Essays on the intersecting worlds of clinical trials, drug development, and venture capital

Launching a newsletter on why it's so expensive and slow to develop new drugs, and on what can be done about it.

I was trained as a quantitative trader and I’ll probably always think like a quantitative trader, but I’ve spent nearly three years now obsessed with a different truth-seeking exercise: clinical trials. In that time, I’ve worked at a philanthropic grantmaker with a budget in the tens of millions, tried to arrange a vaccine trial in a small island nation, built DCF models for biotech companies and investment funds, made investments that worked out, made investments that didn’t, raised money for investments where the jury’s still out, picked the brains of professors and postdocs and program officers and ambassadors and billionaires and patient advocates ex-FDA staff and clinicians as I’ve tried to understand: why is it so expensive and slow to develop new medicines?

This newsletter is a place to collect the pieces of that puzzle and to move towards the more important discussion: what can be done about it?

If you’re coming from the Complex Systems podcast, welcome! If you’re not, you might find the episode a good jumping-off point. And if you’re used to following my personal blog, don’t worry—I still intend to post on a wider set of topics there (as I find and make the time), and most newsletter posts will get cross-posted back there. The newsletter, however, will stand here for readers mostly interested in the subset of my writing in the trials / biotech / venture cluster of topics.

If you want to dig into anything deeper (or tell me that I’m horrifically wrong about something!), the comments are and will be open; if it’s something you’d rather not share like an investment opportunity or a discussion in confidence, you can reach out here instead. And I’m _rossry on Twitter.

Oh, and for our last piece of housekeeping before we get into it: A soletta is a mirror put into space around a planet you are trying to make warmer and more habitable. It’s there to increase the number of photons that make it from the sun to the planet in question by giving them a second path to get there. The rest of the metaphor is left as an exercise to the reader.

Now, onwards to…