The Ledger
Every statement that passed quotation and attribution checks. Mix any filter with any other: certainty 1/5, debate potential 5/5, or both at once.
why aren't all 75 resolved? a statement only gets an assessment when the public record can support or contradict it. opinions and what-ifs never can, and 2 checkable ones are still open, waiting for their date. predictions held up or didn't; assertions are supported or contradicted. on every card: ▮▮▮▮▮ certainty · ▮▮▮▮▮ debate potential. speakers are clickable
Conde: AI has not yet compressed biotech clinical trial timelines
“We still haven't seen, and I think it's coming, but it hasn't happened yet. We haven't seen artificial intelligence or other technologies massively compress the amount of time it takes us to do the clinical development, the clinical trials, the enrollment of p…”
Novartis's one-time gene therapy for spinal muscular atrophy costs $2.1 million
“You know, in the case of treating a baby that had, you know, something like somatic muscular atrophy that would have otherwise died, a one and done gene therapy from Novartis, this is a therapy that's worth about, it's cost about 2.1 million dollars, effective…”
Conde: Engineering principles make later drug programs more valuable than earlier ones
“The second drug is more valuable than the first if you're using engineering principles, because what you learn from example one sort of imbues value to example two and so on and so forth.”
Conde: Biology is transforming from experimental science into an engineered discipline
“It's really just one subset of what we think is the broader theme here, which is the shift away from biology being primarily an empirical or an experimental science to becoming more of an engineered discipline.”
Conde: Platforms focused solely on target discovery struggle to capture value
“And so if your platform is to identify novel targets, it's going to actually be very hard. That's sort of the end of the line for what your technology can do. It's really hard to capture value there. And certainly hard to get that from a collaboration standpoi…”
Conde: Engineering principles make subsequent drug candidates more valuable than earlier ones
“But in your world, in the world you're describing, this engineering world, it's actually the reverse is true. That the second drug is more valuable than the first if you're using engineering principles, because what you learn from example one sort of imbues va…”
Conde: Medicine will cure sickle cell anemia within 10 years
“And so if I had to bet, I would bet that in the next 10 years, we will have solved sickle cell anemia, much like we've solved cystic fibrosis, that had a very similar profile in terms of what we understood about the disease.”
Conde: FDA regulatory risk is fundamentally scientific risk
“FDA risk or regulatory risk is really just another way of saying scientific risk, of saying we're going to conduct an experiment, and we are not quite sure what's going to happen.”
Conde: Healthcare payers are value assessors, not cost cutters
“But the reality is payers aren't cost cutters. They're assessors of value. And if you have transformative drugs, or if you can transform how we think about diagnosing and screening disease, the payers are willing to pay for that value.”
FDA creates new office and Warp Speed pilot for rare diseases
“The FDA is looking to the skies and taking a page out of the FAA's approach to aviation safety, rigorous yet adaptive. Recently launching its own new office for therapeutic products and piloting Operation Warp Speed for rare disease to create more transparent …”
FDA approves first CRISPR gene editing therapy for sickle cell anemia
“The breaking news is that the first CRISPR therapy has been approved. This is a therapy for sickle cell anemia and beta thalassemia that was developed by a biopharmaceutical company called Vertex Pharmaceuticals, working with another company called CRISPR Ther…”
CRISPR progressed from initial discovery to FDA approval in just 10 years
“It's barely been 10 years since the concept of CRISPR was discovered and described in the scientific literature. So we went from the initial discovery of CRISPR as a potential use as a medicine, all the way to an approval in just over 10 years. That is lightni…”
Advanced cell and gene therapies require novel pricing and reimbursement models
“If we're gonna make this widely accessible to patients that need them, it's gonna have to be affordable. So we'll need new models for how pharmaceutical companies charge for this, and we're seeing early days of this. We're going to need new models for how paye…”
Conde: CRISPR and Asimov are turning genetic engineering into true design
