[Music]

GLP-1 drugs have become increasingly

popular. Eli Liy coming to save us here

>> has had its market capitalization

increase by about 860% since he became

CEO and the stock price is up a little

bit more than a,000%.

>> No need for needles. Eli Liy says it has

a pill.

>> Eli Liy's experimental pill appears to

work as well as the injected drug.

>> It's everyone's job to move the science.

We should always be pushing forward.

[Music]

>> Ladies and gentlemen, please welcome Eli

Liy CEO Dave Ricks.

[Music]

How are you?

>> Hi, David. Good to see you. Good to see

you. How are you? How are you,

>> Dave? All right.

>> You want to say thank you? I just want

to

>> Dave.

>> Yes.

>> I don't want to make it awkward.

>> Well, we were sitting here three years

ago on this pod and Chimath was calling

me a fat bastard.

>> He wasn't wrong. I was 213 lbs. I'm

afelt

172 right. Awesome.

>> And it's because of what you've done.

>> Thank you.

>> Can I give you a hug?

>> You can. Yeah. Bring it in here. Bring

it in here.

>> I appreciate it.

>> Congratulations. That's

>> also Sax lost 20 pounds. So together

we've lost a Freedberg. That's actually

my husband. Come on.

>> Nice. Nice.

>> How much money are you guys printing? My

lord.

>> What do you do with it? You have

wheelbarrels. What do you do with Can I

please start?

>> Yes. Go ahead. Okay. Sorry. I got four

more jokes. I'll get them in the end.

>> Um I mean you really have built one of

the most incredible business in America,

but you've done it because you took an

enormous bet long time ago.

>> Yeah. Um, do you want to talk us through

the journey and the process you had to

go through and what you saw early on and

um, how you made the bet on this class

of drug?

>> Yeah, great. And thanks for having me

here. I'm trying to up my cool factor.

That's what they tell me in M Midwest I

need to do.

>> Can you get a Tomas Ford uh, suit as

well?

>> No, I'm actually disappointed in the in

the ties. Like that's I don't know.

That's not

>> You and I are you and I guy wears ties.

>> Dave Suit Supply does a great job. Just

own it. Okay, there we go. Just donate.

Okay, so uh yeah, GLP1 drugs, we all

know about it. It feels like an

overnight success, but what what

happened? You know, drug development is

hard and long and requires a fair amount

of failure and discipline, a huge amount

of capital. So, actually in 2006, we

launched the first GLP-1 drug. Nobody

really knew the name of it. It was a

twice a day injection for diabetes, but

the cover of our annual report uh in

2007 had a lady on it and she said

there's a quote. It says, "Oh, my

diabetes is under control and I'm losing

a little bit of weight." So, that was 18

years ago. I mean, and since that time,

we're now we've been inventing new

versions of that, solving various

problems with that twice a day. We

wanted to make it more convenient.

Needed to get the dose up and people

tended to lose weight, more weight when

you when you got the dose up. And then

tzepide which um you ask how much money

we're making but in actually in Q2 we

reported uh global sales which surpassed

Kitruda to becoming the bestselling drug

in the world. Actually the bests selling

drug in the world of all time in Q2 this

year.

>> How much did it make in Q2?

>> We 8.1 billion in revenue

>> and growing at 80%. Yeah.

>> And and how many people are on a GLP1

globally now?

>> I'd estimate around 20 million take

prescription GLP1s. some unknown amount

of people take nonprescription. But

anyway, so

>> that would be compounding

>> compounded or synthetic.

>> Yeah. Or just like not for human use. We

can talk about all that. Yeah. So

anyway, um 2014 comes along. Uh four

scientists at Lily decided to combine

GLP-1 with another peptide that your

stomach produces when you eat that's

appetite suppressing. They made the

single molecule culture. That's what's

Mjaro now. But that happened in 2014.

