If you're investing in radiopharmaceuticals, you should study the parallels with cell therapy

In both, the supply chain is the key limitation.

If you'd like PDFs of the graphics below, comment below! Some takeaways: Inherent product instability / decay requires systems optimized for speed. This means rapid processing, shipping and deployment of fragile or radioactive materials. It also means special procedures and infrastructure are needed from production to delivery

Gene therapy landscape

Pulled together 42 companies and charted the preclinical and clinical assets of each, segmented by approach and vector

Some takeaways: The analysis above is just a sample of the overall activity in the space - there are 450+ programs across 200+ companies, the vast majority of which are very early (~60% are preclinical and majority of clinical assets are in Ph 1/2). This also excludes gene editing approaches.

Refreshed obesity competitive landscape

Updated thoughts on this massive market following today's positive SELECT trial readout ($NVO) and Mounjaro sales beat ($LLY): Obesity refresher:
• Defined as BMI >30kg/m^2
• >750M patients globally, including ~40% of US adults --> expected to increase to 1B people / ~50% of US adults by 2030
• Linked to 1/5 US adult deaths

However, just ~2% of people (15M) are on anti-obesity medications (AOM)

Gene editing landscape

I pulled together 42 public & private companies and charted the preclinical & clinical assets of each, segmented by approach & editor

Some takeaways: In the context of therapeutics, gene editing is the insertion, deletion or replacement of sections of a patient's DNA to treat disease

The Cowen team pulled together the helpful graphic below noting the nuances between gene therapy and gene editing

Radiopharmaceuticals market map ☢️

66 companies are segmented by radioisotope and highest stage of development

Further thoughts on this emerging market below:

*After a brief hiatus, we'll be back to regular breakdowns & thought pieces here* What was once a dormant space has seen rapid growth over the past few years

Since 2018:
• 3 novel FDA-approved therapeutics
• >$1B in investor funding
• >$10B in M&A and licensing deals

With the current industry pipeline showing >60 clinical-stage and >100 preclinical assets

IBD competitive landscape & disease primer

Exploring the highly competitive space on the heels of Merck's $10.8B acquisition of Prometheus $RXDX IBD (inflammatory bowel diseases) are recurrent, chronic inflammatory conditions of the GI track

IBD is segmented by 2 distinct conditions: ulcerative colitis (UC) and Crohn's disease (CD)

Prevalence estimates vary, but there are ~2-4M IBD patients in the US & >5M worldwide

Alzheimer's Competitive Landscape 🧠

+ a deep dive into the unmet need and future of treatment: Alzheimer's disease (AD) is a progressive neurological disorder that destroys brain cells, resulting in dementia

• 7th leading cause of death (US)
• >6M patients in US, >45M WW, expected to 3x by 2060 due to aging population (~$1T/yr in US)
• >99% clinical trial failure rate

A primer on psychedelics in drug development 🍄

Digging into the emerging science, competitive landscape and convoluted path to market

Let's take a trip: First, let's define psychedelics

For this thread, they encompass classic hallucinogens & agents that produce comparable effects, as well as non-hallucinogenic derivatives

Gene therapy landscape

I pulled together 42 public companies and charted the preclinical & clinical assets of each, segmented by approach & vector

Some takeaways: The above analysis is not exhaustive: there are >350 developmental gene therapies across >115 companies

~62% are preclinical or IND-enabling. Of the remaining ~38% in the clinic / approved, the majority (~31%) are in Phase 1/2

Obesity Market Overview

A deep dive into the unmet need, competitive landscape and future of treatment: Obesity primer:

• Defined as BMI >30kg/m^2
• >750M patients globally, including ~40% of US adults --> expected to increase to 1B people / ~50% of US adults by 2030
• Linked to 1/5 US adult deaths

However, just ~2% of people (15M) are on anti-obesity medications (AOM)

Public market performance of AI-enabled drug developers (a subset of the #TechBio space)

How they've performed (and why they've struggled): Following several high-profile IPOs, shares of AI-enabled drug developers (AIDD) briefly peaked in Q1'21, before underperforming every quarter thereafter

Collective underperformance of this group:
vs. XBI: (~52%)
vs. NBI (~69%)
vs. S&P (~74%)

What happened?

My view on the top acquirers for $MDGL after yesterday's stellar data announcement in NASH

+ key late-stage pipeline assets in NASH & catalysts through 2023 & beyond: I pulled together the initial list above based on big pharma exposure to the NASH / metabolic space and then gave each a score based on these criteria:

(1) Current NASH pipeline
(2) Past BD and M&A activity in NASH
(3) Mgmt. commentary on M&A preferences
(4) Gut feeling

Snapshot of cell therapy M&A and IPO activity from 2013- 2022 YTD

+ select 2022 private financings and recent BD deals: After Gilead / Kite (2017) and Celgene / Juno (2018), M&A has been slow, aided by a robust IPO market from 2019-2021

Indexed performance for these companies trailed the XBI by (~60%) since 2021

With public markets locked up in 2022, companies have shifted their strategy

Cell therapy landscape 🧬

I pulled together 44 companies with a range of approaches & segmented assets by development phase

Let's take a deeper look Keep in mind, this is not the entire cell therapy landscape, but a good snapshot of clinical progress & key assets

With 6 approved products, >$5B in aggregate sales & a shift into earlier treatment lines, cell therapy awareness and adoption has hit a commercial inflection point