Avid Radiopharmaceuticals

Today's speaker in my Health Care Entrepreneurship class was none other than Dan Skovronsky, Founder and CEO of Avid Radiopharmaceuticals. I don't think we'll have a better speaker in the class.


Avid Radiopharmaceuticals is based on a molecule that Dan invented while doing his MD - PhD at Penn. This radioactive molecule, called florbetapir, is an amyloid imaging agent. When delivered to patients intravenously, the molecule passively diffuses through the blood-brain-barrier to light up amyloid plaques in the brain. These plaques often indicate the presence of Alzheimmer's disease. It turns out that Alzheimmer's is the #1 fear of the elderly, even more than heart disease or cancer.

Dan, who did not have any business training, founded Avid in 2004 and sold the company a few months ago to Lilly for $800M. Avid's acquisition by Lilly was one of the biggest successes in life sciences this year.

One of the most heart warming aspects of this fairy tale of entrepreneurship was the way in which the clinical trials were conducted. Avid recruited elderly patients near the end of their lives (these patients faced end-stage renal disease, cancer, etc.) for their initial testing. These patients knew they were dying and wanted to do something to help patients of Alzheimmers. They therefore agreed to donate their brains to Avid so that Avid's imaging agent could be tested on them. Avid used the brains of 1,000 patients for compound development and tested their compound on about 250 live patients in Phase III clinical trials. Avid later received the obituaries from the families of the patients who had donated their brains for the development trial.

There were two quotes that stuck out from this talk that I'll leave you with:

"Vision without execution is hallucination" - Thomas Edison
"Great companies position themselves to be bought, not to be sold" - Dan Skovronsky

Read below for the press release on the acquisition:
http://www.avidrp.com/press_releases/Avid%20Closing%20Press%20Release.pdf

Semester 2 Begins

My friends, it has been too long since I last wrote. Semester 1 at Wharton is in the books, and Semester 2 is well under way.

I spent the first week of my winter break at home, writing cover letters for job applications. I spent the second week of break at school, taking an abbreviated Managerial Accounting class. This class was much more manageable than Financial Accounting.

Since then, it has been all about recruiting. I had 15 interviews during DIP (dedicated interview period) and am waiting to hear if I move forward in the process or if I'm one-and-done. Surprisingly, I'm not too worried because I know that something, somewhere, will work out.

I used to wonder why MBA bloggers went quiet from January - March in the first year. Now I know. Recruiting is a huge time suck. If Q1 was about academics and Q2 about Employer Information Sessions, then Q3 is definitely about recruiting. Maybe Q4 will be about fun?

Meanwhile, the most fun I'm having right now is submitting a business plan for the Wharton Business Plan competition. Get ready for a heart warming tale of entrepreneurship (not mine) in my next post...

Vibrams Five Fingers Bikila

I usually buy new running shoes ever year or two. This time, I decided to try something different. A few weeks ago I bought a pair of Vibrams Five Fingers Bikila. What the heck are those? Shoes, socks, or something else? I guess 'something else' is most appropriate.

I have had a long and disappointing history with running shoes. You see, I have a normal but lowish arch in my left foot and a flat right foot. My legs also curve outwards from my knee before coming down to my feet - the term for this is 'bow-shaped'. My feet are also relatively big and wide. Put together, I don't have the ideal build for running. Yet, I do it anyways because I enjoy it. Despite my awkward build, I slowly clawed my way to the finish in the 2004 Boston Marathon, one of my proudest accomplishments.


In the last few years I have mostly bought Brooks Stability and Asics Motion Control shoes. These shoes, especially the latter one, are built for people like me who 'over-pronate'. The feet of over-pronators bend inwards at the moment the foot strikes the ground because the runner lacks an arch to counter-balance inward movement foot. This results in excessive pressure on the knee and meniscus. As a result of this pressure, I have torn the meniscus in each of my knees (although only the right foot is flat). This injury takes a long time to heal. A few years ago I started wearing Superfeet orthotics in my shoes to provide additional arch support.

While the orthotics and shoes have reduced pressure on my knees, they have taken the fun out of running. The arch support can be especially uncomfortable and can pinch my feet where I'm lacking an arch. So, after going on a run with a classmate who was wearing the Vibrams shoe, I decided to get a pair for myself.