2016 I be I was named a CEO and I got a

call that fall and one of our chief

scientists called me and said hey we're

we have to stop an early phase study for

tepatide that's usually a bad call so

I'm like ah like this is the followup to

our second gen version of the GLP1 he

said no no it's actually good good news

we were running this study in Singapore

with healthy male volunteers you can

imagine what a healthy male Singaporean

looks like at baseline right they're

they're not overweight And we had to

stop the study because they were losing

too much weight too quickly. They were

basically not eating. So scientists like

actually it's good news. We can tune the

dose down. We can work with this. And

from there it was kind of just just

execution. We knew it was going to be

huge. And we started building out supply

chain, building out factories, running a

massive clinical program. We currently

have over a hundred clinical studies

with the medicine going on for all kinds

of other uses as well, not just slowing

down.

>> We're going to go there in one sec, but

I just want to go back to this. So the

problem now, and maybe you can comment

on this, is you have this enormous

success.

>> Yeah.

>> There is a very active gray market,

particularly in China, peptide

synthesis, that are producing drugs that

are basically the equivalent of your

drugies,

>> working around copies. Y

>> um talk to us about that. How do you

deal with that and what do you do about

that and what should people do about

that and when they encounter it?

>> Yeah, it's an unusual situation. I think

there's always been counterfeit

medicines. We're not used to it in the

United States because we one have a for

most people a pretty good system to

subsidize some of the benefit via the

insurance markets. So there's not a lot

of incentive to go outside the system.

That's different for these drugs because

insurance quality is poor. or most I

don't know if you bought out of your own

pocket but most people have um and so

>> did you pay out of pocket?

>> Well, interestingly when I first got it

four years ago I had this revelation

when I was in forto de Mar and um I had

heard Tim Ferrris talk about it on his

podcast with a friend of mine Kevin Rose

and I went to my doctor and I said hey I

want to get on this. He said what is

that? He said oh no you don't need that.

That's for people who are diabetic.

You're not even pre-diabetic. I said no

I want to do it for weight loss. It's

off market.

>> He said I don't know if I can do that. I

said I'm going to get a different doctor

if you don't. and he said, "Let me try."

>> Yeah.

>> And he got it on prescription. After I

lost 20 pounds and my BMI got below 30,

which really, I mean, I don't want to

get emotional, but I got three

daughters. I want to stick around. And

it really changed my life incredibly.

>> And in in many ways, I was embarrassed

that I couldn't have the discipline to

do it. And then I realized there was a

food noise that I had that was

constantly screaming. And once I cycled

off of it for many months and now I'm on

extremely low dose, the food noise and

my discipline has come back. There's

something about a certain moment where

you get too far over it. So now I I do

have to pay for

drug.

>> Yes.

>> You've always Yeah. And I I think you

know the the question I have for you

about this big picture is

>> there's a lot of demand for it. It is

still a bit too expensive. You're wildly

profitable. This going to be a pill

format. I think you're

>> Yeah, that's ours. That's coming next

year.

>> So, is there some thinking when your,

you know, head hits the pillow, hey, I'm

having such a profound impact on so many

people's lives that all of the diseases

we have are downstream of obesity. We

know that this thing is helping with

many other things.

>> Do you have a moral imperative to bring

this down, you know, 50% in price? I

would think you that must weigh on your

conscience that it's too expensive and

you're too profitable in a way and

there's shareholders who want you to

print money but there are lives at stake

here and there's longevity and there's

health span so maybe unpack that.

>> Yeah, we're committed to bringing the

pricing down and I want to come back to

the supply situation because that led to

some of the compounding but also affects

pricing. Um you know we've we've led in

reducing the out-of- pocket costs but

from it was originally $1,000 now it's

$4.99 from us. Um, we'll push that down

further with new medicines like orals.

>> What's the goal for orals?

>> The the main goal is to get it

reimbured. Why is it we pay for

anti-hypertensive drugs that the moment

you stop taking them, you have the same

exact risk as before, but we don't pay

for anti-obesity drugs? That makes no

sense to me. Why do we pay for surgeries

that don't work, but we don't pay for

these?

>> What's the number on the pill? What's

the target? You can tell us.

