YouSaid · the spoken record

D.A. Wallach

lines on the record: 76
first: 2020-03-31
most recent: 2020-03-31
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“Involved because trust me, he's going to help us bring Spotify to the US. And that was like a huge break. Obviously, my parents, you know, it's the greatest gift is life. So that's probably the kindest thing anyone's done for me. Although I don't know that it was totally altruistic. So, man, I wish I had a really nice, pithy answer for you, but I feel like it's a constant influx of generosity and friendship that I'm on the receiving end of.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“There are just so many. And I feel like my career, at least so far, my life has sort of been this like falling up phenomenon where, you know, it's like I'm in college and we're on the verge of needing to go and wait tables and I hadn't bothered to go do an internship at McKinsey or anything. And then Kanye shows up like Deus ex Machina and saves us. You know, I'm in the music business and I'm an artist and I hate touring and I don't know what I'm going to do next in life. And I learn about Spotify. And one really wonderful person in my life was a guy named Shaquille Khan, who was one of the early investors in Spotify. And he really believed in me as having the potential to not just be an artist. with Daniel Ack and Martin, who had founded the company and said, you know, I know this is weird, but we got to get this guy.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“To the content because now you've got all these platforms that have to compete with each other for consumer affection. And the way they do that is to try to offer unique differentiated content. So now the powerful position is to actually be a content creator. And I love that, obviously, as an artist at heart, but it's been great for Hollywood because the actors and the production companies, anyone who knows how to make TV shows or knows how to make movies is back in the driver's seat because they've got this diversity of competitive buyers who are all fighting to get the best content.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“The history is not been long enough in the media industries to make sweeping arguments about any kind of laws. But one pattern that people have pointed to repeatedly is that there's this kind of pendulum that swings between content being king and distribution being king. And what you saw happen in the past decade was Spotify, Apple Music, Netflix, Amazon Prime. Those were new distribution platforms that were the great successes of the past decade. So 10 years ago, the way to make money in media would have been to back the right platforms. Now that that distribution ecosystem has reached a sort of new equilibrium that corresponds with streaming, it seems that the pendulum has sort of shifted back”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Was certainly profitable, but it was also seen as largely promotional. You'd go tour in order to build your fan base so that they would buy your records. And when I came into it, it was the exact opposite. It was that you would put out a record and people would basically steal it. And then you'd go tour to make money. And hopefully those people who had stolen it would buy a ticket. So what this led me to was my involvement and investment in Spotify, which was really my big break as a business person. And I recognized that opportunity because what Spotify had the potential to do was get all of these free music listeners back into a paid behavior model. And that's exactly what they've done. And now streaming music represents a significant majority of the recorded music business.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“My experience in those years is what launched me into my investing life because the music industry that I came into was really a shadow of its former self. And what had happened in the 15, 20 years prior to our record deal was that the recorded music business was eviscerated by the internet, starting with Napster. And you had ended up with a market where none of the music fans paid for music. They were all either downloading stuff illegally or they were going on YouTube, which had become the world's biggest music service. And so what I discovered as an artist was that on the commercial side, we had entered an industry where the only way to make a living as an artist was to basically be on tour all the time. So I think musicians in the past might have made half or more of their money from selling their music. And then the rest of the touring part.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“And we did a record deal ultimately with Pharrell and a guy named Jimmy Ivan, who then built and sold beats to Apple. And at the time he ran Interscope Records, which was our label. And I spent three years making music and touring the world with Lady Gaga and Pharrell and Weezer and Blink 182. And it was just an amazing experience.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“You just described it very well. I had started a rock band freshman year at college. With four of my classmates. And three months before we graduated, we had been sending out literally thousands of copies of the CD we'd made. And we had slaved over this for months and months and actually, I mean, years at that time in the basement of one of the dorms at Harvard where there was a recording studio. And we just got... And we ended up selling a record deal. I mean, it was surreal because we were living in dorms. And, you know, then on the weekends flying out to LA and hanging out at Kanye's house and, you know, in the studio with all these big artists.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Timing's everything. And I think in the case of this microbiome work, I sure hope that some of these companies succeed because they're working on cures for things like irritable bowel disease that are really in need of solutions. But my guess is that it's probably a little early.