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Sunday, September 16, 2018

Juno Sold for $9,000,000,000

Long ago, when I first began working in biotechnology, I read a book called, "The 800 Million Dollar Pill" It was a book that told the story of an industry gone mad. The cost of bringing a drug to market was out of control and something needed to be done. The book came out in 1998. Twenty years later Juno, a company that has yet to get a drug approval, sells for nine billion dollars.

How does this happen?

Juno has a promise. As usual in our cargo cult companies, Juno provides an animated illustration on how their technology works. Their pipeline page shows 11 candidates. Eight are in phase 1 and three are in phase 1/phase 2. The promise is the cargo that we look for up in the sky. We've heard about the cures for cancer. When do they arrive?

For the investors and higher ups at Juno, the cargo has already arrived. $9 billion is a big deal. And they never even got to phase three with any drug candidate.

Another company that is on our list as a cargo cult is Serepta. I discussed how they got their first drug approved from a trial with only 12 patients here.  The company has since gone on to improving their stock price by releasing a new study that only has 3 patients. AAVrh74.MHCK7.micro-dystrophin (that's the name of the drug) was shown to have increased micro-dystrophin and reduced serum creatine kinase. As you can see from their handling of data from the previous trial, they have a way of making data fitting into the preconceived narrative. Does it help the young boys in their daily struggle with the disease? We do not hear from the parents. Since the studies are done on only a few kids, why not follow them as the disease progresses? What do the drugs do besides change the numbers on the charts submitted to the FDA?

Since beginning this blog, the Cargo Cults of Biopharma have evolved. They no longer need to spend $800M and get a drug approval. They have improved their ceremonies. The man in the watch tower with a coconut headset now looks more like a real air traffic controller. The deals continue to be made and money continues to flow into companies like Juno and Serepta. What do we the consumers get in exchange? Cures for cancer? Treatment for DMD?

It's about money. Science is losing. Before we leave the planet our money will be spent on these useless products. Currently our money is funding research that will one day become another biotech start-up. Are we getting our moneys worth?

Saturday, May 26, 2018

The Narrative These Days - Theranos


We all live by a narrative. Our narrative is the reality that we perceive. It is the explanation we have for why things happen. It is the world we think everyone is experiencing just like us. The only difference between us and our neighbors narrative is that ours is correct and theirs is not.

Take for example, how people behave "these days". My aging relatives often talk about how the kids today are rude. Apparently things were not so back in the day. In my narrative that is exactly what older people said about my aging relatives when they were young.

Take for example, our political turmoil "these days". In the first half of last century we experienced two world wars. There must have been turmoil. The leaders managed to get the people behind the idea of fighting an enemy. Currently we are breaking down internally. We see our fellow Americans as enemies. We are also breaking down in our relations with Iran and North Korea. Are we any worse or better than previous generations on how we live in peace? Are we marching towards war overseas or even here in our own country?

The place to be intellectually is in between or off to the side of the battles. We need to be on the outside looking in. We need to witness events as if a Martian studying planet earth. Are you a Trump fan or a lefty? What if there were a third option where you stand back and watch the two sides make their arguments? What if you took note of the arguments, not the conclusions? Where is that place where you are a journalist gathering information to tell a story.

That is the subject that I have been working on. Before we can present our narrative to the world however, we have to learn how to make the presentation. Anyone, these days, can share their narrative. YouTube, Twitter, and Facebook are a few ways of annoying people with your thoughts. Rarely does someone intrigue you enough to make you take notice. I certainly never went viral. But I still think of my narrative here on the CCS. I think about the bad science that goes into the life sciences and how it effects our lives. I think how food is our medicine yet we still cling to pills. I think of the scientific method and it's counterpart, the cargo cult scientific method. I think of how to present an argument against it.

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George Shultz was a life long "fan" of science. When he heard the arguments presented by Theranos' Elizabeth Holmes he was sold. Once Shultz was on board Theranos took off financially. It turns out that G. Shultz was a life long fan of the cargo that science provides. Nonetheless, a man with his power can make a cargo cult airport into a hub as well funded as LaGuardia. He was not aware of the simple tests one could do to verify Holmes' story. See here for a link to the simple test, second to last paragraph.

Theranos is an interesting story. It has been told, will continue to be told and may even one day made into a Hollywood movie. The CCS version will not be the same. It is not a story about a perceived scam by one or a few people. It is about an industry based on promising the cargo. It will be about leadership who promise anything under the sun because they honestly think they can facilitate the landing of the planes. They know what the cargo should be and they will assemble their airport just right... some day. Yet they are missing something. The shape of the antenna on the coconut headphones. The arrangement of fire along the runway perhaps.

Theranos has the same problems all cargo cults have. The narrative is too simple. The explanations of how it will all work are too complex. The complicated pieces can be sussed out by low paid highly educated nerds with no power within the organization. The leadership has all of the power, but no real technology solutions. They specially in the narrative.

Before I end we must remember Atossa, a small breast cancer biotech in Seattle. They did exactly what Theranos did. They promised a simple test. They did not have one. They lied. They are still in business. The leadership are from the finest schools. They make wonderful promises about the best cargo we can hope for. The planes do not land.

The narrative these days continues to pile up the loss of billions of dollars in investments. Just as the narrative did in 1985, 95, 05 and 15, the planes have not landed. We need to get to the heart of the matter. We need to talk about why we fail. How does one present the argument that our great leaders are merely Cargo Cult Scientists?