Last Call! Apply by Thu March 4th for Spring 2021 “Business of Biotech” discussion sessions (Wed, 3-5pm ET, March 10/17/24). If can’t make it, our virtual Thinkific materials (listed below) are available indefinitely & more discussions to come. Register at racap.com/courses
RA Capital hosts course b/c we are inspired by all that we've seen the biotech industry accomplish for human health, have learned a lot of the past couple of decades, and want to share lessons learned so that biotech can be even better than it has been.
And now more than ever, we think it's important for everyone in biotech to understand and unite around Biotech Social Contract that governs what the public expects of innovators and insurance.
Below I'll summarize what we'll cover in the discussion sections and describe the required prep for the course, with direct links to those materials you can access even outside of Thinkific.
In our 3 discussions (& 4th optional "pitch-off" on March 31, 3-6pm ET), participants discuss complexities of drug pricing, innovation, & investment, building on thegreatamericandrug.com, covering insurance, NPVs, M&A, & investment diligence process w/ & w/o price controls.
In 1st session, we'll cover the Biotech Social Contract, how “ordinary” cost-effectiveness overlooks value (most notably that drugs go generic) & examine impact of competing healthcare reform proposals (HR-3 vs nopatientleftbehind.org) on affordability and innovation.
2nd session is on competitive game theory & why some companies are more attractive acquisition targets than others. In all sessions we do small group breakouts so people can work through questions with peers b/f coming together to get our insights.
3rd session is a big change-up. Last Fall it was how COVID is a microcosm of healthcare industry. This time we’ll reverse-engineer successful & failed biotech companies to figure out how they differed at the outset (if at all!).
Optional 4th session: we’ll cap this series off w/ a “pitch-off” competition, tournament style to identify BEST pitch of an existing public or private company. This is also a chance to get to know more of RA Capital's investment team, which can help polish the pitches each round.
Goal of discussions is to BUILD on materials in Thinkific (explainer slide decks, recorded lectures, readings, & even worksheets/exercises). The discussions assume people put in the time to prepare on their own.
To join for discussions (Wed, 3-5pm, starting March 10th), sign up at RACap.com/course, inhale required reading (incl: thegreatamericandrugdeal.com; save time by getting eBook/audiobook) & watch recorded lecture b/f the March 10th 1st session.
List of Req readings/viewings: My book covers the Biotech Social Contract, insurance and its reform, and value of drugs going generic and fixes for when they don’t. (This is the heaviest req reading assignment; get started asap w/ebook or audiobook). thegreatamericandrugdeal.com
This trilogy of explainer slides we created for @NPLB_org cover the healthcare reforms the US needs, how private sector integrates w/ public funding to drive innovation, & impact of price-controlling winners on entire drug portfolios. Lawmakers read these. nopatientleftbehind.org/presentations
"If Trikafta Isn’t Good Enough for ICER, What Drug Is?" Great article by my colleague on limitations of conventional cost-effectiveness analysis when assessing value of a drug (and therefore why Congress shouldn’t use such math to set prices) timmermanreport.com/2020/05/if-tri…
After you’ve read The Great American Drug Deal, read this article, which we submitted to a Senate panel. "It’s Time to Bring Generic Drug Manufacturing Back to the U.S." Combines thinking about getting value w/ generic drug quality concerns. statnews.com/2020/06/02/bri…
Some think price increase caps are a benign price control. Here’s freakonomic analysis that shows how even that measure would harm patients due to unintended consequences (though would be workable w/ some tweaks). "When Raising Drug Prices Helps Patients" timmermanreport.com/2020/07/when-r…
Watch the recorded Lecture 1 from the first online Business of Biotech course that covered some of the topics in the book and articles on insurance, price controls, & Biotech Social Contract. Only available on Thinkific - Register at racap.com/courses
Article on Solution Development vs regular drug development. What's difference? In former, company defines itself by the problem it aims to solve, not the technology it happens to have. It's how Gilead dominated HIV & HCV & explains a lot of acquisitions. racap.com/media/Perspect…
Article I wrote 10 years ago (still relevant) on tension between a company’s lead drug and its pipeline, which can result in business model instability. Solution to problem is Solution Development (prior article) or having a TRUE platform. racap.com/media/Perspect…
HCV Explainer slides that teaches how the Hepatitis C chess game played out, step by step, over 15 years, leading to Gilead, AbbVie, and society winning. Here's the powerpoint. Relevant for Discussion Session 2. peterkolchinsky.com/s/LessonsOfHep…
Watch recorded Lecture 2 from the first online Business of Biotech course that covered some of the topics in the book and articles. Only available on Thinkific - Register at racap.com/courses
Exelixis case slides teach story of company that persevered through incredible challenges. NPV model that builds line by line, shows where M&A synergies come from, & why it’s hard for a successful company to escape acquisition. On Thinkific - Register at racap.com/courses
So even if you don't register on Thinkific for the course, you can access a lot of the article and slides that are already out there. And we have more in RA Capital's Perspectives section (including podcasts). racap.com/perspectives
Thinkific course is free & gives you access to more content you won't get elsewhere (primarily recorded Lectures I mention above). Periodic discussion session we host are where you get to practice what you learn w/ more hands-on exercises & meet some peers. Knowledge sinks in.
And the learning never stops. Former students of our Business of Biotech course (~1000 by now) host meet-ups and clubhouse chats, organize on LinkedIn, and trade ideas for continued learning. So join in, absorb lessons of the past, and lead the advancement of biotech.

