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  1. a16z Podcast
  2. The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation
The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation

a16z Podcast · Nov 14, 2025

The Biotech Paradox: Why is the science exploding while the business struggles? Experts discuss regulation, China's rise, and AI's potential.

The Three Horsemen of Biotech's Stagnation

The decline in R&D productivity (

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The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation

a16z Podcast·3 months ago

To Compete, US Biotech Must Invent, Not Just Iterate

Faced with China's superior speed and cost in executing known science, the U.S. biotech industry cannot compete by simply iterating faster. Its strategic advantage lies in

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation thumbnail

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation

a16z Podcast·3 months ago

Industry Inertia, Not Regulation, Is a Key Bottleneck

While the FDA is often blamed for high trial costs, a major culprit is the consolidated Clinical Research Organization (CRO) market. These entrenched players lack incentives to adopt modern, cost-saving technologies, creating a structural bottleneck that prevents regulatory modernization from translating into cheaper and faster trials.

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation thumbnail

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation

a16z Podcast·3 months ago

The Biotech Paradox: Exploding Science, Imploding Business

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 Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation thumbnail

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation

a16z Podcast·3 months ago

The Next Biotech Wave: The Platform is the Product

The future of biotech moves beyond single drugs. It lies in integrated systems where the 'platform is the product.' This model combines diagnostics, AI, and manufacturing to deliver personalized therapies like cancer vaccines. It breaks the traditional drug development paradigm by creating a generative, pan-indication capability rather than a single molecule.

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation thumbnail

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation

a16z Podcast·3 months ago

Blockbusters Win on Modality and Market, Not Just Biology

Breakthrough drugs aren't always driven by novel biological targets. Major successes like Humira or GLP-1s often succeeded through a superior modality (a humanized antibody) or a contrarian bet on a market (obesity). This shows that business and technical execution can be more critical than being the first to discover a biological mechanism.

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation thumbnail

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation

a16z Podcast·3 months ago

China's Biotech Edge: From Cost Arbitrage to Speed & Innovation

China is no longer just a low-cost manufacturing hub for biotech. It has become an innovation leader, leveraging regulatory advantages like investigator-initiated trials to gain a significant speed advantage in cutting-edge areas like cell and gene therapy. This shifts the competitive landscape from cost to a race for speed and novel science.

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation thumbnail

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation

a16z Podcast·3 months ago

We Need an 'Orphan Drug Act' for Common Diseases

The Orphan Drug Act successfully incentivized R&D for rare diseases. A similar policy framework is needed for common, age-related diseases. Despite their massive potential markets, these indications suffer from extremely high failure rates and costs. A new incentive structure could de-risk development and align commercial goals with the enormous societal need for longevity.

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation thumbnail

The Brutal Truth About Biotech: Why $2B Per Drug Is Killing Innovation

a16z Podcast·3 months ago