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Elon's trying to do this. And now it may actually be the right time because the technology's gotten there. The other funny connection to Elon's entrepreneurship is that my other investment was a company called Zap, and they were a San Francisco company that made electric scooters. And these were basically just like the limes or the birds. I mean, basically the same form factor, but 25 years ago, and they were like $1,000 apiece. But as a 12-year-old, I thought, man, this is the coolest thing. Like, who isn't going to want one of these? And also, cities are getting congested. Like, why are we all going around in cars that are 15 times the size of our bodies? Our vehicles should be not much bigger than us. And I was totally wrong, both of those companies totally ate it and don't exist anymore, I think.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Lesson about this the hard way. My mom was in the investment industry. She built 401k businesses for large insurance and mutual fund companies. And when I was 12 years old, my first lesson in investing was she gave me a thousand dollars in a Schwab brokerage account and she said I could buy whatever I wanted. I bought two stocks and they were both far ahead of their time, I think, but nonetheless huge mistakes. The first was Iridium, which at the time was trying to put satellites all around the world so that we could have global cell phone and ultimately internet coverage from space. Turns out 30 years later I'm an investor in space.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“So, this is like this whole new universe. We're throwing the kitchen sink of research tools at it to try and quickly figure out what the heck's going on. And that's where the DNA sequencing comes into play, among other tools. And you've also, in the past five years, seen a number of very well-funded startups arise that are promising to leverage this new universe to create novel types of drugs. One approach to this would be to use bugs as drugs. So could patients swallow a pill that includes bugs that they're missing in their gut without which they may be deficient in certain functions? And so there are companies working on that. Now, my perspective is that it's probably a little bit early in the science. People might be jumping the gun a little bit on the technology. I learned a lot.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“That's a fascinating one. So, we can talk about it for a second. I mean, the short answer to your question is there are dozens of these frontiers, and I can go on and on about all of them. The microbiome is a really interesting one because I think for investors, it sort of begs this question of timing, as you put it, this is really a frontier. It's as if we've discovered a whole new universe of biology. And the short of it is that we've now learned that within our bodies and on the surface of our bodies is enormous ecology of non-human microbes that we have cooperated with in evolutionary history. They live on us and in exchange they do stuff for us. And that stuff probably includes aiding in our digestion and even manufacturing essentially drugs in our gut that get absorbed into our bloodstream and do all kinds of essential things in places as far from there as our brains. Go figure.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“So there is basically, in my view, a consensus among the smartest minds and technology that the next major waves of innovation are going to be in healthcare and biotech. And that's why they're placing their bets there.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“As I understand it, 60% of their investments last year were in healthcare and life sciences. If you look at what Apple is doing both with the AirPods and the watch, they're trying to get closer and closer to your physical body such that they can measure things that are going on, including, for example, your voice With the AirPods and the Apple watch even explicitly now has an FDA approved hard application. Google bought Fitbit. So what you can see is that these large public technology companies are internally looking out at the future and they're saying what are the big next markets we can go after and healthcare is the first answer for all of them. Same goes for Microsoft, by the way.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Think that's right. And one of the points I'd make that I think is boding well for healthcare, and it's part of why I jumped into it with my weird background as an artist and all of that. 10 years ago, or let's say it's 15 years ago to be safe, I don't know if any public market analyst would have predicted that the biggest entertainment companies in the year 2020 would be Apple, Amazon, Netflix, and Google. And yet that's the world we live in. And I think in our space as well, in healthcare, you see the same things on the horizon. If you look at where Google is investing, they have a venture capital fund called Google Ventures.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Make sure you're handled on that front, and I invested in that actually, it turns out with a fund that I'm an advisor to, Will Smith's Venture Fund, which is called the Dreamers Fund. We love that product because it sort of straddles these worlds of consumer wellness and healthcare It's great data, but folks like you are buying that with your own hard earned money. And I think it's a great product.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“And the aura ring is great, by the way. I'm sorry to hear it broke. So we got to get you a new one. I'm an investor in Aura.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“You know, abstaining from alcohol over time is helpful on the cancer front. And so I think you can probably have a pretty big impact on your long-term health by not drinking.