Is Andreessen-Horowitz Right That Software’s Poised To Eat Healthcare? – Forbes

These sorts of problems can be solved along with software, which may be continuing to get much better and cheaper.  Representative companies: foundation Medicine cited as organization inside the oncology diagnostics space.

(1) Digital therapeutics. Important hurdles we encounter throughout achieving this include: (a) figuring out exactly where far better to implement emerging technologies; (b) retaining a wholesome respect for your difficulties involving modifying behavior for the point involving achieving meaningful impact; (c) retaining any similarly wholesome respect for that difficulties associated with knowing biology for the point associated with identifying a new promising opportunity pertaining to intervention; (d) guaranteeing our primary focus — along with ultimate measure associated with success — remains the particular lives we’re in a new place to impact, and never the particular technology we develop within effort to accomplish this. These types of lab facilities will enable biotech startups to accomplish the actual experiments they want together with higher reliability as well as without having the particular capex spend; scalable research facilities will be available when needed, and you just spend with regard to everything you use (again, similar to cloud computing). Physicians as well as researchers must contend by having an overwhelming and also ever-increasing amount involving data. Your notion of enabling more researchers do to more early studies as well as far better studies with the exact same sum of money can furthermore be appealing (if true); perhaps it’s going to take a visionary entrepreneur plus a persuasive use case (analogous from what Benioff does using customer relationship management making use of the particular cloud) to demonstrate the actual power and possible involving this emerging technology.

The a16z take a peek at this space, as a whole, may be split into three parts: (1) Digital Therapeutics; (2) Cloud Biology (not what you think); and (3) Computational Medicine.

(My usual disclosure: I work with a cloud genomics company; I don’t believe we both do enterprise with as well as immediately take on companies backed by simply Andreessen-Horowitz, nor get we received funding from this firm. Regarding instance, a vital challenge in oncology will be matching many prospective cancer drugs to the exact characteristics with the tumor within question. Perhaps productive clinical development programs are fairly costly (i.e. Representative (and portfolio) company: Omada Well Being (my 2012 post about the business is actually here; our latest Tech Tonics interview together with founder Sean Duffy will be here).

When Ben Horowitz had been requested final November through Stanford Professor Tom Byers the method the enterprise capital firm Andreessen-Horowitz (“a16z”) became thus successful thus quickly, and also ended up being capable of crack open up what ended up an exclusive as well as self-perpetuating club involving best VCs, Horowitz replied, “We were the extremely first VC firm in order to super-aggressively market itself.”

Presumably 1 manifestation of this strategy is actually a phenomenal podcast series the firm produces, featuring senior partners, distinguished guests, and frequently both, discussing with a few granularity any topical issue within technologies or entrepreneurship.

First, I be concerned a16z profoundly underestimates the problems associated with developing any behavioral intervention that’s truly clinically effective, as well as underestimates the price of rigorously proving this (and payors are generally likely to demand credible information prior to agreeing to cover the expense of an intervention like Omada’s or perhaps Propeller Health’s, which both, simply by design, goal the relatively big number of covered lives).

A16z’s high level thesis – together with which usually I strongly agree- is that there are profound opportunities at the confluence of biology along with technology, especially as growing figures of undergraduates emerge who are trained throughout each (apparently many Stanford students consider at least one computer course, even though the majority of don’t wind up within pc science or even engineering). 1, 2010, enterprise capitalist and also Netscape co-founder Marc Andreessen, left, and his longtime enterprise partner, Ben Horowitz, pose in their workplace in Menlo Park, Calif. Although many VC as well as other investment and also advisory firms have got begun to provide promotional podcasts, these frequently come across as guarded, scripted, and corporate; the a16z podcasts, throughout contrast, often project immediacy as well as refreshing candor.

I fervently hope these three focus areas revolutionize biology as well as health the way in which a16z envisions, yet I’d location my bets deliberately at the moment.

Second, I worry a16z misunderstands why drug development is indeed expensive: it’s largely simply because it’s therefore difficult to figure out early on which is actually along with isn’t going to work, therefore anyone wind up investing an extraordinary number of us dollars on phase 2 as well as phase 3 studies which ultimately fail. Representative companies within this space: Emerald Cloud Labs; Transcriptic.

