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Jeremy Levin Discusses the Future of Biotech · Get Real with Jim Weiss

0:00
Speaker 1: Hey, everyone. I'm really excited to have my next guest,
0:03
Speaker 1: Jeremy Levin, walk us through the world of biotechnology then
0:08
Speaker 1: and now. Jeremy is such a legend in our industry.
0:11
Speaker 1: He's written a book recently talking about the promise, but
0:15
Speaker 1: also the peril of biotech and scientific research today and
0:21
Speaker 1: how it will impact tomorrow. There's so much evolution and
0:25
Speaker 1: revolution going on in the world of biotechnology. and biomedicine.
0:31
Speaker 1: This book comes at a perfect time during an era
0:35
Speaker 1: of patent cliffs for the pharmaceutical industry, so many other
0:39
Speaker 1: risks and unknowns from funding at the NIH to coverage
0:45
Speaker 1: with Medicare, what the international landscape looks like with China.
0:50
Speaker 1: So I'm very excited to talk to him about all
0:52
Speaker 1: these things that are affecting the biotechnology industry. and life
0:56
Speaker 1: sciences industries and stock market. He was the architect of
1:00
Speaker 1: the string of pearls strategy. And many of those lessons
1:03
Speaker 1: still are relevant today. So the more things change, the
1:07
Speaker 1: more they stay the same in many industries. And I
1:09
Speaker 1: think we're going to learn a lot from Jeremy Levin,
1:12
Speaker 1: who's done so much in his career. So I look
1:15
Speaker 1: forward to sharing all this with you, ASAP. Good to
1:20
Speaker 1: see you.
1:21
Speaker 2: It's good to see you, and thanks for doing this.
1:24
Speaker 1: How's the book doing? I imagine well.
1:27
Speaker 2: Well, I don't know how you measure it. I don't
1:30
Speaker 2: really look at sales. According to my guys, it's doing
1:32
Speaker 2: well for its niche there. But I do know what's
1:36
Speaker 2: happening is that it is having an impact on the
1:38
Speaker 2: Hill because staff is now asking to see it, both sides.
1:44
Speaker 2: And I do know it's had an impact in China,
1:46
Speaker 2: believe it or not. People are actually reading it. So
1:49
Speaker 2: I'm getting messages, would I come and talk about this there?
1:53
Speaker 2: And the same in Europe. So it's interesting. There will be,
1:56
Speaker 2: and obviously I'll ask you to keep this confidential, Nature
2:00
Speaker 2: Biotechnology has taken the 10 commitments, edited them, and they
2:06
Speaker 2: will put it out as one of their feature programs,
2:10
Speaker 2: as feature articles a little later for the industry. So
2:15
Speaker 2: if one measure doesn't sell, I'm not going to get
2:17
Speaker 2: rich on that. That's for sure.
2:19
Speaker 1: Well, that's not why you did it. I mean, that's
2:21
Speaker 1: really not why you did it, I know. But anyway,
2:24
Speaker 1: I'm so glad to be talking to you about this.
2:26
Speaker 1: This book is coming out. I think at the perfect time,
2:29
Speaker 1: I think will become a really important touchstone for a
2:33
Speaker 1: lot of folks. The nice part is it's nice and
2:36
Speaker 1: thin and easy to read. It's well put together with
2:38
Speaker 1: tenets and commandments and commitments and things that are really critical.
2:43
Speaker 1: Why did you write the book? What compelled you? You know,
2:46
Speaker 1: you've done so much in your life and career, but
2:49
Speaker 1: why this manifesto and why this now?
2:52
Speaker 2: Chairman, it's very clear to me that as an industry,
2:56
Speaker 2: we've gone through an extraordinary evolution starting actually in 1947.
3:02
Speaker 2: And then 1973, that critical moment when Genentech was about
3:06
Speaker 2: to be born, well, conceptually born, and then 76 when
3:10
Speaker 2: it was born. From that time forward, there's been a
3:13
Speaker 2: sort of unseen development there. of all sorts of things
3:16
Speaker 2: which support the industry, and they include NIH funding, the
3:21
Speaker 2: development of a functional FDA, the CDC, whole institutions for
3:26
Speaker 2: paying for medicines. What's not seen at the same time
3:30
Speaker 2: was the incredible buildup of distrust in, quote-unquote, the industry, actually, quote-unquote,
3:39
Speaker 2: in the pharmaceutical industry, because the biotech industry was never seen.
3:44
Speaker 2: You never saw it. But it's a completely different industry.
3:48
Speaker 2: It's one that depends on all of that infrastructure that
3:50
Speaker 2: I described critically. It needs science. It needs education. It
3:55
Speaker 2: needs immigration. All of these things. And as we saw
3:59
Speaker 2: for the last five, six, seven years, gradual deterioration of them.
4:03
Speaker 2: So the point was all of these were converging. Policy
4:06
Speaker 2: was changing. Public trust was changing. Politicians were treating innovation
4:12
Speaker 2: as if they were treating drugs. It's a very different thing.
4:15
Speaker 2: In other words, biotech innovation was being beaten with the
4:18
Speaker 2: same stick that pharma was. And that led to damaging policies,
4:27
Speaker 2: some of which were completely inadvertent. And it came from
4:31
Speaker 2: the fact that people weren't understanding or appreciating what was
4:36
Speaker 2: and is. And I felt that if we didn't correct
4:39
Speaker 2: this and begin to push back against it within the
4:43
Speaker 2: industry and externally, we would lose the capability which had
4:46
Speaker 2: been built up. So the timing was specifically related to
4:51
Speaker 2: what I saw as a convergence of extraordinarily damaging events,
4:56
Speaker 2: which will, it won't stop innovation, not at all. Innovation
5:00
Speaker 2: will continue around the world. It just won't be here
5:02
Speaker 2: in America.
5:03
Speaker 1: Okay, wow. All right. So that's the big warning sign.
5:07
Speaker 1: Let's get back to what one of the things that
5:10
Speaker 1: made America great is and has been its biotech industry.
5:14
Speaker 1: So we have to protect it. So that's a big message.
5:17
Speaker 1: So Jeremy, take us back. You have a BA and
5:20
Speaker 1: a doctorate from Oxford, where we have an office of
5:23
Speaker 1: real chemistry. You also have a bachelor of medicine and
5:26
Speaker 1: surgery from Cambridge. How did your studies and then work
5:30
Speaker 1: as a practicing physician impact your work in biopharma today?
5:35
Speaker 1: How did all that lead to this?
5:37
Speaker 2: Jim, I've always thought of myself really as a physician
5:40
Speaker 2: scientist rather than pretty much anyone who moved from one
5:44
Speaker 2: career to another. So I guess Oxford really taught me
5:47
Speaker 2: how to ask a scientific question and then challenge the assumptions.
