# Episode 170 - January 23, 2026

An episode of [Biotech Hangout](https://invisiblenetwork.ai/podcast/1568911820), 23 Jan 2026, 59 min.

Audio: https://anchor.fm/s/55bdff38/podcast/play/114460801/https%3A%2F%2Fd3ctxlq1ktw2nl.cloudfront.net%2Fstaging%2F2026-0-23%2F416713804-44100-2-6b5132d7c4fb.m4a

On this week’s episode, Grace Colon, Tim Opler, Graig Suvannavejh, and Eric Schmidt kick off with an overview of Tim’s “The Case for Optimism” report, highlighting that macroeconomic conditions will need to stabilize and that M&A is likely to be significant in the coming year. The group also notes how quickly things can shift in biotech, citing recent inconsistencies at the FDA. Next, the co-hosts discuss the reopening of the IPO market after a quiet period, and how this could reshape M&A dynamics and company valuations compared to when acquisitions were the primary exit route. The conversation then turns to recent deals, including GSK’s $2.2B acquisition of RAPT Therapeutics for its next‑generation food allergy drug and Janux Therapeutics’ up to $850M cancer collaboration with BMS. On the policy front, the co-hosts cover the United States’ official withdrawal from the WHO and the FDA’s new draft guidance outlining how minimal residual disease and complete response could support accelerated approvals in multiple myeloma. They also highlight Corvus Pharmaceuticals’ positive Phase 1 results in atopic dermatitis and the company’s stock jump. Tim closes the episode by discussing his recent women’s health report and the growing interest and investment in the space. *This episode aired on January 23, 2026.

## Transcript

[0:00] You're listening to Biotech Hangout alive and unedited
[0:03] weekly discussion of all the latest news in our industry with
[0:06] a group of biotech leaders and experts.
[0:08] I'm Grace Cologne and my Co host today are Tim Opler, Greg
[0:11] Sivanovich and Eric Schmidt. For more information about our
[0:15] hosts and guest speakers or to listen to the most recent
[0:17] episode, please go to biotechhangout.com.
[0:21] I hope everyone has recovered from a busy and fun week at JPM.
[0:25] And it was sunny and nice, a little cold.
[0:28] And I hope that many of you were able to make it to the hangout
[0:30] event. I didn't get there until very
[0:32] late, so I heard most of the Co hosts that were there had left.
[0:35] But I hope to make it earlier. But it was super packed and
[0:39] we'll have another one next year.
[0:40] And also please join us, those of you who joined Pink Day on
[0:45] the Tuesday, it was phenomenal. We had hundreds and hundreds of
[0:49] people show up, including a lot of allies.
[0:51] So please mark your calendars for the Tuesday of JPM next year
[0:54] and join us for that as well. So let's get started with Tim.
[0:59] Tim, it's always a pleasure to have you on.
[1:02] I think many of us devour your weekly reports and there's been
[1:07] a couple already this year that were very, very interesting and
[1:12] very timely with what everything's going on.
[1:15] So I think we're going to start and set the stage with the one
[1:18] you released a couple of weeks ago, which was the biotech case
[1:22] for optimism and obviously after a brutal flu a few years with
[1:26] XPI up more than 30% now M&A is back, capital markets reopening,
[1:33] I'd love to hear and I'm and share with the audience your
[1:36] perspective. Grace, thank you very much and
[1:40] happy to do that. Maybe just a comment a little
[1:43] bit on sort of what's happened in the last few weeks and then
[1:46] we can dive into the report. You know, the XPI is up 5% this
[1:50] year. We've had extraordinary flow of
[1:54] financing activity. The amount of M&A rumors like
[1:58] this Monday was unprecedented, like there were like 5 or 6
[2:01] different M&A rumors on the tape.
[2:05] The actual volume of M&A this year has not been that high.
[2:08] So, so far we've seen $6.7 billion in deals including three
[2:13] biotech takeouts which were the RAP takeout this week, the
[2:17] Ventix take out by Lily and also dark blue was acquired by Amgen.
[2:22] The biggest M and a deal this year was his admits who's go
[2:25] private for 2 1/2 billion dollars.
[2:28] If you actually kind of annualized the pace of deal
[2:31] activity so far this year be less than half of last year's
[2:35] piece. So we're all sort of watching,
[2:38] you know, what's going to happen to companies like Rev Med.
[2:41] You know, I'm personally, and I'm not an insider, just to be
[2:44] clear. I'm personally not so sure that
[2:46] Rev Med gets bought anytime soon.
[2:48] It's an incredibly high price tag that, you know, the company
[2:51] will go for. And so, you know, buyers have to
[2:54] think very carefully before they pull that trigger.
[2:57] At the beginning of the year, we published a piece arguing for
[3:01] optimism and biotech. And what that means practically
[3:04] speaking is, you know, at the time I wrote the report, XPI was
[3:08] around like 122. Now it's up at 1:30.
[3:12] I sort of said, hey, I think it's going to go over 150 this
[3:15] year, but that's really just the beginning.
[3:18] I personally think biotech could go much higher.
[3:21] And you know, I'm not the one to predict, you know, biotech is
[3:24] going to go up so much next week or whatever.
[3:26] It's hard for any one of us to know, but you know, the reasons
[3:32] that I think we all talk about for optimism are twofold.
[3:35] The first is that macro is under control and the second is that
[3:39] M&A was high last year and is likely to be high this year.
[3:44] So just to comment a little bit on the M and A1 of the things we
[3:47] wrote about in the report is that pharma has at least a $90
[3:51] billion revenue hole that is, you know, needs to be covered by
[3:57] M&A that is can't be covered by pipeline.
[4:01] The average M and A deal last year took place at 6.5 times
[4:06] forward revenue and I define forward revenue at the time as
[4:08] 20-30 revenue. So last year pharma spent $90
[4:13] billion. So if you do the math, pharma
[4:15] covered less than 1/6 of the revenue hole with M&A that
[4:20] happened last year. So they have a lot more to do
[4:24] and if anything, I would expect M&A to be busier this year than
[4:28] last year. Other factors that people need
[4:31] to talk about that are very important and certainly causes
[4:34] of uncertainty of what's happening with the policy
[4:36] environment. And you know, every day is an
[4:38] interesting day with this administration and you know, I
[4:43] think it's important to keep an eye on valuation.
[4:45] So at some point valuations get high enough that, you know,
[4:49] people aren't going to go out and buy as aggressively and, you
[4:52] know, maybe the it's time for the market to go the other way.
[4:55] In the report we put out, we argued that valuations are still
[4:58] very much under control. And so we looked at sort of that
[5:01] 6.5 times revenue sort of purchase and sort of where's the
[5:06] market now. So the typical company is still
[5:08] trading at sort of, you know, roughly half that benchmark.
[5:12] And so I think there's still plenty of room to run.