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, I'm not a super nut here. I wish I were healthier than I am, and I wish I exercised more than I do. I try to exercise every day. I've got a peloton now and I ride that thing for 20, 30 minutes in the morning when I get up. And, you know, having it right near my bed makes it really easy. I don't have any good excuses. The glucose monitor is interesting. I think the one that is very obvious to me, but not widespread, at least among older generations, is I've basically stopped drinking. I mean, there's just no question that alcohol is not good for you. So notwithstanding that there are, you know, various antioxidants and all these kinds of things, there are other ways to get the good parts of wine. And, you know, I find that not drinking really helps me with my sleep. And I think there's probably a lot of, it's a known carcinogen, you know, in sufficient quantities. So probably...”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Incorrectly say have it and be given a false positive to. We're starting to see very well funded companies roll out what are called liquid biopsies. These are blood tests that are aiming to detect cancer very early in the bloodstream. And one of the problems that we're really worried about with these tests is that if the specificity is not high enough, then we could have a very dangerous false positive rate. In other words, imagine next year that 300 million Americans get tested and there is even a 99% specificity. I mean, that sounds great, but it means that one out of every hundred people we test, we're going to be giving a false positive to. And then we're probably going to go and spend a bunch of money doing biopsies on them or putting them through CT scans or even giving them unnecessary surgeries. And so that's why it's”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“End up with is a dynamic where we look at everything but we treat less. And one of the risks of that constant sensor approach is that it may lead us to overtreat. In diagnostics, there are these confusing concepts of sensitivity and specificity. Sensitivity refers to the percentage of patients with a disease who you test and will successfully detect. So if 100 people walk in with a disease and you have a sensitivity of 70%, you will detect 70 of those people and 30 of them you will give false negatives. Specificity, on the other hand, refers to the true negative rate, which is to say if 100 people come in who don't have the disease and you have a specificity of 70%, 70% of those people you will correctly say do not have it, 30% of them you will”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Of the prostates that we biopsy come back with a result that is sort of ambiguous as to whether or not we should operate or not on the patient. It's probably the case that a lot of those operations are unnecessary and that they actually cause more harm than good because they leave the men who receive them with incontinence or erectile dysfunction or other problems that they didn't have. And the slow growing cancer that they may have would not have killed them before something else would have. So I do think it's reasonable to ask where are we over deploying medicine and in those instances obviously we should do less of it. But again, I believe in this future where we're going to be collecting a lot more information. We're going to be doing all this kind of ongoing monitoring of people. And in that paradigm, hopefully what you'd”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“And large, I think it's wrong because there are patients like my mother in law today whose lives are being saved definitively by amazing drugs without which they would die. So, folks, with that point of view, I'd say go talk to those patients. That being said, there is such a thing as overtreatment. And it's, in fact, one of the problems with our system is that we significantly overtreat people who maybe don't require it. So a great example would be back surgeries. is a huge overuse of back surgery in America. And many of the studies have demonstrated that a large percentage of patients who get back surgery would essentially do as well or better with consistent physical therapy. So that's an example where we're spending a lot of money intervening where we shouldn't be. The same is true also of, for example, prostate cancer. So we test people for prostate cancer, and unfortunately our testing is not all that helpful. So a large percentage”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“So we're always looking at it and thinking about it because obviously the delivery of care is where all of this medical innovation ultimately touches patients. So it would be a tragedy if we had this renaissance in medicines and yet a total sclerosis in the way that we deliver that medicine. That being said, I'm a little more sober on the healthcare delivery market given that your audience here includes all kinds of investors I would say I think it's a great place for”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Services. And in that negotiating process, the respective leverage of the insurance company and the hospital will drive the level of prices. So in many small towns or cities, there might only be one hospital. And what that means is that any insurance company who wants to offer a product there is going to have to play ball. And it is basically negotiating with a counterparty who has all the leverage. Because if the insurer doesn't accept the prices that that hospital is offering, get lost, get out of the city. You don't need to offer a product here. And you can't. These are the sorts of things that have led to our sort of cost disease, legal monopolies, absence of price discovery, and de facto monopolies resulting from geographic control of markets by hospitals.