Anshul Khandelwal retweeted
Unfortunately, the old ethos of build it and they will come doesn’t work these days.
It’s so easy to build software so there are more startups than ever. Every day many new products launch. It’s hard to get anyone to pay attention. Founders can’t build in a vacuum anymore.
Marketing has been a dirty word in tech but the bar to attract customers, talent, downstream capital etc is a lot higher now.
Brand videos, launch videos, paid media campaigns, Twitter and LinkedIn takeovers, PR, content, podcasts, founder-led social media and content storytelling are all now important levers to build awareness.
Building something people want is still important but making sure people know it exists is just as important.
It’s so easy to build software so there are more startups than ever. Every day many new products launch. It’s hard to get anyone to pay attention. Founders can’t build in a vacuum anymore.
Marketing has been a dirty word in tech but the bar to attract customers, talent, downstream capital etc is a lot higher now.
Brand videos, launch videos, paid media campaigns, Twitter and LinkedIn takeovers, PR, content, podcasts, founder-led social media and content storytelling are all now important levers to build awareness.
Building something people want is still important but making sure people know it exists is just as important.
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Every Diwali, most of us go through the same exercise of working out what to get our parents. They already have more than they use, and they’ll tell you every year that they don’t need anything. What we actually want for them is harder to wrap. We want them to be well, and we re well.
A lot of our members seem to feel the same way. Many of them finish their own Cent Check, sit down with our doctors to go through the report, and before they leave they’re asking whether their mother or their husband could come in too. Once you’ve seen your own health laid out clearly, it’s hard not to want that for the people you worry about.
Parents are usually the hardest to convince. Most of us have had the conversation where they say they’re fine and it can wait till next year. A gift is a lot easier to say yes to than a lecture from your children.
So this Diwali, we’re launching the Cent Gift Card. @centai_health
It’s a complete Cent Check for someone you love: a full body scan, 100+ biomarkers, a report reviewed by our doctors and a year of follow through with our team. It arrives in a box with a letter from you, so the person opening it knows exactly why you chose it.
If there’s someone you’ve been meaning to have this conversation with, this might be a gentler way to start it. You can gift a Cent Check here: cent.health/gift-card
Happy Diwali to you and your families.
A lot of our members seem to feel the same way. Many of them finish their own Cent Check, sit down with our doctors to go through the report, and before they leave they’re asking whether their mother or their husband could come in too. Once you’ve seen your own health laid out clearly, it’s hard not to want that for the people you worry about.
Parents are usually the hardest to convince. Most of us have had the conversation where they say they’re fine and it can wait till next year. A gift is a lot easier to say yes to than a lecture from your children.
So this Diwali, we’re launching the Cent Gift Card. @centai_health
It’s a complete Cent Check for someone you love: a full body scan, 100+ biomarkers, a report reviewed by our doctors and a year of follow through with our team. It arrives in a box with a letter from you, so the person opening it knows exactly why you chose it.
If there’s someone you’ve been meaning to have this conversation with, this might be a gentler way to start it. You can gift a Cent Check here: cent.health/gift-card
Happy Diwali to you and your families.
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Anshul Khandelwal retweeted
Healthtech Startup Cent Raises $15 Mn, Acquires AI Radiology Platform Medsee. 👇
Healthtech startup Cent, founded by Practo cofounder Shashank ND, alongside Anshul Khandelwal and Arpit Garg, has raised $15 Mn (₹143 Cr) in a Series A round led by Blume Ventures and existing mons, with participation from individual investors.
The fresh capital will be used to strengthen R&D and expand its AI, engineering and clinical teams. Cent has also acquired Medsee, an AI-powered radiology reporting workflow platform, to make scan reporting faster and more consistent as volumes grow.
🔗 Read more about Cent’s plans to scale AI-powered preventive healthcare here: 4-2.co/3UibSTk
#Cent #Healthtech #PreventiveHealthcare #StartupFunding #News #AIEconomy #Inc42
Healthtech startup Cent, founded by Practo cofounder Shashank ND, alongside Anshul Khandelwal and Arpit Garg, has raised $15 Mn (₹143 Cr) in a Series A round led by Blume Ventures and existing mons, with participation from individual investors.