5:52
Speaker 2: And Cambridge taught me that every scientific question ultimately has
5:56
Speaker 2: a human face, a patient who really sits right there
5:59
Speaker 2: in front of you. So from my career, I've tried
6:03
Speaker 2: to carry both those perspectives throughout. And the bottom line
6:07
Speaker 2: is that good science matters enormously, but it only matters
6:11
Speaker 2: if I can improve a human's life, somebody that I see,
6:16
Speaker 2: somebody that I touch.
6:17
Speaker 1: Awesome. Why did you leave medicine for biopharma then? Did
6:20
Speaker 1: you feel you could have a bigger impact outside of
6:23
Speaker 1: the hospital or what was going on? What happened?
6:26
Speaker 2: You're going to laugh because I never really felt that
6:29
Speaker 2: I left medicine. I simply changed where I practice it.
6:33
Speaker 2: As a physician, I could help one patient. And sort
6:36
Speaker 2: of changing the venue, as a physician, I could help
6:40
Speaker 2: one patient and one family at a time. Biotechnology gave
6:45
Speaker 2: me the opportunity to help thousands. And then, of course,
6:48
Speaker 2: when I did generics, millions through medicines that outlived pretty
6:52
Speaker 2: much any one individual's physician's career. So for me, it
6:56
Speaker 2: was never really leaving medicine. It was practicing medicine at
7:00
Speaker 2: just a different scale.
7:02
Speaker 1: And I do hear that a lot. As co-founder and
7:04
Speaker 1: executive chair of Ovid, your company develops small molecule medicines
7:08
Speaker 1: for brain disorders with significant unmet needs. How would you
7:12
Speaker 1: explain what small molecule medicines do and how they target diseases?
7:17
Speaker 1: I mean, they're different than what we think about when
7:20
Speaker 1: we think about biotechnology, right? Sure.
7:24
Speaker 2: The fact of the matter is that science evolved. I
7:26
Speaker 2: often describe medicines as tools, each designed for kind of
7:31
Speaker 2: a different job. Small molecules are tiny chemical compounds that
7:35
Speaker 2: can enter cells and in many cases cross the blood-brain barrier,
7:39
Speaker 2: allowing them to reach places that these larger biologic medicines cannot.
7:44
Speaker 2: And the really exciting part isn't simply that they're small.
7:48
Speaker 2: It's now that because of biotech, we understand biology well
7:52
Speaker 2: enough to design these molecules to interact very specific targets
7:57
Speaker 2: inside the body. So rather than broadly affecting many systems,
8:01
Speaker 2: we can increasingly, because of the tools of biotech, can
8:05
Speaker 2: develop medicines that correct the particular biological process that drives
8:10
Speaker 2: the disease. And at Ovid, my whole focus was on
8:15
Speaker 2: neurological disorders where patients had just very few options. And
8:19
Speaker 2: Our object there wasn't about managing systems. It was sort
8:22
Speaker 2: of break open new biology, hyper-excitability, and see could you
8:28
Speaker 2: make a big change there that nobody else had really tackled.
8:32
Speaker 2: It was an opportunity made possible by all the tools
8:37
Speaker 2: of biotech over the last 20 years.
8:39
Speaker 1: Kind of where are the small molecule treatments the most effective?
8:43
Speaker 1: Like why would you use that versus a big, I mean,
8:46
Speaker 1: for the people... out there who wonder, even some of
8:49
Speaker 1: the policies, as you and I both know, you know,
8:52
Speaker 1: that you're trying to fix relate to small versus large molecules. So,
8:57
Speaker 1: and people's misunderstanding of the differences. Is there a reason
9:01
Speaker 1: one versus the other?
9:03
Speaker 2: Well, I think the way to think about it is there,
9:05
Speaker 2: that small molecules are particularly valuable whenever you need to
9:11
Speaker 2: reach tissues that are incredibly difficult to access. The brain's
9:16
Speaker 2: the obvious example, but it's not the only one. But
9:19
Speaker 2: they're important in certain types of cancer where you need
9:23
Speaker 2: to get into the cell. Infectious diseases, obviously. Inflammation and
9:29
Speaker 2: many rare disorders. The broader point is, honestly, I think
9:33
Speaker 2: is to think about this is to say that every
9:35
Speaker 2: disease has got its own biology and that every therapeutic
9:40
Speaker 2: approach has its own strengths. Sometimes a small molecule is ideal.
9:45
Speaker 2: Sometimes a biologic, sometimes gene therapy, cell therapy is better,
9:51
Speaker 2: et cetera. So I think about increasingly medicine and our
9:56
Speaker 2: industry is not about choosing one technology over another. It's
9:59
Speaker 2: about matching the right technology to the right biology as
10:04
Speaker 2: something that we weren't able to do at all before
10:07
Speaker 2: biologic biotechnology came on the scene.
10:10
Speaker 1: We've seen a resurgence after a kind of what felt
10:13
Speaker 1: like a long nuclear winter in the biotech market. It's
10:16
Speaker 1: seems to be largely driven by acquisitions. What's driving this?
10:21
Speaker 1: What's happening in the field?
10:23
Speaker 2: Yeah, I think several forces have converged almost exactly at
10:26
Speaker 2: the same time. First of all, and most importantly, the
10:29
Speaker 2: science has become dramatically better. We're understanding human biology at
10:33
Speaker 2: a level of precision that simply wasn't present 20 years ago.
10:38
Speaker 2: At the same time, many large pharmaceutical companies are facing
10:41
Speaker 2: these massive, massive patent expirations over the next decade, and
10:46
Speaker 2: they've just got to replenish their pipelines. What's interesting is
10:52
Speaker 2: you and I know that smaller biotech companies have become
10:56
Speaker 2: very efficient engines of innovations, but the capital markets have
11:01
Speaker 2: been terribly challenging, making, frankly, acquisition an attractive part for
11:07
Speaker 2: many now That wasn't the case in the past. It's
11:10
Speaker 2: also interesting to note that at the same time, one
11:13
Speaker 2: consequence of this has been a sort of change in
11:15
Speaker 2: venture capital itself. Venture capital was created, of course, to
11:19
Speaker 2: finance ventures, to bat scientists and great ideas. Otherwise, you
11:23
Speaker 2: wouldn't have had a Genentech. But over the last decade,
11:26
Speaker 2: much of the industry has shifted towards investing in later
11:30
Speaker 2: stage de-risked assets, sort of exactly the kind of things
11:35
Speaker 2: that big pharma loves because it doesn't want to take risk.
11:39
Speaker 2: And those investments have their place. But if, frankly, the
11:43
Speaker 2: acquisitions that we're seeing, if we want the next generation
11:47
Speaker 2: to break through medicines, venture capital has to start building
11:51
Speaker 2: this again. So to become genuine venture again. And then
11:56
Speaker 2: you'll see another wave in the future of acquisitions. So
11:59
Speaker 2: for me, that confluence of venture focusing on late stage,
12:04
Speaker 2: pharma need for fully filling up their pipelines. And then
12:08
Speaker 2: the capital markets turning only to these later stage things
12:11
Speaker 2: has driven it. But truly, we've got to have investors
12:16
Speaker 2: build science platforms, not simply to finance molecules that are
12:21
Speaker 2: largely understood and de-risk, so to speak. It's investing in
12:25
Speaker 2: the past. So it's not just a financial cycle that's
12:28
Speaker 2: driving this. It's the natural consequence of a biotech ecosystem,
12:33
Speaker 2: sort of. where you see discovery increasingly happens in small companies.
