The primary investment risk is permanent loss, not price fluctuation. Volatility becomes a tangible risk only due to external factors like an investor's psychology, career pressures, or institutional needs (e.g., daily fund withdrawals, university budget draws).

Despite biotech comprising a significant portion of benchmarks, generalist managers consistently remain severely underweight. They perceive this as risk-averse, but it actually exposes their funds to massive tracking error and unintended risks by forcing them to be overweight in other healthcare sub-sectors.

The biotech sector lacks mid-cap companies because successful small firms are typically acquired by large pharma before reaching that stage. This creates a barbell structure of many small R&D shops and a few commercial giants. The assets, not the companies, transition from small to large.

The primary driver of market fluctuations is the dramatic shift in attitudes toward risk. In good times, investors become risk-tolerant and chase gains ('Risk is my friend'). In bad times, risk aversion dominates ('Get me out at any price'). This emotional pendulum causes security prices to fluctuate far more than their underlying intrinsic values.

Conventional definitions of risk, like volatility, are flawed. True risk is an event you did not anticipate that forces you to abandon your strategy at a bad time. Foreseeable events, like a 50% market crash, are not risks but rather expected parts of the market cycle that a robust strategy should be built to withstand.

In a capital-constrained market, positive clinical data can trigger a stock drop for biotechs with insufficient cash. The scientific success highlights an immediate need for a highly dilutive capital raise, which investors price in instantly. Having over two years of cash is now critical to realizing value.

One of the few working quantitative models in biotech is to systematically purchase stocks after they have crashed on bad news. This low-batting-average, high-slugging-percentage approach is terrifying but can work by getting favorable odds on a recovery, provided the company has sufficient cash runway to survive.

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 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.