Latest / Making Medicine / How Venture Capital Backed America's Biotech Engine | How America Makes Medicine Ep. 5

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How Venture Capital Backed America's Biotech Engine | How America Makes Medicine Ep. 5 · Making Medicine

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Speaker 1: At Making Medicine. We're reporting on the headlines, not making
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Speaker 1: medical recommendations. For personal health questions, always ask your doctor.
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Speaker 1: Nothing in this episode constitutes investment, financial or legal advice.
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Speaker 1: Consult your own advisors before making decisions.
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Speaker 2: I would say it is it's worth not getting too
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Speaker 2: distracted when you see a headline, and it really comes
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Speaker 2: down to looking at the data. So you might have
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Speaker 2: a stock that is up one hundred percent or two
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Speaker 2: hundred percent on the news when you actually present the
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Speaker 2: data at a medical meeting, that gives you the opportunity
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Speaker 2: to come to a fulsome conclusion.
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Speaker 1: Welcome back to the Making Medicine podcast for science, policy
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Speaker 1: and innovation meet I'm your host John Stanford. On today's show,
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Speaker 1: we're looking at the early stage venture capital that turns
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Speaker 1: promising science into new medicines. America built the modern biotech
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Speaker 1: VC model, a world we know very well here at
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Speaker 1: Making Medicine, and we're excited to highlight its critical role
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Speaker 1: in the ecosystem as part of our seventh part How
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Speaker 1: America Makes Medicine series, celebrating two hundred and fifty years
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Speaker 1: of American pharmaceutical innovation. Our guest today taking us on
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Speaker 1: this journey into venture capital is Michael Rome, Managing director
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Speaker 1: and head of Therapeutics Investing at Foresight Capital.
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Speaker 3: That's where he.
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Speaker 1: Leads company formation, mergers and acquisitions, and structured financing across
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Speaker 1: both public and private markets. He's watched capital move in
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Speaker 1: and out of the industry through IPO booms, m and
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Speaker 1: A cycles, and policy shocks alike. Michael's going to walk
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Speaker 1: us through why venture capital is so essential to the
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Speaker 1: drug development pipeline, and how a firm actually decides what
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Speaker 1: to fund and the signals that move money in or
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Speaker 1: out of biotech. Let's get into the show. As it
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Speaker 1: turns out, the news doesn't stop for how America makes
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Speaker 1: medicine series and so this week we've had a few
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Speaker 1: news items that are too big to not cover for
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Speaker 1: our listeners, including the highly anticipated next pick for the
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Speaker 1: next leader of the FDA. So let's cover a few headlines.
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Speaker 1: Our first news item is one we should all be celebrating,
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Speaker 1: albeit cautiously because we're not all the way to approval.
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Speaker 1: But it comes from the world of mRNA. Our friends
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Speaker 1: over at merk and Maderna announced this week that their
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Speaker 1: personalized cancer vaccine hit the mark in its first ever
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Speaker 1: late stage trial. It's the first positive phase three result
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Speaker 1: ever recorded for an mRNA cancer vaccine. The study enrolled
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Speaker 1: over eleven hundred high risk melanoma patients who'd already had
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Speaker 1: surgery to remove their cancer. Half of them received Merk's
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Speaker 1: key Trudah alone, and half of them got key Trudah plus,
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Speaker 1: this personalized vaccine, which is custom built for each patient
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Speaker 1: based on the specific mutations found in their tumor. The
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Speaker 1: combination therapy significantly cut the risk of melanoma coming back
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Speaker 1: and also reduced the odds of its spreading to other
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Speaker 1: parts of the body. The companies haven't released full data yet.
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Speaker 1: That'll come at a medical meeting and with regulators in
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Speaker 1: the weeks and months to come, but the initial readout
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Speaker 1: sent Maderna stock soaring more than forty percent in pre
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Speaker 1: market trading today and Merks up as well. But it's
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Speaker 1: a milestone moment for the technology that's had a rough
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Speaker 1: few years politically. We've been talking about mRNA on this show,
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Speaker 1: and today's study validates an idea that Merk and Maderna
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Speaker 1: have been chasing for over a decade. Now you can
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Speaker 1: build a vaccine not for a virus, but for one
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Speaker 1: person's own cancer. This is truly a headline we should
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Speaker 1: all be excited about. As if that wasn't enough, we
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Speaker 1: also received news about the very person whose job it
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Speaker 1: will be to approve of cancer vaccine like the one
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Speaker 1: Maderna and Murk announced. The long wait for a permanent
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Speaker 1: FDA commissioner appears to be over. Multiple outlets reported this
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Speaker 1: week that President Trump has chosen doctor Heidi Overton, a
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Speaker 1: deputy director at the White House Domestic Policy Council, to
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Speaker 1: lead the agency. Overton was one of three finalists, but
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Speaker 1: she ultimately had the inside track, thanks in part to
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Speaker 1: a close relationship with Chief of Staff Susie Wiles and
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Speaker 1: a long standing rapport with President Trump. Acting Commissioner Kyle Diamontes,
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Speaker 1: who's been running the agency since Marty McCarey resigned back
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Speaker 1: in May, had actually been asked directly by Trump to
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Speaker 1: take the job and turned it down, citing his young family.
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Speaker 1: Overton is a physician by training and a veteran of
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Speaker 1: the American First Policy Institute, the think tank closely associated
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Speaker 1: with President Trump. She's been a visible player in the
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Speaker 1: administration's health policy efforts, including the overhaul of the childhood
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Speaker 1: vaccine schedule, and that record is already drawing fire industry
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Speaker 1: voices worries she'll unwind the progress Diamontes made recently rebuilding
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Speaker 1: ties with industry, while allies call her a strong pick
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Speaker 1: focused on patient care. Either way, assuming she is nominated,
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Speaker 1: and we have every reason to believe the veracity of
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Speaker 1: these reports, she'll face a tough confirmation fight. Not only
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Speaker 1: will Democrats be lining up against almost any nominee out
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Speaker 1: of the Trump administration, but the Senate Health Committee just
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Speaker 1: went through a bruising fight over the CDC nomination. It's
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Speaker 1: Chairman Bill Cassidy, who, if we'll recall, loss to a
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Speaker 1: President Trump nominee in a primary Republican fight, has publicly
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Speaker 1: broken with the administration on vaccine policy before he'll have
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Speaker 1: the gavel in his hand for this nomination fight.
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Speaker 3: More to come.