12:38
Speaker 2: And then these giants who simply cannot do what the
12:42
Speaker 2: small companies are doing and actually emphasizes the enormous difference
12:48
Speaker 2: between a large pharmaceutical company and a small biotech company.
12:52
Speaker 2: And at the same time, the biotech companies cannot have
12:55
Speaker 2: these capabilities of the larger organizations. So this is a
12:59
Speaker 2: confluence of interest.
13:01
Speaker 1: I mean, do you think our government gets any of this?
13:04
Speaker 1: I know you said the book is getting a lot
13:07
Speaker 1: of play on both sides of the aisle in Washington.
13:10
Speaker 2: The failure to understand what's driving that innovation is critical.
13:15
Speaker 2: Most of the legislators do not understand it. Unlike China,
13:20
Speaker 2: where China went out of its way over 25 years
13:26
Speaker 2: to fully understand what drove innovation, And in five specific steps,
13:33
Speaker 2: developed a fundamental innovation engine in China, starting with just
13:39
Speaker 2: building simple chemicals, then building the ability to test them,
13:43
Speaker 2: then building testing Western drugs, and then doing copycat drugs,
13:48
Speaker 2: and then finally bringing back lots of different scientists, opening
13:51
Speaker 2: up the ability to do innovation. They fundamentally... drove an
13:57
Speaker 2: innovation engine, which in this country was never recognized because
14:01
Speaker 2: biotech was under the radar. It was always hidden by
14:06
Speaker 2: being in the pharma environment and seen as being pharmaceutical companies.
14:10
Speaker 2: So we were effectively, every time there's a question on price,
14:15
Speaker 2: biotech was hammered with the same policies that were hammer
14:19
Speaker 2: pharma and make pharma very difficult and make their own
14:23
Speaker 2: lives very difficult. The capital markets fleeing away. Innovation, the
14:28
Speaker 2: reduction in funding at the NIH, the reduction in basic,
14:33
Speaker 2: clear science at the FDA or the CDC, for that matter,
14:39
Speaker 2: removal of the National Science Foundation board. Each one of
14:43
Speaker 2: these steps was an erosion. Now, that doesn't affect the
14:47
Speaker 2: M & A wave. Because we're dealing with the past,
14:50
Speaker 2: stuff that was invested in years ago.
14:52
Speaker 1: Right. We're buying stuff from China, right? I mean, do
14:56
Speaker 1: patients give a damn where innovation comes from?
14:58
Speaker 2: The core element is where's the best medicine? How will
15:03
Speaker 2: it get to a patient? Can we be sure that
15:06
Speaker 2: we have the kind of medicines that we need? And
15:09
Speaker 2: as we've seen, medicines now fall into a political pinata.
15:15
Speaker 2: So there's a very real possibility. that while patients should
15:19
Speaker 2: never worry about where the medicine comes from, never, what
15:23
Speaker 2: is the real possibility is as we look at legislation
15:26
Speaker 2: building up in this country, instead of building and making
15:30
Speaker 2: our innovation stronger, we're putting up barriers for China, which
15:36
Speaker 2: is appropriate for the areas where there is security leaks.
15:41
Speaker 2: This I get. Everybody should get. On the other hand,
15:44
Speaker 2: it's putting up barriers to invest in innovation. and not
15:48
Speaker 2: building it in this country. There's a dual thing here
15:51
Speaker 2: that's very clearly articulated in the book. You need to
15:55
Speaker 2: be able to build that innovation, and you should allow
15:58
Speaker 2: competition to drive what's best for patients.
16:02
Speaker 1: The string of pearls at BMS, which you're famous for.
16:05
Speaker 1: Are there any through lines or lessons from your days
16:08
Speaker 1: of putting together That string of pearls. And is this
16:12
Speaker 1: a back to the future moment for you, right, when
16:15
Speaker 1: you're looking at this M & A phenomenon in biotech
16:19
Speaker 1: and pharma?
16:19
Speaker 2: The string of pearls was very clear. The central insight
16:23
Speaker 2: around it was that innovation was at that time, and
16:28
Speaker 2: increasingly so, becoming incredibly distributed, particularly amongst the smaller companies
16:34
Speaker 2: and now flowing abroad. And large companies are increasingly incapable
16:41
Speaker 2: of generating that innovation. They're fantastic at doing the marketing
16:45
Speaker 2: and sales and access. They used to have, 50 years ago,
16:49
Speaker 2: a monopoly on discovery. That monopoly is gone. It's in
16:52
Speaker 2: the hands of the small industry. So extraordinary science in
16:57
Speaker 2: the string of pearls was emerging. But because of universities
17:02
Speaker 2: being funded, entrepreneurs, no matter where they're coming from, being here,
17:06
Speaker 2: and then venture capital driving it. So the central insight
17:10
Speaker 2: was that innovation was becoming distributed. And our job at
17:14
Speaker 2: that time wasn't simply to acquire companies. This was the
17:18
Speaker 2: key element. It was to recognize exceptional science early. I'm
17:23
Speaker 2: not talking about the late stage stuff. Early. Remember, PD-1s
17:27
Speaker 2: when Bristol bought it was a phase one drug. There
17:33
Speaker 2: were only four trials. And there was a profound desire
17:38
Speaker 2: for many to reject the area. So you had to
17:40
Speaker 2: be bold. You had to recognize exceptional science and then
17:44
Speaker 2: drive it. And of course, a decade later, half the
17:47
Speaker 2: industry was in that area. Half the industry or research
17:50
Speaker 2: was in that area. So that becomes much more relevant today.
17:56
Speaker 2: The whole ecosystem is built around a collaborative approach having
18:03
Speaker 2: large companies and other small companies understand what's driving innovation.
18:09
Speaker 2: And it's no longer one big company discovers a beta
18:11
Speaker 2: block and then everybody copies it. This is a moment
18:14
Speaker 2: where you learn about what is biology, how do you
18:18
Speaker 2: expand it, and who and where you can access it.
18:22
Speaker 2: So it's that central insight. And is it a back
18:25
Speaker 2: to future moment for me? In many ways, yes. I
18:29
Speaker 2: think the central principle remains the same today as it
18:32
Speaker 2: was in 2009. Great science creates values. Partnerships accelerate development.
18:38
Speaker 2: Patients benefit when the right organizations work together. I think
18:42
Speaker 2: what's different, though, Jim, today is the quality of science. Frankly,
18:47
Speaker 2: it's chalk and cheese. We know vastly more about human
18:51
Speaker 2: disease today than we did 15 or 20 years ago.