Vibrams has historically made the soles of shoes. For example, my Merrill hiking shoes have soles made by Vibrams. In the last few years, they have ventured into shoes. Vibrams Five Fingers are meant to simulate barefoot running, the act of running without shoes. Proponents of barefoot running believe that humans were built to run and are quite capable of running without shoes. This is essentially the premise of Born to Run a book (which I hope to read) about the barefoot running habits of humans. However, years of wearing shoes have weakened numerous muscles that are no longer needed when shoes do the work. One example of a weakened muscle is the Achilles tendon, which grows shorter when people wear shoes with heels. Shoes have also changed the biomechanic motion of running. Because shoes contain significant shock absorbing material in the heel, runners can land on their heels (a heel strike) and take long strides without pain. However, this is not the correct /natural motion for running. Rather, the barefoot method of running involves striking in the midfoot and taking shorter strides.

The Bikila, which costs about $100, is the running model of the Vibrams Five Fingers. The shoes features five slots for the five toes, a strap for holding the shoe on, and light tread on the soles of the shoe. There is no lift in the heel. All of this means that running in the Bikila is pretty darn close to running barefoot.

City Sports in Philadelphia, where I bought my shoes, is a big believer in Vibrams and has figured the shoes prominently in the center of their shoe section. Traditional shoe manufacturers have taken notice as well - Nike, Adidas, and others have started making their own minimalist shoes. Vibrams has the potential to really shake up the shoe industry. As shoe technology gets more complex (Nike Air Max, Reebok air pump, Speva Asics sole, etc.), Vibrams says simple is better. I do believe that the barefoot running movement is symptomatic of the minimalist trend that is taking place in the world: 'raw' or 'organic' diets, increased privacy in computer software, etc. The minimalist movement says that we should get back to basics.

I have now run 6 times in my Vibrams: 2 miles on the treadmill, 3 miles on the treadmill, 7 miles outside on the Schuylkill river path, 3.2 miles on the Schuylkill path, 3.4 miles around my house, and 3.4 miles around my house. Here are my experiences so far:

• Socks are needed. When I ran without socks, I got some chafing above my right heel and on the side of my foot just below my big toe. So I bought socks with toe holes and the chafing doesn't happen. The Bikilas are also a little hot so I like the thin socks/liners unless I'm running in the cold.


• The shoes work a lot of muscles that I don't typically use, so there has been a significant adjustment period. I have had soreness in my Achilles tendon, lower calf, and in my right calcaneofibular ligament, which goes from the ankle to the outside of the foot. Because there is no arch support in the Bikilas, my foot does move inward, which is putting pressure on this ligament in my right foot. Hopefully all of this soreness goes away as the muscles get stronger.


• I have had some arch pain in my right foot. This will need to be monitored.


• I may have slightly injured my left knee. A few sessions ago, I tried to run fast and probably the landed the wrong way on one of my strides, causing shock to my left knee. Hopefully it's not a big deal and will heal with time. I'm continuing to carefully run though as there is no shooting pain.


• So far I haven't had any issues with running over rocks. The soles dull the impact of most stones - I can still feel them but generally don't get any sharp pain.


• I felt self-conscious wearing these odd-looking shoes the first few times, but not anymore.


• My running form seems to be changing. I'm consciously avoiding the heel strike and am trying to take smaller slides, while lifting my knees.


• Most importantly, it's a lot of fun to run in these shoes. I get valuable 'ground feedback' with these shoes. It's especially fun to run on soft surfaces like grass or mud. I am also able to run faster since my arches have an opportunity to expand and contract, giving me a bounce in my step. Also, I am able to push off my toes, something I can't do in regular shoes.


• I've had a positive-enough experience with the shoes to want to get another pair of Vibrams. I have my eye on the black Trek-Sport model, which I can use for hiking.

So there you have it. I really like the Vibrams Bikilas. To be fair, I have had some issues, particularly the knee injury and soreness in my right foot. However, the best thing about the shoes is knowing that they haven't caused the injuries, so you can't blame them. If things heal up properly, I'd like to do a 10 mile run in the Bikilas when I get back to Philly. I think I'm only going to attempt this in 30+ weather, though.

HCMG 890

I can safely conclude that HCMG 890 - a.k.a. Medical Device Seminar, is my favorite class of my first semester at Wharton. The picture to the left illustrates a transcatheter aortic valve replacement procedure. The Transcatheter Valve is possibly the most cutting edge piece of technology in interventional cardiology.

HCMG 890 meets once a week on Wednesday from 4:30pm - 7:30pm. During this time, we hear from various industry speakers on various medical device topics. The class has a good mix of science and business - in the end I am always more excited when the primary discussion is science, with some business mixed in.

The best thing about the class is the opportunity to have dinner with the speakers. So far, we have had entrepreneurs, venture capitalists, Medtronic VPs, medical device sales managers, medical device lobbying groups, etc. At these dinners, food, drink, conversation, and money flows freely. This class might be the best kept academic secret at Wharton.