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Speaker 1: To be sure, for regular listeners to the How America
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Speaker 1: Makes Medicine series, you know every episode has a little
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Speaker 1: bit of history before we bring our guests in. So
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Speaker 1: before Michael joins us, let's talk about how venture capital
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Speaker 1: became a part of the drug development pipeline at all,
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Speaker 1: Because for most of its history, no one would have
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Speaker 1: called biology a venture scaled bet. Venture capital's roots go
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Speaker 1: back just as far as America's and certainly much further
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Speaker 1: than tech or biotech. Historian Tom Nicholas traces the model
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Speaker 1: to the whaling industry, where in the nineteenth century nearly
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Speaker 1: seventy five percent of the world's whaling ships were American born.
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Speaker 1: It's because financiers put up the capital f for voyages
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Speaker 1: that could last years with no guarantee of return. Sailors
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Speaker 1: and captains took a share of the profit instead of
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Speaker 1: a fixed wage, and the whole structure ran on the
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Speaker 1: same logic that defines VC Today. Most bets lose money,
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Speaker 1: and the rare ones that make it through pay for
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Speaker 1: them all. The modern version of science and biotech and
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Speaker 1: venture capital comes in nineteen forty six when Georgies Dorio
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Speaker 1: founded the American Research and Development Corporation in Boston, the
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Speaker 1: first influential venture firm, as it were, and then in
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Speaker 1: nineteen fifty seven, ARDC put seventy thousand dollars into a
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Speaker 1: young company called Digital Equipment Corporation. By DEC's nineteen sixty
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Speaker 1: eight IPO, that stake was worth more than three hundred
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Speaker 1: and fifty million dollars. That single return proved the model
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Speaker 1: could work at scale and pulled a generation of investors
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Speaker 1: into the business, and for the next two decades, venture
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Speaker 1: capital stayed a niche, under funded industry. Then two policy
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Speaker 1: changes hit back to back. In nineteen seventy eight, Congress
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Speaker 1: cut the capital gains tax from forty nine and a
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Speaker 1: half percent to twenty eight percent, and in nineteen seventy nine,
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Speaker 1: the Department of Labor loosened the quote prudent Man rule
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Speaker 1: under ARISA, clearing pension funds to put money into venture
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Speaker 1: funds for the first time. These two policy changes were
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Speaker 1: revolutionary Together they opened the largest pool of capital in
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Speaker 1: the country to an asset class that had barely existed
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Speaker 1: a decade earlier, and commitments to venture funds jumped from
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Speaker 1: around sixty eight million to nearly a billion within just
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Speaker 1: a few years. It just so happened that that was
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Speaker 1: the financial environment biology and the very nascent biotech industry
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Speaker 1: walked into. Where As we've covered on the show in
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Speaker 1: previous episodes, a revolution happened in nineteen seventy six when
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Speaker 1: Robert Swanson, a young venture associate recently let go from
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Speaker 1: Kleiner Perkins, reached out to Herbert Boyer after reading about
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Speaker 1: his work in recombinant DNA. Their partnership became Genentech, and
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Speaker 1: it created the venture backed biotech model, still very much
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Speaker 1: in use today. It would only be four years later
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Speaker 1: in nineteen eighty when Genentech became the first biotech company
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Speaker 1: to go public. The stock opened at thirty five dollars
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Speaker 1: and by the end of the day closed at seventy
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Speaker 1: one dollars, more than doubling the value of the company.
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Speaker 1: The Wall Street Journal called it one of the most
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Speaker 1: spectacular market debuts in recent history, and a wave of
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Speaker 1: biotech IPOs followed, giving investors a new way to finance
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Speaker 1: high risk science and allowing venture capital an opportunity to
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Speaker 1: reap their returns and redeploy it into new entrepreneurs. Put
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Speaker 1: those pieces together and you get the American model. World
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Speaker 1: class science paired with private capital willing to sit through
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Speaker 1: a decade of risk before any return shows up. That
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Speaker 1: combination is what let the US lead in biomedical innovation
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Speaker 1: and get breakthroughs to patients faster than anywhere else. So
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Speaker 1: today we're picking up where history leaves off. Venture capital deployed. Now,
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Speaker 1: what makes investors put capital work? What gives them pause
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Speaker 1: and how does policy change those decisions. I'll take a
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Speaker 1: little bit of moderator's privilege to say I have been
9:12
Speaker 1: around the world with American venture capital, to Japan, to Europe,
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Speaker 1: to places where they lack the capital interest that we
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Speaker 1: have in this country. It's something that should be cherished
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Speaker 1: and certainly something that incubate that we fight for every
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Speaker 1: day and shouldn't be lost on any of our listeners
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Speaker 1: how fragile it is and how desirable it is from
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Speaker 1: other countries that don't have two hundred and fifty years
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Speaker 1: of enterprise, entrepreneurship and venture capital. Michael, Welcome to the show.
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Speaker 3: Hi John, thank you so much for having me today.
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Speaker 1: Well, as we've said before on the show, listeners can't
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Speaker 1: get enough of the individual career arcs that people like
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Speaker 1: you who have made it to these incredible places have taken.
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Speaker 1: And so before we get into the great topics we're
9:56
Speaker 1: going to get into one if you would give us
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Speaker 1: some of your own personal history and how you ended
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Speaker 1: up at Foresight, because I think so many people are
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Speaker 1: intrigued by the success that you've had.
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Speaker 2: So I started my undergraduate education at UCLA. I studied
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Speaker 2: molecular cell and developmental biology, and what was really formative
10:16
Speaker 2: for me during those years was working in various laboratories.
10:20
Speaker 2: I had the privilege of working in a microbiology lab
10:23
Speaker 2: and then working in a neuroscience lab studying the retina,
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Speaker 2: and it sort of solidified that I had a lifelong
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Speaker 2: sort of passion for learning, and that really came across,
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Speaker 2: you know, during my time there, and I got to
10:37
Speaker 2: take many other classes and study things like political science
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Speaker 2: and economics in addition to science. And then I went
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Speaker 2: on to Caltech to receive my PhD in biochemistry, and
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Speaker 2: again the theme there was really the passion for learning.
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Speaker 2: I enjoyed interacting with my colleagues, analyzing data, going to
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Speaker 2: journal club.
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Speaker 3: The one thing I I didn't.
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Speaker 2: Enjoy during that time was actually doing the experiments itself.
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Speaker 2: And so you know, my wife could probably attest to this.
