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Ryan Reeves Profile picture
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27 Jan, 6 tweets, 2 min read
Genomics Meta-Thread ⬇️
Thread #1 - laying the groundwork/understanding DNA and genes

Thread #2 - intro to gene sequencing

Thread #3 - differences between short-read and long-read sequencing and then Pacific BioSciences

Thread #4 - synthetic long-read companies like 10x Genomics and Bionano Genomics

Thread #5 - genetic testing companies and the value chain

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Ryan Reeves Profile picture
3 Feb
Genomics Thread #5

We've already laid the groundwork for understanding DNA, and some parts of the sequencing value chain but now let's talk about genetic testing...
1/ You can think of genetic testing companies as platforms built on top of genome sequencing companies.

Some of the players here are 23andme, Ancestry, Invitae, Fulgent and Natera.

Interestingly, 23andme might come public via SPAC soon: bizjournals.com/sanjose/news/2…
2/ Ancestry and 23andme are probably the most popular DTC genetic testing companies. You receive a test kit, swab your cheek and then you can get insights into your familial history, etc.

However, the DTC market has been more difficult than servicing health care providers.
Read 12 tweets
Ryan Reeves Profile picture
28 Jan
Genomics Thread #2

Let's talk about gene sequencing...
1/ The first genome was sequenced in 1977 by Fred Sanger of a bacteriophage.

The first human genome wasn't sequenced until 2003 after 13 years of research through the Human Genome Project.

It took $3 billion (apparently $1 for each base pair 😅)
2/ In the past two decades, the cost of sequencing DNA has declined at an astounding rate.

From $3 billion with the Human Genome Project to well under $1,000 today.
Read 10 tweets
Ryan Reeves Profile picture
27 Jan
Genomics Thread #1

Before diving into companies, let's make sure we understand some terms.

Spoiler: there's a WHOLE lot to learn...
1/ It starts with DNA (deoxyribonucleic acid) or your "genetic code."

It's a double-helix structure that is made up of chemical base-pairs (A pairs with T via 2 hydrogen bonds and C pairs with G via 3 hydrogen bonds).
2/ DNA sits in the nuclei of your cells.

How many cells do you have?

Roughly 37 trillion.

And our cells aren't static. They are actually dividing constantly.

How often?

Nearly 2 trillion times per day.
Read 11 tweets
Ryan Reeves Profile picture
26 Jan
Some slides I thought were really interesting from @ARKInvest's recent 2021 Big Ideas presentation...

Source: research.ark-invest.com/hubfs/1_Downlo…
1/ "Deep learning could create more economic value than the internet did"
2/ Freemium widens the funnel
Read 9 tweets
Ryan Reeves Profile picture
15 Jan
Following up on how GoodRx fits into this ecosystem...

continued [THREAD] ⬇️
1/ If you haven't already read through the prescription drug value chain, I'll give a super brief breakdown.

Distribution: Manufacturers -> Wholesalers -> Pharmacies

Payment: Employer -> Health insurance companies -> PBMs -> Distribution points
2/ GoodRx sits in an interesting spot, benefitting from the opaque industry and the PBMs specifically.

To be clear, GoodRx doesn't work with insurance.

It works if you're paying out-of-pocket.
Read 17 tweets
Ryan Reeves Profile picture
14 Jan
Took the afternoon to understand the prescription drug market a little better.

Here are some ramblings on the value chain...

[THREAD] ⬇️
1/ It starts with the manufacturer of the drug. These are the pharmaceutical companies like Pfizer, Abbott Labs, AbbVie, Merck, GSK, etc.

Top 5 by revenue (in billions):

Johnson & Johnson – $56.1
Pfizer – $51.8
Roche – $49.2
Novartis – $47.5
Merck & Co. – $46.8
2/ As an aside, we're talking prescriptions which are usually chemical-based rather than organism-based. The latter are often researched by biotechs instead of pharma.

But pharma companies sometimes don't even manufacture the drugs themselves...
Read 23 tweets

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