Big Picture Medicine

Martin Shkreli is an American Investor, Pharmaceutical Executive and Hedge Fund Manager who became the most hated man in America in 2015 when he obtained the drug Daraprim and increased its price from $13.50 a pill, to $750 overnight. 0:00 Intro 1:56 The Big Short 8:04 How to price a drug 20:01 Should we price drugs like iPhones 25:36 Pharma's dirty secret with R&D spend 34:12 Why are we not discovering more drugs? Eroom's Law 43:59 Marting's new AI Doctor — Dr Gupta 51:08 What's the FDA going to say? 53:26 Problems with GPT-4; hallucinations and sources 1:00:00 Mental health impact of being the most hated man in America 1:02:30 How rich are you? 1:08:00 Outro Daraprim is used to treat or prevent parasitic diseases, commonly in patients with HIV or AIDS. He defended the move by saying “If there was a company that was selling an Aston Martin at the price of a bicycle, and we buy that company and we ask to charge Toyota prices, I don't think that that should be a crime.” Unrelated to the Daraprim scandal, in 2017 he was charged with securities fraud and sentenced to seven years in prison and fined a total of over $70M dollars. Martin comes from humble beginnings, his parents are Albanian immigrants — but he quickly ascended the world and became a multimillionaire polymath. And despite having no formal training in Medical Sciences — he has a penchant for consuming medical literature from PubMed, and making novel insights. We talk about how Martin does this, his philosophy around drug pricing — and whether we should think about pricing drugs in the same way we price iPhones, we talk about whether blowing more money into pharma research & development actually leads to more exciting drugs, Martin’s new AI doctor that he just launched and the mental health impact of being the world’s most hated man. You can find me on Twitter @MustafaSultan and subscribe to my newsletter on www.musty.io

Dr Ben Maruthappu is the the Co-founder and CEO of Cera Care; a digitally-enabled social care company which has raised over $400M dollars. He was made a Member of the Order of the British Empire in 2020. 0:00 Intro 0:47 Ben's story 6:10 How to have good ideas, at the right time 12:14 Good decisions Ben made with Cera to scale 21:07 Is the US greener pastures? 28:10 What healthtech can learn from fintech, ridesharing and food delivery 30:17 Anti-lessons from other industries 33:53 How do you stop driving becoming toxic 36:13 Are founders olympic athletes who don't deserve work-life balance? 38:31 Are you full of sh*t? What are your real motives? 41:19 Are successful founders happy people? 43:30 Mo money mo problems 46:51 The power of vulnerability vs the magnetism of certainty 52:21 Networking advice You can find me on Twitter @MustafaSultan and subscribe to my newsletter on www.musty.io

Dr Ala Alenazi is a TechBio Investor at Ascension and holds a PhD in Molecular Genetics from Cambridge University — she describes herself as a recovering scientist with extreme FOMO. 0:00 Intro 0:47 Being bombastic 3:32 Do PhDs make good VC investors? 10:38 How much of VC is luck? 12:47 Network building in VC 19:16 Getting deal flow 22:15 How to ask for things 24:43 Experience being a brown woman in VC 28:42 No one gives you anything, you just have to take it 33:50 Main character syndrome We talk about how being bombastic is the key to getting opportunities, why contrary to popular belief — PhDs don’t suck as investors, how to ask people to do things for you and what it’s like being a brown woman in VC. You can find me on Twitter @MustafaSultan and subscribe to my newsletter on www.musty.io

0:00 Intro 0:54 Is AI Too Powerful? 17:59 Outlive, Peter Attia's New Longevity Bible 45:16 Why Are Americans Dying So Young? Joined by:  Dr Adam Bataineh: Longevity doctor and Co-founder Span Health (acquired by EightSleep).  Dr Imran Mahmud: Investor, Oxford-trained doctor, ex-Mckinsey and Co-founder of NYE Health.  Dr Mustafa Sultan: Creator of Big Picture Medicine and Doctor.

Dr John Whyte is the Chief Medical Officer of WebMD, he’s also worked at Director level at the FDA and was also Chief Medical Expert at the Discovery Channel. 0:00 Intro 0:54 Anxiety as a content creator 2:33 Why should executives think like physicians? 7:23 Decision-making with limited information 10:47 Bayesian reasoning 12:57 Risk, acuity and stress 15:28 What should we NOT learn from physicians? 17:06 Future of health communication, health influencers 22:29 Regulation for health influencers? 24:22 Habit: I've never applied for a job 26:53 Networking building 28:24 Introspection as a habit for success John runs a course called 'Think Like a Doctor to Make Executive Decisions' — and I ask about different frameworks executives can pick up from doctors and use in non-healthcare settings (such as bayesian reasoning and assessing what is a symptom vs a cause). John’s also a veteran of the health communication space, and we discuss where the future of health content is going, and the art of storytelling. John's course: https://www.linkedin.com/learning/think-like-a-doctor-to-make-executive-decisions You can find me on Twitter @MustafaSultan and subscribe to my newsletter on www.musty.io