18:55
Speaker 2: which means you make better decisions.
18:57
Speaker 1: Is that because of AI, or will AI help us
18:59
Speaker 1: do that?
19:00
Speaker 2: Oh, it's very interesting. You know, AI is only in
19:03
Speaker 2: the last... You and I will talk about AI as
19:05
Speaker 2: if it's been here forever. No, it's not because of AI, actually.
19:09
Speaker 2: It's because AI is certainly a part and will become
19:12
Speaker 2: an increasing part. It's because we have built on this
19:16
Speaker 2: incredible foundation since 1947. Then the genome program, which led
19:22
Speaker 2: to the OpenSesame program, of all sorts of ideas. And
19:26
Speaker 2: following from that, all sorts of different technologies coming into play.
19:31
Speaker 2: So as you did that, this created a tidal wave
19:35
Speaker 2: of information, tidal wave of biology. And frankly, I think
19:41
Speaker 2: what's interesting is that you will see much more of
19:43
Speaker 2: this being taken advantage of in the future because of AI.
19:48
Speaker 2: But we're not yet at the moment where AI is
19:50
Speaker 2: generating huge amounts of innovation. This all came from the
19:54
Speaker 2: work of the last 50 years.
19:57
Speaker 1: Yeah, my prediction is that AI will just help all
19:59
Speaker 1: of us in the industry identify faster through lines and
20:03
Speaker 1: commonalities and partnership and We can get there faster in
20:07
Speaker 1: a few areas where it's been stop, start, and slower.
20:11
Speaker 1: I saw this breakthrough in KRAS. I don't know why
20:13
Speaker 1: suddenly KRAS became druggable. I don't know if that was
20:17
Speaker 1: because somebody paid attention, but I do want to ask
20:20
Speaker 1: this question. It's hard not to ask it. Because we
20:23
Speaker 1: have GLP-1s now, do we really need any more innovation?
20:27
Speaker 1: Isn't that going to prevent all the diseases?
20:30
Speaker 2: GLP-1s are not a magic bullet. It's like saying, I
20:35
Speaker 2: love this. It's super exciting. I don't know what the
20:38
Speaker 2: exact percentage is. A vast majority of people are taking it.
20:42
Speaker 2: All sorts of good things are happening, but there is
20:44
Speaker 2: no solution yet. with one drug. Cancer is still roaring
20:48
Speaker 2: through the population. We have autoimmune diseases, which are devastating people.
20:53
Speaker 2: Nothing of this has stopped the huge tidal wave of
20:58
Speaker 2: Alzheimer's that will continue to hit us for decades to come.
21:03
Speaker 2: So no, GLP-1 is a very, very remarkable discovery, which, oh,
21:08
Speaker 2: by the way, was 20 years in the making. Because
21:12
Speaker 2: if you go back to app It was there. It
21:14
Speaker 2: was actually in amylin when it was acquired 20 years ago.
21:19
Speaker 2: Nobody just paid any attention to it. They didn't see
21:21
Speaker 2: being overweight as being a disease. That was the real innovation.
21:27
Speaker 2: Let's be clear. It was the determination in the marketing
21:30
Speaker 2: heads of the people around us, not the science, that
21:34
Speaker 2: in fact by reducing weight was actually a disorder. which
21:38
Speaker 2: many physicians like myself and others really kept on saying,
21:42
Speaker 2: you've just got to reduce your weight. You'll feel better.
21:45
Speaker 2: But we never had a tool. Now there is one.
21:47
Speaker 1: Got it.
21:47
Speaker 2: Okay.
21:48
Speaker 1: Well, that's helpful, and I think that tool will help.
21:50
Speaker 1: But if you were starting a biotech company today, right now,
21:54
Speaker 1: would you aim to grow an independent company or start
21:57
Speaker 1: something so valuable that larger players compete to buy it fast?
22:01
Speaker 1: What's the venture model there? Of the future, which path
22:05
Speaker 1: usually gives medicines the best chance of actually reaching people?
22:09
Speaker 2: Well, I think you've put your finger in. I wouldn't
22:11
Speaker 2: start with either of those objectives. Grow it or buy
22:15
Speaker 2: it or sell it. I wouldn't do that. I would
22:18
Speaker 2: start with that question that you asked. What is the
22:20
Speaker 2: fastest and most reliable way of getting the medicine to
22:23
Speaker 2: a patient? So sometimes, quite honestly, it's building an enduring company,
22:27
Speaker 2: one that will be there. And that's a good example
22:29
Speaker 2: of that is Alnylam or Regeneron. Sometimes it's through acquisition, CGEN,
22:36
Speaker 2: by an organization that's got global manufacturing, regulatory, et cetera.
22:41
Speaker 2: I don't think that founders should optimize for ownership. They
22:45
Speaker 2: should optimize for patient impact. The corporate structure that does
22:50
Speaker 2: that is simply the vehicle.
22:52
Speaker 1: You're the deal man, right? That's what you're well known for.
22:55
Speaker 1: The conversation is always about valuation, and that somehow is
22:59
Speaker 1: the determination of whether it's valuable or not. How should
23:02
Speaker 1: patients and doctors Think about what these deals mean.
23:06
Speaker 2: So, Jim, you know, for me, if I could encourage
23:10
Speaker 2: patients and doctors and physicians to ignore the blink moment
23:16
Speaker 2: of the headline, ignore the headline price. Price and value
23:20
Speaker 2: are completely different things. Price is simply what one company
23:26
Speaker 2: pays another. And value is created only if that transaction
23:32
Speaker 2: allows more patients to get better medicine sooner. For a
23:36
Speaker 2: $ 10 billion acquisition that never delivers a medicine, and oh,
23:40
Speaker 2: by the way, there are quite a few of these.
23:41
Speaker 1: There's a lot of those. They don't get talked about
23:44
Speaker 1: as much as the successes, but yeah.
23:46
Speaker 2: Exactly. That's the value. A billion dollar or even a
23:49
Speaker 2: hundred million dollar acquisition that results in some life-changing therapy
23:54
Speaker 2: reaching millions of patients creates enormous value. By the way,
23:57
Speaker 2: Medirex was bought for $ 2. 3 billion. It has changed cancer
24:03
Speaker 2: treatment completely. And at the time, it was considered a dog.
24:07
Speaker 2: Why would you buy it? And the exact return on
24:10
Speaker 2: that investment, by the way, is probably $ 180 billion in cash.
24:15
Speaker 2: But that's irrelevant. What's really relevant is that you've exploded immunoecology,
24:20
Speaker 2: changed the lives of millions. So the real question isn't
24:24
Speaker 2: what did they pay? The real question, will it help
24:26
Speaker 2: patients sooner? And that's ultimately how I judge every transaction.
24:33
Speaker 1: It seems like Dave Ricks and Lilly have this formula down.
24:36
Speaker 1: They're buying something, what, every few quarters, or they have
24:40
Speaker 1: some plan, right, to buy something in frequency. What are
24:44
Speaker 1: they getting that others aren't? Or do they just have
24:47
Speaker 1: all the cash and they can spend it?
