Biology is breaking out of the lab and clinic—and into our daily lives. Our new ability to engineer biology is transforming not just science, research, and healthcare, but how we produce our food, the materials we use, how we manufacture, and much, much more. From the latest scientific advances to the biggest trends, this show explores all the ways biology is today where the computing revolution was 50 years ago: on the precipice of revolutionizing our world in ways we are only just beginning to appreciate. Through conversations with scientists, builders, entrepreneurs, and leaders, host Olivia Webb (along with the team at Andreessen Horowitz), examines how bio is going to fundamentally transform our future. In short, bio is eating the world.
Regulatory Trends in Telehealth
26:06Perhaps no area of healthcare has undergone such a rapid shift as telehealth during the Covid pandemic. But as the world emerges from the public health emergency, it's an open question what will happen with the regulatory aspects of telehealth. Daisy Wolf, deal partner at a16z Bio + Health, talked to Sarah Thomas, general counsel at Sameday Health, about asynchronous telehealth, working with regulators, how counsel thinks about inducements, and more.
Demystifying DC: Opportunities for Collaboration
17:30In this episode, a16z Bio+Health general partner Vineeta Agarwala spoke with Bobby Franklin, the president and CEO of the National Venture Capital Association, about whether healthcare can be a bipartisan topic, how regulation can potentially enable care models at scale, and the opportunities for collaboration between DC and startups.
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The Consolidated Drug Channel and Cash-Pay Drugs
36:21What’s up with the drug channel? Julie Yoo, a general partner at a16z Bio+Health, joins Adam Fein, the CEO of Drug Channels Institute, and Olivia Webb, the editorial lead for a16z Bio+Health, to discuss this question. We talk about PBMs, the 340B drug program, some of the startups working within and around the primary drug channel, and whether there’s room for entrepreneurs to build in such a consolidated space.For additional reading, see some of Adam’s work on his blog, Drug Channels:https://www.drugchannels.net/2022/08/the-340b-program-climbed-to-44-billion.htmlhttps://www.drugchannels.net/2022/04/the-top-pharmacy-benefit-managers-of.htmlhttps://www.drugchannels.net/2020/05/insurers-pbms-specialty-pharmacies.htmlhttps://www.drugchannels.net/2020/08/how-goodrx-profits-from-our-broken.htmlhttps://www.drugchannels.net/2022/10/five-surprising-facts-about-goodrx-and.html
Bio x Games: Is a Fun, Therapeutic Game Possible?
33:10Can a game be both fun and therapeutic? Vijay Pande, the first employee at Naughty Dog Software and a current Bio+Health general partner at a16z, joins Jon Lai, a Games general partner, and Olivia Webb, the editorial lead for Bio+Health at a16z, to discuss this question. We talk about what constitutes a game, how games and bio can intersect, and what we called the “healthy dessert” problem — the challenge of building a game that’s both fun and therapeutic.Additional reading discussed during the episode:a16z general partner Chris Dixon’s essay “Strong and weak technologies”
Carolyn Bertozzi and Degrading Drugs for Problematic Proteins
24:09In Bio Eats World's Journal Club episodes, we discuss groundbreaking research articles, why they matter, what new opportunities they present, and how to take these findings from paper to practice. In this episode, Stanford Professor Carolyn Bertozzi and former Bio Eats World host Lauren Richardson discuss the article "Lysosome-targeting chimaeras for degradation of extracellular proteins" by Steven M. Banik, Kayvon Pedram, Simon Wisnovsky, Green Ahn, Nicholas M. Riley & Carolyn R. Bertozzi, published in Nature 584, 291–297 (2020).Many diseases are caused by proteins that have gone haywire in some fashion. There could be too much of the protein, it could be mutated, or it could be present in the wrong place or time. So how do you get rid of these problematic proteins? Dr. Bertozzi and her lab developed a class of drugs -- or modality -- that in essence, tosses the disease-related proteins into the cellular trash can. While there are other drugs that work through targeted protein degradation, the drugs created by the Bertozzi team (called LYTACs) are able to attack a set of critical proteins, some of which have never been touched by any kind of drug before. Our conversation covers how they engineered these new drugs, their benefits, and how they can be further optimized and specialized in the future.