11:08
Speaker 2: I have trouble loading the dishwasher, so doing a protein
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Speaker 2: purification over twenty four hours was definitely not something I
11:16
Speaker 2: was inclined to do. So I started looking for alternative careers.
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Speaker 2: I started looking at biotech. There was a biotech club,
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Speaker 2: and started talking to more people in the industry, and
11:26
Speaker 2: so right out of PhD, I ended up working at
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Speaker 2: a small biotech for a year and then really studying
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Speaker 2: the business side, learning how to do financial modeling, some
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Speaker 2: business development, and that really piqued my interest. And then
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Speaker 2: I had a friend who had become a professional investor
11:43
Speaker 2: during that time, really the only person.
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Speaker 3: In graduate school that went that path.
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Speaker 2: I started learning more about it, doing some investing on
11:51
Speaker 2: my own. And then the typical path from a science
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Speaker 2: either a PhD or an MD, is actually going to
11:59
Speaker 2: the l side and working for a bank in equity research. However,
12:04
Speaker 2: I ended up going to a long only hedge fund,
12:09
Speaker 2: and so I spent time there and that really became
12:12
Speaker 2: instantly probably the most thing I've ever been passionate about.
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Speaker 2: You know, working at a hedge fund in the West Coast,
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Speaker 2: you wake up at four point thirty in the morning,
12:22
Speaker 2: years you're studying the markets, and you're really studying hundreds
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Speaker 2: of companies.
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Speaker 3: So I really.
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Speaker 2: Got a passion at that time for you know, looking
12:31
Speaker 2: at different areas like oncology, autoimmunity, and had the privilege
12:35
Speaker 2: of studying under some really great mentors there, and it's I.
12:41
Speaker 3: Should call out.
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Speaker 1: We had a lot of people on the show from
12:44
Speaker 1: San Francisco, a lot of people from San Diego. What's
12:47
Speaker 1: it like being mister biotech investor in LA? Or are
12:51
Speaker 1: we sleeping on LA? Should we start thinking of it
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Speaker 1: more as a central hub?
12:56
Speaker 3: Definitely?
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Speaker 2: I would say LA has more venture capital firms, So
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Speaker 2: in addition to Foresite there's four, there's firms like Vita
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Speaker 2: Ventures or Westlake, and now we're seeing more company incubations.
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Speaker 3: Happen in LA.
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Speaker 2: It's definitely not the ecosystem you find in a San
13:15
Speaker 2: Francisco or Boston. But the nice thing too is LA
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Speaker 2: has a good proximity to San Diego, so we have
13:21
Speaker 2: numerous portfolio companies at Foresight that are in the San
13:24
Speaker 2: Diego area.
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Speaker 1: It's been incredible to watch just the growth out there.
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Speaker 1: I love the idea that if only you liked loading
13:33
Speaker 1: a dishwasher, maybe you'd be in the lab instead of
13:36
Speaker 1: in the boardroom. But tell us a little bit more
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Speaker 1: also about Foresight, because I know it's a broader remit
13:43
Speaker 1: than just biotech, and you lead the biotech for folks
13:46
Speaker 1: who don't know, tell a little bit more about Foresight.
13:48
Speaker 3: Sure thing.
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Speaker 2: So Foresite has been around since twenty thirteen, and it
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Speaker 2: was founded by Jim Cannabaum who had a very active
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Speaker 2: career in biotech and has been a professional investor now
14:00
Speaker 2: for over thirty years. And Jim's vision was to really
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Speaker 2: have a firm that looked at all areas of healthcare.
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Speaker 2: So about seventy percent of what we do is on
14:09
Speaker 2: the therapeutics biotech side, but we also have a practice
14:13
Speaker 2: in healthcare services. We've had an emphasis of using AI
14:17
Speaker 2: tools over the past few years now over pretty early
14:20
Speaker 2: in that trend, and we focus really on companies all
14:25
Speaker 2: over the biotech landscape. So we do about fifty percent
14:29
Speaker 2: or so on early stage and company incubations, and we
14:32
Speaker 2: have a full service incubator called Foresight Labs that helps
14:35
Speaker 2: make that happen. And then we spend another fifty percent
14:38
Speaker 2: of our time on later stage, so we'll do syndicated
14:41
Speaker 2: financings with other biotech vcs, we'll do direct public investing.
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Speaker 2: We have a full time trader, a full time partner
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Speaker 2: who oversees that practice, and we'll support our portfolio companies
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Speaker 2: early on in their journey as they're growing up, and
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Speaker 2: then we'll participate even the later stage round and then
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Speaker 2: publicly we'll do denovo investments where we're a lot of
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Speaker 2: times participating in public finance and things. Our view is
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Speaker 2: that the line is very blurry between private and public biotech.
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Speaker 2: So having the ability and a fund to invest in
15:16
Speaker 2: all areas we think suits us, and then it allows
15:19
Speaker 2: us really to adapt to different market cycles. So if
15:23
Speaker 2: biotech is depressed on the public markets like it was
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Speaker 2: in the two thousand call it twenty two, twenty three
15:30
Speaker 2: time period, we put more emphasis on publics. At times
15:34
Speaker 2: when the public markets are really warring, we think valuations
15:37
Speaker 2: are high, maybe we'll step back.
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Speaker 3: And do a little bit more on the private side.
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Speaker 1: I think that makes so much sense because it's not arbitrary,
15:46
Speaker 1: to be sure, the difference between a private and a
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Speaker 1: public but it's certainly not necessarily scientifically driven, and so
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Speaker 1: having the ability to scoop up opportunity depending on market
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Speaker 1: cycles and things like that, it makes a ton of sense.
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Speaker 1: I think you're the right person during our How America
16:02
Speaker 1: Makes Medicine series to really kind of do some VC
16:06
Speaker 1: one oh one for our listeners. What's your day to
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Speaker 1: day like, where did deals come in, how do you
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Speaker 1: evaluate them, how do you decide where to deploy capital?
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Speaker 1: What's what does that cycle look like? As if we
16:21
Speaker 1: weren't in the industry.
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Speaker 2: I would say a typical day for US is both
16:26
Speaker 2: taking calls with new companies and also working with our
16:30
Speaker 2: existing portfolio companies.
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Speaker 3: It's probably an equal mix there.
16:34
Speaker 2: So we have a twelve person team on the On
16:37
Speaker 2: the therapeutic side, we have very diverse backgrounds. We have
16:41
Speaker 2: three medical doctors, two of which you still see patients.