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Hospital pricing is very often that there's an insurance company that would like to offer an insurance, a health insurance product in a given geographic market. So they go to Madison, Wisconsin and they say, you know, we would love to launch an insurance product here. In order to offer a product that patients are going to want or that employers are going to want to choose, they need to build a quote-unquote network of service providers, which is to say if you have this insurance, here are the people you can go see. Here are the hospitals you can go to, here are the doctors you can go to that we will cover. What establishing a network requires is for that insurance company to go and do deals with all of those providers. So they go to the hospital and they say, we would like to be able to send patients that we insure to you. Let's negotiate all the prices for which we will reimburse your”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Although it's not perfect, and we are missing the incentives to develop, for example, much better anti-infectives. So right now, as you know, we're in the midst of this coronavirus pandemic. And one of the things that that reflects is that we have underinvested in infectious disease prevention, monitoring, and pharmaceuticals. And part of that results from the lack of incentives for entrepreneurs to develop new types of antibiotics or anti-infectives. The other type of monopoly, though, that exists is among healthcare providers. So maybe this is a nice foray into the world of the sort of delivery side of healthcare. Chief culprits in our cost disease in America, I believe, are hospitals. And you can look at many hospitals as essentially being local monopolies. So the dynamic that”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“So I think there are multiple issues within that. One of them is this issue of price discovery. And that's where the opaqueness and the complexity of the supply chains really gets in the way. So I think you're correct. There is very limited price discovery in healthcare as a general statement. Beyond that, there are also a lot of monopolies. And some of those monopolies are driven by patents. So when the FDA approves a new drug and there are patents on that drug, not only does the patent provide a competitive moat for the drug developer, but the FDA's approval comes with market exclusivity, which is another form of a legalized monopoly. We have established these legal monopolies in the drug market for the purpose of incentivizing people to develop drugs that don't yet exist. And we have indeed succeeded at creating that incentive.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“So, we are essentially by paying up today, giving a gift to people in the future. But the second issue is that drug prices have been driven up and up on drugs that are not that new or innovative, including drugs like insulin that are taken by type 1 and type 2 diabetics. And everyone has been trying to point the finger at the pharma companies or at the insurance companies. And so that brings up this second price, which is the net price, which is to say the actual net cost of the drug to your insurance company. What has been going on is that the list prices have been charging up and up and up every year, but so too have the amounts of these rebates. So in reality, the net prices of drugs have not been going up very dramatically, but it looks like they are because these list prices keep going up.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“In the universe. So making a dose of this product for a patient might even cost up to $200 or $300,000 cost. That's before you think about the pharmaceutical company trying to recoup all of their research and development investments that led to the marketing of that product. And so indeed, some of these breakthrough new drugs have been charging price tags that on the surface appear outrageous, like a million dollars a patient. But in fact, are much more reasonable. I think if you put them in their proper context. And also if you consider the fact that 20 years from now or less, they will become generic. Their patents will expire, and those products will become very inexpensive for all people in the future.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, the starting point for that essay is that if you've been watching the Democratic primary debates for folks in the future, this is the year 2020. And so there's been a very diverse field of democratic candidates vying for the nomination. And one of the consistently hot topics has been drug pricing. So you've heard over and over again about these big, evil pharmaceutical companies charging hundreds of thousands of dollars for treatments. Within that, there are at least two issues. One of them I'll just briefly address, and that is that some of the new breakthrough drugs that are coming out have very, very high cogs. So as one example, there are cancer cell therapies today where you actually use a patient's own immune cells as a drug to treat them. These are effectively nanorobots. And this is the most advanced human technology.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Their role a decks have experienced biopharmaceutical business people and initial founding team, and they'll water it with money and create something from scratch that they, the investor, oftentimes own 80 or 90 percent of from day one. Now, the investing that I primarily do is a different model. I require that when we're going to back someone, there is not only great technology, but also a great entrepreneur, and that that entrepreneur has a lot of skin in the game. And so I in fact want them to own a significant amount of the company because I want their future fortune to depend on it. And in some ways, this is an older form of venture capital in biotech, given how popular this venture creation model has become.