24:49
Speaker 2: No, Dave Ricks is looking into the future. They are
24:52
Speaker 2: looking at their incredible patent cliff. It won't just be
24:59
Speaker 2: a patent cliff of the kind that we see today.
25:02
Speaker 2: It is a patent cliff of such consequence that never
25:07
Speaker 2: before in the pharmaceutical industry will anybody have experienced anything
25:12
Speaker 2: like this. So wisely, what they're doing is saying, we
25:16
Speaker 2: need to start now and build for 10 years and ahead.
25:22
Speaker 2: And I have to take my hat off to those
25:23
Speaker 2: guys because most people, when that change comes, Dave Ricks
25:28
Speaker 2: won't be in the seat. It'll be some other CEO.
25:32
Speaker 2: Most CEOs today do not do that. They buy for
25:36
Speaker 2: what will give them reward at the end of the year.
25:39
Speaker 2: They do not buy strategically. The ones who are buying strategically,
25:44
Speaker 2: and Rix is one of them, is they're looking 10
25:47
Speaker 2: years ahead. When they're gone, they won't be there. So
25:51
Speaker 2: I applaud what they're doing. It is thoughtful, strategic, and
25:57
Speaker 2: if they didn't do it, frankly, in 12 years' time,
26:00
Speaker 2: when he's, well, 15 years' time, whatever, when he's sitting
26:03
Speaker 2: on a beach somewhere, there'll be a collapse of that company.
26:06
Speaker 2: And everybody will say, well, why did we not take
26:08
Speaker 2: account of this in the past? And oh, by the way,
26:11
Speaker 2: that's been done repeatedly by other pharmaceuticals in the past.
26:15
Speaker 2: They've just ignored it.
26:17
Speaker 1: Yeah, no, we've seen that. I mean, you couldn't have
26:19
Speaker 1: predicted the whole thing with RNA, mRNA vaccines, the whole picture.
26:26
Speaker 1: You were involved with Pfizer, so you get it. But
26:29
Speaker 1: how that went when the pandemic's over, where do you
26:33
Speaker 1: go from there? But look, they bought C-Gen, as you know,
26:37
Speaker 1: and that probably will keep things moving. The big question
26:43
Speaker 1: really is, your book talks about it. How are we
26:46
Speaker 1: going to get trust and some of the things you
26:48
Speaker 1: warn us about in the biotech and the balance book.
26:53
Speaker 1: How are we going to get that back? What do
26:55
Speaker 1: we got to do? Can we fix it?
26:57
Speaker 2: I think that trust existed, but it was often implicit
27:02
Speaker 2: and not explicit. So patients believed that medical innovation was
27:06
Speaker 2: fundamentally working on their behalf. But then over time, health
27:11
Speaker 2: bid became incredibly complicated. Drug pricing debates intensified. The biotech
27:17
Speaker 2: industry was painted with the same color as exploiting patients.
27:22
Speaker 2: Insurance became incredibly confusing. Frankly, the insurance companies have played
27:28
Speaker 2: an enormous role in this lack of trust. The PBMs,
27:33
Speaker 2: invisible actors, started entering into the chain and making pricing
27:38
Speaker 2: of these drugs the central issue. At the end of
27:41
Speaker 2: the day, public confidence in the institutions declined generally, and
27:46
Speaker 2: biotech became associated with the broader healthcare system. So the
27:51
Speaker 2: really extraordinary innovation engine suddenly got painted with all the
27:56
Speaker 2: bad elements that were seen in this other area. So
27:59
Speaker 2: the irony behind this is the science has never been stronger.
28:04
Speaker 2: Scientific capability, amazing. So I believe it's a leadership challenge.
28:09
Speaker 2: I think that people always look to leaders not only
28:14
Speaker 2: to solve problems, but to explain why the work matters.
28:18
Speaker 2: We spend too much time defending biotechnology and not enough
28:22
Speaker 2: time talking about its contribution to humanity. DTC is one
28:28
Speaker 2: of the very important marketing elements. But if we spent
28:32
Speaker 2: even a fraction of what we do on DTC to
28:35
Speaker 2: explain what innovation is to the public, I think we'd
28:38
Speaker 2: have a lot more trust involved. If we don't tell
28:41
Speaker 2: the story, at the end of the day, somebody else will,
28:44
Speaker 2: and we see that. policymakers looking for an easy pinata
28:48
Speaker 2: to beat, tell it.
28:49
Speaker 1: But isn't that why bio and pharma exist? Are they
28:52
Speaker 1: not telling that story? Are they not well-funded enough to
28:55
Speaker 1: do it?
28:56
Speaker 2: Oh, the funding that goes into DC dwarfs what goes
29:00
Speaker 2: into pharma and bio. Those organizations are designed to create
29:06
Speaker 2: and encourage and educate policymakers. They're not there to educate
29:10
Speaker 2: the populace at whole, and it's the populace at whole
29:14
Speaker 2: that matters. it's the voter, it's you, it's me, our
29:18
Speaker 2: friends who vote. They need to be able to say, wow,
29:21
Speaker 2: I love biotech. If you go to people in China
29:25
Speaker 2: and speak to those who are educated, they'll tell you
29:29
Speaker 2: it's a great thing to have. If you go to Australia,
29:31
Speaker 2: they'll tell you it's a great thing to have. There's
29:34
Speaker 2: no lack of trust there. There's lack of education. What
29:37
Speaker 2: is it? Why does it work? Blah, blah, blah. In
29:39
Speaker 2: this context, you go to anybody in the street and
29:42
Speaker 2: tell me about pharma, complete lack of trust. Politicians take
29:46
Speaker 2: advantage of that. So we've got to go to the
29:50
Speaker 2: person in the street. Now, I believe that that trust
29:54
Speaker 2: can be absolutely rebuilt, but it can only be rebuilt
29:59
Speaker 2: from our perspective, by demonstrating transparency, consistency, and that in
30:06
Speaker 2: every interaction, and I mean every interaction, that the patient
30:11
Speaker 2: is right at the center of every decision we make.
30:14
Speaker 2: And if we don't do that, the person in the
30:16
Speaker 2: street has every right to say, I don't know what
30:20
Speaker 2: they do, but I do know that when I go
30:22
Speaker 2: to the pharmacy, I get punished for being sick by
30:26
Speaker 2: having to pay for my drug. That thought process needs
30:30
Speaker 2: to be flipped. Insurance companies should take that off the
30:33
Speaker 2: table and patients say, heavens, I'm delighted to be getting
30:38
Speaker 2: this medicine. It's going to help me. I'm going to
30:40
Speaker 2: be more productive. I can be with my children, et cetera.
30:43
Speaker 2: But we can do that, but we have to shift
30:46
Speaker 2: our thinking on where we invest our time and how
30:50
Speaker 2: we actually articulate what we do to the public.