16:44
Speaker 2: We have four PhDs NBA CFAs all working on the team,
16:49
Speaker 2: and we probably screened thousands of companies a year, and
16:53
Speaker 2: this includes looking at, you know, every private and public
16:57
Speaker 2: company in the US and Europe. We spend a lot
16:59
Speaker 2: of time in Asia, where we've been active on the
17:02
Speaker 2: in licensing front, so early in the morning or late
17:06
Speaker 2: at night are usually the times when we're speaking to
17:09
Speaker 2: those companies, and then.
17:10
Speaker 3: We're attending board meetings.
17:12
Speaker 2: And I think a theme in the investing world is
17:15
Speaker 2: you're jumping from topic to topic pretty quickly. It's different
17:19
Speaker 2: than sitting in a biotech where you could be working
17:22
Speaker 2: as a scientist or on clinical development and you're very
17:25
Speaker 2: focused on a program. We are jumping around from topics
17:30
Speaker 2: and then at the same time we're performing research, so
17:33
Speaker 2: we're digesting all the news that happens during the day,
17:37
Speaker 2: or we're at a medical meeting, or there's a public
17:41
Speaker 2: disclosure that happens with data and that can have feedback
17:45
Speaker 2: into our portfolio and also inform how we talk to
17:49
Speaker 2: our portfolio companies. So the fun thing is we are
17:52
Speaker 2: studying all these different areas like oncology, autoimmunity, cardiovascular medicine.
17:57
Speaker 2: There's advances that are happening so quickly there. But a
18:01
Speaker 2: common theme that we observe among successful investors is really
18:04
Speaker 2: being long term and when you have an investment in
18:08
Speaker 2: a company, you know, we like to be fairly concentrated
18:12
Speaker 2: on things we have conviction in, so we're if we're
18:15
Speaker 2: not actively on the board of a company, we're definitely
18:19
Speaker 2: having a dialogue there doing everything we can to support them.
18:24
Speaker 2: And then on the public markets there's a little bit
18:27
Speaker 2: more attention from it from a day to day process.
18:30
Speaker 2: But again, having that long term mandate really helps us.
18:35
Speaker 2: I would say stay focused to not get too distracted.
18:38
Speaker 2: But it's definitely it's definitely a push and pull throughout
18:42
Speaker 2: the day.
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Speaker 1: Yeah, it's because it's certainly not a set it and
18:45
Speaker 1: forget its strategy and we'll come back in a moment
18:48
Speaker 1: to I think how vital your board roles and your
18:52
Speaker 1: guidance for your existing investments. We'll come back to that
18:56
Speaker 1: in a second. But also to not chase after the
19:00
Speaker 1: shiny new thing. I mean, I'll put a practical question
19:03
Speaker 1: to you. In today's news, you know, is it hard
19:07
Speaker 1: you see merk and Maderna's announcement that's exciting stuff, cancer vaccine, mRNA.
19:15
Speaker 1: Is it hard to not jump and say, oh, we've
19:17
Speaker 1: got to find one of those companies. You may very
19:19
Speaker 1: well already have good exposure in that space, but I
19:22
Speaker 1: could also see, oh, I open up endpoints. I want
19:24
Speaker 1: to chase this, I want to chase this. I want
19:26
Speaker 1: to chase this. That's balancing that versus we can't be
19:30
Speaker 1: everywhere at once.
19:31
Speaker 2: I would say it is it's worth not getting too
19:34
Speaker 2: distracted when you see a headline, and it really comes
19:37
Speaker 2: down to looking at the data. So you might have
19:40
Speaker 2: a stock that is up one hundred percent for two
19:43
Speaker 2: hundred percent on the news and Pajerna is having a
19:45
Speaker 2: huge run today, But when you actually present the data
19:49
Speaker 2: at a medical meeting, that gives you the opportunity to
19:52
Speaker 2: come to a fulsome conclusion. That's not always the case.
19:56
Speaker 2: I mean, you can have a very detailed press release.
19:59
Speaker 2: There could be a conference call where a lot of
20:00
Speaker 2: the data is disclosed, but typically companies save the details
20:04
Speaker 2: for a major medical meeting. So we will typically try
20:09
Speaker 2: to form an opinion when data comes out.
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Speaker 3: Perhaps we can talk to a company if it's.
20:13
Speaker 2: In our portfolio or it's related to our portfolio, but
20:18
Speaker 2: having the opportunity again to really drill down and understand
20:22
Speaker 2: what's going on and kind of be focused there. There's
20:25
Speaker 2: certainly are times where there's a press release or something
20:28
Speaker 2: occurs where it's immediately related to a to a portfolio company,
20:34
Speaker 2: but it really varies.
20:35
Speaker 3: I mean, you've probably seen times when a company puts out.
20:37
Speaker 2: A press release and it says positive trial, and then
20:40
Speaker 2: you read and it's like the trial's not stat SIG
20:43
Speaker 2: and they missed secondary endpoints, And if you're not a
20:47
Speaker 2: professional biotech investor, you might have a different interpretation. So
20:51
Speaker 2: it's really staying patient and trying to get as full
20:54
Speaker 2: some of a picture as you can.
20:55
Speaker 1: So Christmas morning is the medical meeting and the actual
20:59
Speaker 1: day and letting sort of the brilliant minds that you
21:02
Speaker 1: sit around a table with sync into that. That's when
21:06
Speaker 1: you're really finding out if that there's there and along
21:10
Speaker 1: those lines, I wouldn't say it's a battle, but I
21:14
Speaker 1: think their spirited debate at times about is biotech right
21:19
Speaker 1: for generalist investors who don't necessarily have the technical skills
21:25
Speaker 1: to evaluate a headline that says it was a positive
21:28
Speaker 1: trial and you're looking at it saying nothing about this
21:32
Speaker 1: reads positive to me. But if all you're doing is
21:35
Speaker 1: chasing the headlines and you're a layman, where do you
21:38
Speaker 1: see the balance between specialists and experts like yourself and
21:41
Speaker 1: general capital that can put a lot of weight behind
21:44
Speaker 1: some of the early stage investments you make.
21:46
Speaker 2: Yeah, it's a great question.
21:48
Speaker 3: So the industry right now is.
21:51
Speaker 2: Really dominated by biotech specialists, and it's become highly technical.
21:55
Speaker 2: So when I first entered the business, there was certainly
21:58
Speaker 2: an emphasis by doing technical analysis, but it's not like
22:01
Speaker 2: it is today where nearly every healthcare firm has a
22:05
Speaker 2: team of mds and PhDs who are very data focused.