[5:15] Our big argument though in the report is that markets have just
[5:19] gotten bigger. And so if you go back in history
[5:21] and sort of look at when did we have bull markets and biotech,
[5:24] what you'll see is that when there are big changes in the
[5:27] underlying drivers of the market, that's when you saw the
[5:32] market take off. And so the big time that that
[5:35] happened is really when other companies started adopting
[5:39] Genzymes model of charging much higher prices.
[5:42] So you know, back in the day, oncology drugs didn't cost
[5:45] $200,000 a year, they cost $20,000 a year.
[5:48] And then, you know, the market took off when people started to
[5:51] reprice those. So the big event, I think
[5:54] perhaps the biggest event to hit the Pharmaceutical industry in
[5:59] recent years was the agreement last year between Eli Lilly
[6:03] Noble in the Trump administration, where the Trump
[6:06] administration put out this press release saying, hey,
[6:09] Medicare, Medicaid, you're going to get such a bargain.
[6:12] You can now buy your Bonjaro or your Ozempic for $4000 a year.
[6:19] Well, if you do the math, they just agreed in theory to fork
[6:24] over, you know, hundreds of billions of dollars to the
[6:27] Pharmaceutical industry. That's great for obesity.
[6:30] But what I thought was so interesting and so important is
[6:34] that the government essentially just ratified a new price
[6:37] benchmark for drugs for large markets.
[6:40] So in the report, I call this sort of, you know, large
[6:45] markets, medium prices as opposed to small markets, high
[6:48] prices. And I think that trend is going
[6:51] to reshape our industry for like a decade to come.
[6:54] And so that's the real reason I'm optimistic.
[6:57] I think the macros to some degree has been priced in, think
[7:00] the M&A to some degree has been priced in.
[7:02] But what people have not got their arms around is that our
[7:05] industry is just going to be a lot bigger, a lot more
[7:08] successful in the future due to changing pricing regimes.
[7:14] Those are super helpful perspectives.
[7:16] And in particular, it'd be great to see more focus on, you know,
[7:21] large scale treatments for chronic diseases, especially
[7:24] complicated ones with a lot of comorbidities like we see with
[7:26] the GLP ones. We're starting to see other
[7:29] benefits, right, in terms of it'd be beyond diabetes and
[7:33] obesity. And so it'll be interesting to
[7:35] see that data emerge and it would be great to get more
[7:38] coverage. It'll save, it'll save money in
[7:41] the long term, obviously. So Eric, I know you had some
[7:46] comments on this and you wanted to have a bit of a, a bull and
[7:50] bear debate on the sector. So we're going to spice things
[7:53] up a little bit. Do you want to add your
[7:55] comments? Well, yeah, thank you, Grace.
[7:59] You know, first let me just say kudos to Tim.
[8:02] I I love reading his stuff. He writes with such clarity of
[8:05] thought and precision language that the concepts are, are so
[8:10] well communicated. And I'm also going to give him a
[8:11] shout out. I, I remember reading a piece of
[8:13] his, I think it was in mid 2025, about six months ago, that was
[8:18] similarly bullish and, and laid out a very, very positive
[8:22] outlook for stocks in the sector.
[8:23] And of course, you know, the XBI has gone nothing but, but
[8:27] straight up from them that from that point in time.
[8:29] So, you know, not only is he, he doubling down, but he deserves
[8:33] to take a, a victory lap for, for being very, very spot on
[8:36] correct over the last six months.
[8:38] I'll also share that I, I generally share Tim's view of
[8:42] positivity. I mean, I, I could even one up
[8:44] him here and, and call out that I, I, I think the XBI is going
[8:49] to end up maybe in the 150 plus range this year.
[8:53] I, I don't see any signs, at least from where we sit today.
[8:58] Now the year is still long and we've no one biotech things can
[9:01] turn on a dime. But I, I agree with him from
[9:04] where we said we're, we're seeing, you know, in particular,
[9:07] good fundamentals, very, very positive fund flows.
[9:10] And I would agree the pricing dynamic is under appreciated and
[9:16] and favorable. So with all that said, what,
[9:18] what am I worried about? What, what could go wrong?
[9:21] Well, there are some things that, you know, we, we
[9:23] definitely need to be mindful of the FDA is in a really, I think
[9:27] tumultuous place. We even saw last week again, a a
[9:32] complete response letter. I'm, I'm thinking of the one
[9:34] that Atara received for tab cell.
[9:37] This is a cell therapy that's been through the works,
[9:42] seemingly treats a a rare and severe oncologic indication that
[9:47] has no therapies and was on the cusp of approval prior to Vinay
[9:52] Prasad inserting himself into the discussion and and derailing
[9:56] it. So, you know, any time that an
[9:59] agency like this is responsible for approving new drugs is
[10:02] acting this erratically and and potentially on the cusp of, you
[10:08] know, almost imploding on itself.
[10:10] As we've talked about time and time again on this call.
[10:13] I think that's extraneous risk that that is very, very
[10:17] important to, to not gloss over. You know, Tim mentioned the
[10:22] Trump administration and the deal that was signed with Lily
[10:25] Novo. I, I, I think we've seen now,
[10:28] even for a longer period of time, launch prices of new drugs
[10:32] come out at higher and higher and higher levels.
[10:34] So I agree with him. We've set new standards for, you
[10:38] know, sort of medium sized markets and, and even smaller
[10:41] markets. Everything is being priced for
[10:43] billion dollar blockbuster peak potential success these days.
[10:48] But how long can that really go on for, right?
[10:51] So are we really able to count on the Trump administration to
[10:55] maintain its its side of these bargains to not go back and, and
[11:00] reopen the MFN debate there? There's almost still weekly
[11:04] dialogue about whether, you know, MFN is is now behind us or
[11:08] still in front of us. And of course, if we get into a
[11:11] period election cycle and in the mid cycle elections where Trump
[11:16] feels like he's losing the population's favor and the drug
[11:19] pricing is an issue, I think all bets are off.
[11:22] We could completely reopen that can of worms.
[11:24] That would be, you know, another very substantial threat to the
[11:28] industry. The last thing I'll say is
[11:30] China. You know, I think Tim argues
[11:32] that China can be a good or or bad thing for industry and I'm
[11:37] not sure I have a strong view on that.
[11:39] I would just say it's potentially disruptive force.
[11:42] It's a new thing for our industry.
[11:44] And I think we just need to be mindful that that what we think
[11:49] about biotech drug discovery, what we've considered it to be
[11:52] for the last 30 or 40 years, having the whole panoply of
[11:57] preclinical into clinical development activity sourced out
[12:00] of the United States. That's that's changed.
[12:02] And and it may not be, you know, necessarily all the time a good
[12:06] thing for the US based industry. So I'll pause there.
[12:10] I've taken up probably too much time and and would love to hear
[12:13] Grace your and Greg's views on this.
[12:15] Yeah. Greg, do you want to go first?
[12:18] Yeah. I mean, first of all, it's great
[12:20] to be back on this podcast, an honor to be on.
[12:26] And in terms of the broader market, I mean, let me, I'll
[12:29] just add a few comments just on the broader market.