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“We first encounter they may continue to work with the inventor and that physician or scientist is probably going to remain on the scientific advisory board of the company or maybe even be a chief scientific officer. But as I said, they're not usually going to be the CEO. What that has led to in the venture capital market in life sciences is that many of the best investors in the space, and almost all of them are in Boston and San Francisco. So let's get to that in the future, but I'll start by making this point that they're very geographically concentrated. And what they are largely doing today is as venture firms, they are trying to build companies around technologies. So these investors will find a really cool piece of intellectual property at MIT or at Harvard or somewhere like that or Stanford. And then they will recruit entrepreneurs from”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“It's very unique. And you're right, most of the originators of the technologies we look at are either physicians or academic scientists. Now, one of the things that's unique about those inventors is that they've got great jobs already. So many of the academics are tenured faculty members at great universities. And their mindset is they want to invent stuff. Yes, they'd like it ultimately to reach patients and have an impact, but many of them are not trying to leave their jobs and start a company. And so in many cases have a situation where the inventor of a technology is not actually going to be the entrepreneur. Maybe they will be at the very early stages, but pretty quickly it is often the case that someone else is going to take a technology and run with building a company. And that will very often be the person who”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Essentially, a forced buyer that every year is purchasing $20 to $30 billion worth of startups, and there's no reason to expect that they're going to stop needing to make those acquisitions. So as investors, what we think a lot about is how do we build the things that they're going to need to buy in order to remain competitive?”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“I mentioned they used to do that by trying to develop the next great drug internally. And they would try to invent these products from the very earliest stages. So they might collaborate with academic scientists in universities and then immediately try to translate their discoveries within the company, or they might even try to discover basic biology de novo internally. What has happened over the past 20 years is that all of the big pharma companies, almost 201, have divested from internal research and development, especially at the early stages. And they have all pivoted to a model of buying startups, either from the private market or biotech from the public market. This is the seismic shift in our industry that has created a structural opportunity for venture capital that didn't exist before because we now have”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Have these huge global multinational pharmaceutical companies who have massive incumbent advantages. And one of their big advantages used to be that they employed each of them thousands or tens of thousands of scientists whose jobs it was to develop new drugs. And the impetus for this was that big pharma companies have portfolios of products, but most of those products have expiration dates that correspond with the patents that they own on those drugs. So a typical pharma company has this portfolio of products and they know a priori the expiration dates of those products and they can pretty well estimate how much revenue they're going to lose when they hit those patent cliffs. And so they have an inescapable need to replace expiring products with new products.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“The returns you generate are a function of how you exit the investments. So when we talk to entrepreneurs, we're very transparent about this. I mean, we're not suggesting that we are engaging in quick flips here. Our goal is to build startups to the biggest version of what they can become as quickly as possible. And if they've got amazing ambitions, let's go for it. But still, ultimately, our returns are going to come from the exits. So in the markets that we play in, a lot of the exits are ultimately driven by big pharma. And so the first question is, over the next five to ten years, what is Big Pharma going to need to buy or develop to remain competitive? That's a great segue into.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“And furthermore, I think it's very likely that we're going to cure some of these very stubborn diseases like cancer. So those are all future things. And with it, all of this quantified self and monitoring and everything. Now, in the nearer term, in the field investor, the question is, how are you going to make money over the next five to ten years, which is the time horizon that we play in as venture investors funding private startups? When you ask that question, I think the starting point has to be asking what the exits for these companies will be. It's much easier to get into venture investments than it is to get out of them.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“We've been talking about so far are these big lofty visions about what the future looks like. And as an early stage venture investor, I think it's important to do those explorations because you need to have a sort of north star that orients you towards the opportunities you encounter. So when I think about this future, in fact, the distant future in many ways is much easier to predict than the proximate future. So I have no doubt that in a hundred years we're going to be broadly applying genetic editing technologies. I have very little doubt personally that assisted reproduction through technologies like IVF is in fact going to become much, much more pervasive than it is today. I'd even go so far as to suggest that I think there's some chance that a majority of babies born 100 years from now will have been born as a result of reproductive technology.