US biotechs increasingly use sites like Australia to accelerate development, as Create Medicines did by moving from concept to clinic in under 12 months. What was once viewed with suspicion is now a key strategy to generate data faster and more cheaply, competing with the speed of China's ecosystem.

Founder Sean Ainsworth intentionally started his pioneering AAV gene therapy in an ocular setting before any Western approvals existed. Because an intravitreal injection uses a very small vector amount, it provided a significant safety advantage and a manageable way to prove the technology before attempting systemic delivery.

Early-stage biotech companies struggle to navigate clinical development for autoimmune diseases. Disease-specific foundations hold crucial insights on patient subsets, recruitment, and key opinion leaders, yet the interface between VCs and these foundations is often inefficient and difficult to navigate, leading to missed opportunities and flawed trial execution.

Dr. Abelson’s career spans the transformation of clinical research from an endeavor led by a single physician-scientist to a complex industry with specialized companies for statistics, patient recruitment, and regulatory affairs. This specialization has enabled the current rapid pace of drug development.

The field of ophthalmology is particularly well-suited for a hub-and-spoke model because it utilizes a wide range of treatment modalities (small molecules, biologics, devices, gene therapy). This allows a central hub to leverage shared expertise in areas like ocular delivery and regulatory pathways across multiple, diverse spokes.

A crucial piece of advice for biotech founders is to interact with patients as early as possible. This 'patient first' approach helps uncover unmet needs in their treatment journey, providing a more powerful and differentiated perspective than focusing solely on the scientific or commercial landscape.

Responding to Wall Street pressure to de-risk, large pharmaceutical firms cut internal early-stage research. This led to an exodus of talent and the rise of contract research organizations (CROs), creating an infrastructure that, like cloud computing for tech, lowered the barrier for new biotech startups.

Founded in Minnesota, Cellcuity taps the University of Minnesota and the region's medical device industry for scientific talent. For specialized roles like clinical development, it embraces a distributed team, demonstrating a viable model for building a biopharma company outside of traditional hubs.

The most impactful medical advances come from 'clinical scientists' who both see patients and work in the lab. This dual perspective provides a deep understanding of disease mechanisms and how to translate research into treatments, a model that Dr. Abelson believes is now under threat due to economic pressures.