22:11
Speaker 2: So now it's got even harder especial for generalists to
22:16
Speaker 2: enter the field. Generalists tend to get involved when they're
22:20
Speaker 2: positive economic.
22:21
Speaker 3: Tailwinds going on in the industry.
22:23
Speaker 2: So a classic example was during the twenty twenty period
22:26
Speaker 2: during COVID when the FED lowered interest rates to zero
22:29
Speaker 2: and we saw the most impressive rush of capital into
22:33
Speaker 2: the sector. People putting more emphasis on risk assets in
22:37
Speaker 2: biotech was certainly in the news during that time with
22:41
Speaker 2: COVID vaccines, So there are are periods where.
22:45
Speaker 3: That's going on.
22:45
Speaker 2: And actually right now you can see in the market
22:47
Speaker 2: we're in an M and A driven market right now
22:50
Speaker 2: that's almost decoupled from interest rates, So generalists are coming
22:53
Speaker 2: back into the field. But the lesson historically is that
22:57
Speaker 2: it's been hard for generalists to handicap developmental stage biotech.
23:01
Speaker 2: So when you're a pre clinical biotech or you're in
23:04
Speaker 2: phase one or phase two, those are almost always dominated
23:08
Speaker 2: by specialists. And I think a great role spe for
23:11
Speaker 2: generalist capital is to come in after you have a
23:13
Speaker 2: d risk biotech. And this is very important because the industry,
23:18
Speaker 2: we don't always want to be dependent on M and
23:21
Speaker 2: A from larger pharma. Pharma's priorities can be shifting at
23:25
Speaker 2: any given time, and so it helps to have larger
23:29
Speaker 2: investors come into the sector and support companies as they're
23:33
Speaker 2: growing up. We want biotechs, the smaller biotechs to become
23:38
Speaker 2: the next.
23:39
Speaker 3: Merk or Lily or a Novo.
23:42
Speaker 2: And so once you have a d risk drug, and
23:45
Speaker 2: you can take a company like Revmed who's had.
23:49
Speaker 3: A breakthrough in.
23:50
Speaker 2: Treating the largest genomic alteration in cancers for raths, and
23:56
Speaker 2: that company now is pre revenue, but it's as of
23:59
Speaker 2: today as a market gap that's north of forty billion,
24:02
Speaker 2: And having that enables a company like Revman not to
24:06
Speaker 2: be dependent on M and A. And the story is
24:11
Speaker 2: de risked now that generalists can understand it, start to
24:15
Speaker 2: model what revenues are going to be.
24:16
Speaker 3: It's a lot more predictable newsflow.
24:19
Speaker 2: So I believe having the general's capital intentionally come in
24:23
Speaker 2: after the clinical data cards and a lot of the
24:26
Speaker 2: volatility has been there really suits.
24:28
Speaker 3: The industry well.
24:30
Speaker 1: I think we'll I think in the coming months we'll
24:32
Speaker 1: be having more conversations about the reforms needed in capital markets.
24:36
Speaker 1: But I love your point that a stronger, healthier IPO
24:40
Speaker 1: market is going to give more power to that up
24:43
Speaker 1: and coming entrepreneur to choose whether M and A is
24:46
Speaker 1: right for them, or to choose whether capital markets are
24:49
Speaker 1: in order for them to be the kind of company
24:52
Speaker 1: scale that can bring a medicine to patients. We are
24:57
Speaker 1: reflecting on history and where different parts of the ecosystem stand.
25:02
Speaker 1: And so I wanted to put to you a curveball
25:05
Speaker 1: sorts of questions. What would a world of biotech, of pharma,
25:11
Speaker 1: of medicine look like without venture capital? Imagine we just
25:16
Speaker 1: didn't have these risk on wide sets of bets. How
25:20
Speaker 1: do things change if there's no VC?
25:23
Speaker 2: I would say that's a scary notion because I would
25:26
Speaker 2: be out of a job.
25:28
Speaker 3: But we keep you not sure I'm qualified to do
25:32
Speaker 3: much else.
25:33
Speaker 2: So in a world without venture capital, it would probably
25:36
Speaker 2: look pretty different than where we are right now. For
25:40
Speaker 2: better or for worse, venture capitalists professional investors are really
25:45
Speaker 2: playing a role in.
25:47
Speaker 3: Capital allocation to biotechs.
25:48
Speaker 2: I think the other areas we're discussing major forces are
25:53
Speaker 2: certainly academic research, academic medicine or where most of the
25:58
Speaker 2: funding comes from the ni H or the NSF. Also
26:02
Speaker 2: bigger pharmas bigger biotechs have their own research units, they
26:07
Speaker 2: would be a lot more influential.
26:09
Speaker 3: In what ends up, you know, getting funded.
26:12
Speaker 2: And certainly we're seeing a trend now where farm is
26:15
Speaker 2: really dependent on those smaller biotechs to fill their patent
26:18
Speaker 2: holes and their pipelines. So without VCS, you would probably
26:24
Speaker 2: get less companies that are formed. So not only as
26:28
Speaker 2: an industry providing capital, we're really involved in the formation
26:32
Speaker 2: of management teams of finding drugs could be in other geographies,
26:38
Speaker 2: taking that academic research and making.
26:42
Speaker 3: That the basis of a company.
26:44
Speaker 2: So what's really great is having our system and having
26:48
Speaker 2: a culture where we foster entrepreneurship. So I would say
26:53
Speaker 2: you would probably see more academic influenced trials that are
26:58
Speaker 2: going on. What's key to the sector though, is drug
27:02
Speaker 2: development is so expensive. It can be in some cases
27:06
Speaker 2: several billion dollars to develop a drug, So we need
27:09
Speaker 2: ways of finding capital to find different ideas, and this
27:15
Speaker 2: can certainly come from pharmaceutical companies and other larger biotechs,
27:19
Speaker 2: but again their priorities might not be consistent with finding
27:24
Speaker 2: the best therapies and the best unmet medical needs and
27:27
Speaker 2: more of a business and larger shareholder driven type strategy.
27:32
Speaker 1: Well, the good news is ben it seems to work,
27:36
Speaker 1: and so I think your job is safe because as
27:40
Speaker 1: we look around the globe, and I spend a lot
27:42
Speaker 1: of time in Europe and a lot of time in Japan,
27:45
Speaker 1: and that role of the VC is weaker, it's not absent,
27:50
Speaker 1: and there's some incredible vcs out of Europe, and Japan
27:53
Speaker 1: is getting its ecosystem going. But I think this is
27:57
Speaker 1: quietly one of the real crown Jews of our ecosystem.