The fresh capital will be used to strengthen R&D and expand its AI, engineering and clinical teams. Cent has also acquired Medsee, an AI-powered radiology reporting workflow platform, to make scan reporting faster and more consistent as volumes grow.
🔗 Read more about Cent’s plans to scale AI-powered preventive healthcare here: 4-2.co/3UibSTk
#Cent #Healthtech #PreventiveHealthcare #StartupFunding #News #AIEconomy #Inc42
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This one is for every person whose life Cent has helped save over the last year. For everyone who found out early enough to act, and now has many more good, healthy years ahead with the people they love. It’s also for everyone we haven’t reached yet, because nobody in India when it’s already too late! Read more here: lnkd.in/gj6P6QUh
Today we’re announcing Cent’s (@centai_health ) Series A, co-led by @BlumeVentures and @spc, and our acquisition of AI radiology platform Medsee.
What I didn’t expect when we started was how quickly the conversation would change. A year and a half ago, most people we spoke to check as something you do after a scare. Today many of the people booking with us have no symptoms at all. They come because of a family history, because they’ve turned 40, or because they simply want to know where they stand.
That puts a responsibility on us. A scan is only useful if the person understands what it found and has someone to help them act on it. Behind every Cent Check, our AI brings the results of each test into one picture, and our doctors use it to walk members through what matters and what to do next. Medsee will help those reports reach members faster and more consistently as we grow.
This round helps us take that whole experience to more cities and make it easier to reach. We’ve set ourselves the goal of 10 million scans by 2035, and through them, helping save 1 million lives.
Thank you to @BKartRed, @prateekmehta42 Arun Sarin, @snsf, @sharathk83, @krishna_srd and @AprameyaRadhaK for backing us, and to our team and every member who has trusted us with their health.
Read the full story: cent.health/blog/series-a-…
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Anshul Khandelwal retweeted
Practo co-founder Shashank ND’s new startup Cent raises $15 Mn led by Blume, acquires Medsee entrackr.com/news/practo-co…
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Anshul Khandelwal retweeted
📣 @centai_health has raised a $15M Series A, co-led by @spc and @BlumeVentures, to build a full-stack preventive health platform for India. Cent was founded in 2025 by @shashanknd, @akhandelwal and Arpit Garg.
We met them @spc_india, and were their first investor.
In India, metabolic diseases, are usually found, when it's too late. Cent is built to catch diseases earlier, when we can still do something about it. Maybe even prevent it.
They combines purpose-built hardware, AI-driven radiology, diagnostics, and bioinformatics, to find disease years before symptoms appear. They've completed 10,000 scans across BLR, Mumbai & Delhi NCR, and are targeting 10M scans by 2035.
That’s millions of lives impacted.
Congratulations to this team! We’re proud to be your partners, as you build a future where healthcare is preventive, continuous and personalised.
And no one finds out too late.
We met them @spc_india, and were their first investor.
In India, metabolic diseases, are usually found, when it's too late. Cent is built to catch diseases earlier, when we can still do something about it. Maybe even prevent it.
They combines purpose-built hardware, AI-driven radiology, diagnostics, and bioinformatics, to find disease years before symptoms appear. They've completed 10,000 scans across BLR, Mumbai & Delhi NCR, and are targeting 10M scans by 2035.
That’s millions of lives impacted.
Congratulations to this team! We’re proud to be your partners, as you build a future where healthcare is preventive, continuous and personalised.
And no one finds out too late.
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This is for all the lives saved through Cent in the last 1 year. For all the families who could know well ahead in time, to live more good and healthy years! Read more here: cent.health/blog/series-a-…
Cent has raised $15M in Series A funding, co-led by Blume Ventures and South Park Commons.
This milestone belongs to the families in this video. People who booked for themselves, children who brought their parents in, and couples who came side by side. They chose to look early in time.
We’ve completed 10,000 scans across Bengaluru, Mumbai and Delhi. Among people who felt well when they came in, 1 in 4 had a finding worth acting on.
What’s next:
→ More centres in more cities
→ AI-led radiology and diagnostics, with Medsee now part of Cent
→ Indian health baselines and clinical research
Our mission is to help save 1 million lives by 2035.
