman in her seventies is biologically and clinically a different problem from an aggressive triple-negative cancer in a woman in her thirties. Tumor size. Lymph-node involvement. Hormone receptors. HER2 status. Age. Systemic treatment. These characteristics change not just how aggressive we need to be, but whether we need to be aggressive at all. The word breast cancer tells us where the disease started. It does not tell us the whole story. As we became better at measuring those differences, my conversations with patients changed too.

What “we got it all” actually means

When a surgeon says the cancer was completely removed, that statement has a specific meaning: the tumor came out with a rim of normal tissue around it, and a pathologist found no cancer cells at the edge. That is excellent news. But it does not mean zero percent chance that an individual cancer cell remains somewhere in the breast. No imaging can find a microscopic cluster. No surgeon can see it during an operation.

That is where radiation comes in. After breast-conserving surgery, radiation substantially reduces the chance that cancer will return in the breast. For generations of women, that combination allowed us to preserve the breast without sacrificing cancer control. But there is another part of the story: not every woman benefits by the same amount.

Some women can consider skipping radiation

This is one of the things that surprises many patients: there are women with breast cancer for whom radiation after lumpectomy may reasonably be omitted. Two landmark trials followed carefully selected older women with favorable, hormone-sensitive breast cancers after lumpectomy. Radiation substantially reduced the chance of local recurrence. Without radiation, roughly 1 in 10 women experienced a local recurrence within 10 years; with radiation, it was closer to 1 in 100. But that large reduction in local recurrence did not translate into longer survival. At 10 years, overall survival was essentially the same whether women received radiation or not.

That creates a very different conversation. Suppose one treatment reduces a woman’s chance of cancer returning in her breast but does not appear to change how long she lives. Is that treatment worth having? There isn’t one answer. One woman may say, “I want to do everything reasonable to minimize the chance this cancer ever comes back.” Another may say, “If my risk is already low, avoiding another treatment matters more to me.” Both can be rational choices. My job is not to tell someone that radiation works. My job is to help her understand how much it is likely to help her.

Less radiation does not necessarily mean worse treatment

The amount of radiation we deliver has changed too. For years, five or six weeks was standard. Then strong evidence showed that shorter courses worked just as well for many patients. Three- to four-week schedules became common. Now some appropriately selected women can complete breast radiation in five treatments. Others may not need the entire breast treated at all. Partial-breast radiation focuses treatment on the region surrounding the original tumor, where recurrence is most likely.

To someone who learned medicine under the assumption that more treatment equals better treatment, this sounds counterintuitive. It shouldn’t. The goal of cancer treatment is not to deliver the maximum amount of therapy a person can tolerate. It is to deliver enough.

A mastectomy doesn’t always eliminate the need for radiation

I hear this question regularly too: “If the whole breast is gone, why would I need radiation?” The logic makes sense. A mastectomy removes almost all breast tissue. For many women with early-stage breast cancer, no radiation is needed afterward.

But a mastectomy does not automatically make the risk of recurrence disappear. Cancer can extend beyond the breast into lymph nodes or surrounding tissues. Certain combinations of tumor size, lymph-node involvement, and other features can leave enough risk that radiation to the chest wall and regional lymph nodes meaningfully reduces the chance of recurrence. This is why two women who both undergo mastectomy may receive completely different recommendations. One may need no radiation. Another may benefit substantially from it. The operation is only part of the story.

The deeper shift

When I started in this field, I spent much of my thinking on how to deliver radiation effectively while protecting the normal tissues around the tumor. That remains enormously important. But somewhere in the middle of my career, another question became equally important to me: How much treatment does this person actually need?

I cannot point to the moment that changed. It happened gradually, through hundreds of conversations with women after treatment. I began paying more attention not only to whether treatment worked, but to what we were asking someone to endure for the benefit we expected it to provide.

And I started asking myself a harder question: Did I know that benefit existed before I recommended treatment? Or did I know it theoretically? There is a difference.

The theoretical position is: radiation prevents recurrence. The specific position is: How likely is this woman’s cancer to return without radiation? How much will treatment lower that risk? What does that difference mean to her? How does she weigh it against the inconvenience, side effects, and risks of treatment? That is a different conversation. It respects her time, her body, and her right to decide how much benefit is enough. I was not having that conversation early enough.

Sometimes the answer to “how much treatment” is more than a patient expected. A woman may undergo a mastectomy and still benefit substantially from radiation. A tiny tumor may have biological characteristics that make more treatment appropriate. But increasingly, the answer can also be less. Less surgery. Less radiation. Fewer treatments. Smaller treatment areas. For some carefully selected women, no radiation at all.

I did not learn this from being a better doctor. I learned it from listening to women describe what treatment actually costs them. That is not retreating from cancer. It is understanding what progress in cancer medicine actually looks like. When I began my career, progress often meant finding ways to treat cancer more aggressively. Thirty-six years later, I think progress sometimes means having enough evidence to know when we don’t have to.

The question I couldn’t answer well early in my career is the one I now spend the most time trying to answer: How much treatment does this particular woman actually need?

Your health deserves the same kind of individual attention. Take my free 3-minute Capacity Checkup to see where sleep, mood, focus, and physical capacity may be asking for more attention.

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However, there is a question we rarely ask when introducing a new technology, administrative requirement or checkpoint process into health: “Did we actually eliminate work, or did we simply kick the can down the road and move it to someone else?”

Too often, what looks like efficiency on one side of the health ecosystem table is experienced as friction on the other. The insurer automates a process while a physician practice hires someone to navigate it. The hospital creates another digital portal, while the patient becomes responsible for connecting information that the health system has failed to connect with another. New technology promises to give clinicians time back, only to add another inbox, alert, or screen demanding attention.

In Healing the Sick Care System: Why People Matter, I describe fragmentation as one of the forces that separates people from the care they need and health professionals from the people they are trying to help. Friction is what that fragmentation feels like in our day-to-day life. It is the extra call, the repeated form, the missing information, the wasted hour and the handoff nobody owns. Worse, it is the yelling and arguing between the patient’s physician and the payer’s prior authorization approval team.

There is a cost to all of this. Call it the friction tax.

The Work Did Not Disappear

Prior authorization offers one of the clearest examples. It is intended to control unnecessary spending and encourage appropriate use of diagnostics and treatments. Those are legitimate, responsible goals. The problem amplifies when the administrative mechanism created to save money begins consuming enormous resources elsewhere.