28:01
Speaker 1: Is this forty to fifty billion a year that backs
28:04
Speaker 1: wild bets in the hopes that they pay off. I mean,
28:07
Speaker 1: it's very entrepreneurial, very American. I want to switch gears
28:11
Speaker 1: a little bit because taking another look at your career,
28:17
Speaker 1: I would imagine twenty years ago you didn't necessarily pay
28:22
Speaker 1: a ton of attention to Washington. And one of the
28:25
Speaker 1: themes we've picked up on is that Washington, under the
28:30
Speaker 1: last two administrations play is a bigger actor. They're playing
28:35
Speaker 1: a bigger role in the entire ecosystem. And so I'm
28:39
Speaker 1: curious if you agree with that. Do you find yourself
28:42
Speaker 1: thinking about what's happening in Washington more than you used to?
28:46
Speaker 3: I would say largely, yes.
28:48
Speaker 2: We still paid attention to Washington in previous administrations.
28:52
Speaker 3: You might recall during.
28:54
Speaker 2: The election cycle, I think it's two election cycles ago
29:00
Speaker 2: when Hillary Clinton was running and she had a tweet
29:03
Speaker 2: about drug prices and the stock market ended up freaking
29:06
Speaker 2: out because that became more of an emphasis, So we
29:09
Speaker 2: were trying at that time. I remember we were trying
29:10
Speaker 2: to understand what the implications of that would be. Or
29:13
Speaker 2: during the Biden administration we had the ERA which ended
29:17
Speaker 2: up putting a limit on the exclusivity of small molecules
29:21
Speaker 2: and larger molecules like antibodies, So we were trying to
29:25
Speaker 2: understand those and those can certainly be structural changes. I
29:28
Speaker 2: think what different here is that we're seeing multiple policy
29:33
Speaker 2: initiatives on many different fronts. So that could be bringing
29:38
Speaker 2: pharma and biotech manufacturing back to the US. That's less
29:42
Speaker 2: important in the early stage biotech area. There's certainly now
29:48
Speaker 2: a more emphasis on regulating what's going on in China,
29:51
Speaker 2: and there's a recent initiative to have biotech included in
29:55
Speaker 2: the Coins Act. So yesterday, for example, we were having
29:59
Speaker 2: a call with the policy expert trying to understand that.
30:03
Speaker 2: And probably the biggest thing going on is again the
30:05
Speaker 2: theme of drug pricing, so that we've been really trying
30:09
Speaker 2: to wrap our minds around. An interesting trend is now
30:13
Speaker 2: you're starting to see more direct to consumer so Eli Lilly,
30:17
Speaker 2: for instance, is offering an moral GLP one starting at
30:19
Speaker 2: one hundred and fifty dollars a month. I think that's huge.
30:22
Speaker 2: I mean, in a lot of cases that's less than
30:24
Speaker 2: your iPhone payment. And so that I think is a
30:28
Speaker 2: trend that's going to continue as we're still grappling with
30:31
Speaker 2: higher drug prices. And then lastly, the FDA has gone
30:34
Speaker 2: through a lot of change and there's at the time
30:36
Speaker 2: of this recording, there's still no head of the FDA,
30:39
Speaker 2: and we've been trying to understand what the implications of
30:42
Speaker 2: that are. Largely, there's a lot of headlines and we've
30:47
Speaker 2: kind of quantified this in our portfolio. We're not really
30:49
Speaker 2: seeing too much of a slowdown there, but we've just
30:53
Speaker 2: seen different areas kind of all coming at us at once.
30:57
Speaker 2: So we're trying to make sense of that.
31:00
Speaker 1: I want to come to China in a second. But
31:02
Speaker 1: going back to the IRA under President Biden, you alluded
31:05
Speaker 1: to that small molecule delta, what we call the pill penalty,
31:12
Speaker 1: and I'm curious, when a small molecule gets nine years
31:15
Speaker 1: and a biologic gets thirteen years, did you find yourself
31:20
Speaker 1: more interested in biologics. Does that four years delta in
31:25
Speaker 1: the MPV actually play a role in your decision making.
31:28
Speaker 2: It does, and when that legislation came out, it started
31:33
Speaker 2: it got investors to think about their financial models and
31:36
Speaker 2: how they model small.
31:38
Speaker 3: Molecules versus biologics.
31:40
Speaker 2: So there's really been a trend actually over the last
31:44
Speaker 2: five years, call it when the IRA has been settling it,
31:47
Speaker 2: maybe it's more like four years ago, and investors have
31:51
Speaker 2: been spending a lot of time on biologics and making
31:55
Speaker 2: antibodies to validated targets, or making buy specific antibodies to
32:00
Speaker 2: two different validated targets, or making them more convenient, and
32:04
Speaker 2: all of that is more conducive to having a policy
32:09
Speaker 2: where you have a longer patent life, and so that
32:13
Speaker 2: trend we've definitely observed. I think that's also coupled with
32:17
Speaker 2: the fact that we went through a pretty big rerate
32:19
Speaker 2: of our sector post COVID as interest rates went up
32:23
Speaker 2: and there was a flight to safety, and really antibodies
32:27
Speaker 2: allow you to do that on a very.
32:29
Speaker 3: Fast time scale.
32:30
Speaker 2: There's also China, as you said, we can talk about
32:33
Speaker 2: they're very good at making antibodies.
32:35
Speaker 3: So I think.
32:36
Speaker 2: The confluence of factors there and the irs certainly one
32:40
Speaker 2: of them. We've seen biotech companies favor biologics.
32:45
Speaker 1: It's a concerning one and we do hope, you know,
32:48
Speaker 1: just like we were able to get orphan cures over
32:50
Speaker 1: the finish line in order to incentivize secondary indication research.
32:54
Speaker 1: We're hopeful about the epic act and Cubate definitely leads
32:57
Speaker 1: sort of the fight on fixing the small molecule penalty.
33:00
Speaker 1: So hopefully if we can't get it done this Congress,
33:02
Speaker 1: we get it done so you can get back to
33:05
Speaker 1: weighing small molecules more favorably. But the eight hundred pound
33:10
Speaker 1: gorilla across the Pacific is the topic du jour, and
33:15
Speaker 1: you have been saying some things in our conversations. One
33:20
Speaker 1: aspect we could pull China in so many different directions
33:23
Speaker 1: KSM and APIs I think there's consensus there should we
33:27
Speaker 1: be doing clinical trials over there? I think there's one.
