“All Hat, Ton of Cattle…”

Had a remarkable day today in Houston crawling around the Texas Medical Center. I was in town to speak at the Xconomy Healthcare event – an incredible roster of speakers and attendees I must say. As Ron DePinho, President of MD Anderson, characterized that this part of Houston is as if someone put the Kendall Square and Longwood regions around greater Boston into a giant centrifuge and spun it down – what an extraordinary concentration of healthcare expertise/technology/discovery – 54 healthcare institutions, 21 hospitals in only 1.6 square miles! If you have not been there before, make a point of hanging out at the Texas Medical Center.

The Texas Medical Center has 8 – 9 million patient visits per year and as Bobby Robbins, CEO of Texas Medical Center, lamented that until recently the most important part of his job has been dealing with parking. More specifically, MD Anderson sees 1.4 million of those patients and has a $4 billion annual budget; more impressive – of that amount, $700 million is on research. There are 11,000 patients enrolled in clinical trials being run at MD Anderson and the productivity of their development pipeline is exceptional.

Much of the discussion today was centered on how best to build an end-to-end healthcare innovation economy. John Mendlein, serially successful biotech entrepreneur and current CEO of aTyr Pharma, portrayed numerous possible roadmaps (he called them recipes) on how one might go about building great start-up companies, but the common refrain was that it was all about the aggregation of talent – scientific, clinical, commercial, financial, managerial talent – and they all need to be present for the ecosystem to survive. With this important awareness, it certainly feels like it is only a matter of time, and not much time at that, before we see a Genzyme or Genentech launched in Houston.

Other interesting observations I gleaned over the course of the day…and some are meant to be more thought provoking.

• Academic centers of excellence seem to be increasingly prepared to embrace that innovation must co-exist with commercialization. DePinho stressed the need for “informed” clinical trials and the powerful role of integrated diagnostics (which was music to my ears)
• Houston, like many other emerging healthcare hubs, has numerous grass roots efforts to raise awareness, build community, create dialogue – these activities are important precursors to successful ecosystems (see Bloomberg in NYC)
• Surprised how many leading academic hospital systems are “exporting” their expertise in the care service delivery models that they have built (see Hopkins in Saudi Arabia, Cleveland Clinic in Abu Dhabi, MD Anderson with its numerous international partnerships, etc). There is something profound here and I am not sure all of us fully understand the implications with this phenomenon – they are probably all good though. For Foundation Medical Partners we have seen the increased focus placed on Asia, specifically China, and the ravenous appetite for new healthcare delivery service models.
• We need to better “democratize” expertise from academic centers which plays directly into the “consumerization and retailization” investment themes our firm is exploring. How can we best deliver to the consumer/patient very complex clinical information? How can we ensure the superior standards of care we are accustomed to receiving from leading providers are made available to people who cannot access those providers? Innovative healthcare technology platforms will provide that consistency of care.
• What is a human life worth now? The old therapeutic pricing models were predicated on inadequate therapies which showed poor efficacy for many (only great outcomes for few) and many of these drugs merely extended life by few months, and in many of those cases, it was very low quality of life. Soon we will see therapies which will profoundly extend life for many – should those drugs be more expensive or less expensive? If across a population we extend life expectancies, are we not raising overall healthcare costs to society because we all know most of healthcare care costs are incurred by those over 75 years of age. Complicated issues are going to be raised by extending life expectancy.

But none of that mattered earlier today as I toured my brother’s pediatric ward; he is an extraordinary pediatrician at the University of Texas Health Sciences Center. At one point we stood at a large window looking down Main Street across the entire complex at Texas Medical Center and I remarked “this is the Las Vegas Strip of Healthcare.”

Fortunately for all of us, what happens at the Texas Medical Center does not stay at the Texas Medical Center…