Dear clients and friends: Given your interest in health and medicine, we would like to share with you our collection of the most interesting perspectives on our industry's trends and developments. We are happy to share them with you — and hope you share your thoughts with us.

1. A Market Failure of Modern Science

The “replication crisis” in science isn’t a science problem. It’s an economic one, according to Jim Olds, longtime veteran insider of the NIH and NSF. Consider the market incentives from a researcher’s point of view:

You have limited time and resources. You can either:

1. Pursue novel findings → potential Nature paper, grant funding, tenure

2. Replicate someone’s work → maybe a minor publication, minimal funding, colleagues questioning your creativity

The expected value calculation is obvious. Replication is a public good with privatized costs.

2. The Next Word in Medicine

Dr. Eric Topol shares new evidence that we may be at “the dawn of primary prevention.” Just like your phone can predict what word comes next in your text message, AI tools are learning to predict what diseases come next in your life:

Not only are there many new layers of data—organ clocks, biomarkers, genomics, biosensors—but we have multimodal A.I. and agentIc A.I. to analyze the data. For the first time, we are seeing a large health model (Delphi-2M) that has learned the grammar and language of health, tokenizing it to predict diseases with temporal anchoring. From Delphi-2M, we learned that person’s health story can be projected 20 years ahead. This represents a jump from my prior piece on precision medical forecasting. Future models will keep improving on precise medical forecasting.

Topol is optimistic: “it will ultimately wind up being seen as the most important contribution of A.I. for promoting human health.”

3. Bonfire of the Opacities

The Economist crunches the numbers and concludes that while Americans spend “$6,000 [per person, annually] more on average [for healthcare] than other rich countries,” big, bad pharma is not to blame:

The bulk of the rents is captured instead by providers of health-care services such as hospitals and the system’s true money-makers: insurers, pharmacy-benefit managers and other middlemen taking advantage of its opacity.

4. Lattes, not Cheesesteaks

 The battle over the next biopharma hub is tilting westward. Not long ago, it seemed that Philadelphia was primed for victory:

Companies were sprouting up and out of university labs and raising tens of millions of dollars in venture capital — well before they could even dream of sniffing profitability. In 2021, New York and Silicon Valley venture capital firms invested $8.4 billion in Philly companies — more than the previous nine years combined — with biotech being a big part of that. It felt like a turning point — Philly finally breaking through with homegrown, commercial successes. Today, however, that unbridled enthusiasm is gone.

Now momentum has shifted to Seattle, where the secret ingredient is – wait for it - AI:

“Seattle has a perfect marriage of tech and life sciences,” echoed Naiteek Sangani, who is helping lead Microsoft’s use of generative AI in biology. The region offers “a very well-structured way for us to accelerate the inclusion of AI, health and life sciences.” As the city strives for the No. 1 spot in this rapidly evolving field, new startups and initiatives keep bolstering its standing.

5. A Liver Transplant

So often, the hard work of healthcare is relegated to powerpoints, spreadsheets, and Teams meetings with Legal Affairs. A recent post by Donna Vatnick at Asimov Press sends an electrifying reminder of the power of a good story well told. It’s safe to say this is the most gripping – and refreshingly instructive – piece you’ll ever read about a liver transplant:

A liver procurement begins with a buzz. Using an instrument called a bovie, a narrow wand whose electrical current cuts skin while sealing the bleeding soft tissues beneath, Dr. Lee made the first incision, from collarbone to pubis. Seconds later, the room filled with the smell of burning hair and a fleshy aroma that only surgery veterans feel comfortable comparing to barbecue. The cutting revealed layers: first, something fluffy and white, like the inside of a cattail, then glistening, yellow fat. Above the belly button, Dr. Lee carved a horizontal line, forming a crucifix. Flaps of skin were pulled back with metal clips, and the inside of the abdomen rose into the light, still moving.