33:29
Speaker 1: But what I want to talk to you about is
33:31
Speaker 1: around licensing and this concept of is licensing technologies out
33:38
Speaker 1: of real Chinese innovation. And I can't tell you enough
33:41
Speaker 1: how many policy makers we really have to explain this
33:45
Speaker 1: is not China stealing ip or just making cheap copycats.
33:50
Speaker 3: This is really.
33:50
Speaker 1: Innovative science and we want to be able or should
33:56
Speaker 1: we be able to license things out so that they
33:59
Speaker 1: can be avail here. I know you have some thoughts
34:02
Speaker 1: on that, in particular where the value ends up being creative.
34:05
Speaker 1: So as as Treasury and as Congress debate should we
34:11
Speaker 1: be in licensing innovation out of China? Curious what you think?
34:16
Speaker 2: Yeah, this is a very active debate right now. I
34:20
Speaker 2: would say it is a complex issue. You can look
34:24
Speaker 2: at it from both sides. Right you can say a
34:27
Speaker 2: lot of pre clinical development has been shifted to China.
34:30
Speaker 3: So we have a.
34:31
Speaker 2: Number of our portfolio companies that end up doing small
34:34
Speaker 2: molecule work at CROs or they end up doing toxicology
34:38
Speaker 2: studies in China, and the reason is it's just much
34:42
Speaker 2: cheaper to do that. It can be upwards of eighty
34:45
Speaker 2: percent cost difference depending on what you're doing. So there
34:49
Speaker 2: is an argument that you could get some job shifting
34:52
Speaker 2: to China, primarily through pre clinical development. And there's a
34:58
Speaker 2: risk if you have all of your menu actoring in
35:00
Speaker 2: China that.
35:03
Speaker 3: You know, the US could be at a disadvantage in
35:05
Speaker 3: certain situations.
35:07
Speaker 2: I think what's lost in the argument is that when
35:10
Speaker 2: you have a licensing transaction occur in China, and these
35:14
Speaker 2: can vary from you know, double digit millions sing single
35:18
Speaker 2: digit millions upwards to hundreds of millions of dollars. When
35:21
Speaker 2: you get a pharmaceutical company involved, that evolves bringing that
35:25
Speaker 2: drug back to the US. And the reason for that
35:28
Speaker 2: is because the FDA mandates that fifty percent of the
35:32
Speaker 2: patients in clinical trials are in the US. And so
35:36
Speaker 2: what has happened in our experience is we would go
35:39
Speaker 2: through a licensing transaction. It can even be from a
35:42
Speaker 2: company that's incorporated in the Cayman Islands but as a
35:44
Speaker 2: research operation in somewhere like Shanghai. We then incorporate a
35:49
Speaker 2: US company, We hire a US based management team, and
35:53
Speaker 2: then they they prosecute clinical development primarily in the US.
35:58
Speaker 2: So you can end up spending you know, low double
36:01
Speaker 2: digit millions for the licensing and then you could spend
36:03
Speaker 2: half a billion dollars to do the development in the
36:06
Speaker 2: US or otherwise that might not happen because there would
36:09
Speaker 2: be a cost.
36:10
Speaker 3: Barrier to making that drug.
36:13
Speaker 2: And when you kind of look at the math from
36:16
Speaker 2: a venture capitalist point of view, everything's gotten more expensive
36:19
Speaker 2: in the US. We've had inflation happen in the biotech industry,
36:24
Speaker 2: especially in non clinical areas, so we have to raise
36:29
Speaker 2: more capital. As a consequence, we own less of the company. Historically,
36:33
Speaker 2: venture capital has been a harder asset class than public investing,
36:37
Speaker 2: and so we've found that China has been incredibly enabling
36:43
Speaker 2: to bring medicines to the US, to enable drug development
36:47
Speaker 2: here and as a result, you get a lot more
36:50
Speaker 2: hiring going on. You then fulfill the requirements for these
36:55
Speaker 2: companies to get acquired by larger pharmaceutical companies, which again
36:59
Speaker 2: can lead to more or spend in the US, especially
37:03
Speaker 2: as you end up commercializing here.
37:05
Speaker 1: Can I ask you about that latter point, because you
37:08
Speaker 1: make a really good point. Okay, you pay twenty million
37:11
Speaker 1: upfront in China that goes to a Chinese entity or
37:14
Speaker 1: the Caymans entity. But you can argue that China benefits
37:17
Speaker 1: from that upfront deal. But then it gets brought over
37:21
Speaker 1: here and you're spending hundreds of millions, half a billion
37:26
Speaker 1: with US workers teams. So there's the economic gains there.
37:32
Speaker 1: But let's say Foresight does have a sizable percentage in
37:35
Speaker 1: a new co that eventually gets acquired and it's a
37:39
Speaker 1: multi billion dollar windfall for that company. The acquirers happy,
37:47
Speaker 1: what's for Foresight's now going to return to investors. But
37:51
Speaker 1: in theory you're going to redeploy that capital and start
37:54
Speaker 1: the whole thing over. But the value and your investors,
37:58
Speaker 1: your LPs, A lot of that's going to stay in
38:00
Speaker 1: the US.
38:01
Speaker 2: I would think, Yeah, almost all of our LPs, or
38:04
Speaker 2: the largest percentage, are based in the US, So you're
38:07
Speaker 2: absolutely right, John, that money will get recycled in a sense,
38:11
Speaker 2: back into investing, and then you know we're doing things
38:14
Speaker 2: besides China. Obviously, I'd say it's a relatively small percentage
38:17
Speaker 2: of our strategy still, but yeah, that's that's the mechanics
38:23
Speaker 2: of that are correct. We have an acquisition, more money
38:26
Speaker 2: goes back to our LPs. Those LPs are putting that
38:28
Speaker 2: exposure back into biotech, or we could be in the
38:31
Speaker 2: early part of our fund where we're still investing, we
38:34
Speaker 2: have an early exit, we can redemploy that money back
38:37
Speaker 2: into the same strategy we're using.