0:00 Intro 1:00 AI drug development 7:04 Big picture impact of AI drug development 9:14 Counterintuitive facts about drug development 11:06 Why can't we just make novel drugs with AI? Biology is hard 19:06 Microsoft's GPT-4 healthcare play 26:48 The hardest thing about health startups 31:49 Outro Joined by:  Dr Adam Bataineh: Longevity doctor and Co-founder Span Health (acquired by EightSleep).  Dr Imran Mahmud: Investor, Oxford-trained doctor, ex-Mckinsey and Co-founder of NYE Health.  Dr Mustafa Sultan: Creator of Big Picture Medicine and Doctor.

Dr Shivdev Rao is a Cardiologist and CEO/Co-founder of Abridge, who have raised over $22M. Think of Abridge like an Alexa or Siri (or other voice assistant) that sits there whilst the physician and patient talk. Instead of the physician writing notes during the consult, or staying late and charting — Abridge listens to the conversation and writes up the notes for them. Similarly, instead of the patient frantically taking notes, or being bombarded with information — most of which they will forget — Abridge can send them an appropriately-pitched record of what was said, with key takeaways. We talk about how Shiv built and grew this company, I ask him about the existential threat of LLMs like ChatGPT, how being in the intensive care unit is similar to building a startup, and how operating from a place of abundance is a key to success. 0:00 Intro 1:35 Shiv's story 8:50 Cross pollination as a tech CEO 12:02 Abridge, idea to execution 17:19 Possibilities with big data 19:53 Threat of LLMs like ChatGPT 23:52 How will Abridge fail? 25:22 How to stay focused 27:10 Leadership lessons 31:14 Habits that have helped Shiv You can find me on Twitter @MustafaSultan and subscribe to my newsletter on www.musty.io

0:00 Intro  1:27 Semaglutide (Wegovy) lowdown, use in longevity clinics  6:38 Is a 'pill for everything' a bad thing?  10:39 What's going to happen to all the DTC weight loss startups?  13:37 Is Semaglutide a TikTok conspiracy by big pharma?  14:55 The new alcohol-free alcohol, GABA  21:07 Where are all the big UK healthtech exits?  24:16 US investors/entrepreneurs are more ambitious  27:41 Is DTC digital health the way to go?  32:40 Is there much point building in the UK?   Joined by:  Dr Adam Bataineh: Longevity doctor and Co-founder Span Health (acquired by EightSleep).  Dr Imran Mahmud: Investor, Oxford-trained doctor, ex-Mckinsey and Co-founder of NYE Health.  Dr Mustafa Sultan: Creator of Big Picture Medicine and Doctor.

0:00 Intro  1:09 David Sinclair's New Startup   11:25 ChatGPT for Drug Development  28:32 Transhumanist Gene Editing to Sleep Less  37:38 Banter/Audience Feedback   Dr Adam Bataineh: Longevity doctor and Co-founder Span Health (acquired by EightSleep).  Dr Imran Mahmud: Investor, Oxford-trained doctor, ex-Mckinsey and Co-founder of NYE Health.  Dr Mustafa Sultan: Creator of Big Picture Medicine and Doctor.

Dr Ignacio Medrano is the Founder of Savana (raised $44M dollars with over 100 employees). They use AI to unlock all the value out of clinical records and produce real world evidence. 0:00 Intro 0:34 Ignacio's story 1:30 Learnings from Neurology -> Entrepreneurship 3:27 How to build good health products/services 5:03 Downsides of being a doctor in health entrepreneurship 7:21 Just in case vs just in time learning 9:14 Perils of perfectionism in healthcare 12:34 Do you need to be a d**k to be a good leader? 14:27 Dunbar's number — leading bigger organisations 17:52 Differences in operating in Europe 20:12 Diagnostic medical AI is a waste of time 23:15 SWOT analysis of Savana 26:07 Threats to Savana — LLMs? 29:22 Being eccentric as a competitive advantage 31:09 Becoming a better speaker/storyteller 34:02 Declining Royal Academy of Sciences invite 36:24 Arrogance as a competitive advantage 38:48 Tribes — exclusion criteria importance 40:27 Billion $ Health Idea 41:38 Not watching TV as a competitive advantage 46:40 Outro You can find me on Twitter @MustafaSultan and subscribe to my newsletter on www.musty.io