Alex Telford - Unlocking Innovation in Pharma

**Patrick O'Shaughnessy** (0:00)
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**SPEAKER_2** (2:00)
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**Patrick O'Shaughnessy** (2:29)
My guest today is Alex Telford. Alex is the founder of Convoke, a software platform to help streamline drug development and commercialization. He has also been writing frequent blog posts on the biotech industry since 2019, keeping a pulse on the direction of innovation. He joined me today to talk about the history of the pharmaceutical industry and what's becoming possible in medicine in the coming years.
Alex helped break down the complexities of investing in new drug development, breakthroughs in gene therapy on the horizon and the dance between timely progress and restrictive regulation. This industry has a ton to unpack and Alex thoughtfully lays out the landscape. Please enjoy my conversation with Alex Telford. Alex, we're going to spend a ton of time today talking about pharmaceuticals, not just the industry, some of the companies, but the process by which the world has created incredible technologies for our health and also the impediments to creating more of them in the future.
Could you give your version of just a sweeping overview of the process and evolution of how we find drugs?

**Alex Telford** (3:34)
Yeah, so it starts with academic research. This is mostly funded by government research and it occurs in universities. So the NIH is the biggest funder of biomedical research in the world. And they support scientists trying to understand the basic science of how diseases work. What are the mechanics of diabetes? What are the mechanics of heart disease?
What are the different genes, proteins involved in those pathological processes?
And to some extent, how could we modulate those processes to affect disease? But that's only really a small part of the story. So once you have an idea for how you might intervene in a disease, you then have to do a lot of work to convert it into a drug. So these initial hypotheses, these target specific proteins, RNA, whatever, that you can modulate to affect the disease, are then taken up by mostly for-profit biotech companies who then do all the hard work of turning this into a drug, producing a molecule that can modulate these targets, either inhibit it or increase the activity in a certain way, and then running everything through first, these in vitro systems just basically cells in a petri dish, then up to animal models, so testing them in mice, monkey models of disease potentially. Once it's safe enough, then you can go into human trials. You have a steadily escalating sequence of trials, starting from phase one, which is just basic safety trials in human volunteers and dosing, to phase two where you try to get a sense of initial efficacy of the drug, and then phase three, which confirms the efficacy and safety to the extent we can, and then you have to go to the regulators, FDA, EMA, the MDA, and they'll review the package of information and make a determination for whether or not the drug can be marketed for a certain specific use case, which is called an indication.