Think about the ways that technology has completely changed your life over the last 15 years. The App Store ignited an entirely new era of possibility and opened the door for people around the world to innovate, solve real problems, and change the lives of billions. Amazon completely changed commerce and cloud computing. Uber transformed transportation. Facebook revolutionized communication. These technology giants all have one very important thing in common: they are all platforms.
A “platform” is a technology that both delivers a new solution and allows others to build on top of it, enabling endless possibilities for improvement, innovation and expansion.
Major platform technologies have impacted almost every area of your life, and yet this kind of completely radical change is still missing from the single most important area of life: your health. Nano is changing this by bringing the first ever platform approach to health, opening the door to innovators everywhere to build and deliver new solutions to health challenges.
Steve Papermaster (Nano’s CEO) and Arun Kant (CEO of Leonie Hill Capital) sat down together during the 2019 World Economic Forum in Davos to discuss the state of healthcare today and the importance of taking a platform approach to effect major change. Listen to their conversation or read the full transcript below.
Steve: So, I’m delighted to be joined in this conversation with Arun Kant, who is a very, very well-known investor, and a visionary entrepreneur in his own right with Leonie Hill Capital. He has been involved for decades as a critical partner in, not only multiple industries and multiple companies, but multiple themes of transformation. Delighted to be partnered up with what we’re doing with Nano Vision, and our shared goal to absolutely transform our ability to cure curing, and to cure those ills of lack of advancement relative to where we desire to be.
So, Arun, thanks for joining in the conversation. We’ve had a very dynamic set of exchanges here in Davos over the last several days and it’s a great time to reflect on where and how our opportunity to team up and tackle our vision for Nano and think about how it relates to the themes that we’ve been talking about and that we are now collectively focused on. And so, would love to get your perspective on some of these issues and topics, and on what our opportunity is to build Nano Vision and how that kind of relates, in your mind and your perspective, to some of the other significant areas that you are, and have been involved with, including with companies like SpaceX, and Alibaba, and other really seminal, transformational companies.
Arun: Thank you, Steve. We have to first look at why we have interest in Nano. Because being a disruptive technology, it requires a founder with a vision, and the right team. It is the same way you evaluate technologies, like SpaceX ten years ago, for Tesla 15 years ago, and 18 years ago with Alibaba, and Amazon, or with PayPal.
This is true for all disruptive technologies, and people always have suspicion about whether these companies will ever make it. Because change in our industry is always difficult for normal people to see. It can be only seen by visionaries. That’s why you see there are very few companies which make it big, like Amazon, Facebook, Google, Yahoo, Tesla, SpaceX, Alibaba.
We all know that the medical system is broken. The way we have drugs today for discovery, to bring it to market takes a long cycle. The drugs have many side effects and are very expensive.
So, healthcare, every year, is becoming more and more expensive, and affordability with people is decreasing, but they’re not able to cure. They’re just putting a bandaid. But the reality is, any drugs you take today, from diabetics, to hypertension, they have severe side effects. Then, they take more drugs, and eventually that hits the bottom line for the health industry, and as a human being, you’re not able to cure.
So, with Nano, you become proactive, not reactive. Today we do medicine reactively, but being proactive is the way of the future. So, if you look at any of the technologies you develop through Nano, you basically, are able to find out from the technology this company has if he or she, in the future, will develop some diseases, and can you prevent those by having a combination of, lifestyle changes, and medicines, before it becomes a problem.
So, I think that’s how we should see this company. It’s not a magic cure, It’s not a magic bullet, but eventually you will see many partners with the ecosystem of other major drug companies, and biotech companies, they will all find that the data they were missing all these years were so critical for the drug delivery, and in fact it will shorten the time by half. And when you go to clinical trials, you will actually know well in advance the set of targeted patients you should target for the trials.
Today, the medical system just puts an ad in the newspaper, says, “I will pay $500 a day,” and you take part in the trials, but not much research is done for finding out actually what the patient had gone through, or what is the genetic problem this patient faces in the future.
So, the drugs may be successful for that person X, but may fail for person Y or Z. I think that’s where it’s important that you start somewhere proactively with Nano type of platform.The drugs which Merck, Johnson, and other companies develop have a proper way of a platform where they can actually have the discovery for the drug based on certain targeted diseases and individuals.
