Creating an ecosystem for white space moonshots in bio

Written in summer 2025 (timing may be relevant to this post)

Making a drug company is really fucking hard. It’s also one of the most important vehicles that we have to invent disease treatments for your mom, grandpa, neighbor. I believe it’s one of the most incontrovertible and empirical forms of value creation to throw yourself into. But biopharma has become a harder and harder space to succeed (for reasons extraneous to biology). A question more pressing today than ever: How can we create a better ecosystem and structure to innovate more & better healthcare technologies? [1]

Some spicy takes that I’ve been ruminating on:

  • Economics of biotech are broken (perhaps not spicy anymore- people are catching onto this one). XBI has been flat for over a decade. Chinese biopharmas are nipping at our heels. Something needs to change… Will not be fixed with new science/technology as the root problem lies in capital mismatch x bio innovation cycles.

  • Generalist VC seed/series A flywheel as a low barrier entry point for white space ideas is not a good path towards creating an enduring bio company [2].

  • Consolidate small biotech assets and throw concentrated funding to create more commercial stage biopharma’s (aka companies who aren’t reliant on VC dollars that can actively innovate in biotech) [3]

  • Winning companies will innovate strategic backdoors into white space, not brute forcing against macro headwinds

I think there are many claims that SV biotech companies will be better by being 1) organizationally different (corporate culture will be stamped out and we’ll stay founder-led!) 2) tackling white space with empirically higher market upside or 3) doing the deed more efficiently (AI, computation, etc). But I’m naturally skeptical when a company’s core claim indexes on being more efficient or maximizing upside without some serious rationale grounding a claim that an entire industry has missed.

Can we buck this trend and create a large scale, generational pharma today? What would Pfizer look like if it were started today? What would we double down on? What would we change? How would we start?

Starting point:

  • Build a critical mass of assets in an

[1] To those who may object, drug development margins may never look the same as software. Simple maths. But you also cannot argue that approved drugs can hold their own (& even better) than many tech products. Finding a better way to create value here is essential (not just for money’s sake)

[2] Got my start in silicon valley biotech with more responsibility/exposure than I would’ve gotten anywhere else. I love the ethos and ambition (& want this to continue). But I don’t think it can be a sustainable ecosystem without a later stage support system emerge (which we’ve yet to see step up).

[3] Too many biotechs structured like hedge funds leveraging binary readouts. Drug development is always unpredictable, but we need to stop treating startups as corporate lottery tickets towards drug approval.

Key thoughts:

  • Silicon Valley remains unproven as an epicenter for white space therapeutics.

  • Economics of biotech is broken. XBI has been flat for over a decade. Something needs to change… Will not be fixed with new science/technology so wins will remain capped.

  • How to advance white space drugs that really move the needle on human health? Create a more resilient vehicle to advance drugs into later stages without adhering to late stage bio money pattern matching.

    • SV funded efforts - haven’t seen one win yet. Clearing series A/B into commercialization is a valley of death bc dependent on biotech big checks or public markets (which are massively distressed right now)

  • I want to create a drug company and set it up to sail with critical mass within the next three years.

    • Instead of a one-off company betting on X targets or drugs, create a concentrated bet in a therapeutic area with overlooked technology. Right now, this is metabolic mechanisms -> sarcopenia aka diverse MoAs for obesity/related chronic diseases. Rivus doing a small example of this but not built to buy.

    • Plan: Consensus -> white space

      • Current state:

        • Have a ppar delta drug (w/ good human data) that could be repurposed for novel sarcopenia indication.

        • Potentially adiponectin

        • Potentially uncoupler

      • Immediate plan: Create a company around technologies for metabolic modulation

        • What are the overlooked clinical applications?

        • Who is the ideal team that I want to recruit?

        • What is the short & long term clinical plan rn? (maybe work w Phil on this)

        • How much money and from who? Map out who would fund into later stages.

      • Long term white space swings:

        • OR once there is good phase 2 data, take into more risky use cases (i.e. defense applications)

        • Post commercial stage: Take smaller swings developing one-off, well validated white space drugs (i.e. concussion)