>> Yeah, I don't have a target in my mind,

but lower is the direction. We've told

we've told the street expect singledigit

deflation in this category over time.

>> 5% a year it goes down

>> uh or more. Yeah.

>> Or more. 10%. So you get it down from

5%.

>> But here's here's the risk Jason is if

if we cut the price to say I don't know

$100, there will be no more new

medicines in this category.

>> Okay?

>> Because we'll have snuffed out

essentially the incentive to create the

next thing

>> R&D.

>> So we have to balance that. We want to

create the next better medicine. We

spend 25% of sales on R&D. This year

that'll be 14.2 2 billion. Wow.

>> That has to get paid for paid for

through revenue.

>> So, so with the cash flow that the

business is generating, is that how you

think about capital allocation? Some

percent to R&D, some percent I'm

assuming, to capex and supply chain

durability,

>> some percent maybe to buybacks. I mean,

how do you think about where the capital

should be allocated? And maybe on the

R&D side, you can tell us a little bit

about diversification and and how else

you think about deploying capital.

>> Yeah. Well, I think we're we've had this

totally asymmetric uh success. So what

do we do with it? I think one version of

it is to sort of play out the cash flow

game, return it to shareholders and

return at some future date remembering

that in pharma all our we have no

enduring franchise. Everything we make

goes to zero because of the patent

system. So in 2030 something Mjaro will

go to zero.

>> Yeah.

>> And so should we think about our company

as one that will just return to the

previous baseline, send all that money

back to our shareholders who took that

risk over 15, 20 years with us and pay

them back. That's a little bit like I

don't know how kind of Apple is running

their company, right? Yeah. And

>> that's viable. That's great for

shareholders. I And at Lily, we think

about our job a little differently. We

want to create a solution to some other

problem people have. And we think we're

good at that and can uniquely do it. So,

we should try.

>> We should not try to no end. That's

wasteful. You can just bury all that

money. And that's sort of the history of

the industry is people have found

success. Wasted money. they go back to

the baseline anyway, but the

shareholders don't get rewarded. That's

the So, we're we're running this

experiment now. We're betting a lot on

organic R&D buildout. We currently have

about 4,200 PhD scientists at Lily, by

the way. That's about the same as MIT

and Harvard combined.

>> So, the scale of the science enterprise

is huge.

>> How do you Dave, how do you push people

on the risk spectrum? There's a tragedy

of riches that can happen because you're

so successful. There's this one drug.

There could be like some emergent

scientist in your organization who wants

to take a long shot but then just

doesn't feel motivated because like h

it's just like this is not going to do

anything. Yeah.

>> How do you get that person unlocked so

that they go for the big moonshots?

>> You mean that their idea isn't big

enough to matter.

>> They think that but they may not know

and they may stumble in a different

path.

>> I don't think that's our bigger problem.

I think in big companies in general and

pharma companies maybe in particular the

bigger problem is people thinking they

have a big idea but having no way to

advance it. Right.

>> So I'm trying to work on that side which

is if you think you have something that

could be big, how does it become easier

>> to advance your idea in our company

versus leaving us and raising money in

venture? We can talk about venture and

biotech in a second because it's totally

totally broken broken right now. But um

anyway back to David's question. So

first priority invest in organic R&D.

Secondly build out the supply chain.

What's different about MARO and the

following drugs is they're injectable

drugs. These are very capital intensive

technically difficult things to scale.

We've committed with President Trump uh

to build all that in the US. We're

currently constructing six plants. We're

going to announce four more in the next

6 months. I was hoping to be able to

announce one today, but that'll come in

a few weeks. So, yeah, this is creating

um 20,000 construction jobs in this

period and ultimately five or six

thousand manufacturing jobs. Um and so

we'll become a net exporter at scale for

these. And unless some Chinese

stateowned enterprise gets in this

business, it'll be very hard for others

to build that out and follow.

>> Well, they're doing in the car business.

So,

>> yeah, if they're determined, they might.

But then the final is is actually to buy

external innovation where it makes sense

to tuck it in.

>> And maybe that leads us to market. You

just you bought that gene therapy,

right?