The American Medical Association reported in 2026 that physicians and their staff spend an average of 13 hours each week completing prior authorization requirements. Physicians average about 40 authorization requests each week and 40 percent report having staff who work exclusively on prior authorization.

That work is not free. Its cost simply moved.

An insurer’s utilization decision results in forms, electronic submissions, phone calls, appeals, and follow-up work within a physician practice. Even when the authorization is eventually approved, someone has paid the friction tax. The patient may pay another portion through delayed treatment or by exhausting the effort required to fight for something a clinician has already determined to be necessary. In rare but tragic cases, the friction does not merely delay care. It helps determine whether care arrives in time.

We celebrate efficiency where it was created, without always counting the burden it created elsewhere.

When Waiting Becomes a Bill

Consider something far more ordinary: waiting for the doctor.

Physicians run late. Medicine is unpredictable and sometimes the person in the examination room needs more time than anyone anticipated. That is not friction. The friction is knowing the doctor is running 30, 60 or 90 minutes behind and failing to tell the next patient.

The technology needed to send a text saying, “Dr. Smith is running about 45 minutes late. Please adjust your arrival time,” is hardly futuristic. Airlines alert us when our flights are delayed. Restaurant buzzers tell us when a table is ready. A delivery app can show us a sandwich moving across town. Even items ordered from other countries have shopper apps to keep us posted on their global journeys.

Yet people still leave work, arrange childcare, drive to a physician’s office and sit for an hour because nobody communicated information the practice already knew. This is where a simple principle becomes very practical: communication is care. A timely message respects someone’s time, reduces anxiety and helps strengthen ties before the health encounter even begins.

People’s time has economic value. A national study published in The American Journal of Managed Care found that an ambulatory medical visit lasted an average of 121 minutes, including 37 minutes of travel and 84 minutes at the clinic. Researchers estimated the opportunity cost at $43 per visit in 2010, totaling approximately $52 billion annually across the United States. For every dollar spent reimbursing a physician visit, patients absorbed another 15 cents in the value of their time.

Those figures are more than a decade old; however, the principle is not. Every unnecessary 30 or 60 minutes has value, particularly for the hourly worker losing wages, the parent paying for childcare, the caregiver juggling another person’s needs or anyone forced to surrender a piece of the workday because a practice did not communicate.

According to the American Family Physician, 10 million patients visited a primary care physician this week. Multiply that experience across millions of appointments and waiting stops being a minor annoyance. It becomes an enormous invisible expense.

People Eventually Route Around Friction

There is another consequence to inconvenience that cannot be measured only in dollars. People change their behavior using their buying power.

Urgent care centers and retail clinics offer something traditional medicine too often lacks: walk-in availability, extended hours and shorter waits. Research examining retail clinic use has repeatedly identified convenience as an important reason patients choose these settings.

That matters because people eventually route around friction.

The growth of convenient care cannot be attributed to waiting rooms alone. Primary care shortages, appointment availability, location, cost and changing consumer expectations all played roles. Yet convenience became a competitive advantage because traditional primary care frequently asked patients to organize their lives around the system rather than designing the system around people’s lives.

The loss can be subtle. A walk-in clinic can treat a sore throat or an infection just as efficiently. What it cannot always replace is the long-standing relationship with a primary care professional who has known the patient over the years, notices changes, encourages prevention, and connects today’s complaint to yesterday’s history.

The convenient alternative solved a friction problem. It did not necessarily replace everything that was lost.

Health Professionals Pay Attention

The friction tax also falls heavily on health professionals.

A time-and-motion study published in Annals of Internal Medicine found that for every hour physicians spent in direct clinical face time with patients, they spent nearly two additional hours on electronic health records and desk work during the workday. Physicians also reported another one to two hours of personal time each night devoted largely to EHR tasks.

Some of that work is essential. Documentation protects patients. Medication reconciliation matters. Reviewing laboratory results matters. Safety checks matter.  The goal should never be completely frictionless medicine because some friction protects people from harm.

The problem is friction without corresponding value: entering information that already exists, moving data between systems that cannot communicate, clicking through low-value alerts or requiring highly trained clinicians to perform tasks that do not require their expertise.  How many times have you entered a doctor’s office and been greeted with a clipboard with papers on your medical history?

Every unnecessary minute has an opportunity cost. It is time unavailable for examining someone, explaining a diagnosis, listening to a family or simply looking another human being in the eye. When process begins consuming the relationship, efficiency has defeated its own purpose.

Families Have Become the Integration Layer

Another group quietly absorbs enormous friction: family and friend caregivers.

When organizations cannot coordinate, close connections often coordinate for them. They maintain medication lists, arrange appointments, call insurers, locate specialists, monitor portals, manage bills, and relay information from one clinician to another.

AARP estimated in 2026 that 59 million family caregivers provided 49.5 billion hours of unpaid care annually, work valued at approximately $1.01 trillion.

Not all of that time represents administrative friction. Much of caregiving is essential, personal and deeply human. Yet some portion exists because families have become the connective tissue between organizations and professionals that do not consistently connect.

We have created millions of unpaid care coordinators and rarely count their time as part of the cost of care.

Start Asking Who Pays

None of this is an argument against technology, utilization management or administrative oversight. Innovation can remove enormous amounts of friction. The challenge is determining whether it actually did.

Before introducing a new process or technology, health system innovators should ask: “How many steps does this remove? How many does it add? Whose time does it save? Whose time does it consume? What new work does it create? What happens to the person who lacks the time, digital skills, financial resources or family support to navigate it?”

Eventually, those questions should become measurable. They mean even push the fragmented health ecosystem to share and prioritize a common metric: patient and health professional experience.

Imagine evaluating innovation not only by clinical benefit and financial return but also by a friction score that measures time, clicks, handoffs, repeated information requests, administrative hours, delays, and work transferred to patients and caregivers.

A sick care system is not healed simply by adding more technology. It becomes healthier when innovation reconnects people, information and care rather than placing another obstacle between them.

The next great advance in health may not come solely from adding something new. It may come from finally recognizing the cost of everything we have already added. When a system saves itself time by consuming someone else’s, it has not eliminated cost. It has simply sent the bill to someone who cannot invoice it back.

The post The Hidden “Friction Tax” appeared first on Medika Life.

Scientists have known about this problem for years and are now speaking up more openly. Most drugs that pass animal testing still fail once they are tried in humans. Different studies report different numbers, but many put the failure rate above 90 percent. That means for roughly every ten drugs that look promising and safe in a mouse or a rat, only about one will end up helping a real patient. Some researchers say that number gets used out of context, since animal testing is meant to catch problems early, not guarantee a drug will succeed. Nearly everyone in the field agrees the gap between animal results and human results is real, and it is large.