Fourth, a16z appears to use a somewhat outdated look at biotech entrepreneurship as well as life science venture. Fifth, and also perhaps the majority of importantly: I worry in which inside applying his or her “software eats your world” model thus insistently, a16z may well overlook crucial discrepancies, locations the place where the analogies these people reach with regard to don’t quite capture the difficulties they’re describing. matching the proper individual for the right drug at the best time. Rather, the more substantial challenge, I’d argue, may always be the not enough virtually any successful drug for most cancers, as well as the have to come on leading of way far better treatment method selections for most. Thus, using a few of the price from early research may not necessarily be especially transformative – although, whether it somehow boosts the probability of good results (i.e. Pertaining To instance, we’ve currently seen an upswing involving ultra lean, asset-focused drug companies (as David Grainger and also I have discussed here, here, here), along with providing rise to the kind of structural considerations Bruce Booth describes here. I’d point out Counsyl (no economic relationship to disclose) – a new diagnostics organization not really within the a16z portfolio, however co-founded by simply Balaji Srinivasan before he joined a16z like a companion – being an example of a company which seems to obtain this all exactly right.

Collectively, a16z says, these three developments will lead to an “explosion” of experimental biology as well as digital health startups, providing the opportunity develop clinically impactful goods to find a fraction with the price of a standard lifestyle science startup, as well as representing a pointed contrast for the ever-increasing expense associated with classic biotech drug development, which seems to follow so-called Eroom’s Law (Moore’s Law inside reverse).

The central arguments regarding a16z:

Third, I’m not sure that will the principal element difficulty we confront inside places for example oncology may always be the algorithm challenge a16z describes – i.e. Moreover, the particular pitying tone used to describe poor people life science VC contemplating any enormous richesse investment in the new biotech organization additionally contrasts using the information shown in this submit through Booth and also Bijan Salehizadeh, debunking a new quantity of myths about life science investing.

In this photo taken Monday, Nov. Your concern is the really fact that in searching so intently to always be able to replicate effective technology structures (like the actual cloud) inside new domains (like biology), that they may lean too heavily on superficial similarities, and also miss substantive distinctions.

(3) Computational Medicine. Nevertheless, I realized by the actual end I didn’t completely agree with most of the actual assertions, as well as I believed it may be worth several discussion.

Even with these reservations, I emphatically discuss a16z’s optimism that will emerging technologies – and additionally the inventive believing that usually accompanies these people – may possess a profoundly positive impact on healthcare and also medicine. It’s furthermore correct that the brand name new possibilities aren’t simply getting in a new position to do existing activities quicker or in larger scale – rather, it’s the possibility to ask along with pursue questions anyone couldn’t possess even conceptualized in an earlier era.

In this context, I has been thrilled to end up being able to discover a current episode entitled “When Bio Meets computer Science.” Since expected, it absolutely was articulate, thoughtful, and also relatively grounded. (The recent progress throughout immuno-oncology seems especially promising.) In case fancy algorithms could help us identify potent new drugs (or new uses for existing drugs) – that will will be an amazing advance, and many Silicon Valley companies (Capella Biosciences, led simply by Pek Lum, along with NuMedii, led by Gini Deshpande) are generally intensively operating upon these two respective challenges.

I has been furthermore surprised by the a16z perception that doctors view medicine as “here’s an issue and we’re planning to fix it.” Inside my experience – so when I argued explicitly in among my earliest weblog posts – it’s more regularly the particular technologists whom often deliver this solutionist mindset to end up being able to healthcare; providers and researchers who’re living in, and also mired in, the wonderful, frustrating, chaotic mess of healthcare delivery and medical science frequently have an overabundance nuanced, much less binary take a peek at their particular role and their challenges.

(2) Cloud Biology. Your arrival involving highly automated labs will revolutionize biology startups within the same manner your arrival of cloud computing revolutionized technologies startups. That is valid in which one of probably the most perceptive content articles I’ve study just lately with regards to genomics has been written by simply Mark Kaganovich, the actual CEO along with co-founder regarding SolveBio, an a16z-backed company.). Several healthcare complaints are behavioral, and also digital health companies may well address these challenges much more effectively, and less expensively, when compared with drug companies. because of for you to increased toughness for the particular data, since the founders typically argue), in which could be significant.  (AP Photo/Paul Sakuma)

While the podcast frequently features a new portfolio business (which the hosts are not shy regarding mentioning), the worth of the actual podcast lies within the quality and (apparent) authenticity with the conversation – it’s rather remarkable to listen to Marc Andreessen talk about the cloud along with Salesforce founder Marc Benioff, with regard to instance, or hear Benedict Evans looking at the particular perspectives involving Apple and also Google. even if you never add inside the cost of failures)