Smaller, Faster, Cheaper

For most of the last fifty years, the story of why medicine is slow and expensive has been told as a story about science. The biology is hard, the failure rate is high, the trials are long. All of that is true. But it is not the whole story, and over a decade of building laboratory infrastructure I came to believe it is not even the binding constraint for many young companies.

At Fortune's Brainstorm Health in 2016, I argued that drug development cycles were getting smaller and faster, and that the reason had as much to do with how research gets resourced as with any single breakthrough. A small team with a good idea no longer needs to recreate the entire apparatus of a large pharmaceutical company to test it. If the infrastructure, the space, the equipment, the operations, the compliance, can be drawn on as a service, the team can move at the speed of its science rather than the speed of its real estate.

I made versions of this case for years, in an interview with Contract Pharma about maximizing discovery while minimizing cost, and later in a conversation with Executive Platforms titled, in their words, the future of medicine will cost less and move faster than we ever imagined. The throughline was always the same. The cost of a laboratory is mostly fixed and mostly duplicated across the industry. Every company pays again for the same thing. Pool that cost, and you change the economics of starting and scaling a therapeutics company.

The thesis got more pointed as the science got more complex. When I spoke with Fierce Pharma about the rise of multiple modalities, cell therapy, gene therapy, and the rest, the question was whether more modalities simply meant more problems. My answer was that it does not have to, if the infrastructure is designed to flex. A platform built to change as the science changes absorbs that complexity instead of passing it to every team as a new buildout.

None of this replaces the hard work of biology. A better building does not make a bad molecule good. But the gap between a promising idea and a tested one is filled with cost and time that has nothing to do with the idea itself. Closing that gap was the work. Smaller, faster, cheaper was never a slogan about the science. It was a claim about everything around it.