This isn’t a small technical detail. It means patients wait longer for treatments. It means research money gets spent chasing drugs that would never work in people. And for conditions like cancer, Alzheimer’s, and other brain diseases, it may be one reason so few genuine breakthroughs have reached the people who need them most.

Why a Mouse Body Isn’t a Human Body

The core issue is that animals and humans, while similar, are not the same. A disease that shows up in a mouse doesn’t always behave the way it does in a person. Sometimes it doesn’t show up in the animal at all.

Matthias Zilbauer, a doctor and researcher at the Cambridge Stem Cell Institute, put it plainly: “A lot of human diseases either do not occur in animals or occur in a different way because they’re not human. We want tests and models that can tell us which treatments work, and in what patients, and a mouse cannot tell us that.”

A recent study from Stanford looked closely at why dementia treatments that work well in mice keep failing in human trials. The researchers found that most mouse studies test a drug early, before any real signs of disease appear. Human trials almost always involve people who are already sick. Giving a drug to a healthy mouse before a disease starts is a very different test than giving that same drug to a person who already has memory loss or brain damage.

The study also found that most mouse research only used male mice, which means treatments that might work differently in women were never properly tested to begin with. In this sex bias, it is something that, in the past, has been endemic in research, with most results reflecting work with males, not females.

None of this means animal research is worthless. It has led to real, life-saving treatments for vaccines, cancer, and countless other conditions. But it also means animal results have limits that haven’t always been discussed honestly, and those limits matter most for diseases we still don’t know how to cure.

New Tools Built From Human Cells

Because of gaps like these, researchers in the UK are now building tools made directly from human tissue instead of relying only on animals.

In Cambridge, scientists are growing tiny clumps of human organs, called organoids, using cells donated by NHS patients. These clumps, some smaller than a millimeter, can mirror how an actual organ behaves, including how it responds to disease and to new drugs. Researchers are starting with organoids for bowel diseases like Crohn’s disease and ulcerative colitis, along with organoids to study tumors and brain conditions.

Other researchers are building “organ-on-a-chip” devices, small devices lined with real human cells that mimic how a drug moves through the body. One company, VivoSphere, is growing heart cells in small gel spheres to catch dangerous drugs before they ever reach an animal or a patient. As the company’s Yuan Tian explained, “If something is going to fail, there’s a lower risk for the animals and also for the patients.”

The UK government has backed this shift with money and deadlines. Under a new national roadmap, regulatory skin and eye irritation testing on animals is set to end by the close of 2026. Botox strength testing on mice is expected to end by 2027, replaced by lab-based methods that don’t require a live animal at all.

By 2030, the government wants to sharply cut testing on dogs and primates that tracks how drugs move through the body. In total, the UK has committed 75 million pounds to build out these new methods and make it easier for researchers to get them approved for use.

The United States is moving in a similar direction. In 2025, the FDA announced it would begin accepting artificial intelligence models, advanced lab-grown tissue tests, and other non-animal methods in place of some animal studies, starting with a pilot program for a class of drugs called monoclonal antibodies.

Why Animals Still Matter, and Why This Isn’t Simple

None of this means animal testing is about to disappear, and it would be unwise to suggest otherwise. Under UK law, animals cannot be used in research if a working non-animal method already exists to answer the same question. But for many questions, that alternative doesn’t exist yet.

Wendy Jarrett, who leads the group Understanding Animal Research, made this point clearly: animals have been fundamental to the discovery of most medicines available today, and to treating disease in people and animals alike. Edith Heard, director of the Francis Crick Institute, said much the same, noting that animal research remains necessary for complex diseases like cancer and Alzheimer’s, even as her institute works to reduce and replace it wherever possible.

This is also, importantly, a question of animal welfare, not just scientific accuracy. Last year in Britain alone, 2.54 million animal testing procedures were carried out, most involving mice, rats, fish, and birds. A small percentage involved dogs, cats, horses, and monkeys. Reducing that number matters on its own terms, separate from whether animal tests are scientifically reliable.

Groups on both sides, from the RSPCA to the pharmaceutical industry, have welcomed the UK’s new roadmap, which suggests this is one of the rare issues where scientists, drug companies, and animal welfare advocates largely agree on the direction, even if they disagree on how fast to move.

What seems to emerge is not a choice between animals and no animals, but a more honest reckoning with what animal testing can and cannot tell us. As Dr. Juliet Dukes of the charity Replacing Animals in Research put it, tools built from real human tissue have the potential to deliver something animal testing never could: medicine built around the actual patient in front of a doctor, not just the mouse in the lab down the hall.

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Its leaders were visible throughout the convention, participating in discussions on biopharma innovation, precision medicine, artificial intelligence, investment, genomics and policy. Partnership announcements emerged throughout the week. Delegations moved between panel discussions and private meetings with investors, entrepreneurs, researchers, and industry leaders. The message was clear. Abu Dhabi is making a strategic effort to become a notable player in biotechnology and the life sciences.

The timing is not accidental.

Around the world, governments increasingly view biotechnology as a strategic investment industry. Scientific innovation drives economic growth. Advanced therapeutics create new manufacturing opportunities. Genomics and precision medicine are reshaping approaches to disease prevention and treatment. Nations that attract talent, investment and scientific expertise position themselves at the forefront of one of the century’s most consequential industries and life-sustaining movements.

Abu Dhabi is determined to be among those countries.

Building the Innovation Foundation

Substantial investments and partnerships in infrastructure, research, education and health innovation support the Emirate’s ambitions.

In April 2025, Abu Dhabi launched the Health, Endurance, Longevity and Medicine (HELM) Cluster, an initiative designed to establish a globally competitive ecosystem spanning biotechnology, pharmaceuticals, medical technology, genomics, digital health, artificial intelligence and advanced manufacturing.

Officials project the initiative will contribute AED 94 billion to the economy by 2045, attract more than AED 42 billion in investment and create approximately 30,000 jobs.

Those figures reflect more than economic development goals. They signal a growing recognition that biotechnology is a cornerstone of future growth and global competitiveness.

