An anonymous reader quotes a report from NPR: Billions of dollars are traded every week on the lightly regulated prediction market sites, where users bet on everything from movie reviews to elections to conflicts in the Middle East. Clinical trials are just the latest area where the industry's rapid growth is raising ethical questions. Kalshi claims such bets will provide a new source of information about which drugs will get approved, and what clinical trials will show promising results, which the company says can help investors decide what new drugs to fund. "If you want to ban profiting from the failure of clinical trials, you would start with the stock market, where the financial incentive for this type of profit is orders of magnitude larger," said Kalshi spokesman Jack Such, pointing to stock market short sellers who have profited from clinical trial failures. "While Kalshi and the stock market are the same in this regard, they do differ in one important way: the stock market doesn't give any valuable information to researchers," Such said. Drug trial researchers, though, are far from convinced. David Tsai, who runs clinical trials at a biotech company in the San Francisco Bay Area, started an online petition pushing for such betting to be banned, making the case that betting on drug trials "threatens the very foundation of trust and integrity in biotechnology." Tsai is concerned that the prospect of betting provides those involved with a clinical trial a reason to tamper with the results for a prediction market payout. "If we were running a trial for an oncology drug that requires an infusion, a pharmacist who had placed a bet saying that it's gonna work well, or doesn't work well, could obviously adjust the infusion rate, could adjust the source temperature of the drug," he said. "They could change any number of variables that could obviously have a direct impact [on] how the trial and the data and the patient safety would come out." Another skeptic is Nicholas Zaorsky, a professor of radiation oncology at the Mayo Clinic in Jacksonville, Fla., who has helped run clinical trials and agrees that prediction markets can interfere with the advancement of life-saving drugs. "Prediction markets can be valuable in some settings because they aggregate information, but clinical trials are fundamentally different: investigators, coordinators, and sometimes even participants can directly influence aspects of the outcomes being wagered on," Zaorsky said. "That creates financial incentives that risk undermining trial integrity." Bettors should not be rooting for an experimental medicine to fail just to earn a buck, says Joshua Pederson, the father of a 12-year-old cancer patient enrolled in a clinical trial. "It's a dark idea," he said. "It's quite ghastly." Kalshi, for its part, argues that its prediction markets could help patients track promising medical breakthroughs and clinical trials, enlisting experts including 23andMe founder Anne Wojcicki to make the case. "Most patients don't know about the choices available in clinical trials or which programs are most promising. The opportunity to have an open, transparent dataset about trial probabilities is extremely promising and empowering for people," a white paper sponsored by Kalshi stated.

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