2016 In Rearview

At first, finding any two pieces that might fit together in a complex jigsaw puzzle is a Herculean task.  Painstakingly, colors and shapes can be sorted one-by-one into groups that seem to be related.  One satisfying match is then followed by another, sometimes preceded by long frustrated periods of searching yet in other moments an almost magical placement and orientation allows for instant recognition.  With each piece connected, the picture becomes clearer and the pool of remaining pieces smaller.  Each becomes easier to find than the last, and easier to place until at last the puzzle is complete.

So it is with understanding the biologic underpinnings of disease.  At first there is a confusing mixture of molecules, interacting with each other in undecipherable pathways.  Slowly the different types of molecules are identified, separated and tested to see what they interact with and how.  As the function and interactions of each molecule are placed in turn, the picture of causation becomes clearer, and the work to identify the remaining molecular players becomes easier and easier.  

Since the unveiling of the human genome nearly 20 years ago, progress in elucidating the underpinnings of disease has occurred at an exponential pace.  Gone are the days when insights are shared in only annual gatherings or through publications which can be separated from the work to produce them by years.  Instead, this is an age where insights are often shared real time over the internet.  In this way, laboratories learn which pieces have been placed in near to real time and the chase to create the finalized picture is made all the more rapid.  Meanwhile, technological advancements in the tools used to identify important molecular players and to tease out their exact roles is shifting the pace of discovery into entirely new gears.

And thus we find ourselves as we enter 2017, with many of the pieces in many important diseases discovered and those remaining to be placed before there are cures becoming smaller and smaller.  Accordingly, our expectations for advancements in medicine over the next decade should be high.  Very high.  Already we see drugs targeting new molecular pathways, sometimes by making use of our growing understanding of our own body’s disease-fighting functions, entering the market.  The Food and Drug Administration, cognizant of the deepening of our understandings and the importance of new discoveries has created a new regulatory pathway for breakthrough therapies.  Some new products have made it from conception to market in a handful of years.  This timeframe contrasts starkly with the decade historical medicines have required.  Therefore not only will discoveries occur more quickly, but their approval for human use as well.

The stock market has not been sitting idly by.  2012 through 2015 were years in which the biotechnology indexes tripled.  In the private markets, valuations of private biotechnology companies rose correspondingly.  That is until 2016, when the biotechnology index fell approximately 20%, the potential for companies to go public changed abruptly, and funding for earlier stage enterprises began to become difficult again.  What happened?

While the pace of invention is historic, that does not mean it will go in a straight line, or that everyone should have the stomach for the inevitable failures along the way.  During the years of strong performance, many who lacked this perspective joined the joyful fray to participate in the gains.  When the market retraced, however, they found themselves wondering if they could evaluate those companies in which they were invested, and the answer was often no.  Thus, bad market performance led to worse performance by virtue of selling by those headed for the door.  The party, after all, seemed over for now, particularly with a seemingly certain Clinton win on the way and all that could accompany that in regard to what was expected to be negative changes in drug pricing and reimbursement.  The surprise Trump win caused a moment of reflection where prospects for biological innovators seemed brighter, followed by general confusion as campaign promises to overturn the Affordable Care Act became more muted and as bystanders waited to see what a Trump administration might actually look like.

This is all a side show in which it is easy to lose perspective.  Throughout the world there are many different payment systems for new drugs.  Most of them are government operated.  Despite penny pinching and hurdles that have made drug launches more complex in certain countries, there are vanishing few instances where a drug that actually does something new and important receives an inadequate price.  In the United States, whether you have a Hillary Clinton or a Donald Trump, this will be the case in the future.  And the drugs that are to come will do important things.

What is more problematic are the disconnects between academic medicine and the commercial world.  Academia is where most of the interesting new science is emanating.  Yet in the academic setting, it is difficult to marshal all of the technical expertise and funding required to advance a medicine past the conceptual stages.  Meanwhile, the venture industry and the pharmaceutical industry have sought to cherry pick the best academia has to offer.  However, identifying the cherries is something no one has been good at, leaving behind a disappointing morass of missed opportunities, wasting assets and frustrated faculty.

We are proud this year to have announced the formation of Bridge Medicines, a bold attempt to overcome many of the barriers to translational research.  This new company is a collaboration between ourselves, Takeda Pharmaceutical Company, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine and The Rockefeller University, along with Bay City Capital.  Through this entity, the intellectual property from prominent academic institutions is moved forward through pharmaceutical technical expertise, and combined with funding and the ability to create new enterprises.  In this manner, the barriers between a discovery and the ability to find the drug we need in our medicine cabinets, are removed.

We hope Bridge will not be just one piece of the puzzle, but rather a catalyst for bringing many pieces in the beautifully complex puzzle placed, oriented, and connected.  Please keep reading to learn what makes Bridge so unique, and why it is an important new venture for advancing healthcare.