Thank you for trusting us with your health and your loved ones’ health 🙏
Read the full story: cent.health/blog/series-a-…
#Cent #PreventiveHealth #EarlyDetection #SeriesA
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Anshul Khandelwal retweeted
In India, 7 out of 10 cancers are detected at stage 3 or 4, often when treatment becomes more difficult. Early detection remains one of the biggest gaps in our healthcare system.
Shashank ND (@shashanknd), Anshul Khandelwal (@akhandelwal) and Arpit Garg are working to address ntai_health), a preventive healthcare platform that combines advanced imaging, diagnostics and AI to detect serious diseases before symptoms appear.
We're excited to share that Cent, our portfolio from Trifecta Capital's Venture Debt Fund, has raised $15 million in its Series A round from an incredible set of investors and announced the acquisition of AI radiology platform Medsee. The funding will help Cent expand its preventive screening capabilities and make early detection more accessible.
Cent has already conducted around 10,000 scans, with 1 in 4 people showing findings that required further attention and 1 in 40 requiring immediate medical attention. The company is now working towards its ambitious goal of 10 million scans by 2035.
Our relationship with Shashank goes back to his journey with Practo, and we're excited to continue being part of his entrepreneurial journey with Cent.
Congratulations to Shashank, Anshul, Arpit and the entire Cent team on the Series A fundraise and the acquisition of Medsee. We look forward to many more milestones ahead!
Shashank ND (@shashanknd), Anshul Khandelwal (@akhandelwal) and Arpit Garg are working to address ntai_health), a preventive healthcare platform that combines advanced imaging, diagnostics and AI to detect serious diseases before symptoms appear.
We're excited to share that Cent, our portfolio from Trifecta Capital's Venture Debt Fund, has raised $15 million in its Series A round from an incredible set of investors and announced the acquisition of AI radiology platform Medsee. The funding will help Cent expand its preventive screening capabilities and make early detection more accessible.
Cent has already conducted around 10,000 scans, with 1 in 4 people showing findings that required further attention and 1 in 40 requiring immediate medical attention. The company is now working towards its ambitious goal of 10 million scans by 2035.
Our relationship with Shashank goes back to his journey with Practo, and we're excited to continue being part of his entrepreneurial journey with Cent.
Congratulations to Shashank, Anshul, Arpit and the entire Cent team on the Series A fundraise and the acquisition of Medsee. We look forward to many more milestones ahead!
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Anshul Khandelwal retweeted
Cent stands for the belief that people should live long enough to reach their century.
Getting there is harder than it should be in India, where most serious disease is found late. 7 in 10 cancers are diagnosed only at stage 3 or 4.
@centai_health looks for disease in people toms yet. Around 10,000 people have come in so far, and for 1 in 4 of them, the scan found something worth acting on.
We’re excited to co-lead Cent’s $15M Series A with South Park Commons. Congratulations to @shashanknd, @akhandelwal and Arpit Garg! They’re aiming for 10 million scans by 2035, and we’re glad to be part of this vision.
@BKartRed @sanjaynath @AshishFafadia @arpiit @sajithpai
Getting there is harder than it should be in India, where most serious disease is found late. 7 in 10 cancers are diagnosed only at stage 3 or 4.
@centai_health looks for disease in people toms yet. Around 10,000 people have come in so far, and for 1 in 4 of them, the scan found something worth acting on.
We’re excited to co-lead Cent’s $15M Series A with South Park Commons. Congratulations to @shashanknd, @akhandelwal and Arpit Garg! They’re aiming for 10 million scans by 2035, and we’re glad to be part of this vision.
@BKartRed @sanjaynath @AshishFafadia @arpiit @sajithpai
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Anshul Khandelwal retweeted
Proud to be your earliest partners, in this truly worthy journey!
Here's to building generational companies that change people's futures, and lives.
@spc_india @spc
Here's to building generational companies that change people's futures, and lives.
@spc_india @spc
Today we’re announcing Cent's $15M Series A, co-led by @BlumeVentures and @spc , and our acquisition of AI radiology platform Medsee.
