Il­lu­mi­na is go­ing to have a lot of work to do to prove Grail was worth those $8 bil­lion.

To­day, Ex­act Sci­ences an­nounced that it will ac­quire Thrive, Grail’s chief ri­val among the ear­ly can­cer de­tec­tion star­tups, for a size­able but rel­a­tive­ly mod­er­ate $2.15 bil­lion. The yawn­ing gap in part re­flects the vast dif­fer­ences in cap­i­tal that have been in­vest­ed to date in each com­pa­ny.  But both have gone toe-to-toe over the last year and a half, with Grail hav­ing pub­lished da­ta in over 50 can­cers but Thrive re­cent­ly beat­ing them to a key test for liq­uid biop­sy com­pa­nies.

In­vestors greet­ed the Thrive buy­out with more en­thu­si­asm than they did the Grail buy­out. While Il­lu­mi­na lost $8 bil­lion in mar­ket cap af­ter news of a like­ly Grail buy­out broke, Ex­act shares have surged 18% — $19 — this morn­ing.

The two liq­uid biop­sy com­pa­nies have now sold for a com­bined $10 bil­lion in a lit­tle over a month. The col­lec­tive bet re­flects a deep faith in cor­ners of the di­ag­nos­tic and se­quenc­ing worlds in the pow­er of a tech­nol­o­gy now years in the mak­ing.

The field has moved for­ward sub­stan­tial­ly since both com­pa­nies launched. In April, Thrive pub­lished re­sults in Sci­ence that showed for the first time that a blood test could help doc­tors de­tect and treat mul­ti­ple types of can­cer in oth­er­wise healthy peo­ple, hit­ting a long-await­ed mile­stone for a sci­en­tif­i­cal­ly chal­leng­ing field, where the most vo­cif­er­ous back­ers think it can even­tu­al­ly save lives and re­make on­col­o­gy.

Still, al­though they’ve been dis­cussed in the same breath for years, both Grail and Thrive have tried to down­play the ri­val­ry. Both have point­ed out that they will need to se­cure in­sur­ance cov­er­age and re­im­burse­ment for a field that does not yet ex­ist. Hav­ing mul­ti­ple tests on the mar­ket could aid in that fight. If one test fails, it could sig­nif­i­cant­ly ham­per the ef­fort.

Ex­act Sci­ences makes for a more like­ly buy­er than Il­lu­mi­na. The di­ag­nos­tic com­pa­ny is best known for Co­lo­guard, their stool-based test for col­orec­tal can­cer, and they’ve been ag­gres­sive over the last year, ac­quir­ing Ge­nom­ic Health for $2.6 bil­lion and sign­ing ad­vanced mar­ket­ing agree­ments with Pfiz­er. The com­pa­ny en­vi­sions Thrive’s even­tu­al mar­ket as worth over $25 bil­lion.

“The ac­qui­si­tion of Thrive is a gi­ant leap to­ward en­sur­ing blood-based, mul­ti-can­cer screen­ing be­comes a re­al­i­ty and even­tu­al­ly, the stan­dard of care,” CEO Kevin Con­roy said in a state­ment. “We couldn’t be more ex­cit­ed that Ex­act Sci­ences will be at the fore­front of this in­cred­i­ble op­por­tu­ni­ty to serve pa­tients.”

The deal is worth $1.7 bil­lion in up­front, paid in 65% Ex­act stock and 35% cash. An­oth­er $415 mil­lion is avail­able through in­cen­tives.

The FDA on Tuesday released a warning letter sent earlier this month to the Mason, OH-based site of Procter & Gamble Manufactura, raising questions about the list of ingredients on the label and in the electronic filing.

The warning says that for P&G’s over-the-counter Vicks Nyquil Severe Hot Remedy Cold and Flu Plus Congestion, there’s a “mismatched” list of active ingredients between the labeling and the electronic listing file. The listing file for the active ingredients did not match the active ingredients in the electronic file.

The Federal Trade Commission has gotten involved in a patent feud over Supernus’ Parkinson’s drug Apokyn, a case the agency said may have ‘‘significant implications” for patients who rely on the drug.

Sage Chemical won the first generic approval for its Apokyn formulation (also known as apomorphine hydrochloride injection) back in 2022. The non-ergoline dopamine agonist is approved to treat Parkinson’s symptoms during “off episodes,” such as difficulty moving, tremors and intense cramping. However, regulators specified that the approval pertained to the generic drug cartridges only, not the injector pen required for administration.

The White House’s Office of Science and Technology Policy (OSTP) last year sought to find ways to better coordinate large-scale clinical trials in the US — as the UK lead by example during the pandemic — especially for these emergency clinical trials.

The lobbying group PhRMA Tuesday called for more clinical trial diversity in underserved areas, including by making participation less of a burden, and expanding eligibility criteria when appropriate.