September 28, 2020 BARRON’S 23
testing and treatment, the treatment of
rare diseases, gene therapy—all these
areas are making progress. It is an
incredibly productive time across the
industry.
Casdin: The industry has been in a
period of technology transformation
for the past 15 years. That has brought
down barriers to entry and enabled
small companies to behave like big
companies. Small biotechs now have
access to much of the same technology
platforms that large pharmaceutical
companies do.
Yoon: We spend a lot of time talking
about therapeutic advances and human
biology, but drugs still account for only
15% to 20% of what we spend on
health care today. Covid put a spotlight
on how frail our health-care delivery
infrastructure is. The pandemic has
accelerated the adoption of digital
medicine and telemedicine by three or
four years. Hopefully, we are going to
see another big wave of investment in
public health to prevent the next
pandemic from becoming anything like
this one. We need to rebuild the
American health-care system at its
core, and various companies are
enabling this. I don’t want to take the
conversation off therapeutics, but there
are an amazing number of innovations
happening in health-care delivery that
put the primary-care doctor and
patient back at the center of the
discussion, where they belong. We are
bringing to market a better consumer
experience that treats the patient more
holistically, and it is being done at
lower cost. If we can do this on a
national scale, it will create room for
more capital investment in the more
expensive specialty medications
coming through drug-company
pipelines.
How might the U.S. health-care
system change under a Biden
presidency—or in a second Trump
term?
Porges: Nine biopharma CEOs just
signed a public letter opposing
accelerated drug development at the
expense of safety demonstrated
through Phase 3 clinical studies. The
letter, and the discussion around it, got
me thinking that we should all live in
fear of undermining the FDA. We have
seen the Centers for Disease Control
and Prevention politicized. Taking a
medication is the ultimate act of faith. If
consumers lose confidence in the
system, the profitability of the drug
industry is at risk. I have shifted my
thinking dramatically: The biopharma
industry can afford to give up 10% or
15% on price, but it can’t afford to give
up public confidence in the FDA. So
I’m going to say that a Trump victory
in November would be worse for the
industry than a Biden victory.
Casdin: Regardless of who is in the
Oval Office, the core problems of our
health-care system aren’t going to
change. We need to continue to support
America’s biopharmaceutical
innovation engine, whose output is
exported globally, and address the
problems of the uninsured and
underinsured. How we do all that
might be a bit different at the margin
under a Republican administration and
a Republican Congress than a
Democratic administration and a
Democratic Congress. But both sides
need to find better ways to treat sick
people and create a healthier world.
Better information, diagnostics, and
more efficacious therapies are the
fastest path forward, not politics.
Eddie, which health-care stocks do
you favor these days?
Yoon: Humana [HUM], the health-
insurance company, is one of my top
holdings. It is a leading seller of
Medicare Advantage plans. Humana is
Eli Casdin
Thrive Earlier
Detection*
Burning Rock
Biotech
BNR
$20.69
Allogene
Therapeutics
ALLO
$34.78
Relay
Therapeutics
RLAY
$40.19
Revolution
Medicines
RVMD
$31.41
Blueprint
Medicines
BPMC
$88.24
*Privately held
Prices as of 9/24/20
Source: FactSet