When you look at how healthcare works in India, almost all of it is organised around the moment someone falls ill. Hospitals, doctors and to treat, and very little of the system is built to look for disease in people who feel well. It’s a big reason most cancers here are still found at stage 3 or 4.
We started Cent to work on the other side of that problem. Over the last year, about 10,000 people have come to us without symptoms. 1 in 4 had something worth acting on, and 1 in 40 needed to see a doctor right away. Very few of them had any reason to suspect it.
Finding disease this early, for millions of people, takes technology built for the purpose. This round lets us invest more deeply in our own hardware, AI and clinical research, and Medsee brings a strong AI reporting team into that work.
Our goal is 10 million scans by 2035, and through them, helping save 1 million lives.
Thank you to @BKartRed , @prateekmehta42 , Arun Sarin, @snsf , @sharathk83 , @krishna_srd and @AprameyaRadhaK for backing us, and to our team and every member who has trusted us with their health. Read more: cent.health/blog/series-a-…
@akhandelwal Arpit Garg
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Anshul Khandelwal retweeted
All the power to you. Can say from first hand experience, the entire experience was amazing, and the exhaustive coverage of tests are really good! Not to mention your kickass CS team!
Today we’re announcing Cent's $15M Series A, co-led by @BlumeVentures and @spc , and our acquisition of AI radiology platform Medsee.
When you look at how healthcare works in India, almost all of it is organised around the moment someone falls ill. Hospitals, doctors and to treat, and very little of the system is built to look for disease in people who feel well. It’s a big reason most cancers here are still found at stage 3 or 4.
We started Cent to work on the other side of that problem. Over the last year, about 10,000 people have come to us without symptoms. 1 in 4 had something worth acting on, and 1 in 40 needed to see a doctor right away. Very few of them had any reason to suspect it.
Finding disease this early, for millions of people, takes technology built for the purpose. This round lets us invest more deeply in our own hardware, AI and clinical research, and Medsee brings a strong AI reporting team into that work.
Our goal is 10 million scans by 2035, and through them, helping save 1 million lives.
Thank you to @BKartRed , @prateekmehta42 , Arun Sarin, @snsf , @sharathk83 , @krishna_srd and @AprameyaRadhaK for backing us, and to our team and every member who has trusted us with their health. Read more: cent.health/blog/series-a-…
@akhandelwal Arpit Garg
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Anshul Khandelwal retweeted
Today we’re announcing Cent's $15M Series A, co-led by @BlumeVentures and @spc , and our acquisition of AI radiology platform Medsee.
When you look at how healthcare works in India, almost all of it is organised around the moment someone falls ill. Hospitals, doctors and to treat, and very little of the system is built to look for disease in people who feel well. It’s a big reason most cancers here are still found at stage 3 or 4.
We started Cent to work on the other side of that problem. Over the last year, about 10,000 people have come to us without symptoms. 1 in 4 had something worth acting on, and 1 in 40 needed to see a doctor right away. Very few of them had any reason to suspect it.
Finding disease this early, for millions of people, takes technology built for the purpose. This round lets us invest more deeply in our own hardware, AI and clinical research, and Medsee brings a strong AI reporting team into that work.
Our goal is 10 million scans by 2035, and through them, helping save 1 million lives.
Thank you to @BKartRed , @prateekmehta42 , Arun Sarin, @snsf , @sharathk83 , @krishna_srd and @AprameyaRadhaK for backing us, and to our team and every member who has trusted us with their health. Read more: cent.health/blog/series-a-…
@akhandelwal Arpit Garg
When you look at how healthcare works in India, almost all of it is organised around the moment someone falls ill. Hospitals, doctors and to treat, and very little of the system is built to look for disease in people who feel well. It’s a big reason most cancers here are still found at stage 3 or 4.
We started Cent to work on the other side of that problem. Over the last year, about 10,000 people have come to us without symptoms. 1 in 4 had something worth acting on, and 1 in 40 needed to see a doctor right away. Very few of them had any reason to suspect it.
Finding disease this early, for millions of people, takes technology built for the purpose. This round lets us invest more deeply in our own hardware, AI and clinical research, and Medsee brings a strong AI reporting team into that work.
