HHS launched the Simulation-augmented, real-time platform for adapted seamless trials (SURPASS) program, aimed at accelerating trial design and operations by combining digital twins, shared infrastructure, and inference engines to adapt trials in real time. The initiative is administered through ARPA-H and is intended to reduce duplicated setup work and the time needed to assess whether trials are on track. HHS said SURPASS will support digital twins to test trial designs before launch and develop AI-driven agentic systems to automate trial start-up, onboarding of new treatment arms, and data cleaning and dataset construction. The program also targets reduced reliance on large conventional control groups while maintaining evidence rigor. For biotech sponsors, the program could change the cost and timeline calculus for complex adaptive designs, potentially improving speed-to-decision during early and mid-development phases where patient and operational constraints often drive delays.