Steve: So, you’re touching on several major themes, Arun, that are critical to us with Nano.
First, I would call out the platform approach, and that is something that has been largely non-existent or missing in modern medical development, where each disease state, and each potential targeted, development of a drug, is it’s own little moon shot. There is not even a space platform, if you will.
Each one is developed by it’s own set of researchers and developers in an academic setting, or a small biotech setting, or a very large pharma setting, largely the process of theorizing what could be a possible combination of molecular structures and genetic markers and the ability to design and construct what we call a drug today is an initiative based largely on, even if there’s hundreds of people involved, a handful of instincts of one or two researchers. Then that hypothesis is taken forward in the form of a prototype. A molecular prototype, which has just enough evidence that it might be effective in certain conditions against certain problem areas or certain types of cancer cells, for example.
It then moves through a highly, highly regulated process, well intended to preserve health and safety, and yet so onerous that it has now become a process that extends out over many years to even decades. And so, on average, it takes between nine and 18 years to bring a drug through clinical trials to marketplace, and costs over 1.8 billion dollars per approved drug to move into the marketplace. And yet, we’re talk about those approvals and successes, that’s literally one out of a hundred because we have a nearly 99% failure rate of all drugs that are attempting to move through the clinical trial process, certainly under the U.S. FDA, and its counterparts worldwide, the numbers are really not any different.
So, the odds of coming up with a successful, approved drug have become so minimal, the time frames so long, and the cost so high that we are not only inhibiting innovation, we are placing it in hands of the very, very few companies with the capital, the wherewithal, or the patience and the regulatory capabilities, to actually get these to market.
Going back to the platform approach, and to the very model of how do we even do this is one of the most fundamental issues that we grapple with. So, what we are doing with Nano Vision is, first of all, just acknowledging that, and saying, this process in total, while very well intended, is utterly broken. On an economic, basis, on a time-to-market basis, on an R&D model basis, on an ability to serve customers basis at reasonable cost and on a global basis. Because the result of all of this cumulative development and investment is an output that is so small in total, very, very few new drugs developed brought to marketplace and available to an exceptionally small percentage of people, even those who are actually afflicted with the overall disease state, at costs that are exorbitant, and unaffordable, even in the most wealthy nations on the planet, by the most wealthy people in those nations. And that simply cannot be accepted as the best that we can do.
A platform approach, like we’ve seen in software in developing modern microprocessor technology, like we are seeing in advanced space technology, modern transportation, and in automobiles and, flight, are advancing themselves off of major platform changes.
In transportation, just as an example, if you look at the move towards self-driving cars, if you look at the engineering of the cars themselves, and of their components, and everything it takes to move towards autonomous vehicles, although we’re not yet there, we’re moving forward at, collectively, a tremendous rate of advancement, and society has embraced the collective benefits of at least moving towards that. So, self-driving cars and autonomous vehicles, even ride sharing, ride sharing has transformed what it means to live in at least the top two to three hundred cities in the world, in how you get around, in affordability and availability and access to basic transportation, and it’s been a marvelous advancement.
And that itself has ridden on top of platform changes from mobile computing and smart phones to geolocation services, sharing of data, location-based capabilities, payment structures, a combined integration of multiple innovations into platform approaches.
So, it’s clearly proven that when you’re dealing with tackling enormous societal challenges, that platform models are the only effective solution. And that’s what Nano is all about.
So, Arun, your thoughts on how this compares to some of these other advancements that we’ve enjoyed, and that we are still enjoying in other industries. I think it’s an exciting, powerful prospect, and, more than that, we owe it to ourselves, as society to say, “we shouldn’t accept anything less than this.”
Arun: I agree with you, Steve. When we are going to spend money on buying a smart phone to keep us connected, and talk about food, and everything, but resistant to change for monitoring our health is something I’m not able to believe why it is happening.
So, you know, we want to have a Fitbit to measure how many steps we have taken. That’s okay, but we don’t want to have a monitoring device to say when I’m going to get a stroke, which is potentially going to paralyze me, and I will be in a daycare for a long, long time.
So, I think resistance to change is something. It’ll happen, but it will be overcome in a very short duration. It has happened for generations of technology. From the flip phone, we moved to smart phone, from buying from a shop, we bought from e-commerce, from payment using cash, we are going towards wallets. So, there’s going to be change, and the medical system will have to change.