we know medicare fraud is a major problem. it could be 5-10% of the entire amount spent each year (that's $40-80b)! a taskforce has existed for a long time, but is only able to get back a couple billion annually. if elon's doge team can level up the tech and talent to improve this, it would be a big win for everyone.

treasury secretary bessent saying trump is focused on getting the 10yr treasury yield down. if they can pull that off biotech would be a big beneficiary given the high cost of capital right now. of course delivering on that is no easy task.

RFK confirmation hearings - incremental learnings from today: 1) will not change or delay vaccine reviews. 2) trump wants to end late-term abortion. 3) nih should continue to support gene therapy. 4) trump priority to manufacture essential medicines in the US. 5) glps are miracle drugs, but should not be firstline for 6 year olds. 6) trump is absolutely committed to negotiating lower drug prices. 7) should move medicare, medicaid, and obamacare to value-based care. 8) NIH too focused on infectious disease instead of chronic disease.

last portion of RFK hearing Q&A from earlier today. says a few key things: 1) Trump knows we're paying 10x more for drugs than Europe, we should end that disparity (how is the key question - we think it may include reducing free riding), 2) Trump wants to get excess profits away from PBMs, 3) Trump wants to make Medicaid better, not cut it, and 4) he doesn't want to do anything that inhibits the pace of innovation, innovation is key to public health.

now i'm going to make a couple inferences: he understands that >20% of gdp spend on healthcare is driven by high chronic disease combined with a non-transparent fee-based payment system. he believes private solutions are better. Medicaid is a key cost driver that needs reform. he offered medicare advantage, cooperatives, and HSAs as examples of private market solutions. u need transparency so patients can be empowered and then held accountable for systems that are more outcomes based. 2/2

huge relative outperformance day for biotech vs tech, one of the rare ones. people being reminded by deepseek that picking the winners at the beginning of major technological change can sometimes be even harder than picking blockbuster drugs.

@PSchlakman if i were to put them in order: rates, rates, rates, then m&a (5b+ deals only), then potential surprises like fda does step change in flexibility (def possibility with new admin). companies have been innovating and launches have gone well, hasnt been enough - too micro.

u can see clearly how IRA is impacting drug development in this paper. one sentence takeaway: less pills for the elderly. other key result: innovation is shifting towards biologics because of the pill penalty (9 vs 13yrs until IRA negotiations start).

HNY everyone. steph and i talk about glps and the obesity revolution

IRA reform would most likely be in favor of innovation, (eg less aggressive price negotiation, small fixes for orphan drugs, etc). the whale would be improving the 'pill penalty' which has majorly disincentivised small molecule cancer innovation, but odds of a fix are low. the sad reality is to get EV subsidies (centerpiece of IRA) pols needed a payfor (source of revenue), and it came from pills.

excited to unveil our latest newCo alongside our colleagues at bain and atlas.

really enjoyed chatting with matt, who clearly knows his way around biotech. got to touch on some bigger picture aspects of the ecosystem.

thank you sarah for sitting down with tip to talk about your journey with avidity

@fin_capital fans of findell’s brian finn. we don’t frequently overlap on names but always read what he writes

RT @fin_capital: We just put our investment memorandum on $ESTA - see and we'll be speaking at 10am - to register s…