[12:33] Certainly, I do think I will agree with both Tim and also
[12:37] with Eric about fundamentals being in a good place.
[12:42] You know, the sentiment is so important in this sector and we
[12:48] finally over the past, let's call it maybe six months or so
[12:52] are in a place where I, I do feel that from my conversations
[12:56] with the buy side, you know they are looking positively again at
[13:02] biotech and this is beyond the biotech specialists.
[13:06] I do think we're going to have a good year in biotech for all the
[13:09] reasons that were mentioned previously.
[13:11] I do think also, while geopolitical factors and, and
[13:18] maybe FDA risk are certainly going to be a factor in the
[13:22] performance of the sector this year, I do also think that if it
[13:28] is indeed an important thing for the current administration to
[13:35] continue to look to lower interest rates, that can only
[13:39] help with the narrative. And I so you know, for, for the
[13:43] innovation reasons for the progress that we're seeing, good
[13:47] fund flows, companies being able to announce positive data sets
[13:51] and then raise, you know, nicely around those data events.
[13:56] And many of those deals get upsized deals, you know, right
[14:00] now seem to be subscribed anywhere from 4 to 10 times
[14:04] depending on the deal. I do think that we're going to
[14:07] have a very another very good year in biotech.
[14:12] Fantastic. And and I have a question for
[14:14] you guys. Piece of we hear a little bit of
[14:16] debate back and forth on this. Given that the IPO markets seem
[14:21] to be opening up, knock on wood, do you think that will it used
[14:25] to be a complete buyer's market with respect to the M&A because
[14:28] companies didn't have other options.
[14:31] So maybe they, they were sold because they couldn't, you know,
[14:34] great data obviously, but they, you know, they, they might have
[14:37] had other options where the markets open with that going on.
[14:40] Is that going to change the dynamics and maybe the
[14:42] valuations for the M&A or just because you know companies will
[14:46] try to move before companies can get out?
[14:51] I do think that supply of IP OS is always something to keep an
[14:54] eye on and you know, some IP OS can be really good for the
[14:58] market and others maybe not so good.
[15:00] And what I mean by that is, you know, not all IP OS are of the
[15:04] same quality. And so if you look at the
[15:07] calendar of stuff that's coming up, there's some very good
[15:09] companies, but they're not all great.
[15:11] Some of the companies are going public kind of like they have to
[15:14] go public and you know, the very best IPO candidates that are
[15:19] sort of out there. So think of like a company like
[15:21] Candid, they're not going public this month or next, but to my
[15:25] knowledge. And so I guess I think the best
[15:30] is yet to come in the IP OS. I do worry a little bit that,
[15:33] you know, there's like 100 plus companies go public, that a
[15:37] couple of, you know, belly flops get out there and then the
[15:40] market starts to feel a little shakier.
[15:42] So I hope that doesn't happen and you know, we'll see how the
[15:46] the market trades the next couple months.
[15:51] And thanks to anyone else. Maybe I'll just say that I do
[15:57] get the sense from where I sit and Greg can comment too that
[16:00] there are a lot of companies that are gearing up for IP OS.
[16:04] I think that we saw the active steel price and price well and
[16:08] and trade at least initially fairly well here.
[16:11] So that has spurred a lot of companies to at least begin the
[16:16] process. It can be a 3456 month process
[16:19] as we all know, and we're seeing a lot more companies in the last
[16:22] two or three weeks start that process and get ready to go.
[16:25] I, I agree with Tim's views that the first tranche may not be the
[16:29] best. In fact, you know, if you're a
[16:31] venture investor and you have what you think is a surefire
[16:34] winner, you'd probably don't want to take the risk of a, a
[16:38] shaky IPO. Many of these IP OS are going in
[16:40] the early part of 2026 or probably holdovers from 2025 in
[16:45] fact and couldn't get out in a choppier market and are now you
[16:48] know still on file or near file and and trying to make a go of
[16:51] it in 2026. So agree 100% with that view
[16:54] that we need to be mindful of quality.
[16:57] On the other hand, I'd say the bigger picture here and this is
[17:00] something that my my colleague Josh has I think talked about in
[17:03] the past, we really haven't had an IPO market for three or four
[17:07] years now. There, there's been almost no
[17:09] possibility of good quality companies going public.
[17:13] They've been really captivated in the private market and and
[17:20] forced to mature in the private market.
[17:22] Many cases forced to go through Phase 2 proof of concept
[17:26] milestones that, you know, historically we tend to see read
[17:30] out in the public markets. So the fact that there has been
[17:33] a roadblock on many IP OS and and that venture investors have
[17:38] been sort of forced to take on the risk of, of binary events,
[17:42] at least from where we stand at Cantor, we see a lot of well
[17:46] seasoned mature companies that have proof of concept behind
[17:51] them that I think are going to be very, very attractive to
[17:55] public market investors. And and the other thing is their
[17:57] valuations are still coming at a very attractive level.
[18:01] We, we haven't seen the private funders flush with cash bidding
[18:06] these companies up because there hasn't been a public IPO market
[18:09] to to guarantee exits on. So many of the last rounds have
[18:13] been down or flat rounds. And relative to where publicly
[18:16] traded companies are in their valuations, I think many of
[18:20] those private companies have the potential at least to come to
[18:22] the market at a valuation that allows for a lot of public stock
[18:27] price appreciation. So from those two angles, from
[18:31] the fact that we're seeing more mature companies and that are
[18:33] priced potentially very attractively, I think this could
[18:37] be a really wonderful IPO window with the caveat that we need to
[18:41] maintain our quality screen. I'll add that I think it was
[18:48] maybe 2 months ago that I was a guest on the Biotech Hangout and
[18:53] I was part of a very spirited conversation with Paul Matisse
[18:59] at Stifel and and Josh over at Cantor about trying to predict
[19:03] the number of IP OS that we might see in 2026.
[19:09] We were talking about over and under numbers and I think Paul
[19:14] had let off with, you know, maybe 15 and then Josh came out
[19:19] immediately and said I think it's going to be 50.
[19:21] I came out somewhere in the middle and, and, and I'm hopeful
[19:25] for 20 to 25. You know, my bank doesn't have
[19:28] the visibility that Eric's bank has maybe on the IPO pipeline
[19:34] and backlog. But I do think it's really
[19:36] important to think about a couple of things from an
[19:39] investor perspective and particularly from the generalist
[19:44] investor perspective. We really big picture want to
[19:49] see, you know, very solid issues come out.
[19:54] Do you risk names, and they're likely to be later stage names,
[19:58] Maybe they have phase two, maybe even phase three data already in
[20:01] hand or somewhere in that? Life cycle and we want to see I
[20:09] think you know a really disciplined market because we we
[20:14] do want a very good 2026, but we also want a very good 2027 and
[20:19] 2028. And I think big picture fears
[20:24] might be that if we do have a window that is wide open that
[20:29] there might be understandably maybe from a banker perspective
[20:33] and from a private company perspective a rush to get out.
