Aug 12, 2026
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Add us on GoogleIt’s one thing to bet on a horse race. It’s another to bet on the outcome of a clinical trial. But the online prediction markets Kalshi and Polymarket are making it easier to do just that.
Prediction markets have extended the reach of online wagers far beyond sports to include betting on the outcomes of everything from elections to economic announcements.
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Now, as the New York Times reports, Kalshi and Polymarket have opened the door to bets on whether the Food and Drug Administration (FDA) will approve certain cancer medicines. Kalshi is considering letting people wager on the success or failure of medical trials themselves.
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It’s not hard to see the motivation: Money. According to the Pew Research Center, prediction markets have exploded to $24 billion in monthly global trading this year (up from $5 billion last September). That eclipses the $14 billion spent monthly on legal sportsbook gambling in 2025.
A source of data, or just gambling?
The price of bets on prediction markets is determined by user input. It costs more to bet “yes” on an outcome that users deem more likely to happen.
Laying wagers on these platforms is not just a game. Stock market traders, policymakers and other experts look at the charts and data from these bets as “market sentiment”; almost a type of polling. However, the population of people betting on these markets is not representative the way a poll would be.
Kalshi goes so far as to claim that placing bets on the likelihood of FDA drug approvals on its site is a public service that will provide valuable, public-facing data that investors, drug developers, clinicians and patients themselves can access and use to make informed decisions.
“Banks, expert networks, and pharmaceutical companies all produce estimates, but they stay behind closed doors,” Kalshi’s announcement reads. “These markets close that gap.”
But Prof. Michele Goodwin, faculty director of the O’Neill Institute for National and Global Health Law at Georgetown University, said that people could easily misread the output of prediction markets, and make simplistic decisions without understanding the complex variables and science involved in medical trials.
She added that the potential impact of such wagers on drug trial participants is far greater than the impact of a sports bet on athletes. People who pull their investments out of trials prematurely based on the data they see could even undermine life-saving research.
“Things like this should be shut down,” she told Moneywise. “It’s a no-brainer.”
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Joshua Pederson agrees. He’s a Boston University humanities professor and a father whose 12-year-old son has cancer.
“The possibility that somebody out there might be wagering against my son, hoping that the treatment fails so they can make money, is enraging,” he wrote in the Guardian. “How is this not just another type of ‘death market’ — like markets for war or assassination?”
There already is a market for betting on wars on Polymarket, with ramifications far beyond the people who lay those wagers.
In 2025, 404 Media reported a case in which a live map tracking the war in Ukraine, maintained by the U.S. think tank Institute for the Study of War (ISW), was edited to show a nonexistent Russian advance on the city of Myrnohrad. The edit coincided with the resolution of a bet on Polymarket. It was quickly changed back after the gambler collected their winnings. ISW apologized at the time, but did not go so far as to confirm that their product was definitely manipulated internally for the purpose of betting. It later told the Guardian, “We strongly condemn and have never consented to the exploitation of our products for the abhorrent purpose of gambling on war.”
The case raises concerns about the people using and watching prediction markets and real-life outcomes.
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Potential for insider trading
One of the biggest concerns with prediction markets is insider trading — fears that people directly involved in clinical trials will bet on the outcomes, skewing the results for monetary gain in a way that could manipulate and interfere with both the medical science and the patients’ hopes.
While Polymarket is not legal in the United States (though that can be circumvented), Kalshi is federally regulated under the Commodity Futures Trading Commission (CFTC) and has to follow federal laws against fraud and insider trading. That doesn’t mean it doesn’t happen.
As Fortune reports, this year, Kalshi had to suspend the accounts of political staffers for suspected insider trading, including former Congressman George Santos who bet on whether he would attend President Donald Trump’s State of the Union address in February.
The day before the event, Santos announced on X that he’d be there. The day of the event, he was a no-show. The Department of Justice is investigating whether he rigged the bet for personal gain.
Despite existing issues with insider trading on prediction platforms, Kalshi said it will prevent insider trading on drug trials by requiring that all traders verify their employment, and that it will only open up wagers to the outcome of late-stage trials after all patients have been enrolled, so recruitment isn’t affected by reported odds on the site.
That’s not good enough for Dr. Robert Califf, who served as the FDA commissioner in President Joe Biden’s administration.
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“Turning loose a betting market in an ongoing randomized clinical trial really is a breach of scientific conduct,” he told the New York Times.
The long history of unethical clinical trials
Part of the problem is that clinical trials are already fraught with ethical risks without adding prediction markets to the mix, Goodwin told Moneywise.
She notes that throughout history, the very people who should be trusted — governments, doctors and medical teams — have breached medical ethics in the name of research. Some examples:
- Nazi doctors used concentration camp inmates as medical subjects to see how to treat war wounds, cutting open their legs and inserting wood shavings, cloth, dirt and glass into their wounds to watch infection and gangrene set in.
- The U.S. Public Health Service recruited Black men to take part in the Untreated Syphilis Study at Tuskegee from 1932 to 1972. The men thought they were signing up for a healthcare program. In fact, the researchers’ goal was to study untreated syphilis, so they never treated the 399 men who had the disease, even once penicillin became available and they could have been cured.
- In 1996, Pfizer treated 200 Nigerian children aged 3 months to 18 years old with the antibiotic Trovan amid a meningitis epidemic — despite the fact that the FDA did not approve the drug’s use in children. Pfizer did not get informed consent from parents, but set up its field station near Doctors Without Borders, whose doctors were offering an approved antibiotic. A month later, 11 children who received the Pfizer antibiotic died.
Goodwin notes that all levels of government — local, state and federal — have a duty to protect the public. In the wake of the Tuskegee syphilis study, the U.S. government established a range of laws and policies to protect people in medical trials.
Goodwin said such cases are horrific enough without compromising trials further with prediction markets.
“Can you imagine betting on who would or wouldn’t survive the outcomes?” she said. “There’s a reason why we police these spaces.”
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Laura Boast is a Senior Reporter with Moneywise.com and a lifelong content creator who has reached international audiences at Discovery, CBC, Blue Ant Media, Bond Brand Loyalty and more.