There is an interesting conflict in the perception of medical devices. On the one hand, these devices are exceedingly simple - what are clips, stents, and catheters but clips, barbed wire, and tubes? Yet they cost tremendous sums of money, which insurance companies pay. Ultimately, slight differences in the geometries and materials of these products can have slight differences in clinical effectiveness. But this industry persists on slight differences. Because, in the end, how much would you pay to mitigate adverse reactions (like death) by 3%, or to increase blood flow by 2%? Apparently you would pay a lot (but that number is probably coming down).

Until we can elegantly solve these problems before they start using gene therapy, we'll have a need for devices.

If these devices excite you, check out some of the clips below. If they don't excite you, check out these clips anyway, and you might get excited:

Mitral Clip:
http://www.metacafe.com/watch/2908701/mitra_clip/

Transcatheter aortic valve replacement:
http://www.youtube.com/watch?v=ZkgEf1EvRGc

Medtronic BD Competition

This past weekend I worked with two teammates on the Medtronic Business Development case competition. Our objective was to present a BD strategy for Medtronic's Surgical Technologies division. The Surgical Technologies division is comprised of ENT tools, Neurosurgery tools, and Navigation / Imaging tools. My team worked Friday, Saturday, and Sunday to come up with our BD strategy:

1) Partnership with ENTrigue, a venture-backed company developing surgical tools for ENT doctors.
2) Partnership with Xoran, maker of portable ENT CT scanners.
3) Partnership with Cochlear, maker of implanted hearing devices for the severely hearing impaired.

Unfortunately, we did not progress to the finals. But, it was still a good learning experience. BD is extremely open-ended, and I don't think there are any right or wrong acquisition targets. Success will depend on execution. But, without intimate knowledge of the division and its needs, it's hard to do well in this kind of case.

Q1 Ends, Q2 Begins

The whirlwind that was Q1 ended yesterday, and now the whirlwind that is Q2 begins. The focus of Q1 was squarely on academics. I got through it, but it wasn't pretty (not that it needed to be). Accelerated accounting was the toughest class, but also, surprisingly, it was the most interesting. I'm no fan of accounting, but the cases we did illustrated that general managers need to know enough about accounting in order to make informed management decisions.

My other classes varied in quality but were generally good. My heart just wasn't in Finance. I did finance in undergrad and having worked in it, I view this subject as too theoretical. Statistics was interesting and should be especially useful for me, though the pace was slow. Marketing was fun and well taught. Healthcare Systems is a full semester class that often seems too high level to be practical.

All in all though, I was pretty impressed with the classes in Q1. Most of my classes had cold calling which I think is a great way to elicit class participation. The quality of discussion was high and few comments were extraneous. Lastly, people mostly showed up on time and were attentive, which was in stark contrast to a lot of my engineering classes, where there was very little classroom discipline.

Now Q2 begins, and the focus shifts from academics to recruiting. I am focused on industry companies and start ups with a preference for start-ups. Right now, I'm interested in product marketing positions because I think this will put me on the path to general management (having P&L responsibilities), and hopefully to CEO one day. In terms of classes, I will be taking Managing People at Work, Competitive Strategy, Healthcare Systems, and Medical Devices. This set of classes will be less technical / quantitative then Q1 classes.

Strengths or Weaknesses?

It's 2:45pm on Thursday in the Lipincott Library, and my Accelerated Accounting Final is in 3 hours and 15 minutes. I have all but thrown in the towel. I'm reading the words on the page but I don't understand what they mean. This reminds me of my undergrad days in classes like Microelectronics when the words on the page might well have been written in another language. It's an unsettling feeling of defeat. Pure and utter defeat. You don't want to give up, but giving up would be so comforting. Looks like this is going to be my first LT of my Wharton career. If I can avoid an LT here, it will be a small miracle. The irony? I got an A in this class in undergrad. I guess that tells you something about the quality of the competition at Wharton.

This led to a conversation with my neighbor in the library about strengths and weaknesses. At this point in our lives and careers, do we focus on our strengths or weaknesses? I'm starting to understand what my strengths and weaknesses are. I've usually considered myself to be 'well-rounded' in that I can hold my own in most areas. But, being that as it may, I've realized that you can't compare yourself to the general population. If you do, you'll come out pretty far ahead in most categories and won't really know what are your true strengths and weaknesses against the people who matter. Rather, you need to compare yourself to your peers (classmates for example), so the bar is set higher in every aspect. Then, with this new mean, see where you are relative to your peers. That will give you a better idea of your strengths and weaknesses.

My current thinking is to spend 3/4 of my time focusing on my strengths and 1/4 on my weaknesses. With my real career beginning now, there's not much time to waste doing things I'm not good at. I think my 20s were the time to address those weaknesses. What do you think? Should we focus on our strengths or weaknesses?