[20:36] But I worry about, you know, what we saw from the 2020 to
[20:41] 2021 period where it became a little bit bubblish.
[20:44] Valuations at the height were very not disciplined at all.
[20:51] And with that said, I do think that if we can keep the number
[20:56] of IP OS within reason so that it sets up the market for
[21:00] success and pulled through to 2027, I think that would be
[21:03] really important. Great.
[21:04] Well, thanks for your perspectives.
[21:06] We'll keep our fingers crossed. Let's go to deals.
[21:09] So Eric and Greg, yeah, I think you both wanted to cover the GSK
[21:12] and the BMS deals announced this week.
[21:15] Why don't we start with the GSK 1, Eric or Greg, who wants to go
[21:18] first? Eric.
[21:22] Do you want me to? Take that.
[21:23] Go ahead, Greg. The GSK deal.
[21:26] OK, great. Yeah.
[21:27] So we saw a really interesting deal this week where Glaxo Smith
[21:30] Kline announced A definitive agreement to acquire Wrapped
[21:37] Therapeutics. It's a publicly traded biotech
[21:40] company working in the allergy space.
[21:43] You don't see a lot of deals in the allergy space.
[21:45] This is a long acting anti IGE antibody.
[21:49] Everyone may be familiar with the drug Zolair, which has been
[21:53] on the market for quite some time.
[21:55] That is a drug that is injected every two to four weeks.
[22:00] I think the differentiation of what Wrapped is developing and
[22:05] again, this is also an anti Ige is it?
[22:07] It's an injection that can be done perhaps once every 8 to 12
[22:11] weeks. You know, it was a very healthy
[22:14] premium. I believe it was around 6065%
[22:19] premium to where Wrapped was trading the day prior.
[22:22] And again, the acquisition price was in total consideration a
[22:27] little over $2 billion. It is very strategic for GSK.
[22:32] They are, you know they have quite a nice presence and kind
[22:35] of like the immunology space. It is interesting we haven't
[22:39] seen too many deals as I mentioned in the allergy space.
[22:41] I did one point in time in my career cover a peanut allergy
[22:46] company called DBV Therapies. They are still trying to get a
[22:51] peanut allergy product approved. It's more of a patch versus an
[22:57] injectable. And I do think that they've had
[23:01] to run a few more clinical trials and they originally had
[23:04] it hoped, but I think they are looking to refile a BLA sometime
[23:09] in the first half of this year. But prior to that, we did see
[23:12] Nestle by a company called a Immune Therapeutics and that
[23:17] that was a pretty hefty deal way back when.
[23:21] That might have been a $2 billion deal that was announced
[23:24] sometime in, let's call it the 2020 time frame.
[23:29] It's interesting. That's also a peanut allergy
[23:31] therapy. But I think what ended up
[23:36] happening after Nestle acquired the asset is that a couple years
[23:40] later they ended up divesting this peanut allergy therapy and
[23:45] they didn't disclose the sum. So that end up being a
[23:48] disappointment. But I do think that with GSK
[23:51] acquiring wraps and given that Zolair is a very established
[23:56] product, I think that can be a very good product.
[23:59] I don't, I don't cover wraps. I don't know what you know the
[24:01] data personally, but a very good deal to keep the M and A train
[24:06] going in for biotech. Yeah.
[24:09] I think the other really interesting thing here is the
[24:11] history. Many of our listeners will
[24:13] probably know that that rapid says sort of a torturous,
[24:19] torturous history since it went public a few years back and it
[24:23] actually went public on a CC RX4 inhibitor that failed in the
[24:27] clinic due to liver toxicity. I think that was being developed
[24:31] for atopic derm and they found this asset, they now call it Ozu
[24:36] repro art out of China. So this deal that wrapped is
[24:41] being acquired for for $2.2 billion around the GSK
[24:45] relationship. That asset is coming from China
[24:49] in a, in a transaction that wrapped consummated in December
[24:53] 2024 and they paid only $35 million upfront for this asset.
[24:59] So great turn of events for this company.
[25:03] They've not done anything with this asset since in licensing it
[25:07] a little over a year ago. The Chinese company that that
[25:10] did the initial discovery and development of the asset did
[25:14] have some additional data. So I guess that's the reason why
[25:18] a drug that was acquired for $35 million upfront 13 months ago is
[25:22] now now worth over 2.2 billion. But you know, a nice, nice turn
[25:26] of events for this company and this management team and this
[25:28] shareholder group and just shows you that biotech always has
[25:32] another life. Yeah, kudos to CEO Brian Wong
[25:37] and and Board Chair Lori Lyons Williams, who's also CEO of
[25:41] EBDARA. This team has, like you said has
[25:43] really turned it around. So very exciting.
[25:47] Tim, any comments on that deal before we move to the BMS one?
[25:50] I'll. Make a slightly different
[25:53] comment, which is, you know, again coming to the backdrop of
[25:56] biotech. Rapt is a company that had sort
[26:01] of some bad data and they pivoted and they pivoted with
[26:04] great results and great success. I cannot tell you how many
[26:08] companies as a banker I've talked to the last three or four
[26:11] years that they just wouldn't pivot.
[26:14] They needed a pivot and they wouldn't.
[26:17] And investors are also very hesitant to get on board with
[26:23] these pivots and so on when they happen.
[26:24] So there's a, there's a lot of nervousness about it.
[26:27] And if you look at the history, pivots really work.
[26:30] One of the things that was kind of buried in my report in
[26:33] January was if you'd looked at companies that had great data in
[26:39] 2022 and converted to companies like RAP that didn't have great
[26:44] data, you would have been better off as an investor buying the
[26:48] portfolio of all biotechs that sort of did not have that great
[26:51] data. And some people talk about this
[26:54] notion of, you know, the haves and have nots tail of two
[26:57] cities, whatever you want to call it today, we're still in
[27:00] that world. So if you look at the market
[27:02] companies that have, you know, really good data sets can raise
[27:06] money all day long. They have high valuations.
[27:08] And then we still have these companies that look like rap
[27:11] used to look like that are not doing so well.
[27:16] And so investors are very much not in a risk on mode.
[27:20] Investors are very much congregating run certain
[27:23] companies. And I do think that, you know,
[27:27] encouraging your companies with, you know, let's say mediocre
[27:30] data to kind of think about getting aligned with new stories
[27:35] like did it is something that probably not done enough in our
[27:39] industry. Yeah.
[27:42] Thank you for that. So why don't we go switch to the
[27:47] other deal? Who wants to go first on that
[27:49] one? I think all three of you had
[27:52] comments on that on the BMS deal.
[27:57] I mean, I'll just say that you know, Jannex, it's a really
[28:00] interesting company, conditionally active sort of
[28:04] approach to sort of immunotherapy, T cell and
[28:07] Gators. The company's stock has come
[28:10] down a lot on some disappointment around some of
[28:11] their lead programs. And I do think this BMS deal
[28:15] this week is a big coat of confidence in the platform.