The Emirate is not starting from scratch. Organizations including M42, PureHealth, Mubadala Bio, Khalifa University, and the Mohamed bin Zayed University of Artificial Intelligence have established a foundation that combines research, clinical capabilities, advanced analytics and investment resources. The UAE Genome Program has surpassed 900,000 sequenced genomes, making it one of the world’s largest population genomics initiatives and providing a valuable resource for scientific research and precision medicine.

These investments provide the ingredients necessary to compete. Partnerships provide the opportunity to accelerate progress.

Building Through Collaboration

Biotechnology has long been a collaborative enterprise among private equity and entrepreneurs, academic medicine and corporations, and, now, nations working side by side with other countries’ governments.

Scientific discovery depends on the exchange of knowledge among researchers, entrepreneurs, clinicians, manufacturers, regulators, and investors. No single country possesses every advantage. Successful ecosystems learn how to connect their strengths with those of others.

Abu Dhabi’s recent actions suggest its leaders understand this reality more than anyone else. They act on it.

During the BIO International Convention, the Department of Health – Abu Dhabi announced a strategic collaboration with Sanofi focused on vaccine development and life sciences innovation. The previous year at BIO in Boston, the Department established a partnership with Boehringer Ingelheim that expanded access to the company’s OpnME research platform, creating new opportunities for translational research and scientific discovery.

An additional 2025 agreement was signed with Abbott, focused on pharmaceutical innovation, manufacturing capabilities, and emerging technologies.

These were not isolated announcements. They represented a broader effort to connect Abu Dhabi with leaders across the global life sciences community. That strategy continued at BIO 2026.

On June 23, 2026, the Department of Health – Abu Dhabi announced a strategic partnership with Biocom California, one of the world’s largest life sciences associations representing more than 1,800 biotechnology, pharmaceutical, and medical technology organizations. The agreement creates a formal gateway between the California innovation ecosystem and Abu Dhabi’s growing life sciences sector, strengthening opportunities for collaboration among researchers, entrepreneurs, investors, and innovators across both markets.

The significance of the announcement extends beyond California. It reflects Abu Dhabi’s effort to connect itself to some of the world’s most influential innovation networks and to participate in the exchange of scientific knowledge, talent, and investment that increasingly defines biotechnology leadership.

Moving Up the Biotech Value Chain

If the Biocom agreement demonstrated Abu Dhabi’s commitment to global collaboration, a second announcement made the Emirate’s ambitions even clearer.

On June 24, 2026, the Department of Health – Abu Dhabi, M42, and Mammoth Biosciences announced a partnership to advance gene-editing therapies, clinical research, and advanced therapy manufacturing in Abu Dhabi. The agreement seeks to leverage insights generated through the Emirati Genome Program while supporting the development of next-generation treatments for inherited diseases.

This announcement stands out because it moves beyond ecosystem building and into the development of future therapies.

Mammoth Biosciences was co-founded by Nobel Prize-winning scientist Jennifer Doudna, whose pioneering work helped bring CRISPR gene-editing technology into medicine. Under the agreement, Mammoth will contribute its proprietary gene-editing platform, M42 will provide genomics, health, and clinical research infrastructure, and the Department of Health will support the regulatory and research environment needed to advance development.

The collaboration includes plans to introduce Mammoth’s lead clinical candidate, MB-111, into Abu Dhabi’s research ecosystem, support advanced gene-editing clinical trials, establish advanced therapy manufacturing capabilities, and develop local expertise through workforce training programs.

Perhaps most significantly, the partnership highlights how Abu Dhabi is leveraging its genomics investments. The Emirati Genome Program has created one of the world’s most comprehensive population genomics initiatives. The Mammoth agreement represents an effort to translate those insights into therapies targeting inherited diseases.

As H.E. Dr. Noura Al Ghaithi noted when announcing the partnership, Abu Dhabi is focused on translating genomic insights into therapies to address some of the most complex inherited diseases affecting populations in the region and worldwide.

Leadership Matters

The prominence of Abu Dhabi at BIO 2026 reflects sustained engagement from senior leaders. H.E. Dr. Noura Khamis Al Ghaithi, Undersecretary of the Department of Health – Abu Dhabi, and Dr. Mohamed Al Ameri, Division Director of Genome and Biobank at DoH, are among the officials representing the Emirate’s vision throughout the convention.

Their participation reflects a broader commitment. During Abu Dhabi’s 2025 strategic mission to the United States, approximately 40 representatives from 12 organizations attended more than 20 strategic meetings, conducted 16 institutional visits, participated in 9 BIO-related panels, and established 7 new partnerships and agreements.

Such activity underscores an important point. Building a biotechnology ecosystem requires more than investment capital. It requires leadership, patience, and a willingness to build relationships across borders and disciplines.

A Must-Watch Innovation Hub

For decades, discussions about biotechnology leadership have focused on a familiar collection of cities and regions. Boston, San Diego, Basel, London, and Singapore earned their positions through scientific excellence, entrepreneurial activity, and investment.

Abu Dhabi is pursuing a different path.

The Emirate is leveraging capital, scientific infrastructure, genomics, artificial intelligence, policy support, and international partnerships to establish a presence in the global biotechnology landscape. Its strategy recognizes that modern biotechnology advances through collaboration and that scientific leadership increasingly depends upon connecting talent, expertise, and resources across borders.

BIO 2026 demonstrated that Abu Dhabi is no longer simply expressing an ambition to participate in the life sciences sector. Through initiatives such as the HELM Cluster, partnerships with organizations including Sanofi, Boehringer Ingelheim, Abbott, Biocom California, and Mammoth Biosciences, and investments spanning genomics, research, and advanced therapies, the Emirate is laying the foundations for a biotechnology ecosystem with global aspirations.

Whether Abu Dhabi joins the ranks of the world’s leading life sciences hubs remains to be seen – but it should be watched closely. What is increasingly difficult to overlook is the depth of its commitment and the speed with which effort is being translated into action.

The post Abu Dhabi’s Biotechnology Ambition Comes into Focus at BIO 2026 appeared first on Medika Life.

Despite living longer than men, women spend approximately 25 percent more of their lives in poor health, according to research from the World Economic Forum and the McKinsey Health Institute. Across reproduction, brain health, autoimmune conditions, cardiovascular disease, and mental health, the gaps in research, funding, and care are persistent.

That reality provided important context for the launch of The Shift, a new mini documentary series from BBC StoryWorks Commercial Productions, unveiled at HLTH Europe. The series explores issues ranging from reproductive health and cardiovascular disease to autoimmune disorders, menopause, mental health and healthy aging. Through storytelling, the documentary project elevates the experiences of women while highlighting the challenges that persist and the opportunities for progress.