>> Yeah. We recently bought a gene therapy

company in in June. We can talk about

that. But um we're doing a deal about

every two weeks. Most of them are

smallish. Biotech funding right now is a

is in a dumpster fire. U peak got to

about 20 billion in new checks a year

into biotech. We're now around five.

>> Um and

>> just just walk walk the audience through

the dynamics. So why is biotech

cratered? Why is it so hard for capital

to flow back in? What's what are the

dynamics that are that are that are

driving this market condition right now?

many factors but the first one is

competition for other venture ideas

driven by the industry you guys are in

right so there's just a crowd out going

on with AI and other things that if it

your cycle time to return is just more

visible or faster

>> biotech is hard and slow um secondly I

think too many biotechs IPOed in the

last decade and so the liquidity market

has sort of collapsed because there's a

lot of investors deeply underwater half

of biotech that's publicly traded is

trading at or below cash,

>> right?

>> So

investors look at that and say, "What's

my future here?"

>> Yeah.

>> It's unless you can really analyze the

technology and take a differentiated bet

on the drugs they're working on. I think

general investors don't want to

participate in that.

>> And then you have China, which is the

other factor, right? So China is

investing heavily like they do every

other stateowned thing. They're

subsidizing their own companies. They

have like a swarm model here where

they'll subsidize many small things

really against followon ideas betting

they can execute faster than us. Um it's

a national priority for a long time.

>> Can you talk about issue there the

patent and IP issue? So in the US you

know when we make a filing and what goes

on with respect to China they don't

respect any of our IP do they? Well, I

think right now they they are okay

amongst so if I have a patent and I file

and launch a product, I don't see

immediate copies because it's in their

interest to have a patent system right

now for the reason you're raising. So we

um changed the patent laws in the US in

2011 I think the American vents act

where it's first to file. It used to be

first to invent and all the pat

litigation we had was all about whose

lab notebook said January 5th versus

January 4th on this invention. that was

the case not did you file it in a

reasonable time but did you invent it

first now it's first to file so there's

no question about who we don't care who

invented it first it's just who got into

the patent office as a consequence of

that our biotech companies and big

companies like Lily Fizer etc we file as

soon as we can because we don't get beat

on first to file what does that do it a

patent exposes the invention to the

world China's getting very good at

patent hacking so what they do is they

look at that chemical structure they

work backwards sometimes driven by AI

algorithms to find chemical structure

that will behave similarly but are

outside the patent scope and they go

fast. So they're really quite a

derivative biotech market but that is

also hurting biotech valuations in a

significant way.

>> How old are you?

>> I'm 58.

>> You're 58. You look great.

>> Thank you.

>> You look like 40. What do you want? Off

the menu. You

>> come on. You look great.

>> There's You got some off the menu stuff

going on. What do you got? You're on the

Wolverine. You want

It's actually an interesting question.

What is your lifestyle routine? Like, do

you supplement? Is there anything else?

I know. You have Brian Johnson coming.

Okay. I I follow him on on X. I'm not

doing the Brian Johnson.

>> He's the opposite of you. He looks like

he's dying.

>> You're handsome. That guy looks like

he's turning into a

>> You know, that's a vampire.

>> There's another Brian Johnson, the liver

king. I don't know if you ever follow.

>> Yeah. Both of these guys are taking it

too far. But but seriously, be

>> I get up early. I I work out. I read.

Okay.

>> Try to go to bed early.

>> Sleep is important.

>> Sleep. Okay. There's like four things in

life that I think really matter where

there's evidence. Sleep, eating healthy

foods, mostly plants, movement, and

social relationships. I think those are

the things that over time that's cuz I

got a meditation app. If you got a

feedback,

>> you tried to get me to do that. I

My wife tried I haven't tried yours. But

>> have you been motivated to try some of

these drugs prophylactically?

>> You know, I people ask me if I've used

the GOP one drugs use. I haven't. Um

yet is my answer because what's

happening as with all medicine

technologies you start with the sickest

the most extreme cases and you work your

way as you prove safety to general use.