[28:18] So I'm really happy for Jannex that they were able to get that
[28:21] one done. I don't know much about the deal
[28:27] myself so I I might see if Eric has any comment.
[28:31] Well, I, I think the space is really interesting too.
[28:34] The area that Janix plays in is, is masked by specific antibodies
[28:38] for oncology. There are a couple other firms
[28:41] in the space too that are developing the ability to have
[28:44] these masked antibodies. They're only activated within
[28:47] the tumor microenvironment. So the, the idea here is of
[28:51] course that you can bring the benefit of an efficacious T cell
[28:56] directed therapy to a cancer antigen without having the
[28:59] negativity of, of engaging those T cells outside of the, the, the
[29:04] tumor mass and, and triggering cytokine release syndrome or, or
[29:10] other inflammatory mechanism. So it's a foundational and
[29:14] fundamentally interesting tool. And I do think Tim's right,
[29:17] genetics is shown some proof of concept here with this tool and
[29:21] PSMA masked targets. And and this is a brand new
[29:26] target that the Bristol is buying into for a considerable
[29:29] sum. So I'm really interested, I
[29:32] guess, as you can tell from the technological side on how this
[29:35] field plays out. Again, they're they're not the
[29:37] only ones doing it, but I think if if they or someone else can
[29:41] repetitively do this on a successful level, it's going to
[29:45] be extraordinarily valuable. Absolutely.
[29:49] Thank you for that. So we're going to switch now to
[29:52] some policy topics. So clearly we are in the midst
[29:56] of trying to finalize the 2026 funding bill and right now the
[30:02] House passed all the various parts of it and it's cautious
[30:07] optimism for many implications for biotech.
[30:09] So, for example, the administration last year had
[30:14] requested deep cuts to HHS overall, in particular NIH and
[30:18] CDC and all of that. And actually the proposal now
[30:22] came in up as a slight increase from last year, so about 117
[30:26] billion overall versus, you know, 33 billion above what the
[30:29] administration had requested. And it also protects NIH from
[30:33] the dramatic downsizing plan and keep CDC funding flat at 9
[30:38] billion versus the four billion that the administration had
[30:41] proposed. And there's other wins as well.
[30:44] So PBM reform, which the industry has been advocating for
[30:49] more transparency and other aspects of it that are really
[30:54] impacting biotech innovation. So for example, of prohibit PBMS
[30:59] from time compensation to drug prices in Medicare and requiring
[31:02] much greater transparency. And that in the commercial
[31:05] market forces 100% of rebates to be passed to employer plan.
[31:08] So you know, this could still get stripped if the CBO scores
[31:11] it overalls and its spending increase.
[31:14] But so it's not fully locked yet, but it's, I know there's
[31:16] momentum building PBM reform and actually NIH funded at a slight
[31:22] increase, as I mentioned, about 49 billion and keeps all 27
[31:27] institutes as opposed to some of the institute's that were
[31:30] proposed for a cut. And then there's specific
[31:33] diseases getting additional money such as cancer,
[31:36] Alzheimer's and others and additional support binary for
[31:40] Women's Health, which we'll get to later.
[31:42] So lots of lots of promising areas.
[31:46] We're still not out of the woods.
[31:47] And there's a lot more detail on some of the articles published
[31:50] this week in the, in the biotech trade and another quick, quick
[31:55] policy. And then I'll go around for
[31:56] comments on both of these. Just for context, the US
[32:00] completed, officially completed its withdrawal from The Who this
[32:03] week. And this started during the
[32:05] early COVID years when on Trump's first day back in office
[32:10] and an executive order when he first came back.
[32:14] So for more than 75 years, the US had been the largest funder
[32:18] and the most influential member. The loss of funding has already
[32:22] forced WHO to cut about 1/5 or almost 1/4 of its staff, and
[32:27] it's still about 25% short of the money it needs for the
[32:30] budget. I think the bigger risk though
[32:33] is informational. I think the US will have a lot
[32:36] less access to real time outbreak intelligence and less
[32:40] influence over how pandemics are managed.
[32:42] So this tie to some of the threats against vaccines, mRNA
[32:47] is very concerning in this era where we expect more pandemics
[32:52] to be coming around. So that is an area of concern.
[32:56] Other organizations are stepping up on the vaccine side such as
[32:58] Gates and others, but we're still going to have a big, a big
[33:02] gap. So I'll I'll open it up for
[33:05] comments from the group on some of these policy issues.
[33:07] And I know Eric, you have a after that a comment on the FDA
[33:12] guidance on minimal residual disease.
[33:14] So first let's talk about the funding and WHO and all of that.
[33:18] Any comments? I mean, I would just say
[33:21] whatever your politics are, right, left, middle, you know,
[33:26] in my view, national security and pandemic risk should not be
[33:30] an ideological domain. And so I personally find it, you
[33:35] know, very concerning that the US is pulling out of WHO.
[33:38] Like imagine that the United States said, hey, we're not
[33:41] going to be involved in international air traffic
[33:44] coordination. Like that would just be self
[33:49] defeating. And I kind of view The Who exit
[33:52] as very similar. Somehow we've, you know, made
[33:55] this ideological topic when the reality is the WH O's role is
[33:59] largely non ideological. Yeah, very.
[34:06] I mean also a political, I would hope that no matter where you
[34:10] are on the on the spectrum of of Republican, Democrat, in the
[34:14] middle, etcetera, you're also a supporter of science and of you
[34:19] and, and espouse the view that we could use more science and
[34:22] more scientists in the United States.
[34:24] I don't think that that should be a political view either.
[34:26] So, you know, the fact that the Trump administration had
[34:30] proposed to cut the NIH budget by 40% and graces, as you
[34:33] mentioned, we've avoided that bullet.
[34:36] And in fact, Congress has, has looked to moderately increase
[34:39] the NIH budget. What a what a sigh of relief
[34:42] that is for all of us who, who care deeply about science and,
[34:46] and think that this should be a national priority and is a
[34:49] competitive edge in our society. So I just feel, you know,
[34:56] personally very thankful for congressional leaders who have
[35:00] the foresight to potentially, you know, overrule the
[35:02] administration in this regard and and move forward with with
[35:06] doing what's right for science funding.
[35:07] I know that I manage budget has massive reverberations into
[35:12] academia and I I know that, you know, universities had had
[35:16] considered cutting dramatically back on the number of trainees
[35:19] that they were going to accept in their graduate programs this
[35:22] year when the even threat of a major NIH cut was was being
[35:27] proposed. Oh, absolutely.
[35:30] And the cap on. Overhead as well was an issue.
[35:32] Oh, sorry. Go ahead, Greg.
[35:35] Yeah, I just, I, I just want to quickly add that as someone who
[35:38] went to Graduate School, I do have a PhD.
[35:42] You know, science in the United States, I think has always been
[35:46] viewed as one of the great, you know, gems of our country.
[35:52] And, you know, the threat of the funding being cut was very real.