The HLTH EU panel discussion was timed for the opening of The Shift and featured Shahnoor Abbas, Senior Series Developer and Research Development Lead for The Shift at BBC StoryWorks Commercial Productions; Elena Bonfiglioli, General Manager, Global Health & Life Sciences at Microsoft, and Priya Agrawal, MD, Vice President, Global Health Equity and Partnerships at MSD. Their conversation, moderated by Jody Tropeano Greene, Head of Content for HLTH, explored why women’s health remains one of the most significant opportunities for innovation, investment and system improvement.

A Conversation Decades in the Making

The panelists approached the topic from different perspectives, yet a common theme emerged. Women’s health has received increasing attention for more than a decade, but many of the barriers women encounter remain rooted in the design of health systems.

For BBC StoryWorks, The Shift represents an effort to sustain attention on issues that too often receive episodic interest. The series combines personal stories with broader insights into the realities women face across different countries, cultures and stages of life.

The BBC initiative and the HLTH EU mainstage conversation arrive at a time when women’s health is attracting growing attention from investors, entrepreneurs, policymakers and health industry leaders. New companies are emerging. New technologies are being developed. More organizations are recognizing both the societal and economic importance of addressing longstanding gaps in care.

The timing of The Shift is notable. Women’s health innovation is receiving growing attention from investors, entrepreneurs, policymakers and health leaders. Industry analysts estimate that approximately $2 billion was invested in venture-backed women’s health companies across the United States and Europe in 2025, reflecting increased interest in addressing challenges that extend beyond reproductive health to include cardiovascular disease, menopause, mental health, oncology and healthy aging.

The trend signals growing recognition that improving women’s health is a societal imperative and a significant economic opportunity. Yet as the discussion at HLTH Europe made clear, investment and innovation alone will not be enough if women continue to face fragmented systems that are difficult to navigate.

When Access Exists but Navigation Fails

Dr. Agrawal, an obstetrician-gynecologist by training, whose work has included clinical practice in the UK NHS, global pharma brand stewardship in emerging middle-income nations, maternal health awareness initiatives, and the creation of sustainable health markets, described a reality familiar to many women. Access to care may exist on paper; however, reaching that care, understanding available options and navigating fragmented systems remains a challenge.

“We’ve built systems like mazes with different entry points, different providers and different messages,” said Dr. Agrawal. “Women are often left navigating all of this themselves at the moments where they are most vulnerable.”

Her observation echoed the comments by fellow panelists, which touched on an issue that extends beyond women’s health. Across many countries, patients frequently encounter disconnected providers, inconsistent communication and care journeys that require them to coordinate appointments, referrals and information on their own. The burden of connecting those pieces often falls on the individual seeking care rather than the system intended to support them.

For women, that complexity can be especially challenging. Responsibilities related to caregiving, work, family and personal health often intersect at the very moment care is needed. Understanding what symptoms are normal, knowing when to seek help, determining where to go and finding trusted sources of information become added obstacles.

That reality led to one of the discussion’s compelling observations. “This is not an access problem. It’s a design problem.”

The distinction matters. Discussions about women’s health often focus on whether services exist. Design asks a different question: can people realistically find, understand and benefit from those services when they need them most?

The Power of Stories to Sustain Change

The panel also explored the role technology may play in addressing those challenges. Rather than adding new layers of complexity, emerging digital tools and artificial intelligence applications are increasingly being developed to simplify navigation, improve continuity and support people between clinical encounters.

“What excites me is that technology is finally starting to reduce friction instead of adding layers of complexity,” Dr. Agrawal observed.

That perspective aligned with comments from Bonfiglioli, whose work at Microsoft focuses on helping health systems leverage data, cloud technologies and artificial intelligence to improve outcomes. Technology, however, was not presented as a solution on its own. The discussion repeatedly returned to the importance of human connection.

Those themes are central to the documentary series itself. BBC StoryWorks has built a reputation for transforming complex issues into compelling narratives that audiences can understand and relate to. Through The Shift, the goal is not merely to document challenges but to foster greater understanding of the experiences women face and the opportunities that exist to improve care.

Abbas emphasized the power of storytelling to connect data and lived experience. Statistics can identify a problem. Research can explain it. Stories help people understand why it matters and why action is necessary.

That may be the enduring value of The Shift. The series does not introduce a new conversation. Instead, it brings fresh perspectives to longstanding challenges. Through stories from around the world, the films remind viewers that behind every statistic is a person navigating the complexities of health and care. By fostering greater understanding and empathy, the series encourages health leaders, innovators and policymakers to view women’s health not as a periodic topic of interest, but as an ongoing priority deserving sustained attention and action.

The women featured throughout the series deserve more. The discussion at HLTH Europe reinforces that improving women’s health is more than developing new technologies and expanding services. It is also about creating systems that are easier to navigate, more responsive to people’s medical priorities and ultimately more human in their design.

The post At HLTH Europe, BBC StoryWorks Shines a Light on Women’s Health and the Challenge of Navigating Care appeared first on Medika Life.

Bringing Conversational AI to Scientific Research

The announcement arrives as artificial intelligence continues to reshape nearly every corner of the health sector. Much of the attention has focused on applications designed for consumers seeking information or clinicians seeking support in managing increasingly complex workloads. Briya is directing its attention to a different priority audience: medical researchers in academia, hospitals and life science companies.

The decision reflects a recognition that scientific inquiry often remains constrained by barriers that have little to do with science itself. Researchers routinely navigate fragmented data sources, technical requirements, analytical platforms and resource limitations before they can begin testing a hypothesis or exploring an observation.

The Next Step in Briya’s Evolution

Briya is executing on the established understanding that artificial intelligence can help reduce those barriers.

Researchers using AIRE will be able to explore public health information, including data from the U.S. Centers for Disease Control and Prevention, through a browser-based conversational interface. Rather than writing code, users can ask questions in natural language, refine their inquiry through dialogue and review the analytical pathway used to produce results.

“The last few years proved that AI can generate answers,” Briya co-founder and CEO David Lazerson told Medika Life. “The next challenge is making AI capable of generating trustworthy science. That requires a fundamental shift from general-purpose AI systems to research environments built around transparency, epidemiological methodology and scientific accountability.”

The announcement represents the latest step in Briya’s evolution. Founded in 2020 by Lazerson and Chief Technology Officer Guy Tish, the company initially centered efforts on helping organizations connect fragmented health data while maintaining privacy protections, governance requirements and institutional control over sensitive information.