I think what we're seeing now with the

broad benefits everything from metabolic

disease less drinking lower inflammation

uh our competitor Nova is going to read

out a study in a few months on dementia

risk. It probably won't be positive.

That's my guess. But it will probably be

in the right direction. So you have

these sort of general what scientists

would say pleotropic effect like

broad-based positive things.

>> I think we're going to get to a point

where taking pretty low doses for most

people say over 60 58 is not a terrible

idea and may help you live longer.

>> I just want to follow up on this one

specifically. Um these peptides are

becoming quite the rage in the

biohacking space. Have you been tracking

the Wolverine Protocol, BPC 157, and the

tremendous impact people are reporting

from it?

>> There's lots of communities like this

trying different things. We don't ever

recommend that because we live in a

world of clinical studies and FDA

approvals,

>> but you watch it,

>> of course. Yeah.

>> And what do you think of those

specifically?

>> I are you pursuing them? There are broad

well we're pursuing them in the path we

do which is taking those disease states

or people with the pre- disease state

like pre-diabetes and then we study it

and we prove an outcome. So we did that

with MARO and showed a 93% reduction in

conversion from pre-diabetes to

diabetes. That's kind of how we work is

like slicing the medical stack. These

guys are coming at it the other way

which is sort of saying I'm already

healthy. Can I generally stay healthier

uh with small doses or other regimens,

supplements? That's not our game, but we

watch it.

>> There's a handful of drugs that I would

say are epidemically prescribed in

America. Probably at the top of the list

would be SSRIs and anti-depressants.

>> Yeah.

>> And there's a lot of anecdotal evidence

that GLPS and this class of drug

actually is quite helpful with just the

psychological

>> health of an individual. Um can you talk

to us about that? Like what's ongoing?

What is a readout that you think could

be transformational in that space?

>> Yeah, so this is interesting. I mean

sometimes we engineer a medicine to do

something like we did GLP GIP towards

appetite to reduce body weight, lower

blood sugar and lipids and then

sometimes along the way you discover an

effect you didn't predict. So one of

those is like smoking sensation. When we

started doing these studies at scale it

was immediately obvious people stopped

smoking. Like a lot of people stop

smoking. also gambling and

>> gambling and online shopping all kinds

of

>> this is why on it because he was stuck

in the game

>> poker's not gambling but go on

>> so any anyway

>> I was talking about craps

>> so then there have been reports and

there's a big VA study that read out and

we know our veterans suffer from a lot

of mental health yeah and there were

pretty dramatic reductions for those

that were using GOP1s who had diabetes

so we are now right now starting studies

in bipolar disorder and major depressive

disorder along with these addictive

hedonic pathways where you're sort of

self-medicating

um with a new GOP1 a different one that

probably that has a little less weight

loss but a little more brain activity

>> really

>> so dialed in for these uses so we'll get

that drug in three or four years if it

works and I think it could really change

some of these terrible mental health

conditions

>> well can you take a step back maybe and

jump off from SSRIs

give us a description of the landscape

of the American human health the ma the

maha movement

you know what Bobby and his team are now

doing at HHS.

>> Yeah. Long overdue. I mean, I think the

the food system in particular um I

you're working on this, but could be

changed in a much more positive way. I

think we are the the least healthy

metabolic big country and probably the

reason for that is the food we feed

ourselves. processed food chemicals,

>> highly processed food chemicals. This

whole carb thing that went on for 30

years, which was has been totally

debunked and uh food companies have a

lot of influence and they've

>> you're saying the anti-carb the low carb

or no carb thing,

>> the the anti-fat, high carb diets, which

we were feeding people for 30 years, and

I think most people don't believe in

that anymore, but it led to a big part

of the obesity curve, glycemic index

kind of thing. So, I I'm all for all

that and I think we should reform that

and find ways to make quality food

cheaper and more accessible for many

people Kennedy. You like that he's

shaking it up. It's a big part of Bobby

Kennedy. I think that part I think we we

have a lot of alignment on. I worry

about um I'm all for skepticism of

science. That's what scientific process

is is questioning and challenging. I

worry about some of the stuff going on

with vaccines right now. Uh because I

don't see why we're making the asking

these questions. But it's okay to ask

them. But if we restrict access while

we're asking them, I worry about that.