[35:59] And, and I remember just maybe nine months ago where direct
[36:07] conversations I, I was having, and I'm sure Eric might have
[36:10] been having too, with folks who were either thinking about
[36:14] Graduate School or in Graduate School and then had their, you
[36:18] know, funding cut and then had to think about pivoting their
[36:22] careers. Like this was a very real and
[36:25] has been a very real thing. So again, trying as best as
[36:29] possible to be a political as well.
[36:32] I do think it's still important for the US to kind of, you know,
[36:38] be part of, of the global discussions on very important
[36:44] matters, whether it's WHO or whether it's just just being a
[36:50] good actor on a global stage. So with that in mind, I, I, I
[36:55] was disappointed to hear the news about the US exiting The
[36:58] Who, the public, that organization inefficiencies
[37:02] there. But I'm I'm hopeful that we will
[37:08] get some balance from U.S. policy over the next several
[37:11] years. Thanks all.
[37:15] And I just want to highlight the critical importance of advocacy.
[37:18] A lot of us spend a lot of time on the Hill.
[37:20] Have to give kudos to John Crowley and the bio team.
[37:24] There's a lot of work. This involves a lot of work, a
[37:26] lot of relationship building and education about how all these
[37:30] things are connected. So talking to senators and
[37:35] congressional representatives whose districts are impacted by
[37:39] cutbacks in biotech and how it all connects.
[37:42] It is really important. And, and also PBM reform.
[37:46] I have to give a lot of credit to the industry advocates who,
[37:50] you know, just did not stop going around and trying to
[37:52] educate and, and kind of have people understand exactly what's
[37:57] happening with the money that is supposed to go towards drugs for
[38:01] patients, whether it's PBM reform or 340B or other stuff.
[38:05] So there's a lot of misaligned incentives and it takes breaking
[38:09] through all that and tying it to something that's important to
[38:12] the people who are voting on these things.
[38:15] So anybody can go happy to talk about it with anybody.
[38:19] If anybody wants to reach out, they're always looking for
[38:21] biotech leaders to go on the hill and tell their stories and
[38:25] talk about patients and really, really make an impact.
[38:28] It's we can't stop. They're going to continue to try
[38:32] to chip away at this. So very relieved to see
[38:35] obviously it's not over. This bill needs to be signed by
[38:38] the 30th and it still needs to pass the Senate.
[38:41] So there could be some changes, but we're cautiously optimistic
[38:44] with this bipartisan strong kind of support for biotech.
[38:50] So Eric, do you want to talk about the minimal residual
[38:53] disease guidance? Yeah.
[38:56] We, we can talk about this quickly.
[38:57] I know you got a lot of other topics I want to cover, Grace,
[38:59] but I think this is very notable for those who haven't seen the
[39:03] FDA issued some new guidance this week in the field of
[39:06] multiple myeloma. And essentially the guidance
[39:09] says that you could use minimal residual disease, MRD negative
[39:12] status combined with a complete response to gain approval of
[39:17] myeloma studies in the future. And that that's really important
[39:20] because with all the new therapies that have come into
[39:23] myeloma, this disease has gone from, you know, a death sentence
[39:27] within two or three years to 1 where patients can live 10 to 15
[39:31] years with the disease. And that of course, makes it
[39:34] more and more difficult for drugs to prove that they have
[39:37] long term benefits, especially in in overall survival.
[39:41] It's much easier to prove that you impact survival in a patient
[39:44] who has a two years survival prognosis than a 10 years
[39:48] survival prognosis. So a very welcome event this
[39:52] week and in in the FDA guidance, draft guidance essentially
[39:57] validating what Odak had discussed a year or two ago that
[40:01] that this MRD marker correlates with long term outcomes and
[40:04] should be used. The reason why I think this is
[40:07] interesting is that in some ways it flies a little bit in the
[40:11] face of of efforts that Vinay Prasad has put forth.
[40:15] Doctor Prasad, who? Who obviously is in charge of
[40:18] the Seibert drug approvals has been very antagonistic toward
[40:24] single arm response rate outcomes in oncology.
[40:27] In fact now he's created a little bit of a a track record a
[40:31] history of not approving drugs like replimines drug.
[40:33] I mentioned even earlier on this this webinar, he's rejected ATAR
[40:39] as drug. He also seems to have rejected
[40:43] the drug from Regeneron based on single arm readouts in oncology
[40:47] that use Orr response rate as a marker.
[40:50] So we're getting a little bit of a maybe schizophrenic view from
[40:54] the FDA with his draft guidance. On the one hand you have the
[40:57] broader FDA putting out a policy that says if you have ACR and
[41:00] it's MRD negative, that response rate is robust enough to drive
[41:05] clinical confidence in the outcome.
[41:07] On the other hand, Doctor Prasad is an increasingly steering
[41:11] companies in his Sieber division toward randomized controlled
[41:15] clinical trial outcomes that are going to take a lot longer and
[41:18] delay I think innovation to patients.
[41:21] And in many cases where the response rates are so robust, I
[41:25] I don't think that randomized control trials are are required.
[41:29] That seems to me to be going now back to some prior history where
[41:33] where cancer drugs were stymied in their development and where
[41:37] we delayed bringing innovative patients, innovative therapies
[41:40] to patients for many, many years because we had to prove that
[41:42] everything had a survival benefit.
[41:44] So I certainly hope we don't go back there.
[41:46] But there's a little bit, it seems, of an internal struggle
[41:48] at the FDA these days. Great.
[41:52] Very, very insightful. Thank you for that.
[41:54] And I agree, we need to, you know, we need to be cautious
[41:58] about this area and just make sure we continue to focus on
[42:00] what's best for patients and advocate for that.
[42:04] So why don't we go to some company news I, why don't we
[42:08] start with the atopic dermatitis topic because I know there's a
[42:11] lot there. Greg, you had a lot of comments
[42:14] on a few companies, Corvus and others.
[42:17] And I know Eric, you were going to comment on one or two as
[42:19] well. So why don't we start with that?
[42:20] And I know we have another company topic after that.
[42:24] Yeah. Let me start with saying the
[42:29] entire space over the last, let's say five years are
[42:41] pursuing the development of therapies.
[42:44] It's a very large market. For those of you who don't know
[42:47] if atopic dermatitis is the newer fancier name for what for
[42:51] many decades we used to call eczema.
[42:54] And with that said, there's anywhere depending on the
[42:57] estimates that you want to believe in anywhere from maybe
[43:01] 15,000,000 in the US to maybe 42 plus in the US that have atopic
[43:09] dermatitis. So with that in mind, it is a
[43:12] very large market and not surprisingly industry is very
[43:17] interested in tapping into this market.
[43:19] We do have very good drugs on the market now and the market
[43:23] leaders called Dupixent and that is a drug from Regeneron.
[43:28] But they're also oral drugs like the Jack inhibitors that provide
[43:32] very good efficacy, but they are set back by some safety
[43:36] liability issues and there's a black box warning.
[43:39] So that does limit their use. But there is a whole slate of
[43:43] biotech companies, especially small, smaller midcap biotech
[43:46] companies that are also trying to get in on the action.