“And now I think with the advent of things like CRISPR and things that companies like Asimov are doing where they're actually making DNA a design medium. I think it's, we're actually starting to make genetic engineering be an engineer discipline, but I think th…”
Conde: Enterprise 'land and expand' failed in biotech due to bespoke science
“The famous concept of land and expand on the enterprise side. You can actually start to see some of that in biology. The reason why land and expand historically hasn't existed in biotech. Is because the expand part was really hard. Because things were so bespo…”
Conde: Illumina's sequencing breakthrough was driven by engineering, not biology
“And really what drove that wasn't some fundamental discovery on the biology or the science. What drove that was Illumina was able to apply Three very specific and distinct engineering disciplines and converge them. One was the use of microfluidics, the, just a…”
Conde: Medicine is on the verge of creating intelligent living drugs
“And I think one of the things that we're seeing is that now when we can start to design cells, we can actually start to design cells that have logic, that will know where to go in the body, what to do when they encounter disease, and how to essentially termina…”
Conde: Facebook recruitment reduced Parkinson's trial acquisition costs by 96%
“A great data point that I heard recently was a partnership that Facebook made with the Michael J. Fox foundation to find ways to pilot the use of social networks to recruit patients for Parkinson's disease trial using social media. They were able to reduce the…”
Living medicines are finding cures for leukemia, blindness, and PKU
“And as we can see in leukemia, as we can see in inherited forms of blindness, as we can see in PKU, these living medicines are finally leading us to where we've always wanted to be, which is to find cures.”
Conde: Bio entrepreneurs must prioritize and execute early killer experiments
“If you're developing technology in the biology space, you should know what your near term killer experiment is. And the experiment that if it does not work, It's, you know, kill mode for whatever you're developing. And you should know what that is. You should …”
Conde: CRISPR and new tools make genetic engineering a true discipline
“And now I think with the advent of things like CRISPR and things that companies like Asimov are doing where they're actually making DNA a design medium. I think it's, we're actually starting to make genetic engineering be an engineer discipline.”
Conde: 'Land and expand' business models failed in traditional biotech
“The reason why Land and Expand historically hasn't existed in biotech is because the Expand part was really hard. Because things were so bespoke.”
Conde: Average drugs require $2.5B and 10 to 15 years to develop
“And so when you add all of this up, it takes an incredible two and a half billion dollars and 10 to 15 years of investment to get the average drug to market when you account for all of the failures along the way.”
Conde: Future cell therapies will use programmed logic to target diseases
“Well, if we get really good at understanding biology, and we get really good at engineering biology, on the horizon, we have the ability to begin to program cells so that we can imbue them with logic. So we can take a cell and have it understand how to find di…”
Conde: Facebook reduced clinical trial patient recruitment costs by 96%
“So Facebook, for example, as I mentioned earlier, is using their social network to help us identify and recruit patients for clinical trials. And in fact, they did a pilot project with the Michael J. Fox foundation where they were able to reduce the cost and t…”
Conde: The FDA has become an incredible collaborator to industry
“So I think if anything, the FDA has become an incredible collaborator to industry.”
Legacy drug development is inefficient and single-use like old rockets
“Traditional drug development is painstakingly time-consuming, risky, and expensive. It's highly bespoke too. One molecule has no bearing on the next molecule that gets developed. Like traditional rockets, they're one-time use only.”
Gene therapy delivery platforms enable modular repurposing across different diseases
“If we're able to make a medicine that does that, that can deliver one gene to a given cell type, it becomes increasingly likely that we'll be able to deliver a different gene to a different cell type for a different disease.”
Biology is the most scalable technology on Earth
“If there is one technology on this planet that can scale better than anything else we know of, it's biology.”