Our goal is 10 million scans by 2035, and through them, helping save 1 million lives.
Thank you to @BKartRed , @prateekmehta42 , Arun Sarin, @snsf , @sharathk83 , @krishna_srd and @AprameyaRadhaK for backing us, and to our team and every member who has trusted us with their health. Read more: cent.health/blog/series-a-…
@akhandelwal Arpit Garg
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Today we’re announcing Cent’s (@centai_health ) Series A, co-led by @BlumeVentures and @spc, and our acquisition of AI radiology platform Medsee.
What I didn’t expect when we started was how quickly the conversation would change. A year and a half ago, most people we spoke to check as something you do after a scare. Today many of the people booking with us have no symptoms at all. They come because of a family history, because they’ve turned 40, or because they simply want to know where they stand.
That puts a responsibility on us. A scan is only useful if the person understands what it found and has someone to help them act on it. Behind every Cent Check, our AI brings the results of each test into one picture, and our doctors use it to walk members through what matters and what to do next. Medsee will help those reports reach members faster and more consistently as we grow.
This round helps us take that whole experience to more cities and make it easier to reach. We’ve set ourselves the goal of 10 million scans by 2035, and through them, helping save 1 million lives.
Thank you to @BKartRed, @prateekmehta42 Arun Sarin, @snsf, @sharathk83, @krishna_srd and @AprameyaRadhaK for backing us, and to our team and every member who has trusted us with their health.
Read the full story: cent.health/blog/series-a-…
What I didn’t expect when we started was how quickly the conversation would change. A year and a half ago, most people we spoke to check as something you do after a scare. Today many of the people booking with us have no symptoms at all. They come because of a family history, because they’ve turned 40, or because they simply want to know where they stand.
That puts a responsibility on us. A scan is only useful if the person understands what it found and has someone to help them act on it. Behind every Cent Check, our AI brings the results of each test into one picture, and our doctors use it to walk members through what matters and what to do next. Medsee will help those reports reach members faster and more consistently as we grow.
This round helps us take that whole experience to more cities and make it easier to reach. We’ve set ourselves the goal of 10 million scans by 2035, and through them, helping save 1 million lives.
Thank you to @BKartRed, @prateekmehta42 Arun Sarin, @snsf, @sharathk83, @krishna_srd and @AprameyaRadhaK for backing us, and to our team and every member who has trusted us with their health.
Read the full story: cent.health/blog/series-a-…
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Anshul Khandelwal retweeted
India has focused on treating illness. At Cent, we believe it’s time to focus on predicting health risks earlier.
Founder’s Corner, Episode 3, is now live! Our co-founder, Anshul Khandelwal, shares the thinking behind Cent and our mission to make preventive healthcare more rom building brands like Ola Electric, BlueStone and upGrad to rethinking how we approach health, discover the story behind Cent and the people building it.
🟣 Watch the full episode to learn more, and stay till the end for a surprise!
🟣 Watch here or link in bio: youtu.be/pQEEHc66VFE
#PreventiveHealthcare #HealthTech #EarlyDetection #IndianStartups #Founders #Podcast #TIDPodcast
Founder’s Corner, Episode 3, is now live! Our co-founder, Anshul Khandelwal, shares the thinking behind Cent and our mission to make preventive healthcare more rom building brands like Ola Electric, BlueStone and upGrad to rethinking how we approach health, discover the story behind Cent and the people building it.
🟣 Watch the full episode to learn more, and stay till the end for a surprise!
🟣 Watch here or link in bio: youtu.be/pQEEHc66VFE
#PreventiveHealthcare #HealthTech #EarlyDetection #IndianStartups #Founders #Podcast #TIDPodcast
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Anshul Khandelwal retweeted
Found a lesion on a whole-body MRI in August 2023 with zero symptoms. Brain tumor. Since then: 976 interactions with the health system, and I'm on vaccine #2.
The hardest part wasn't the tumor. It was figuring out what to ask for, who to trust, and how to keep it all straight.
I wrote down everything I wish I'd had on day one: x.com/ArunRLverma/st… and started @trianglehealthx
The hardest part wasn't the tumor. It was figuring out what to ask for, who to trust, and how to keep it all straight.