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, it could be both. I think where those two possibilities connect is that in order to usefully identify deviation from quote-unquote healthy for each of us, you first need to have a baseline understanding of what we look like when we are healthy as individuals. So Google, among others, has been undertaking a huge research project. Theirs is called Project Baseline, where they've taken, I think, as many as 100,000 people and measured all kinds of biomarkers in them, I think every few months, now for several years. And the purpose of that study is to get a sense for multiple individuals of what the healthy values look like across a range of biomarkers. Because what we all need is essentially this baseline profile. And then, as I mentioned, Alerts that are able to identify deviations from those baselines”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“So, in a lot of ways, I think that's the most exciting potential for this kind of personal monitoring is very early detection of progressive disease”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Eric Toppel's formulation, I think, 15 years ago, which is that the model we should be pursuing is essentially that of a car. A modern car today has all of these sensors in the engine and the tires for pressure and the brakes and everything. And as something starts to go wrong, something lights up and tells you, hey, you should go check this out. Today, we largely have a reactive approach to medicine. You don't typically go into the doctor and the doctor doesn't typically do anything for you unless you're already noticeably sick. And biology and disease are so complex that once a condition has gotten to the point where it's obvious that you're sick, it's likely to be much harder to put back in the box than if you had identified it at its earliest onset.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Couple of the things that people are also looking at measuring. In fact, we're already doing it would be ambulation. So how you walk, what your gate is like. You can imagine facial expression and body movement being very interesting. Facial expression, for instance, might provide early indicators of neurodegeneration. You could see almost imperceptible droopiness in a face, for instance, or biomarkers like that, that otherwise we wouldn't detect until much later on. Voice, it turns out is pretty interesting. You know, our voice contains a lot of information about our emotional state, how much variance there is in the pitch of our voice may be a clue as to whether we're depressed or not at a given moment. The things I just described, you could already measure with the technology that's in your cell phone. I think as a blueprint to where this whole sort of quantified self-movement goes, I would refer to my”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Time all day, every day. And I do that not because I'm diabetic, which is the proposed use of this product for most people. It's because I love sweets. I love ice cream and cookies and whatever. And so it's actually helpful for me to be measuring this because it's like being supervised by a teacher or something. There's a consequence that I see in the data when I look at every night that kind of punishes or rewards me for how well I adhered to my goals. I, as an individual, have decided I think is going to help me live a healthy life. I'm spending money on that out of pocket.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“They're also doing it because they genuinely believe that these products are going to impact their health and the happiness of their lives. I think the question is how much potential is there for technology to take us beyond what we can achieve by sleeping well, eating healthily, and exercising. And we know that doing those things is really good for you. So if you just do those things, you significantly juice your chances of living a long, healthy, happy life. Now, there are a class of products that are there to potentially help us do those things better. So, for example, inspired by Peter, I wear a continuous glucose monitor, and this is literally plugged into my body. I wear it on my upper arm, and it is measuring the amount of glucose in my blood in real time.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“A great question because, in addition to the healthcare market, what you're alluding to is that there's also a massive, what people now call wellness market. The distinction being that in healthcare, at least in the United States, the patient is not the customer. In other words, when you go to the doctor almost always, you're not going to be paying the bill. Your insurance company is going to be paying the bill. Most of the medical industry that I focus on is the part where the patient is not actually the direct customer. In the wellness space, by contrast, the patient is spending their own money out of their own wallet on things like gym memberships or smoothies or pilates or wearable fitness trackers and those sorts of things. And of course, people are doing that, not just to show off, that's part of it.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“My mother in law has been on. So I think the answer to your question is that we all have to follow where the biology leads us. In the past decade, that's led the markets into an obsession with immuno-oncology, which is to say using the immune system as a tool to fight cancer. And that has resulted in at times perhaps an overly single-minded focus on the part of investors and big pharma companies on trying to back or invest in competitive new products in that field. But the biology will not stop there. It's going to lead us into other spaces, and you got to go where it takes us.”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source
“Is putting billions of dollars a year into basic research and brilliant scientists are following their own muses to explore nooks and crannies of biology that they think might yield some breakthroughs. And occasionally, thankfully these days, more frequently than in the past, they are stumbling upon amazing insights. So then the next step is how do you take those basic insights or breakthrough technologies from a lab and actually commercialize them ultimately so that they can reach patients. And what we've seen happen in the past 10 years is a total renaissance in cancer biology. And then as a result of it, as I mentioned, really remarkable new products coming onto the market like the one that”
2020-03-31 · Invest Like the Best · D.A. Wallach – Investing in Healthcare - [Invest Like the Best, EP.166] · IDENTIFIED FROM THE TRANSCRIPT · source