Medical records rarely exist in a single location. Information is often distributed across electronic medical records, laboratory systems, imaging platforms, physician notes and institutional databases. Briya developed a federated approach that allows information to remain within source organizations while supporting approved research across participating data environments.

AIRE expands that mission from data access to data exploration.

The platform is designed to support cohort construction, endpoint validation, treatment pathway analysis, chart review and the exploration of structured and unstructured clinical information. Researchers interact with the platform through conversation rather than code, allowing them to start with a scientific question rather than a technical workflow.

The strategy mirrors an approach that has proven successful in other areas of artificial intelligence. Consumer platforms such as ChatGPT and Perplexity accelerated adoption by allowing users to experience the value of AI before deciding whether additional capabilities justified a subscription.

Reducing the Distance Between Questions and Answers

Briya is applying a similar philosophy to research. Many health technology companies continue to pursue adoption through enterprise purchasing processes, institutional pilots and lengthy implementation cycles. The Briya approach places the researcher at the center of the experience and allows investigators to determine the platform’s value through direct, frequent use.

The company believes that approach may be particularly meaningful for researchers working outside large academic medical centers and major pharmaceutical companies. Those institutions often have access to dedicated data science teams and sophisticated analytical resources. Smaller universities, physician-scientists, public health investigators and community-based researchers may not.

The absence of resources does not diminish the importance of the questions they seek to answer. In fact, as many attending HLTH EU head from Amsterdam to BIO International in San Diego, many of the biggest life-changing advances start in smaller research settings.

Giving Researchers a Seat at the Table

A physician observing an unusual treatment response, a public health researcher investigating a local health pattern, or an early-career investigator evaluating a new hypothesis all face the same challenge: transforming observation into evidence. That process frequently requires technical expertise and infrastructure that are not universally available.

Reducing those barriers could expand participation in research and potentially broaden the range of questions being explored. Accessibility alone, however, is not enough.

Scientific inquiry requires transparency, reproducibility and methodological rigor. Researchers must understand how conclusions are reached, what assumptions influence an analysis and where potential bias may exist.

A Move from Observation to Evidence

Recognizing those requirements, Briya recently appointed internationally recognized epidemiologist Professor Jonathan Samet, MD, MS, as Chief Epidemiologist. Dr. Samet is Professor of Epidemiology and Occupational and Environmental Health, and the former Dean of the Colorado School of Public Health.

“Scientific rigor and accountability cannot be layered onto AI after the fact,” Dr. Samet told Medika Life. “If these technologies are going to play a meaningful role in healthcare research, transparency, reproducibility and epidemiological methodology must be built directly into the system itself.”

Samet added that researchers need to understand more than an AI-generated conclusion: “Researchers need to understand not only what an AI system concludes, but how it reached those conclusions and what risks may exist along the way.”

His appointment reflects a broader challenge facing artificial intelligence in research environments. While generative AI systems can produce clear and persuasive responses, researchers and institutions must be able to evaluate the methods, assumptions and analytical pathways behind those outputs.

Trust, governance and cybersecurity have become as important as speed and convenience. Health information remains among the most sensitive categories of personal data. Institutions considering AI-enabled research environments must evaluate privacy protections, security controls and governance requirements alongside scientific capabilities.

Briya says its architecture is designed to allow data to remain within source organizations while supporting anonymization, compliance controls and auditable pathways for approved analysis.

Briya’s decision to open access to AIRE arrives at a time when researchers are under increasing pressure to produce meaningful scientific output while navigating growing volumes of health information. The platform’s no-cost entry point reflects a broader shift occurring across technology, where organizations increasingly recognize that adoption begins with customer experience. By allowing researchers to engage directly with data through a conversational interface, Briya is reducing barriers that have traditionally separated scientific questions from scientific exploration and adoption.

The announcement broadens the conversation surrounding artificial intelligence in health. Much of the industry’s attention has focused on consumer and clinical applications. Briya is directing attention to another critical constituency whose work influences every future therapy, diagnostic and public health intervention.

As HLTH Europe begins, the company is making the case that empowering researchers may represent one of the most consequential applications of artificial intelligence in health. If successful, the approach could help accelerate discovery, expand participation in research and provide investigators with a direct path from observation to evidence to implementation.

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A bill passed by the state legislature in March then signed into law by Democratic Gov. Jared Polis allows Colorado to further uncouple itself from federal guidance.

The law allows health officials to follow the recommendations of national medical groups when making decisions such as purchasing bulk vaccines for the Medicaid program.

“We are insulating our state from the dysfunction coming out of Washington,” said Democratic state Sen. Kyle Mullica, a co-sponsor of the bill and a registered nurse. “We’re going to rely on science.”

“From fighting during the pandemic for Coloradans to get vaccines as quickly as possible to combating the Trump Administration’s barriers to getting vaccinated, we have expanded access to vaccines for Coloradans who want them,” Polis said in a statement when he signed the law.

Colorado is one of at least 29 states that, along with Washington, D.C., have taken steps to bypass the new federal recommendations amid worries that the changes could chip away at public trust in vaccines and erode broad vaccine coverage.

Previously, Colorado, like most states, had followed federal guidance set by the Centers for Disease Control and Prevention. In January, CDC advisory panelists, selected by Health and Human Services Secretary Robert F. Kennedy Jr., removed six pediatric immunizations from the agency’s universal recommendation list.

Last year, doctors, scientists, local leaders, and other supporters came together to form an outreach and advocacy coalition called Colorado Chooses Vaccines.

The group aims to offer a clear, unified voice on the proven benefits of vaccines and reassure residents confused by the many federal changes.

Carol Boigon, a former Denver City Council member, joined the group because she wants more people to hear her own chilling story about vaccine-preventable illness.

“Every summer everybody got sick,” Boigon said, recounting her childhood in 1950s Detroit.

The illness was polio, a highly contagious viral disease that attacks the nervous system, sometimes causing partial or full paralysis.

During the summer of 1953, “the whole block was sick and some of us got crippled, and that was just the way it was,” she said.

New Group Steps Up

Boigon’s personal history will be part of the coalition’s work to educate new generations about the dangers of infectious diseases that were once common in the U.S. but are now relatively rare.

The group, which formed last September, will also compile vaccine information from medical groups and the state health department and advocate for policy proposals with the state government.

“It was in direct response to the federal threats,” said another coalition member, former state lawmaker Susan Lontine. She leads the nonprofit Immunize Colorado.