38:39
Speaker 1: Well, I really appreciate you voicing this. It is it's
38:43
Speaker 1: an ongoing debate. It's a good discussion, to be sure,
38:46
Speaker 1: but I think every time someone like you says, here's
38:50
Speaker 1: how it actually happens in practice, both US and policy
38:54
Speaker 1: makers get smarter and in theory work towards a more
38:56
Speaker 1: informed decision. After the coins REGs drop in the coming hours, weeks, days,
39:03
Speaker 1: we'll see we'll be sure to have you back on
39:05
Speaker 1: and unpack those further. You've been incredibly generous with your time,
39:09
Speaker 1: but I do want to I want to close with
39:11
Speaker 1: one last question. You've got a pretty storied career. It'd
39:15
Speaker 1: be tough to pick one trophy off the wall, but
39:18
Speaker 1: I'm curious, is there a particular deal or medicine or
39:24
Speaker 1: activity that you were a part of that you maybe
39:28
Speaker 1: it is in your favorite but one that that makes
39:30
Speaker 1: you really proud of what you and your team accomplished.
39:32
Speaker 2: We had an exit this year in a company called
39:35
Speaker 2: Candid Therapeutics, and it was a very interesting transaction. It
39:39
Speaker 2: ended up being a licensing based strategy where we license
39:44
Speaker 2: to clinical stage assets actually from China and a third
39:49
Speaker 2: clinical stage asset from a cro that was partially based
39:53
Speaker 2: in China. And it all started. Our team was looking
39:57
Speaker 2: at innovation in the field of carti therapy, and cart
40:02
Speaker 2: therapy has had remarkable advances in oncology and it started
40:07
Speaker 2: becoming a force really in autoimmunity and this became it
40:13
Speaker 2: started to become apparent. There was a key result that
40:16
Speaker 2: came from Georg Chet's lab out in Germany where he
40:20
Speaker 2: repurposed CD nineteen targeting car T cells and autoimmune indications
40:25
Speaker 2: like lupis, and the results, frankly were stunning. We were
40:28
Speaker 2: seeing long term, durable remissions in patients who otherwise using
40:33
Speaker 2: standard therapies, would never achieve that result.
40:36
Speaker 3: And the concept's quite simple.
40:37
Speaker 2: The cartes cells are attacking the auto antibody secreting B cells.
40:42
Speaker 3: We saw this very early on and.
40:44
Speaker 2: It occurred to us that cart has certain challenges, especially
40:48
Speaker 2: in the rheumatology field, so you would likely need a
40:52
Speaker 2: medical oncologist to administer cart and we started looking at
40:56
Speaker 2: other modalities and one that came to mind was in
40:58
Speaker 2: the area of t celling. T cell engagers are somewhat
41:03
Speaker 2: similar to car T where you can target an an
41:06
Speaker 2: egen on a disease causing B cell, but you can
41:09
Speaker 2: also recruit T cells and this got away from all
41:13
Speaker 2: the challenges of car TE where you're giving a patient
41:17
Speaker 2: preconditioned chemotherapy. They have to have their sales engineered x vivo.
41:22
Speaker 2: It's somewhat cumbersome, can involve on a hospital state, and
41:25
Speaker 2: T cell engagers are in concept and antibody that's off
41:29
Speaker 2: the shelf you can give to patients. So we saw
41:31
Speaker 2: this very early, and then we went on an exhaustive
41:34
Speaker 2: search looking literally at hundreds of companies in the US
41:37
Speaker 2: and Asia looking for T cell engagers that we could
41:40
Speaker 2: repurpose into autoimmunity.
41:43
Speaker 3: So we ended up.
41:43
Speaker 2: Finding two assets that we had clinical data. One was
41:48
Speaker 2: at a company called Epimap and the other was at
41:50
Speaker 2: a company called Genre. And as we were assembling the company,
41:54
Speaker 2: we ended up really serendipitously running into the X raised
41:58
Speaker 2: Bioteam had just sold our company for over four billion
42:02
Speaker 2: to BMS. The CEO of that company, Ken Song, was
42:06
Speaker 2: looking for his next venture. He also had the realization
42:10
Speaker 2: that T cell.
42:11
Speaker 3: Engagers could be an important modality here, and Ken ended up.
42:15
Speaker 2: Bringing back his entire team and partnering with us here.
42:20
Speaker 3: And they're really an exceptional group. You know.
42:23
Speaker 2: Even Ken's CFO Arvind Kush, is exceptional. Their CMO, tim Lu,
42:30
Speaker 2: actually came from Dice that that got acquired, and so
42:33
Speaker 2: we really had the A team here and they were
42:35
Speaker 2: instrumental in pulling this all together. So from a transaction
42:38
Speaker 2: point of view. We took these three assets, we had
42:41
Speaker 2: them in three different companies, and we simultaneously raised about
42:45
Speaker 2: four hundred million dollars and can currently did a merger
42:48
Speaker 2: of all three companies, and then we rapidly built out
42:53
Speaker 2: the company. So Ken and team had a vision where
42:55
Speaker 2: they could prosecute clinical development worldwide that included China, the US,
43:01
Speaker 2: Europe to rapidly get clinical data and the execution speed
43:06
Speaker 2: here was incredible.
43:07
Speaker 3: So we formed the company.
43:08
Speaker 2: Within two years, we generated over fifty patients of data
43:13
Speaker 2: and Autoimmunity saw really striking results and that.
43:16
Speaker 3: Led to the culmination of the company getting acquired.
43:19
Speaker 2: By UCB earlier earlier this year for about two billion
43:22
Speaker 2: up in front. So I wish it was that easy
43:25
Speaker 2: for all of our companies, but you know a lot
43:27
Speaker 2: of I would say the stars align there for us.
43:30
Speaker 1: I was going to say that is of all the
43:31
Speaker 1: deals I hear on this show and out in the field,
43:35
Speaker 1: that one was very linear. That is how you would
43:37
Speaker 1: write the book on doing this with some serendipity mixed in. Michael,
43:42
Speaker 1: incredibly grateful for you joining us, Really glad you're doing
43:45
Speaker 1: all of this in LA and you're flagging the burgeoning
43:48
Speaker 1: activity going on there. If only that, because that means
43:51
Speaker 1: we probably get to visit a little more often and
43:54
Speaker 1: get some of the sunshine. So I'm absolutely really pleased
43:57
Speaker 1: you were able to join us. Thank you again, thanks
44:00
Speaker 1: for having me John. That wraps up this episode of
44:03
Speaker 1: the Making Medicine Podcast. A special thank you to Michael
44:06
Speaker 1: for joining us on today's episode and that incredible walkthrough
44:10
Speaker 1: of a day in the life of being a VC.
44:12
Speaker 1: Be sure to subscribe on YouTube and follow us on
44:14
Speaker 1: other channels for all the episodes of How America Makes Medicine.
44:18
Speaker 1: Thanks for listening, and as always, keep innovating.