30:54
Speaker 1: Well, it feels like to me that the DTC ads, look,
30:58
Speaker 1: I have a firm that's focused not on them specifically,
31:01
Speaker 1: but I think there's other ways to promote and educate
31:05
Speaker 1: about your drugs. We used to do it long before
31:07
Speaker 1: we had DTC ads. So the question is, what if
31:11
Speaker 1: we got rid of those and the money went into
31:15
Speaker 1: the things you're saying, right? To talk more broadly about
31:19
Speaker 1: the patient benefit of a strong... medical and scientific infrastructure,
31:26
Speaker 1: pharmaceutical industry, et cetera. Just talk to patients who've done
31:30
Speaker 1: well in these areas. And then charge less, right? Isn't
31:34
Speaker 1: that it? Isn't that what we have to do? And
31:36
Speaker 1: then there's the insurance companies. I don't even know, like
31:38
Speaker 1: get in partnership with insurance companies rather than at odds.
31:42
Speaker 1: So I don't know. Isn't this easy or not? I
31:45
Speaker 1: don't know.
31:46
Speaker 2: Conceptually, it's straightforward. You have to make a great decision.
31:49
Speaker 2: that to use this extraordinary marketing capability, Jim, that we have,
31:54
Speaker 2: whether it be through the digital media, whatever that digital
31:58
Speaker 2: media is, through TV, which is less relevant today, but
32:02
Speaker 2: that doesn't matter through adverts. These things can be used
32:06
Speaker 2: to an incredible power of good. But just you and
32:09
Speaker 2: I know this. When you see an ad for a drug,
32:12
Speaker 2: It goes, blah, blah, blah, we're doing this great thing
32:14
Speaker 2: for you, and it's generally in a beautiful setting. And
32:16
Speaker 2: then you have a list of all of these lousy
32:18
Speaker 2: things that could happen to you, and it's basically the
32:21
Speaker 2: principle there is please don't sue us. Now, imagine a
32:25
Speaker 2: different kind of ad that says, we're tackling cancer. This
32:28
Speaker 2: is what we're going to be doing. You are important
32:31
Speaker 2: to us. There are many companies doing this. Help us
32:35
Speaker 2: be successful, blah, blah, blah. Don't go there with each
32:38
Speaker 2: individual product. That can be done differently. Go with a
32:42
Speaker 2: different product to the physicians. Educate them on that. That
32:46
Speaker 2: can all be done. I believe it's very straightforward. It's
32:50
Speaker 2: just that we're thinking about marketing as if it was
32:53
Speaker 2: in the 1950s, 60s, 70s. We're thinking about drugs like automobiles,
32:57
Speaker 2: which is ridiculous. And I don't understand why every single
33:01
Speaker 2: marketing head shouldn't be told to go back to school
33:04
Speaker 2: and think about this. The patient is at the center.
33:07
Speaker 2: You've got to have your customer really, really like you.
33:12
Speaker 2: And not frighten them. And then on the insurance side
33:14
Speaker 2: to this, which is extraordinary, why are we paying for drugs? Really?
33:20
Speaker 2: Why are you asking for somebody to put their hand
33:24
Speaker 2: into their pocket when they are already sick? Somebody once
33:28
Speaker 2: said that this is because they have to have skin
33:30
Speaker 2: in the game. What an absurd concept. The person has cancer, diabetes, SLE,
33:36
Speaker 2: some terrible disorder. They have been afflicted. They have skin
33:40
Speaker 2: in the game for sure. Now they have to pay
33:43
Speaker 2: for a therapy that they've already been insured for? Let
33:47
Speaker 2: me ask you a question. Is that halfway decent? It's
33:51
Speaker 2: not a question of beating on the insurance companies. It's
33:54
Speaker 2: asking the question, who do they serve, shareholders or patients?
33:59
Speaker 2: And I would argue that their fundamental reason for being
34:04
Speaker 2: here is to better the lives of those patients. And
34:07
Speaker 2: by doing that, they strengthen the economy, and by doing that,
34:11
Speaker 2: they're serving their shareholders. Great.
34:13
Speaker 1: Well, I'll leave that there because I know that debate
34:15
Speaker 1: will rage forever. I've got a lightning round, and then
34:18
Speaker 1: we'll get into some fun questions. Where do you think
34:20
Speaker 1: the next breakthroughs in medicine are coming from?
34:24
Speaker 2: Won't be a single technology. Because of all the different things,
34:27
Speaker 2: it's a combination of convergence of technologies, AI, human genetics,
34:32
Speaker 2: advanced imaging, protein engineering, RNA biology. and much better computational biochemistry.
34:40
Speaker 2: But one other thing, that won't be enough. These are
34:43
Speaker 2: all going to combine. The greatest advantage will come by
34:46
Speaker 2: combining all of them with a much, much better and
34:50
Speaker 2: deeper understanding of human biology, which is why the basic
34:54
Speaker 2: sciences of the NIH and the research institutes are so important.
34:58
Speaker 1: What are you telling founders that you weren't 10 years ago?
35:01
Speaker 2: 10 years ago, we spent an enormous amount of time
35:04
Speaker 2: about financing research Today, I would tell founders, spend much
35:08
Speaker 2: more time discussing biology. Capital is important, but capital follows conviction.
35:15
Speaker 2: Conviction follows biology. If you truly understand the disease and
35:19
Speaker 2: can demonstrate that understanding that convincingly, capital usually will find you.
35:26
Speaker 2: I think you have to also do one other thing.
35:30
Speaker 2: I would also encourage founders to think beyond a single molecule.
35:34
Speaker 2: If they have the opportunity to build a platform capable
35:37
Speaker 2: of generating many medicines, they should do that. Because platforms
35:41
Speaker 2: create scientific value. Individual molecules create individual products. We need both,
35:47
Speaker 2: but platforms have the power to transform industries.
35:50
Speaker 1: So that's the KRAS model, perhaps, you know, looking at
35:54
Speaker 1: something like that. So what would you tell doctors and
35:56
Speaker 1: patients that you wouldn't have 10 years ago?
36:00
Speaker 2: Look, I'd tell them something very fundamental. They're not simply
36:04
Speaker 2: participants in medical innovation. They're partners. Patients shape clinical trials,
36:10
Speaker 2: physicians contribute evidence, and innovations become a collective process rather
36:15
Speaker 2: than something that happens behind lab doors.
36:19
Speaker 1: Got it. So what are you getting real about right now?
36:22
Speaker 1: Is it only biotech or something else?
36:26
Speaker 2: I love that question. I'm getting real about the importance
36:29
Speaker 2: of institutions. It's tough business. We all celebrate innovators, right?
36:35
Speaker 2: But innovators don't occur in isolation. It depends on universities,
36:40
Speaker 2: generate knowledge, regulators, intellectual property systems, investors, healthcare systems. And
36:48
Speaker 2: at the end of the day, countries don't innovate, institutions do.