Can that hasn't really affected the

medicine world. We don't make vaccines.

But um at least recently we have.

>> Let me ask you a hard question.

>> Yeah.

>> Um the mainstream media in many cases

make 25 50% of their revenue off of

advertising from companies like yours.

>> Yes.

>> We allow you to advertise. Should we

allow you to advertise? And have you

captured that mainstream media? Is that

the intent when Anderson Cooper makes

double digits of his money from your

firms?

>> Uh well, I would be for a system where

we don't have nearly as much drug

advertising

>> to be clear. Yeah. Yeah.

>> Well, that that's paradoxical. How do

you then you just want to rise and fall

based on your reputation?

>> Mutually assured destruction, right?

People the ads annoy people. They're

poorly constructed. Why? Because of

regulation built, believe it or not. If

you read the regulation, 1992 FDA

published a regulation on advertising

built for magazine print advertisements.

Yes. And now we have to follow that

regulation for TV advertisements, which

is why you have the scrolling side

effects as if they were printed on the

back of the ad. That's literally how

we're here. So the ads are poor. They

don't represent the patients we're

serving, etc. By the way, more than half

of our consumer spending to reach

consumers is not on TV.

>> So already the technology does work for

you. Does it move the needle when you do

a big ad buy

>> there? It does unfortunately. Um that's

why people keep doing it. Uh of course

the the productivity of that is debased

when your competitor does it but then

you're then everyone wants to go up

above the

>> prisoners dilemma. Yeah.

>> A little bit. So um I would be for a

system where that got reduced. There's

been a lot of legal actions that said

that that were fought over this through

the years and it's pretty clear under

first amendment we can do it. It's hard

to regulate. There's been some efforts

in Congress to tax it differently. I'm

okay with that. Yeah, it doesn't move my

needle at all.

>> You'd rather see that money go into R&D.

I would suspect

>> Yeah. You're not going to know what

what's available off the sh, you know,

on the doctor's shelf to you without any

sort of knowledge or information. Truth

is most primary care doctors are way too

busy right

>> to even attend a continuing education

even know what's happening

people what what do you think of people

using chat GPT and large language models

to do their research and then they come

to their doctors sometimes with much

deeper research than the doctor's aware

of. Is this a plus or a minus? Do you

trust it? Do you do it yourself?

>> I think it's a huge plus I would say and

I do do it myself. I also do it just to

see what the different models are

producing about our drugs. Yeah, it's

like an audit. Um, but mostly it's

accurate and um, they've it's gotten

better over the last two years. I'd say

substantially better. And many,

including Google, to their credit, have

a

>> like a way to sort of uh, click through

and check the facts directly, which is a

useful thing. They've served that up a

little more proactively. That's good.

>> Poor consumers owning their health and

for more information.

>> Do do you work directly with them? Do

you have an arm that will go to Grock,

go to Gemini and say, "Hey, we did these

searches. Here's some things you need to

improve."

>> So, we've pointed things out when there

are mistakes. It does feel a little bit

like we're lobbing into a black hole.

>> Um, and maybe that's a capacity issue on

their end, or maybe it's a they're

taking the point of view that our

model's just trained on the internet,

>> the corpus of information on Reddit.

>> Yeah. Yeah. Right. And it is what it is.

We don't want to own

>> the bastion of intellectual.

Yeah. We don't want to own the outcome

of that.

>> Before we run out of time, I just want

to get your view on um uh research

funding in this country. The NIH uh

budget uh cuts have been that have been

proposed. How what will the follow-on

effects be? Are these cuts going to be

to low ROI research programs that

ultimately wouldn't have translated into

the clinic and and into improving lives?

or are you worried about NIH funding

cuts and what they're going to do to the

pipeline of therapeutics in America?

When will we realize the effects of

that?