[43:50] And one particular company that I follow is called Corvus
[43:55] Pharmaceuticals, the ticker CRVS.
[43:59] They have a very interesting oral drug that is a novel ITK
[44:05] inhibitor. People may be aware of the BTK
[44:08] inhibitors, but this is a novel ITK inhibitor, so somewhat
[44:12] related. And the drug is already in a
[44:15] phase three trial in a lymphoma setting, but the company over a
[44:22] year ago embarked on seeing if this drug could be used in
[44:25] atopic dermatitis. We've had some small data sets
[44:28] over the past year, but we had a little bit more data this past
[44:32] Tuesday, right after the the holiday.
[44:35] And the results, which albeit come from very small numbers,
[44:39] we're talking about, you know, 24 patients or so, but the data
[44:43] were were quite compelling. We're talking about efficacy in
[44:48] atopic dermatitis that almost appears at least at this very
[44:53] early stage, potentially best in class.
[44:57] And again it's an oral drug whereas Dupixent which is the
[45:00] current gold standard is injectable and it came with a
[45:03] very safe and well tolerated profile to stock in this week
[45:10] alone is up over 200% and now it is about a 2 billion market cap
[45:18] company. The company was able to
[45:20] successfully announce a financing that was upsized and
[45:26] so good for the company which had cash only until the fourth
[45:29] quarter of this year. They were able to add in
[45:32] probably close to 200 million and that will obviously extend
[45:36] the cash runway. They will be thinking about
[45:39] expanding this drug and its potential use into other INI
[45:44] type of indications. So the company's already
[45:46] announced that they will fund a phase two studied in atopic
[45:52] dermatitis that will start very shortly.
[45:54] But they're also expanding into asthma also hidradenitis
[45:59] suppurativa. And this is all based on the
[46:02] biology and these will be kind of proof of of signal type of
[46:07] studies. But for an oral small molecule
[46:12] that shows very good efficacy. There's a lot of promise here.
[46:15] Again, it's still early days, but the atopic dermatitis space
[46:20] is very competitive. I know Eric wants to talk about
[46:25] a Claris, which has perhaps a similar drug, but I do.
[46:28] I did also want to comment very briefly that other high profile
[46:32] companies that investors have been gravitating towards in this
[46:36] atopic dermatitis space. And this is not an exhaustive
[46:38] list by any means, but there is a a company called Chimera
[46:42] Therapeutics, they also have an oral drug.
[46:47] It's an oral stat 6th degrader. They had some data in December,
[46:52] granted there were no placebo treated patients, we don't
[46:57] really have a control, but the data were well received again
[47:00] because of its oral nature. The company, I think their
[47:04] market cap moved up over a billion in December based on
[47:07] this phase one data and they were able to raise about 500
[47:12] million off of that. And there's a company also
[47:17] Apogee Therapeutics, which interestingly has a perhaps once
[47:23] a quarter, once every three month injection for atopic
[47:28] dermatitis. So lots of activity in the space
[47:32] and Eric, I'll pass it to you if you have comments about a
[47:34] Claris. Well, what?
[47:35] Well done covering this, Greg. I mean, maybe just to add, yeah,
[47:38] the atopic derm market is large and growing and robust and
[47:43] enormous, But what kind of really excites me about these
[47:47] data and Congrats to, to you on a terrific call.
[47:51] I know my colleague Lee Watson was also with you, one of the
[47:54] two big supporters of, of this name.
[47:57] But what really exciting to me that we now have almost a new
[48:00] validated target in terms of I, I indications.
[48:04] And this can go into so many different indications well
[48:07] beyond AAD. So that's, that's fascinating.
[48:11] You're right, we still need to learn a little bit more about
[48:13] the safety of an ITK inhibitor, but the efficacy has now been
[48:16] established. And, and what's fascinating
[48:18] about this is the history Richard Miller, as you know,
[48:21] who's CEO of Corvus was kind of the leading CEO in his prior
[48:26] life and taking BTK inhibitors forward and BTK inhibitors are
[48:31] transforming a lot of B cell driven diseases and ITK
[48:35] inhibitor may transform any T cell driven diseases.
[48:38] So a little bit of history there.
[48:41] Claris is the other player in the ITK space.
[48:44] They don't yet have clinical data, but their preclinical
[48:47] results look really good. They claim that they might be a
[48:50] little bit more selective and a little bit more potent for this
[48:53] target. So keep an eye on a Claris.
[48:55] ACRS is another company that my colleague Prakar here covers and
[49:00] that stock did extremely well, extremely well on the coattails
[49:04] of Corbis now that ITK has kind of been validated as a target.
[49:11] I do want to also just briefly add that we did have some news
[49:15] today also in the atopic dermatitis space where Sanofi,
[49:20] the large pharmaceutical company, the French
[49:22] pharmaceutical company, they've been developing an OX40, an anti
[49:28] OX40 ligand antibody. I might butcher the name of it,
[49:34] but I believe it's a milotelimab.
[49:38] They had some phase three data today and the market did not
[49:44] particularly like this data. It's interesting I think that
[49:50] this can be studied in a monotherapy but also as a
[49:54] combination therapy. But with that said, the data
[49:59] were a bit mixed. But the company says that they
[50:02] are going to continue to think about filing this drug for
[50:07] approval. But well, I'm not going to opine
[50:09] about the anti OX40 ligand based mechanism of action.
[50:16] I do think that the fact that Santa Fe had news today is
[50:21] indicative of just the widespread interest by industry
[50:26] in, in not only atopic dermatitis, but just the IONI
[50:30] space because it it these inflammatory and immunological
[50:34] based conditions affect so many people.
[50:37] And while it is a very crowded market, there's still lots of
[50:41] room for improvement for patients.
[50:46] Great. Very important topic.
[50:47] And I had no idea that the number of potential patients was
[50:50] that high. I was thinking more was like in
[50:52] the 10 million or something you said it was up to 40 million.
[50:56] Depending on, you know, which company is is touting the Yeah.
[50:59] Exactly, they always pick the highest number, which makes
[51:03] sense. Tim, any comments on that before
[51:06] we switch to the next comment to the next topic?
[51:10] No, I think it's really interesting and exciting to see
[51:12] those data. Awesome, great.
[51:15] Well, now we're going to switch to a topic that I know is near
[51:19] and dear to Tim's heart and my heart.
[51:21] And we've had a few discussions about this, which is Women's
[51:23] Health. I think your second report this
[51:27] year was fascinating and I think it's going to be part of a multi
[51:32] of a series, right. And you know, just for context,
[51:36] as, as folks I'm sure know on the call that there's been a
[51:39] huge, huge uptick in focus of Women's Health in the last few
[51:43] years. And it's long overdue really a
[51:46] push to go back and have a better understanding of the
[51:49] complex biology and the implications not only on
[51:53] reproductive and Women's Health and maternal health, but also
[51:56] far beyond that, right. And there's an interesting,
[51:59] there was a lot of activity at JPM, even more this year than
[52:02] last year, a lot of panels, a lot of discussions and I think
[52:05] groups that Women's Health is so fragmented.