I wrote down everything I wish I'd had on day one: x.com/ArunRLverma/st… and started @trianglehealthx
People who cured / are curing their own cancer on X:
1/ @sytses - bone cancer, billionaire founder of Gitlab, developed 10+ personalized therapies for himself.
2/ @paul_conyngham - shrank his dog Rosie's mast cell cancer tumors after chemo and surgery weren't enough. Now backed by YC and Founders Fund
3/ @miriamgonp - stage 4 breast cancer, tumor sequenced, searching for vaccine manufacturer now
4/ @kevinace - stage 4 lung cancer, angel investor in 300+ companies, first drug stopped working after 18 months. Vaccine designed, now paying $300k out of pocket for the vaccine
5/ @masonbgrant: going founder mode on his his 32-year-old wife's rare liver cancer, sequencing her tumor with AI agents
6/ @ArunRLverma: former product leader at Atoms and Shopify, brain tumor, built a vaccine from his tumor. Now building an AI health agent startup based on what he went through
We're going to make it
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Anshul Khandelwal retweeted
A yearly screening: ~₹25K.
Late-stage cancer: ₹30–40 lakh.
“Economically, it makes sense.”
@akhandelwal , Co-founder of @centai_health , along with @shashanknd and Arpit Garg on why India needs to catch disease early. Cent is India's first comprehensive & advanced preventive healm
Full episode on Founder’s Corner drops tomorrow 🎙️
#PreventiveHealth #HealthTech
Late-stage cancer: ₹30–40 lakh.
“Economically, it makes sense.”
@akhandelwal , Co-founder of @centai_health , along with @shashanknd and Arpit Garg on why India needs to catch disease early. Cent is India's first comprehensive & advanced preventive healm
Full episode on Founder’s Corner drops tomorrow 🎙️
#PreventiveHealth #HealthTech
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Anshul Khandelwal retweeted
Hosting @shashanknd for a fireside chat this Thursday in Palo Alto.
Shashank founded and scaled @Practo and is now building Cent, a preventive healthcare startup in India. I am very curious to dig into how medical imaging, genetic testing and biomarkers are changing longevity and what role AI plays in all of it.
If you’re interested in longevity, healthcare or building in India, please join us.
Thursday, October 15, 6pm
Palo Alto
Register here - luma.com/gr67jqy4
Shashank founded and scaled @Practo and is now building Cent, a preventive healthcare startup in India. I am very curious to dig into how medical imaging, genetic testing and biomarkers are changing longevity and what role AI plays in all of it.
If you’re interested in longevity, healthcare or building in India, please join us.
Thursday, October 15, 6pm
Palo Alto
Register here - luma.com/gr67jqy4
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Anshul Khandelwal retweeted
Scans sound intimidating. The reality is a lot more reassuring.
No radiation in the MRI. A low-dose CT. Suitable across age groups.
Getting checked early shouldn’t come with a worry attached.
#centhealth #preventivehealth #fullbodyscan
No radiation in the MRI. A low-dose CT. Suitable across age groups.
Getting checked early shouldn’t come with a worry attached.
#centhealth #preventivehealth #fullbodyscan
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Anshul Khandelwal retweeted
My bet that medicines will be some of the biggest consumer products of the next 20 years hinges on two questions:
1. Is the demand there?
Emphatically yes.
Tirzepatide, the molecule behind Mounjaro and Zepbound, already generates more in revenue than Netflix.
Equally striking: more than half of these prescriptions are self-pay. People are spending their own money on medicines that meaningfully improve their lives.
Even a product as good as tirzepatide leaves plenty of room for improvement. And weight loss and diabetes are just one part of the opportunity. Better sleep. Less pain. Fuller hair. Clearer skin. Better treatments for cancer and cardiovascular disease. The unmet needs are enormous.
The demand question is relatively easy—the harder question is below.
2. Will we be able to build these medicines?
My bet is yes. But this is where most of the uncertainty lies.
Three reasons I’m optimistic:
- Drug development is becoming like software. Increasingly, a lot of the research & analysis that is required at all steps of drug development can be done via LLMs. As a result, these steps can be composed within systems and automated. This allows small AI-native teams to do in days & weeks what required dozens of PhDs months to do. With billions going into AI × biology, I expect this trend to only accelerate.