Another member, public relations specialist Elizabet Garcia, wants more outreach to Hispanics, whose vaccination rates lag behind other groups’.

“A lot of time it’s this fear that they’re going to have to pay out-of-pocket, that their insurance doesn’t cover it, that they might not even have insurance in general,” Garcia said.

Boigon was 5 when she got sick and was hospitalized for six weeks with a fever. The virus attacked her spine.

“None of my limbs worked immediately afterwards,” Boigon said.

Although she regained function in her other limbs, her right arm never fully recovered. She had to adapt, relearning everyday tasks such as reaching out to shake hands with people with her left hand.

In 1955, not long after she got sick, the new polio vaccine became more widely available to the public. As vaccinations took off, U.S. cases of polio, once one of the nation’s most feared diseases, dropped by an estimated 85%-90%.

Increasing Public Trust

State leaders have taken other steps to promote public health. After the Trump administration pulled the U.S. out of the World Health Organization, several states, including Colorado, decided to join the WHO’s Global Outbreak Alert and Response Network on their own.

Colorado also joined a multistate lawsuit challenging the Trump administration’s changes to the childhood vaccine schedule.

And the new state law has provisions besides allowing the state to diverge from federal recommendations. It codifies pharmacists’ ability to prescribe and give vaccines themselves. It also increases legal protections for healthcare workers who give vaccines.

“This law will provide more clarity to guide all Coloradans, including providers who administer vaccines,” Lontine said.

But the legislation has opponents who say it would interfere with parental choice and claim vaccines might be unsafe or ineffective.

“I just want to make sure we’re not just getting into a big political dispute between the federal recommendations — the CDC and so forth — and different political views in Colorado here,” said Republican state Sen. John Carson, who voted against the vaccine bill.

NPR contacted the U.S. Department of Health and Human Services about Colorado’s new law. Spokesperson Emily Hilliard answered in an email: “The updated CDC childhood schedule continues to protect children against serious diseases.”

Preventable Illnesses Surge

The flurry of statewide activity comes as Colorado and the nation have seen surges in illnesses such as flu and measles.

As of mid-May, Colorado had recorded 22 measles cases this year. In 2025, it registered 36 cases, according to the state health department, far surpassing totals from previous years.

Across Colorado, kindergarten vaccination rates for measles were 88% last school year — with only a few counties achieving rates of 95%, the level needed for herd immunity, according to data published by The Washington Post in December.

This has also been Colorado’s worst flu season in recent years.

Vaccination rates for both flu and covid-19 have dropped slightly in Colorado, according to the state health department.

Eight children in Colorado have died this season from flu; one from covid; and one from RSV, or respiratory syncytial virus. Vaccines for all three are available for children and recommended by the state’s health department.

Kennedy, a longtime anti-vaccine activist, has defended his decisions to overhaul the recommended schedule for childhood vaccinations.

In March, a federal judge put on hold many of the changes.

“We’re not taking vaccines away from anybody. If you want to get the vaccine, you could get it. It’s going to be fully covered by insurance just like it was before,” Kennedy told CBS News in January.

When a reporter suggested the new changes could result in fewer people getting a flu vaccine, Kennedy said: “Well, that may be, and maybe that’s a better thing.”

Boigon is sometimes incredulous at everything that has happened.

“It’s like we’re going backwards,” she said. “It’s like we have decided we don’t want a modern life; we want to be back in the 1950s, where children are sick and dying.”

This article is from a partnership with Colorado Public Radio and NPR.

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Despite this extraordinary pace of innovation, something fundamental remains broken. Patients still struggle to navigate care. Physicians continue to wrestle with fragmented systems, administrative overload and technologies that often add work rather than reduce it. Health innovators repeatedly introduce sophisticated tools into environments overwhelmed by operational complexity, lack of governance, cybersecurity concerns, workflow disruption and communication gaps.

The issue is no longer whether innovation benefits care. The issue is friction.

Consumers compare health care experiences to every interaction in daily life. They compare health care to Apple, where design simplifies complexity, to Amazon, where communication is continuous and immediate, and to banking and travel platforms providing real-time updates and seamless transactions. Some may even compare it to Domino’s Pizza, which promises delivery within 15 minutes or the pie is free. Expectations surrounding responsiveness and convenience have fundamentally changed.

Then they enter health care environments where forms are repeated, portals fail to communicate, prior authorizations delay treatment and updates disappear into silence. Patients are left to navigate disconnected systems during moments of vulnerability. The expectation gap between consumer and health care experiences continues to widen and increasingly shapes reputation.

In Healing the Sick Care System: Why People Matter, the observation is made that “Health care isn’t failing because we lack innovation. It’s failing because the system around that innovation has calcified.” The statement remains painfully real because innovation alone does not create confidence. Experience does.

Patients Remember the Journey, Not the Molecule

The patient and physician experience is shaped less by what a product promises and more by what happens after that promise enters real life. A medicine may be clinically meaningful, yet the experience surrounding it can still become exhausting if coverage is difficult to secure, prior authorization is confounding, specialty pharmacy coordination is slow, follow-up instructions are unclear or support programs require patients to become navigators of their own care.

In those moments, people are not judging science on its own merits. They are judging the total experience of trying to make that medicine or care available and understandable.

Physicians face their own administrative version of friction. A therapy may be medically appropriate, yet before treatment can begin, office staff must determine coverage, complete documentation, respond to payer step-through requirements, manage rejection appeals and explain delays that were never created in the exam room. Every additional administrative step consumes time, stretches staff and places additional strain on the physician-patient relationship. Even non-medical formulary changes can force physicians to restart conversations, explain unexpected medication switches and reestablish patient confidence in treatment decisions already made.

Patients remember counting the hours as they waited for answers. Physicians remember losing uncompensated time navigating systems and approvals. Nurses remember caring for patients through computer screens while typing notes into laptops on rolling carts in crowded hallways. Office managers remember the relentless cycle of paperwork, rejected claims, disconnected portals and endless callbacks trying to move care forward.

The therapy may eventually do its job, yet the pathway becomes inseparable from the memory associated with the brand, the company and the broader health care system. Every new process, technology and treatment promises improvement. For patients and health professionals, however, if the path to care feels uphill, the friction surrounding the experience can overshadow the value of the benefit.

For many patients, repeated uncertainty, delays and administrative obstacles contribute to a form of medical PTSD, where anxiety surrounding the system becomes inseparable from the treatment experience. For health professionals, the constant burden of navigating fragmented systems, managing approvals and compensating for communication gaps has become a leading contributor to burnout.

