2025 Healthcare Wrap Up: Scribes, Jabs, and Government Grabs

Ambient AI  - Everyone Wants to Write Your Notes

If 2024 was known as the year healthcare discovered AI scribes could save clinicians from documentation purgatory, 2025 was the year everyone piled in. 

The numbers tell the story: nearly $1 billion flooded into ambient AI documentation this year alone. Abridge raised $300 million in June, pushing its valuation to $5.3 billion. One month later, Ambience Healthcare closed $243 million at a $1.25 billion valuation. Investors were either convinced the market is big enough for multiple winners—or hedging because they genuinely didn't know who'd dominate.

What appeared to change wasn't just the inflow of capital, it was the pitch. Early ambient AI sold itself on clinician wellbeing: save doctors from pyjama-time charting, reduce burnout, restore joy to practice. By mid-2025, one could make an argument that the messaging had quietly pivoted. Abridge's fundraising materials now emphasised its "Contextual Reasoning Engine" capturing HCC codes and risk adjustment data at the point of care. Ambience positioned itself around "revenue integrity" and clinical documentation improvement. The burnout narrative certainly hadn't disappeared, but the revenue cycle story was starting to do some heavy lifting.

Then came the plot twists. In July, Doximity—already embedded with 80% of U.S. physicians—launched a free AI scribe. When you're the incumbent social network for doctors, you can afford to give away what startups charge hundreds for. The move raised a moot point: is ambient documentation becoming a commodity faster than anyone expected?

A great disruption arrived in August when Epic unveiled its own AI scribe at roughly $80 per provider per month—a fraction of startup pricing. The playbook was familiar: let innovative companies prove market demand, then a large incumbent builds an integrated version. Health systems now face a choice between best-of-breed specialists or good-enough tools already embedded in their EHR. There's a certain circularity to the business model that hasn't gone unnoticed.

The startups aren't dead yet, however: Abridge and Ambience are racing into revenue cycle management, prior authorisation, and clinical decision support, areas where Epic historically moves slowly. But the window to differentiate is narrowing fast.

GLP-1s Go Consumer

The most significant pharmaceutical story of 2025 wasn't a new molecule—it was distribution.

The year began with GLP-1 access in flux. In February, the FDA declared the Wegovy shortage officially over, threatening the compounded alternatives that companies like Hims & Hers had built businesses around. Their stock dropped 19% in a day. In April, the Trump administration killed Biden's proposal to expand Medicare coverage for obesity drugs, leaving millions without a clear path to access.

Then Big Pharma pivoted. By spring, Novo Nordisk had struck partnerships with telehealth platforms—Hims & Hers, Ro, LifeMD—to sell Wegovy directly to consumers at $499 per month, bypassing the traditional pharmacy benefit manager labyrinth. It was a striking, albeit predictable one: manufacturers going direct-to-consumer, treating telehealth companies as distribution channels rather than competitors.

Enter the pricing experiment sandbox. Noom launched a microdose GLP-1 program at $119 per month, betting that lower doses with fewer side effects could capture patients priced out of standard regimens. GoodRx partnered with Novo to offer $199 introductory pricing. By November, Omada Health announced plans to begin prescribing GLP-1s directly, integrating medications into its behavioural coaching programs.

What emerged was a fragmented but functional market: brand-name drugs at $350-500 through cash-pay telehealth, microdosing experiments at the low end, and traditional insurance pathways for the minority with coverage. "Compounding was officially shut down by May, though workarounds persisted. But the access conversation had fundamentally shifted.

Goldman Sachs estimates the global GLP-1 market could exceed $130 billion by 2030. The fight now isn't over efficacy—that's settled. It's over who controls the rails. When every telehealth app sells the same molecule at similar prices, differentiation comes down to convenience, coaching, or customer experience - though 2026 may reveal a wildcard or two. The infrastructure changed, not the drugs. 

The IPO Window Cracks Open

After years of watching private valuations evaporate, digital health companies finally got to test the public markets—and the results were surprisingly encouraging.

Hinge Health led the charge in May, raising $437 million on its NYSE debut. Shares jumped 17% on day one. For an industry that hadn't seen a major venture-backed IPO since the 2021 boom collapsed, this extends past a liquidity event; it was a proof point. Two weeks later, Omada Health filed for its own IPO, and by June had surged 21% on its NASDAQ debut. HeartFlow followed in August with a $317 million raise for its AI-powered cardiac diagnostics platform.

What made these companies different from the class of 2021? They'd done the unglamorous work. Hinge turned profitable in Q1 2025—$17.1 million in net income after years of losses. Omada boasted 90% customer retention over three years and nearly 680,000 enrolled members. Both had moved decisively past the "growth at all costs" playbook that defined the previous era.

The market noticed. Hinge's journey from a $6.2 billion private valuation in 2021 to a $2.9 billion public debut could be read as a correction—or as validation that realistic pricing and actual profits still attract capital. As one investor put it: the markets forced companies to get lean, get profitable, and maintain traction.

More than 50 digital health unicorns remain private, watching from the sidelines. The 2026 speculation lists are already circulating, but don't expect the floodgates to open. The smart money says you'll be able to count next year's health tech IPOs on one hand.

TrumpRx Rewrites the Pharma Playbook

If you had predicted last January that most of Big Pharma would be selling drugs through a government-branded website by Christmas, your HLTH USA keynote would have been quietly downgraded to a breakout session.

Yet here we are. TrumpRx launched in October with a Pfizer deal that traded tariff exemptions for price cuts and direct-to-consumer sales. By November, Eli Lilly and Novo Nordisk had signed on, slashing GLP-1 prices to $350 per month and insulin to $35. In December, nine more manufacturers joined—Amgen, BMS, BI, Genentech, Gilead, GSK, Merck, Novartis, and Sanofi—collectively pledging $150 billion in U.S. manufacturing investment.

Here’s how it works: manufacturers get tariff relief; in exchange, they commit to "most-favoured-nation" pricing that benchmarks U.S. costs against other wealthy countries. The platform bypasses pharmacy benefit managers entirely, selling directly to cash-paying consumers. It's part industrial policy, part political theatre, part genuine disruption to a pricing architecture that's been calcifying for decades.

The listed discounts range from 50% to 85% off typical U.S. retail prices—numbers that would have seemed like negotiating fantasies a year ago. Whether they hold, and whether supply chains can support demand at lower margins, remains the open question.

What's undeniable is the speed. In three months, TrumpRx went from announcement to platform with majority pharma participation. Whatever happens next, the precedent is set.