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More from @PeterKolchinsky

21 Feb
Summary of Clubhouse chat (thanks @BiotechCH)... 5 injustices in a drug NPV model... 1) <100% of patients getting drug they need due to inability to afford out of pocket costs is injustice we mustn’t accept and therefore must push for insurance reforms that lower OOP costs....
2) assumptions of continued high profitability into out-years (eg >15 years) due a drug being hard or impossible to genericize (eg biologics, esp gene therapies) have a far greater cost to society than their contribution to the NPV.
That’s b/c society’s costs are net revenues discounted at 1.5-2%/year but NPV only counts out-year profits discounted at a much higher rate (~8%). So public & Congress is right to challenge drug prices but it’s not that they are too high... it’s that they are high for too long.
Read 25 tweets
10 Feb
This one might tweak your brain. There would be MORE interest in developing new antibiotics if NO ONE needed them today. Huh? Yep... let’s think about it. Today, no one needs drugs for smallpox nor pandemic flu. But those have been developed precisely because... 1/18
...we KNOW that we MIGHT need them in the future. The US contracts through BARDA w/ companies to develop drugs & vaccines (commit to buying a certain number of doses/year at a guaranteed price) b/c it’s buying an insurance policy. Members of Congress understand that. 2/
Media seems to understand that. Academics understand that. Presumably the public understands that. Drugs we don’t need AT ALL today are still worth buying to have in our back pocket JUST IN CASE. Logical. It’s insurance! 3/
Read 19 tweets
4 Feb
Some people think we overpay for only incrementally better medicines. That only home runs deserve high prices. But as in baseball- most are trying as hard as they can & job is to at least get on base. Sometimes, biology allows for a home run, but it’s not the strategy.
However you reward progress, it just takes a certain level of revenues to support industry of certain size, baseball or biopharma. Not paying for singles means paying more for home runs. It means less certain employment since not every disease lends itself to big breakthroughs.
But if you offer little reward for just getting on base in, let’s say, pancreatic cancer or lupus, which are tough pitchers, then no one will bother to step up to the plates against them. Those players will only want to go up against diseases where bigger advances seem possible.
Read 25 tweets
2 Feb
Fascinated by biotech & good it can do? Interested in how industry works & innovators get funding for their ideas? RA Capital opened registration for its virtual Business of Biotech discussion Spring session. Open to students/professionals... lawmakers. racap.com/courses/the-bu…
This is part of ongoing flipped course that RA Capital hosts with lectures, slide decks, & other materials available for anyone to study online anytime... & periodically we host Zooms w/ small breakouts, case studies, & in this case an optional funding pitch competition.
Note: Lots of reading, including of thegreatamericandrugdeal.com, since we’ll be talking about insurance, drug pricing, & how innovators & investors would be impacted by price controls.
Read 4 tweets
28 Jan
New data from Novavax vaccine just showed that UK & esp South African variants are more problematic in real world than lab experiments suggested. Implications are profound for 2021 and beyond. nytimes.com/2021/01/28/hea…
Vaccine worked well to stop original strain (96%), like mRNA vaccines, but less effective for new strains (86% for UK strain, 60% protective against South African strain). My guess is that if mRNA vaccines were tested now in a clinical trial in South Africa...
...they would show similar reduction in effectiveness. Bottom line, new SA strain has evolved SOME (not total) resistance to current vaccines. Current vaccines still help blunt severity, so worth getting even in South Africa.
Read 19 tweets
17 Jan
This new variant is making a lot of people REALLY nervous. Here’s why it should & shouldn’t. I’ll hit on infectivity, lethality, vaccine effectiveness, & some “what ifs”. Yes, it’s more infectious. That means that w/ comparable carelessness... 1/17
...new variant will infect more people. Once a person is infected... new variant is not more lethal (though like original strain, it’s bad enough). While not more lethal at level of individual person once they are infected, it’s more lethal at societal level b/c more infectious.
Lethality aside for a moment, not enough attention has been given to what this virus does short of killing. For example, it can rob you of sense of smell, which means taste, for weeks or months. Sound mild until you experience it- it’s a pretty miserable condition. 3/17
Read 18 tweets

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