Deploying AI Platforms to Identify Sepsis
27:22On this episode, we discuss three recent papers out in Nature Medicine this week, all examining the deployment of Bayesian Health's AI platform in a clinical setting: Two prospective studies focused on clinician adoption and patient outcomes, and one interview-based study focused on clinical experiences with Bayesian’s AI platform, TREWS. First, we get into detail about the design and results of the prospective studies, then we talk about TREWS in context with other clinical decision support tools. Finally, we talk about clinicians’ attitudes toward adoption. Featuring Dr. Suchi Saria, PhD, and the CEO of Bayesian Health; Dr. Neri Cohen, MD, PhD, as well as a collaborator with Bayesian Health; and Dr. Vineeta Agarwala, MD, PhD, and a16z general partner. Hosted by Olivia Webb.
Discovery, Translation, and the State of Bio Today
33:06On this episode, we are taking a pulse-check on the state of the intersection between biology, healthcare, and technology with two scientists that sit at another intersection, that of academia and industry: Alexander Marson and Patrick Hsu, who are professors at UC San Francisco and UC Berkeley, respectively, who both use cutting edge gene editing technology to create next generation therapies, and are prolific biotech founders. Patrick also recently co-wrote an article on Fast Grants, one of the speediest sources of emergency science funding during the pandemic, which you can read about on our media site Future.com. But in this conversation, Patrick and Alex discuss — with a16z bio general partner Jorge Conde — what is different about this moment in bio.
Engineering an Epigenome Editor
31:38On today’s episode we are discussing the results and implications of a recent study that describes the creation of a new set of tools to turn off or on any region in the genome with high specificity. Host Lauren Richardson and a16z general partner Vijay Pande are joined by the senior author of the article, “Genome-wide programmable transcriptional memory by CRISPR-based epigenome editing”, Jonathan Weissman, Professor of Biology at the Whitehead Institute at MIT. Jonathan talks about how they developed these tools using the CRISPR gene editor as a backbone, the advantages of modulating the epigenome as opposed to the genome, and the various applications — both in the lab and in the clinic — for these epigenome editors.
Evolving Embodied Intelligence
31:41On today’s episode, we are making the full arc from the theoretical and borderline philosophical to the applied. Let’s start with the theory: embodied intelligence posits that the body, or the physical form, plays an active and significant role in shaping an agent's mind and cognitive capacities. For example, human intelligence is not just the function of our brain, but a combination of our brain, our body, and the environment in which we exist. But when it comes to designing artificial intelligence (AI), a physical form and an environment are typically not part of the equation. It’s a disembodied cognition. Our guests, Li Fei-Fei and Surya Ganguli of the Stanford Institute for Human-Centered AI, set out to develop what they call an “evolutionary playground” to explore the development of embodied intelligence in AI and its connection with the environment and with learning using in silico experiments. They discuss with a16z general partner Vijay Pande and host Lauren Richardson how they created a suite of virtual environments in which agents evolve through a process that mimics aspects of Darwinian evolution. These agents, called the unimal, or universal animal, start off as a central node, and with each generation can add or subtract limbs and change various properties of their physical forms, like how flexible their joints are. Just like in real evolution, different forms arose based on the particularities of the environment, but what is really exciting is what Fei-Fei, Surya, and colleagues discovered about the intelligence encoded in some of these forms, such as an increased ability to learn a novel task. Which brings us to the applied section of our discussion. These results provide new insights for how we think about designing robots capable of performing unique tasks, and for understanding the possible limitations of disembodied AI models, like GTP-3. The results are described in the pre-print "Embodied Intelligence via Learning and Evolution" posted on arXiv.org. And watch the unimal evolve here!
Building Digital Health's Github
30:49Today’s episode is all about the history and future of infusing tech into healthcare with the goals of improving outcomes and lowering costs, and features one of the leading voices in this field, Jonathan Bush. Jonathan, aka JB, started his career in healthcare as an ambulance driver and army medic, and then met Todd Park, another Bio Eats World guest, while at Booz Allen. Together they founded Athena Women’s Health Clinic, which evolved from a clinic specializing in maternity care to one of the original digital health companies providing cloud-based services and point-of-care clinical and back office tools for providers, later called Athenahealth. In this conversation with a16z general partner Julie Yoo — who is also a digital health builder — JB discusses this evolution, how it mirrors the bigger trend shifts in healthcare, and how it has informed the mission of his new company, Zus, which he compares to a Github for healthtech. JB and Julie cover what’s changed since the launch of Athena, 25 years ago, how to disrupt an entrenched system like healthcare, the role regulation plays in the space, and the under appreciated importance of bottom-up sales. Please note there is some colorful language used in this episode, in case you have young children listening.