The End­points 11: A group of dis­rup­tive up­starts on a do-or-die mis­sion to launch new meds

Over the last 15 years I’ve had the chance to help se­lect about 200 pri­vate biotechs for up-and-com­ing awards like this. Look­ing over the rank and file of this dis­rup­tive crowd, I had my stand­outs, my OK bor­der­line se­lec­tions, and some tru­ly dread­ful, cringe-wor­thy choic­es.

Such is the game of judg­ing pri­vate biotechs, where you al­ways wind up mak­ing hunch­es based on an in­com­plete pic­ture. But then that’s al­so much of the fun, right?

Every­one who does this sort of thing likes to pre­tend that they can pick which of these fledg­lings can shoot the rapids of drug de­vel­op­ment and come out of the white wa­ter do­ing high fives. But the re­al­i­ty is that we all have our good and bad ideas.

And you learn along the way.

With my first se­lec­tion of the End­points 11 (com­plete with a neat lo­go con­cep­tu­al­ized by our cre­ative as­sis­tant ed­i­tor Am­ber Tong), I’m get­ting start­ed on gen­er­a­tion 2.0 of my idea of top com­pa­nies that just may be head­ed for great­ness.

There are sev­er­al key at­trib­ut­es that char­ac­ter­ize each of the E11, and help me hedge my bets. Each rep­re­sents an im­por­tant trend in biotech cre­ation.

Most have top teams that are well rec­og­nized for ear­li­er suc­cess­es. Ex­pe­ri­enced biotech ex­ecs these days can gen­er­al­ly have their pick of the lit­ter when it comes to new com­pa­nies an­gling for a launch. So when you see a promi­nent biotech ex­ec make the tran­si­tion out of in­cu­ba­tion and on­to the stage — of­ten along­side close as­so­ciates that they have known and worked with for years — it may not guar­an­tee a win­ner, but it sure is com­fort­ing when smart, suc­cess­ful peo­ple love the sci­ence be­hind a start­up.

That will serve as my segue in­to tech­nol­o­gy. Me-too drugs have been dis­cred­it­ed for years now. Pay­ers may use them to pick the lock on low­er prices, but it’s a woe­ful de­vel­op­ment strat­e­gy. Every com­pa­ny in this year’s maid­en E11 is swing­ing for the fences, look­ing to drug the un­drug­gable or race with am­bi­tious ri­vals to achieve some­thing re­mark­able.

So sci­en­tif­ic am­bi­tion is key.

Enough mon­ey to get through to the next stage of hu­man da­ta is crit­i­cal.

There is a healthy de­bate go­ing on right now whether the 4-year tidal wave of in­vestor cash cours­ing through the in­dus­try is es­sen­tial­ly caus­ing risky be­hav­ior that will squan­der cash. Giv­en the in­her­ent risks as­so­ci­at­ed with drug de­vel­op­ment, and the ground­break­ing na­ture of what they’re try­ing to achieve, a good chunk of that in­vest­ment mon­ey is go­ing up in flames — un­der the best of cir­cum­stances.

If any­one in the E11 fail, it like­ly won’t be be­cause they were starved for cash. And this busi­ness isn’t cheap. Al­so, if any of these com­pa­nies be­low go bel­ly up, you will hear the ex­plo­sion from halfway around the world.

The right part­ner can be every­thing in this busi­ness, help­ing make all the dif­fer­ence in pick­ing up speed in the clin­ic and pro­vid­ing the kind of com­mer­cial clout need­ed to move mar­kets. That’s an­oth­er big fac­tor in the list.

If there’s one over­ar­ch­ing theme I’d like to high­light most, it’s that drug de­vel­op­ment is a glob­al pur­suit. The US may be where the mon­ey is in terms of wind­fall prof­its, and it may still dri­ve the li­on’s share of the de­vel­op­ment work as the in­dus­try feels the full flush of cash cours­ing through labs, but the sci­ence is in­ter­na­tion­al. So is much of the clin­i­cal work. These com­pa­nies span three con­ti­nents, from North Amer­i­ca to Eu­rope and Asia.

And Asia is com­ing on strong, with ma­jor im­pli­ca­tions for the in­dus­try as a whole.

Fi­nal­ly, just be­cause this is the first E11 doesn’t mean I’m start­ing over. If you’ve al­ready been high­light­ed in an­oth­er an­nu­al award I once man­aged, your chances of a re­peat here were re­duced to nil. We need to share the spot­light.

I’ll be back in the fall with my picks of 2018. And if you have any rec­om­men­da­tions along the way, send them my way as I man­age the next short list. — John Car­roll 

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