While fields like neurology and cancer have a long runway, Edelman notes that some therapeutic areas are reaching a point of diminishing returns. In markets like psoriasis, existing drugs are so effective it's "hard to imagine" they could get much better, signaling saturation and a higher bar for new R&D investment.
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The field of multiple myeloma has transformed from having few treatments to an abundance of effective drugs. The primary clinical challenge is no longer finding a therapy that works, but rather determining the optimal sequence and combination of available options, highlighting a unique form of market maturity.
The decline in R&D productivity (
Edelman argues gene editing is still slightly overhyped if its sole purpose is to replace an injectable drug, as safer alternatives may exist. He sees underhyped gene therapy, previously sidelined by safety concerns, as poised for a comeback due to its enormous power and potential for major breakthroughs.
The biotech industry recently endured its own "dot-com bust." Post-COVID hype gave way to investor impatience with the sector's fundamental realities: it takes over 10 years and massive capital ($200B/year industry-wide) to get a drug approved, leading to a sharp market correction.
With over 5,000 oncology drugs in development and a 9-out-of-10 failure rate, the current model of running large, sequential clinical trials is not viable. New diagnostic platforms are essential to select drugs and patient populations more intelligently and much earlier in the process.
The life sciences investor base is highly technical, demanding concrete data and a clear path to profitability. This rigor acts as a natural barrier to the kind of narrative-driven, AI-fueled hype seen in other sectors, delaying froth until fundamental catalysts are proven.
Despite significant progress in managing symptoms for autoimmune conditions, very few treatments fundamentally alter the disease's course. The major unmet needs and investment opportunities lie in therapies that can induce remission or target common underlying pathologies like fibrosis, moving beyond mere symptom relief.
A massive disconnect exists where scientific breakthroughs are accelerating, yet the biotech market is in a downturn, with many companies trading below cash. This paradox highlights structural and economic failures within the industry, rather than a lack of scientific progress. The core question is why the business is collapsing while the technology is exploding.
The gene therapy field is maturing beyond its initial boom-and-bust cycle. After facing the reality that it isn't a cure-all, the industry is finding stable ground. The future lies not in broad promises but in a focused approach on therapeutic areas where the modality offers a clear, undeniable advantage.
The past few years in biotech mirrored the tech dot-com bust, driven by fading post-COVID exuberance, interest rate hikes, and slower-than-hoped commercialization of new modalities like gene editing. This was caused by a confluence of factors, creating a tough environment for companies that raised capital during the peak.