Hospitals will specialize only in complex surgeries as care moves home
“And that's not to say that hospitals will disappear altogether, but I think what's very surprising is the kinds of procedures and activities that we'll see in hospitals will be specialized to the things that are so incredibly complex, like surgeries that requi…”
Healthcare technology will create new medical specialties like radiology did
“And I think one of the most surprising things we'll see is the emergence of new specialties that come from the use of technology in healthcare, much like radiologists, of course, came on the backs of the ability of the availability of x-ray technologies.”
iPhones can now perform EKGs, manage blood pressure, and sequence DNA
“It's been fascinating to see the broad range of applications that you can do on, on an iPhone today, whether it's an EKG or to manage blood pressure, or you can do DNA sequencing even today.”
Conde: Six Million Dogs Are Diagnosed With Cancer Yearly in the US
“Six million cases a year of diagnosed cancer in the United States in dogs.”
Conde: Traditional synthetic biology requires testing 10,000 candidates per success
“I think one of the big things in synthetic biology has really been, you try 10,000 things to get one thing to work.”
Conde: Human genome sequencing cost dropped from $3B to under $1,000
“Today, because of improvements that were born of the application of engineered disciplines and three very specific ones, we can now sequence a human genome in what used to take 13 years in a matter of hours, and what used to cost three billion dollars for less…”
Conde: Bio-engineering companies will scale and dominate markets like tech
“One of the very interesting things about this particular space is these companies will look very tech-like in terms of their ability to create new markets and scale and dominate those markets, and those are obviously very attractive and interesting opportuniti…”
Conde: Engineering biology will produce tools even more powerful than CRISPR
“As we move biology more and more into an engineer-based discipline, I think we're going to see more powerful modalities like CRISPR.”
Conde: FDA advisory panels passed gene therapy and CAR-T unanimously 13-0
“Gene therapy, an area that historically has been considered to be very risky, has been shown to be so effective in this form of treating inheritable form of blindness, That that passed the FDA panel recommendation unanimously, a 13 to zero vote. CAR T similarl…”
Conde: Biology will expand beyond healthcare to touch every major industry
“Biology is no longer an industry in and of itself. It's something that's going to touch every single industry, and we're already seeing applications in energy, in textiles, in food, of course in health, and in data storage.”
Precise editing and better delivery will expand gene therapy applications
“So as we advance our ability to deliver gene therapy, as we advance our ability to actually very precisely edit the genes, and only the genes that we need to edit, gene therapy will become applicable to a far broader range of diseases, not just limited to thos…”
Synlogic initiated the first clinical trial for an engineered microbe therapy
“And the first clinical trial to do this is already ongoing. A company called Synlogic has engineered a microbe that allows it to break down A, an amino acid in a disease called fetal, phenolketonuria, PKU, in patients that are unfortunately not able to break d…”
Conde: Bio startup pilot projects often take twice as long as expected
“If you were, you thought you would finish pilot, you know, a pilot project and get paid X in Y amount of time, oftentimes you're getting paid X in something like two X, two times the Y amount of time, and you're also working a lot harder if there's been scope …”
Conde: Pharma companies are swimming in targets but lack pipeline drugs
“Pharma companies are swimming in targets, right? The problem they're trying to solve for is how do I fill in my pipeline?”
Conde: Skilled business development teams bridge a fatal chasm for bio startups
“Business development in the bio space is a fundamentally strategic advantage to have. If you have a team that is good at structuring business development deals, in other words, that has experience in the space, that allows you to actually help bridge what is o…”
Conde: Successful drug assets routinely starve underlying biotech platforms of resources
“All of the conversations start to focus on, well, we could always use more resources on making sure that the drug program succeeds, and there's only a fixed pool of resources, generally speaking, and so what ends up happening is the platform Get Start, and I t…”
Conde: Bio platforms should target high-end research institutions before expanding down-market
“And you sell to the high end of the market first, right? So what, you know, what we saw with happening with sequencing was that obviously in the very early days when, you know, the throughput of the sequencer It was low, where the cost was very high. The only …”