36:53
Speaker 2: So what I'm getting real about is that means governments
36:57
Speaker 2: have responsibilities as well. And if America wants to remain
37:01
Speaker 2: the world's biotech leader, we need to have a coherent
37:04
Speaker 2: national strategy. So for me, I guess the most important
37:09
Speaker 2: thing that I've become to believe strongly is that optimism
37:13
Speaker 2: is a strategy and frankly, pessimism is a luxury we
37:17
Speaker 2: simply cannot afford. And we need leaders in government, academia, industry,
37:23
Speaker 2: and finance who are willing to speak out, not to
37:26
Speaker 2: be silent. about the contribution that biotech makes. And that's important.
37:32
Speaker 2: This industry has already done it. It's transformed human life,
37:36
Speaker 2: expectancy and quality more than any others done in the
37:40
Speaker 2: history of mankind. We shouldn't be apologizing for that. We
37:43
Speaker 2: should be inspiring the next generation to become bold. And
37:46
Speaker 2: I'll say it again, optimism is a strategy and pessimism
37:52
Speaker 2: and wringing our hands is not, but we've got to
37:54
Speaker 2: act on it.
37:56
Speaker 1: Yeah, I say it another way. I copy some other
37:58
Speaker 1: folks I've heard. You know, it's really time to organize
38:01
Speaker 1: versus agonize over all this. I'm glad to be in
38:05
Speaker 1: partnership with you to do it. We're going to get
38:08
Speaker 1: everybody to read Biotech and the Balance. We're going to
38:11
Speaker 1: get everybody to understand it. I'm glad that you're out
38:14
Speaker 1: there evangelizing and doing this work. Thanks for doing it
38:17
Speaker 1: because so many of your colleagues have hung up their
38:19
Speaker 1: spurs and gone to the beach. So we need more leadership,
38:22
Speaker 1: as you said. Thanks for setting that example. Let's have
38:25
Speaker 1: a few fun questions before we go. Jeremy, if there
38:28
Speaker 1: was an album that was the soundtrack of your life,
38:30
Speaker 1: music's important to me, got me through a lot, what
38:33
Speaker 1: would that be?
38:33
Speaker 2: Can I have two?
38:34
Speaker 1: You can.
38:35
Speaker 2: Thank you. The first is Abbey Road by The Beatles.
38:39
Speaker 2: I love the way the whole album brings together extraordinary individuals.
38:43
Speaker 2: It's real talented, and it makes it far greater than
38:47
Speaker 2: all the pieces of it. The very last medley is
38:50
Speaker 2: really all about resilience, Reinvention and finishing well. And there's
38:56
Speaker 2: such a wonderful, quiet optimism to it that stayed with
39:00
Speaker 2: me since a little child as I first listened to it.
39:03
Speaker 2: And the final line, and it's important, and in the end,
39:06
Speaker 2: the love you take is equal to the love you make,
39:09
Speaker 2: captures something important about leadership. Ultimately, what matters isn't the
39:14
Speaker 2: position you hold, and I'm really convinced of that, but
39:17
Speaker 2: the difference you make in other people's lives. So that
39:20
Speaker 2: one really, it's really inspiring to me. And the other one,
39:24
Speaker 2: which is a little different but very important to me,
39:27
Speaker 2: is The Dark Side of the Moon by Pink Floyd.
39:30
Speaker 2: And basically, it's fascinating because it explores ambition, time, conflict, greed,
39:40
Speaker 2: just read the words, mortality and pressures that come with responsibility.
39:44
Speaker 2: I've listened to it dozens of times. And every time
39:48
Speaker 2: I listen to it, I hear something different. And in part,
39:51
Speaker 2: it's because I've changed. And that's remarkably similar to science.
39:55
Speaker 2: I guess data doesn't change, but experience changes how you
40:00
Speaker 2: interpret it. So Abbey Road reminds me of why we
40:03
Speaker 2: do the work. Dark Side of the Moon reminds me
40:06
Speaker 2: how complex a journey can be. And I know people
40:11
Speaker 2: will laugh at me, but I'll take that. They've been
40:14
Speaker 2: the soundtrack of very different chapters of my life.
40:17
Speaker 1: Well, there are different chapters. So before we let you go,
40:20
Speaker 1: what is your favorite vacation?
40:23
Speaker 2: Well, I've been to so many different places. It's not
40:26
Speaker 2: about the destination. I think, to be fair, the places
40:30
Speaker 2: I remember most of those where I can really slow down, think, walk, read,
40:35
Speaker 2: spend uninterrupted time with friends, family. And it doesn't matter
40:40
Speaker 2: whether it's where I am right now, like walking and
40:42
Speaker 2: hiking in Colorado, being by the sea, finding a good
40:45
Speaker 2: book where I can read a good book. Those are
40:48
Speaker 2: moments that stay with me. So, you know, in the
40:50
Speaker 2: life that I've had, which has been incredibly grueling and
40:53
Speaker 2: fast moving at times, a good vacation for me is
40:55
Speaker 2: one that restores perspective. And one element of that, by
40:59
Speaker 2: the way, is working on a farm. I do work
41:02
Speaker 2: on a farm. I go there. I shovel the cow manure.
41:07
Speaker 2: I mend fences and that gives me a sense of perspective.
41:12
Speaker 2: I work side by side with others who work with
41:15
Speaker 2: their hands. And perhaps if I had to say the
41:17
Speaker 2: one thing, one vacation I like is the ability to
41:21
Speaker 2: get perspective on what you do. So work is important,
41:25
Speaker 2: but it's the people you share our lives with who
41:27
Speaker 2: ultimately give that work any kind of meaning.
41:30
Speaker 1: Amazing.
41:31
Speaker 3: I saw that parallel between pursuing medicine and studying it
41:35
Speaker 3: and then moving into biotech. And this question that Jim
41:38
Speaker 3: said was unanswerable, which is like, how do we make
41:42
Speaker 3: pharma and how do we make this business care about
41:45
Speaker 3: the patient rather than the shareholder? And how do we
41:48
Speaker 3: even like begin to broach that? Because then flow of
41:51
Speaker 3: capital is always the question ultimately.
41:53
Speaker 2: Well, I can tell you that at the core of it,
41:55
Speaker 2: the bifurcation resides in compensation. In the pharmaceutical industry, Compensation
42:03
Speaker 2: is atrocious. It doesn't compensate for innovation. It doesn't compensate
42:08
Speaker 2: for retaining patients on drugs. It doesn't compensate for doing
42:12
Speaker 2: better research at all, at all. It's the same compensation
42:17
Speaker 2: that you get when you sell cars. It's exactly the same.
42:21
Speaker 2: In biotech, it's different. You put your neck on the line.
42:25
Speaker 2: You get compensated only if you innovate. If you don't innovate,
42:29
Speaker 2: you earn nothing. It's a very different compensation philosophy. And
42:34
Speaker 2: the consequence of that is that the large farmers will
42:36
Speaker 2: continue to grow. They don't really care where innovation comes
42:41
Speaker 2: from at all. But they do care where the bonus
42:44
Speaker 2: comes from.