>> Yeah, great question. I don't think

anyone knows the answers to those. It's

not obvious. Let me put it that way. No

doubt that the NIH over its history has

done some landmark things that no market

could do. And I'm for more of that.

mapping the human genome, a mega project

that could only be done by government

and undoubtedly produced a ton of good

and economic value for the country. Um,

I think if you look at the first of all,

NIH total budget is a little over $40

billion.

Most of that is extra mural. They're

granting that to institutions in very in

smaller checks, sometimes very small

checks. I personally kind of wonder what

the impact of that. Is it sort of a VC

model where we spread a ton of bets and

a few of those will bloom into giant

successes or is it just sort of filtered

out without a strategy? I I think that's

a question that should be asked and

maybe Jay's asking that. Um I think the

other problem with the NH granting is as

you do that like any government

mechanism it gets influenced by the

people who are making the grants. Who

are those people? People receiving

grants. M

>> so there was a little bit of a

backscratching

uh issue here and I think exposing some

sunshine onto that to you know sort of

say what is that process is it truly

competitive and is it truly pursuing

ideas that the market can't solve itself

>> and should it be done at universities

let me just ask you this are

universities the right research

institutions today and going forward

we've got two university leads tomorrow

that we're going to have a conversation

with about this topic amongst others but

what's your you when you look around the

world at how research is done xus what's

the right what's a what's a what's the

right model is this the right model

>> I probably too much that way I'm on the

board of an R1 university so I have to

I'm a little biased maybe myself but I

think a lot of good things have happened

in universities but we should not

exclude that to other applicants I I

think there could be a place for other

participants

>> Dave um tomorrow we're going to have

Mark Cuban

>> yeah great

>> and we're going to talk about PBMs

>> yeah And one of the big

>> he's on fire.

>> Well, one of the big boogeymen in

healthcare are these PBMs. Can you just

explain, you know, quickly 30 seconds.

What do they do? And what's your view on

whether they should even exist in

American healthcare?

>> Probably we're at the end of that S

cycle and we should get to something

else. We actually owned a PBM in the

'90s. Why do they exist? Two reasons. To

match up claims. So you can go into any

pharmacy in the country with a card that

says here's my benefit and that benefit

can be adjudicated to you. That was a

big IT problem in 1993. It's not really

a big IT problem now. And there's dozens

of these so-called transparent or light

PBMs. Actually, our company is moving to

one off of one of the mainline ones

because it's in our business interest,

but also their service is better. The

other thing is negotiate like bulk

discounts. So, gather up a bunch of

employers or plans, go to the drug

companies, get a lower deal. I think

that's fine. I'm for that, too. What

happened is you know the like any uh

consolidated terminal state of an

industry what's the term the inification

of their service is they just they just

become so every every action they make

is about their benefit not the customer

and that's what's happened that's why

everybody hates them

>> s

kind of came out of nowhere as this big

category what if you had to guess what

do you think the next big surprise

category would be that we're not

thinking out.

>> It's hard to predict that, but I would

say probably a brain disease. I think if

you look at human suffering globally,

40% is brain diseases. And it's so broad

we we could spend a whole panel talking

about them. Um, and what we've had so

far has not worked. You know, when

Bobby's raising the question, why do we

have so much autism? That's a great

question. What's causing it? Depression

rates despite the advent of I we

invented Prozac, so many drugs. People

are aided, but it's not solvent. We

still have lots of depression in this

country and maybe it's growing in youth.

So these are huge problems as our

population ages dementia and brain you

know these. So I'd bet there part of

what we try to do is allocate capital

into spaces where there are no drugs

hoping you know to hit hit the dart

board where there isn't a competitor.

That's how we got obesity drugs. We're

working on that but it'll be hard to

it's hard to predict.

>> Ladies and gentlemen, please thank you

David. Take a break.

>> Thanks bro. Great to see you. Yeah, I'll

be I'll get ready. Good to see you,

baby. Yeah. Thanks, baby. Appreciate it.

Congratulations, my man. I appreciate

you. Appreciate it. Take care.