[52:08] When you think about you have to pull together diagnostics and
[52:12] medical devices, you know, surgery as well as therapeutics.
[52:15] And all these groups are beginning to come together and
[52:17] really advocate and really put a focus and show that this can be
[52:21] it's, it is an investable market, right?
[52:23] It's half the population. And there was an interesting
[52:25] report by a ODX that came out over JPM that really focused on
[52:31] the fact that in the last, you know, $100 billion in realized
[52:35] exit outcomes over 25 years for Women's Health, depending on how
[52:39] you count it. But I think part of it is
[52:41] understand, you know, broadening the definition of Women's Health
[52:44] and most half of the exits occurred in the past five years
[52:48] and you know, 27 Women's Health companies achieved billion
[52:53] dollar exits. So I think this really matters.
[52:56] I think there's the right attention.
[52:57] We're focusing more on the early part of discovery and also more
[53:03] on how do we how do we tie the value, how do we get
[53:06] reimbursement and all of that. So why don't you Would love to
[53:09] hear the highlights of this first part, which is really
[53:11] fascinating. If anybody hasn't read it, you
[53:13] really should. It goes back to the history of
[53:15] Women's Health and how female well-being moved from
[53:18] superstition and neglect to to where it's moving today.
[53:23] Would love your thoughts on that Tim, and thank you for doing
[53:26] this. Oh no, my pleasure.
[53:28] And it's great to hear your comments sort of like on the
[53:31] contemporary moment because my, my report has been very much a
[53:35] historical exercise. And so I think we all sort of
[53:39] know this, but it's, it's very interesting when you like write
[53:42] it all down. It is quite striking.
[53:45] So, so women have faced like unbelievably tough healthcare
[53:51] circumstances for many centuries.
[53:54] And you know, what I did is I, I essentially looked at the
[53:58] history going back, you know, 23000 years.
[54:01] And so, you know, the level of misogyny that has created
[54:05] barriers to female healthcare has been very high.
[54:10] Women were largely blocked from entering the medical profession.
[54:15] They were blocked from being able to learn.
[54:19] That is, you know, basic literacy was not something the
[54:21] women had access to really until the 1900s.
[54:26] And most of the world up until 50 years ago, women were not
[54:32] able in any meaningful way to enter the medical profession and
[54:37] traditionally female healthcare roles, such as being a midwife
[54:41] or systematically taken over by men.
[54:43] So, you know, very difficult circumstances.
[54:47] And yet, if you look at the history, things have gotten
[54:50] dramatically better for women from a healthcare perspective
[54:53] over the centuries. I'm both an absolute basis, sort
[54:56] of absolute life expectancy, but also relative basis.
[55:00] So US men today have lower life expectancy than women.
[55:04] But you know, in the past it was the other way around.
[55:08] There have been a number of breakthroughs that have really
[55:11] changed things for women, including the advent of
[55:13] mammography, drugs like Gardasil, the GNRH agonist for
[55:18] endometriosis. No innovation, I think, has been
[55:23] bigger, not just for women, but for our civilization than the
[55:27] oral contraceptive. The oral contraceptive is
[55:30] enabled women to enter the workforce, to live independent
[55:34] lives, to enjoy sex, right? Not to, you know, panic if
[55:38] you're having sex with someone that's not, you know, your
[55:42] husband. I'm not sure that there's been
[55:46] anything really bigger than that in our, in our industry ever.
[55:51] There are still many barriers that remain to good female
[55:56] health. But Grace, it's great to hear
[55:57] the progress that you're reporting on and, and that's
[56:00] very encouraging. I'll add one last thing.
[56:03] The two most fun chapters to write that, you know, let's say
[56:07] a little bit less grim 1 was a chapter on the history of
[56:10] women's liberation, which I didn't know that much about.
[56:14] And so, you know, starting in the 1960s, women just got so fed
[56:21] up with the healthcare system, they started opening up their
[56:24] own clinics. And so I wrote a chapter about
[56:26] that movement in the lasting effect that that is at the other
[56:31] chapter that was really interesting is Grace what you
[56:33] were touching on, which is more the study of female predominant
[56:36] disease. So there's tons of these
[56:39] conditions that impact women much more than men, such as
[56:41] autoimmunity. So I kind of just like went back
[56:44] and sort of tried to do the research on like who is the
[56:47] first person to noticed that women were more likely to have
[56:51] autoimmune disease and sort of document all that.
[56:53] Enough for me at least. Was very interesting what to do.
[56:58] And thank you for doing this, Tim.
[57:00] I mean, I think we need to continue to put out information
[57:03] like that. I have to give kudos to, you
[57:06] know, to some of the the VC firms that are really taking
[57:09] this like Alice from foreground. Also Lucy Paris, my fellow
[57:13] Puerto Rican, a senior partner, McKenzie has been a leader in
[57:17] putting out reports and really looking at the economic impact
[57:20] across all diseases of focusing on Women's Health.
[57:24] So I think there is a lot of great momentum.
[57:27] One last thing on the oral contraceptive, I think there's a
[57:30] huge issue with HealthEquity. I chaired a panel at Biotech
[57:35] Showcase on that and we talked about how 50% of pregnancies
[57:40] still today in the US are unplanned and that primarily has
[57:44] huge socioeconomic impacts on those who can't, who are most
[57:48] vulnerable. And simple things like bringing
[57:52] the birth control counter birth control pill over the counter.
[57:56] The mini pill was approved many a few years ago, but that is for
[58:00] over the counter. But that's just 10% of women who
[58:03] are on the pill. So I know my friend Samantha
[58:05] Miller at Cadence OTC has been working for many years to get
[58:09] the combo pill over the counter and affordable.
[58:13] So even women who don't have access or time to go to the
[58:17] doctor could walk in and, you know, at a very reasonable
[58:20] price, get it every month at ACVS or a Walgreens.
[58:23] So that would have huge impact. So there's lots of things like
[58:26] that that we need to be thinking about and advocating for.
[58:29] And we really look forward to your next reports.
[58:31] Oh, sorry, go ahead. No, Grace, I would simply say I
[58:34] agree with you wholeheartedly. We, we still have so much
[58:37] progress to me, right? There's a long way to go and
[58:40] I'll, I'll make the following comment.
[58:42] I've never had more people right in after getting one of my
[58:46] reports than this report. I didn't expect that at all.
[58:49] I kind of thought that this was a little bit off the run topic
[58:53] that only was interesting to women.
[58:55] I got so many emails from men and women saying they enjoyed
[58:59] this topic. They want to hear more that this
[59:01] needs to be more important in our sector.
[59:03] And, you know, I predict 510 years from now, we'll all look
[59:06] back and say, gosh, why didn't we take Women's Health more
[59:09] seriously back in 2026? I think it's sort of a topic
[59:13] whose moment has come.

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