42:44
Speaker 3: So why does it not match the compensation model of
42:48
Speaker 3: biotech or even a hospital? The more successful the doctor,
42:51
Speaker 3: the more money that doctor makes ultimately. And where's the breakdown?
42:55
Speaker 2: It's very simple. Public shareholders are supposed to be the fault,
43:01
Speaker 2: supposed to be the determinant of that. That's just not true.
43:05
Speaker 2: It's the lie that is espoused by the compensation committees.
43:09
Speaker 2: It's an easy out for them. Shareholders want a dividend.
43:13
Speaker 2: Shareholders want the price to go up. The price will
43:16
Speaker 2: go up if you show you're innovating and you're selling
43:19
Speaker 2: more and you're keeping more patients on. But If you
43:22
Speaker 2: look at the way they structure compensation at the end
43:25
Speaker 2: of the year, increased revenue, reduced costs, nothing to do with,
43:30
Speaker 2: I've launched a new drug. I've got more patients staying
43:33
Speaker 2: on the drug for the next year than I've had before. Nothing.
43:37
Speaker 2: They could change this in a heartbeat. So who's to blame?
43:41
Speaker 2: The boards, because they are not innovative. They all sit
43:45
Speaker 2: there and just take huge fees. I don't have any
43:47
Speaker 2: time for it, to be perfectly honest. Wow.
43:50
Speaker 3: And so if the drugs were more affordable for people
43:54
Speaker 3: and that encouraged more innovation because more people were taking
43:57
Speaker 3: these drugs, then ultimately everybody might win, right? Because the
44:02
Speaker 3: best drugs and the best companies developing them would rise
44:05
Speaker 3: to the top and more people would then be surviving
44:08
Speaker 3: and thriving because they could afford treatment.
44:10
Speaker 2: 40% of people stop taking their drug at the end
44:13
Speaker 2: of the year.
44:13
Speaker 1: 40.
44:14
Speaker 3: Yeah, because they can't afford it.
44:16
Speaker 2: They either can't afford it Or they're not educated. They're
44:19
Speaker 2: not encouraged to do it. And so if you were
44:22
Speaker 2: even to get that to 10% to drop, okay, for
44:25
Speaker 2: all different reasons, you'd have a massive improvement in health. Massive.
44:31
Speaker 2: And if you incented the physicians, not the physicians, the companies,
44:37
Speaker 2: to look for more patients. In other words, it's called
44:40
Speaker 2: net new sales. We're really getting into the nitty gritty.
44:45
Speaker 2: But net new sales is sales to a new patient
44:48
Speaker 2: so that you keep old patients on the drug mall,
44:51
Speaker 2: sales to a new patient, and then conquer new diseases.
44:55
Speaker 2: If they were incented for all of those, we'd have
44:57
Speaker 2: a different industry.
44:59
Speaker 1: Well, I think we're going to have a different industry anyway,
45:01
Speaker 1: because I think people can get their hormones and peptides
45:06
Speaker 1: and all the rest. And I think they'll be more
45:09
Speaker 1: patient agency than there ever has been. I think the
45:13
Speaker 1: access to information, knowledge, et cetera, is getting more democratized
45:17
Speaker 1: with AI and that evolution and revolution. So I do
45:20
Speaker 1: think all these things will converge and create something very
45:24
Speaker 1: different that's more consumer-led. It's the most important consumer product
45:28
Speaker 1: there is, healthcare. And we act like it's not a
45:33
Speaker 1: consumer product. It's bizarre. And I think finally, market forces
45:38
Speaker 1: are moving us more in the right direction. I can't
45:41
Speaker 1: tell you how many guys I know that don't know
45:43
Speaker 1: better when they go in for their near-death heart attack treatment. Oh,
45:48
Speaker 1: you mean I could have been taking Repatha or all
45:53
Speaker 1: these other things to prevent this event? These things are there.
45:57
Speaker 1: I think we're going to be able to make Prenuvo
46:00
Speaker 1: and other preventive, you said it, you know, these like
46:03
Speaker 1: diagnostic tools, AI tools, diagnostics, which will reduce risk and
46:08
Speaker 1: we'll be able to get ahead of it. We have to.
46:10
Speaker 1: We have to get ahead of it. It has to
46:12
Speaker 1: become a prevention industry instead of a treatment industry.
46:15
Speaker 3: And it's interesting that D2C people are willing to spend
46:18
Speaker 3: $ 200 a month to buy their GLP-1 from him and
46:21
Speaker 3: hers online. And that's not a huge expense for them.
46:24
Speaker 3: What really is the bigger expense is their insurance and
46:28
Speaker 3: their drugs through their insurance company. So you have these
46:31
Speaker 3: This parallel model coming out.
46:33
Speaker 1: The parable is move away from the floodplain. And that's
46:37
Speaker 1: not insurable anymore. And I don't think a person who
46:41
Speaker 1: remains obese or alcoholic or whatever is going to be insurable.
46:46
Speaker 1: They aren't now. And I think at the end of
46:49
Speaker 1: the day, we got to look at that because there
46:52
Speaker 1: are drugs literally can stop you from drinking. And there
46:55
Speaker 1: are drugs that can stop you from overeating. And there
46:59
Speaker 1: are drugs and treatments that can do a lot more. Now,
47:03
Speaker 1: to Jeremy's point, that should then redirect, and I think
47:06
Speaker 1: we're seeing it, into neurological, which is why I brought
47:09
Speaker 1: it up and why I'm really excited about music and medicine.
47:14
Speaker 1: The neurological diseases, I don't think, will be fully impacted
47:18
Speaker 1: by those preventive measures, right? So we've got to get
47:21
Speaker 1: to the things that are moving, ALS, Parkinson's, Alzheimer's, which
47:26
Speaker 1: if you live longer, you're going to get. Those are
47:29
Speaker 1: the areas that I know his company and others are
47:32
Speaker 1: focused on. I think that's where we're going to see
47:34
Speaker 1: the next big revolution. All right, well, we'll drop the
47:36
Speaker 1: mic on that. Thank you for being here. Thanks for
47:40
Speaker 1: taking time out of your probably wonderful summer respite. And
47:45
Speaker 1: thanks for just getting this book out there and being
47:48
Speaker 1: a voice that we need right now. Obviously, it's an
47:52
Speaker 1: industry I've been in a long time and loved. And
47:55
Speaker 1: I know you'd feel the same. We're here for it.
47:58
Speaker 1: So let's get more people on board. Thanks, Jeremy.
48:01
Speaker 2: Really appreciate that. I appreciate the time I spent with you.
48:06
Speaker 1: Hey, everyone. Thanks for watching. I really appreciate that you
48:09
Speaker 1: take the time to listen to this and tune in.
48:12
Speaker 1: So please subscribe, follow. I've got a lot of amazing guests.
48:16
Speaker 1: You're going to learn a lot and you're going to
48:18
Speaker 1: feel a lot better because you did it.