MOST INNOVATIVE COMPANIES 2020Launched in Septem-
ber 2019, Apple Arcade
is one of the freshest
ideas in apps since the
App Store debuted
in 2008. The service
offers unlimited access
to more than 100
games for the iPhone,
iPad, Mac, and Apple
TV, all blissfully devoid
of ads and in-app pur-
chases. For consumers,
that’s a remarkable
value at $5 a month;
for Apple, it’s a new
way to monetize
the 1.5 billion active
devices it has sold.
Arcade’s excellence
is the latest sign of how
adept the company
has become at ser-
vices, a powerful
growth business that
hit a record $12.5 bil-
lion in revenue in the
last quarter of 2019.FOR CHANGING
THE GAMES39
In October 2019, Ver-
tex Pharmaceuticals
received FDA a p-
prov al for Trikafta, a
cystic fibrosis treat-
ment that could help
90% of patients with
the deadly genetic
disorder. Cystic fibro-
sis, which affects
about 30,000 peo-
ple in the U.S. (and
has a life expectancy
of 44 years for
patients born today),
is caused by muta-
tions in the CFTR
gene that lead to a
defective protein
being produced.That protein doesn’t
allow chloride to
flow in and out of
cells normally (par-
ticularly those that
line the lungs) and
prevents water from
hydrating the cellu-
lar surface, leading
to a buildup of thick
mucus and difficulty
breathing. While
other researchers
looked to use gene
therapy to address
the disorder, Vertex’s
team created a
small-molecule drug
that can tweak the
faulty protein, allow-The 21-year-old nonprofit best known for its bold anti-smoking ads is rising
to meet the vaping crisis. Truth Initiative’s “Tested on Humans” campaign
last summer (in which anthropomorphized animals expressed concern that
humans are being used as guinea pigs to test the effects of vaping) generated
more than 367 million video views. The organization is finding success with more interac-
tive efforts as well. Its free, text-based “This is Quitting” program, which launched in early
2019, allows users (who sign up simply by texting “DITCHJUUL” to 88709) to receive daily
texts with tips tailored to their age and the particular device they’re trying to break up with.
According to data published in Nicotine & Tobacco Research, more than 60% of program
participants report having decreased e-cigarette usage within two weeks, and more than
80,000 have eventually quit altogether. But for CEO Robin Koval, the most important 2019
metric is 3.7—that’s the current percentage of teens who smoke in the U.S. That number
is down from 23% when Truth launched in 1999, a promising sign that the organization
may be able to influence the 28% of high schoolers vaping today. “We’ve won before,” Koval
says. “And we are ready to win again.”41
ing it to function
more normally and
drastically improving
patient symptoms.
“We were laughed
at when we started,”
says Vertex CEO Jef-
frey Leiden. “No one
thought that using
small molecules
would be enough to
correct the underly-
ing function of a
giant protein.” In tri-
als of more than
400 patients, Tri-
kafta increased lung
function by 13.8%
versus a placebo,
decreased hospital-
izations, and
boosted quality of
life. Based on
strong clinical data,
Trikafta was ap-
proved by the FDA
in less than three
months, the second-
fastest approval
in U.S. history.40
FOR CLEARING THE AIR
ABOUT VAPINGFOR ATTACKING
THE UNDERLYING
CAUSE OF
CYSTIC FIBROSIS80 FASTCOMPANY.COM PHOTOGRAPH BY DINA LITOVSKY MARCH/APRIL 2020 Bratislav^Milenkovic^ (Apple);^ Redux^Pictures^(Maven)