- Our biological toolkit is expanding. CRISPR and base editing. siRNA and mRNA. Bi/tri-specific antibodies, antibody-drug conjugates and targeted protein degradation. CAR-T and emerging in vivo CAR-T approaches. We have more ways to intervene in biology. Better delivery technologies and half-life extension can help medicines reach the right tissues and work longer between doses. Together, these advances expand the range of medicines we can build.
- I have a positive regulatory bias. While regulation is always tough to predict, some of the recent steps from the FDA have been positive. FDA is developing clearer pathways for historical patient data and Bayesian methods in trials, while advancing validated alternatives to animal testing. These changes could reduce development time and cost. As unmet needs continue to grow, I expect more pressure on FDA to keep modernizing.
Twenty years is a long time for these improvements to compound.
Why I could be wrong:
- Biology takes time. Some steps in drug development are inherently incompressible. For example, establishing long-term safety and clinical benefit still requires observing people over time.
- Biology is hard to predict. Compelling mechanisms can still fail in large trials. Last month, Novartis’s long-awaited Lp(a)HORIZON trial showed that pelacarsen lowered Lp(a) but failed to demonstrate a statistically significant reduction in cardiovascular events. This contributed to a selloff that wiped roughly $30B off Novartis’s market value.
These constraints are real. But teams that combine scientific rigor with commercial discipline can bring great medicines to market.
Many of the biggest improvements we can still make to people’s lives are biological. Medicines can deliver them.
What’s a better consumer product than that?
1. Is the demand there?
Emphatically yes.
Tirzepatide, the molecule behind Mounjaro and Zepbound, already generates more in revenue than Netflix.
Equally striking: more than half of these prescriptions are self-pay. People are spending their own money on medicines that meaningfully improve their lives.
Even a product as good as tirzepatide leaves plenty of room for improvement. And weight loss and diabetes are just one part of the opportunity. Better sleep. Less pain. Fuller hair. Clearer skin. Better treatments for cancer and cardiovascular disease. The unmet needs are enormous.
The demand question is relatively easy—the harder question is below.
2. Will we be able to build these medicines?
My bet is yes. But this is where most of the uncertainty lies.
Three reasons I’m optimistic:
- Drug development is becoming like software. Increasingly, a lot of the research & analysis that is required at all steps of drug development can be done via LLMs. As a result, these steps can be composed within systems and automated. This allows small AI-native teams to do in days & weeks what required dozens of PhDs months to do. With billions going into AI × biology, I expect this trend to only accelerate.
- Our biological toolkit is expanding. CRISPR and base editing. siRNA and mRNA. Bi/tri-specific antibodies, antibody-drug conjugates and targeted protein degradation. CAR-T and emerging in vivo CAR-T approaches. We have more ways to intervene in biology. Better delivery technologies and half-life extension can help medicines reach the right tissues and work longer between doses. Together, these advances expand the range of medicines we can build.
- I have a positive regulatory bias. While regulation is always tough to predict, some of the recent steps from the FDA have been positive. FDA is developing clearer pathways for historical patient data and Bayesian methods in trials, while advancing validated alternatives to animal testing. These changes could reduce development time and cost. As unmet needs continue to grow, I expect more pressure on FDA to keep modernizing.
Twenty years is a long time for these improvements to compound.
Why I could be wrong:
- Biology takes time. Some steps in drug development are inherently incompressible. For example, establishing long-term safety and clinical benefit still requires observing people over time.
- Biology is hard to predict. Compelling mechanisms can still fail in large trials. Last month, Novartis’s long-awaited Lp(a)HORIZON trial showed that pelacarsen lowered Lp(a) but failed to demonstrate a statistically significant reduction in cardiovascular events. This contributed to a selloff that wiped roughly $30B off Novartis’s market value.
These constraints are real. But teams that combine scientific rigor with commercial discipline can bring great medicines to market.
Many of the biggest improvements we can still make to people’s lives are biological. Medicines can deliver them.
What’s a better consumer product than that?
My bet: the best consumer products of the next 20 years will be medicines
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