Friction is rarely remembered as an operational issue inside organizations. Patients and physicians experience it personally. This is why communication must be elevated operationally within health care. Communication is not marketing layered onto innovation after development is complete.

Health care organizations often think they are going through the process of delivering a product, therapy or platform. Patients and physicians experience something more personal: time invested in every interaction surrounding the innovation is time lost forever.

Health Technology Cannot Create More Work

The same reality applies to health technology startups and digital health innovators. Technological advancement alone does not guarantee adoption within health care environments already burdened by operational complexity and workforce fatigue.

Health care organizations do not merely evaluate whether technology works. They evaluate whether it integrates with existing workflows, whether cybersecurity standards are state-of-the-art, whether onboarding is manageable, whether interoperability gaps create additional burdens, and whether the institution can trust the accuracy of data.

Every additional step is a friction point, while every unresolved operational issue becomes part of the patient and physician experience surrounding the journey.

A sophisticated AI platform that requires clinicians to validate outputs continuously adds cognitive burden. A monitoring platform generating clinically important alerts contributes to fatigue. A system that requires extensive retraining or manual workarounds may succeed in demonstration but stumble in real-world conditions.

Innovation may arrive elegantly designed; however, it enters health care environments already strained by workflow complexity, disconnected systems, cybersecurity demands and administrative fatigue. The operational realities surrounding implementation often become as important as the innovation itself.

That reality does not diminish the importance of continuous invention. It reinforces the importance of implementation, communication and operational design within real-world clinical environments.

This shift is increasingly visible across the global health innovation marketplace itself. At HLTH Europe 2026, conversations are moving well beyond excitement surrounding artificial intelligence, digital therapeutics and next-generation platforms. The agenda sessions focus on interoperability, workflow integration, governance, patient engagement and operational implementation. Conference themes repeatedly emphasize connected systems, coordinated experiences and technologies that reduce fragmentation rather than add to a growing list of patches.

One of the more revealing themes from HLTH Europe focuses directly on interoperability and the longstanding frustration surrounding disconnected systems. The conference site notes that clinicians continue spending enormous energy managing platforms that fail to communicate effectively with one another. At the same time, artificial intelligence is increasingly viewed not as a replacement for care, but as a bridge helping systems “finally speak the same language.”

Another major focus involves provider realities. HLTH Europe speakers highlight workforce fatigue, cyber risks, operational strain and workflow challenges facing clinicians and health systems across Europe and beyond. These agenda themes reinforce a growing recognition throughout the industry that innovation cannot succeed if it increases the burden for the people expected to use it every day.

Health professionals increasingly describe a workplace dominated by more screens, more alerts, more documentation and less time with patients. Technology interrupting workflow rather than integrating into it creates resistance, regardless of how advanced the platform may appear. The hidden work behind implementation often becomes the defining experience for the people expected to use the system every day.

Cybersecurity provides another important example. Health professionals and patients may never fully understand the technical architecture protecting health information, yet they absolutely understand the emotional consequence of uncertainty surrounding data privacy, reliability and trust. Confidence in health technology is not built solely through functionality. It is reinforced through consistency, service, transparency and confidence that information is accurate, protected and responsibly governed.

Communication plays an equally important role here. If clinicians are left uncertain about updates, system changes or data governance responsibilities, confidence weakens. If patients do not understand how information is protected, trust erodes, regardless of how advanced the technology.

Communication remains inseparable from the care experience.

The organizations most likely to lead the future of health care will not distinguish themselves solely through technological achievement. They will reduce friction around the user interface, workflows and data accuracy.

The Companies That Win Will Simplify Complexity

This reality explains why access organizations such as Hims & Hers Health and Cost Plus Drugs deserve careful study from across the health care sector, regardless of whether industry leaders agree with every aspect of their business models. These organizations are built around reducing friction in how people access and experience care.

Their importance extends beyond convenience or pricing. These companies recognize that many traditional health institutions have underestimated: people increasingly expect health care experiences to reduce anxiety, simplify decision-making and provide continuity throughout the care journey.  They are “Amazon-like,” offering a “Buy It Now” simple click medical oversight option.

The rise of concierge medicine, direct-to-consumer health platforms and walk-in clinics with reduced wait times reflects a broader market signal the health sector cannot ignore. Patients are increasingly gravitating toward experiences where communication is clearer and access is more immediate.

For those able to afford concierge care, the attraction often extends beyond physician access itself. Patients value responsiveness, shorter wait times, easier scheduling, follow-up communication and the sense that someone is helping coordinate their journey through the system. Walk-in clinics and urgent care centers appeal for similar reasons. People are searching for environments where care is readily accessible, understandable and administratively manageable. The downside of loss of care continuity is offset by immediacy, which is what the consumer values most.

This migration reflects frustration with friction embedded throughout the trending health care experience. Long hold times, delayed callbacks, countless portals, disconnected records, repeated paperwork on clipboards and uncertainty surrounding next steps all shape how people perceive quality of care.

Communication once again sits at the center of the experience. Patients rarely separate operational snafus from expert care. They experience the entire journey as one connected reality – positive or negative.

The lesson is not that health care should behave exactly like retail commerce. Medicine carries ethical, scientific and regulatory responsibilities far beyond consumer transactions. Nevertheless, the operational expectations consumers now bring into the setting have changed.

People increasingly expect health care to be as responsive as the communication they experience elsewhere in life. Is that expectation reasonable?

The pharmaceutical industry, payers, providers, and health technology innovators must recognize that they no longer own just the patents on therapies, platforms or services. They also own the surrounding user experience.

Patients experience health as a continuous journey, not a “build your own adventure” exercise in navigating fragmented systems. Most people enter the system anxious and seeking reassurance from their health professionals. A delayed approval, clinically sterile information delivered through a diagnostic portal or a physician struggling to navigate complexity alongside them deepens that burden. These experiences shape how health care is remembered more powerfully than advertising campaigns or corporate positioning statements.

Those experiences ultimately shape reputations.

The future winners in health care will not simply develop innovative products. They will reduce friction around the human experience surrounding those products. They will recognize that communication, workflow design and responsiveness are not secondary considerations attached to innovation. They are part of the experience.

Patients and physicians rarely remember the elegance of molecular or system architecture behind a therapy or platform. They remember whether the experience made care delivery easier and more humane during moments that mattered.

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