We are joined by Imran Eba of GlaxoSmithKline’s Bioelectronic Medicine fund – Action Potential Venture Capital to talk about investing in Bioelectronic Medicines. APVC is the only fund that invests exclusively in bioelectronic medicines – and they’ve been here since the beginning.
This leads to the ongoing question: what is and what is not a bioelectronic medicine (hear all three answers.)
After we get through the personal grooming habits of the hosts and our guest as well as the obligatory cricket references (it’s hard to put JoJo on her heels in professional sports parlance – but Arun and Imran manage to keep her quiet for a record time) we launch into a casual conversation about what’s happening in neurotech investing.
We talk about the trials and tribulations of how the world perceives Bioelectronic Medicines, what it should be, and what the reality is. Generously, Imran also shares with us some insights that every investigator, inventor, and investor should consider when preparing to raise funds in the field of neurotechnology, wait, no – BCIs, no -neuromodulation, gah – I mean… bioelectronic medicine.
And if you are looking for the framework for Bioelectronic Medicine that we discuss, you can get it here.
Special thanks to our sound engineer, Mr. Swaminathan ThiruGnanaSambandam for his artsy work on audio mixing/mastering and sound design for this episode.
Special thanks to our sponsors, CorTec Neuro & Cirtec Medical.
JoJo, Arun Sridhar, Imran Eba
Arun Sridhar 00:01
This is a SKRAPS studio production, and you’re listening to Skraps bioelectronic medicines.
Hey, everybody is JoJo,
Arun Sridhar 00:08
and it’s Arun here.
But Arun before we start, I want to let everyone know that Skraps will always remain free, but the production of Skraps is not. We would very much appreciate donations that will be used for the cost to bring these episodes to you. Please go to skrapspodcast.com/donate. To do this for something as little as a cup of coffee or a pint of beer. I know which one’s my choice!
Arun Sridhar 00:33
We want to thank our sponsors CorTec and CirTec medical for the kind donations to enable us to bring these episodes to you. Cortec does a phenomenal job with a brain interchange one system, which is inductively powered and completely wireless system that enables experiments in conscious animals in their native environment. This is super important. So look up CorTec-neuro.com
And CirTec medical can help make your medical device a homerun. They do everything from active implantables to minimally invasive therapeutics, check out their full list of service offerings at cirtecmed.com. Then give them a call and tell them the Skraps team said hey. Alright, Arun, what are we talking about today?
Arun Sridhar 01:18
Before we start, I’m going to do a quick recap. A recap to go back to the first episode where we proposed a framework for bioelectronic medicine. There are a few nuances. We did not call or introduce a new terminology, like how every scientist or a group likes to brand themselves. In fact, we hate the acronyms and the terminologies. We think it’s god damn confusing for everyone else, except the ones who coined the term and used our framework we set out in episode one of the season divides the field of bioelectronic medicine into five verticals. Let me explain. First is the evolution of existing devices. The ones that was used for psychiatric disorders initially, then move to treating movement disorders and pain. This includes a deep brain stimulation devices and the spinal cord stimulation devices. We like to refer to them as a hammer looking for a nail. Second, is the vertical that provides the world with clickbait and headline worthy news, the brain computer interfaces. We do not call them as BCIs or BM eyes, brain machine interfaces. But as musketeers do get the pun. After all, if the world decides to provide clickbait headlines, we it’s craps we’ll do the exact opposite. We love to parody them. Nevertheless, companies in this area have made huge improvements to help the patients to communicate with the external world. Third, are the self proclaimed cool kids who are rediscovering the phenomenology of what the implantable cardioverter defibrillators did in the cardiac space many years ago, and are using machine learning and artificial intelligence to run digital biomarker, data and digital platform companies. It remains to be seen though, however, as to what the utility is beyond the core disorders, that deep brain stimulation treats. Fourth are the non electrical target practice groups. These folks and we did two episodes of them. In fact three, episode two, four and five. These folks use non invasive modalities like ultrasound or magnetic stimulation to selectively target these energy modalities with an aim to selectively target and treat or try to treat disorders of the brain or the periphery. While evidence is becoming stronger in the brain disorder space, new preclinical evidence is giving us hope that this could actually become primetime in the future for non neurological disorders. So go back and listen to those episodes if you want to know more. Fifth is the group that we haven’t covered much so far in the season, and for a special reason as well. But we will spend a significant chunk of time in the next three episodes of the series. This vertical is called as novel therapeutics helps us move beyond the traditional brain and spinal cord targets into peripheral autonomic nervous system and into the viscera. With the goal to treat far more patients than what the traditional neurologist can do and have done for the last 20 years in the field. Neuro technology, the area from which most of our podcast listeners are from us We’ll refer to themselves as neuro technologists, I must say, are hugely bias predominantly towards the deep brain stimulation and brain computer interfaces area. But let me tell you a dirty secret. Even the neurotechnologists do not know their potential. And we urge them to look beyond the cocoon, and understand what they can do beyond just one vertical. After all, guys, you neuro technologist in our minds, span the verticals and enable the products across the five verticals. So feel proud and call yourself that and explore the world beyond just one vertical. That’s the message from us, to you. Finally, to the guest of the day, he’s a dear friend, or colleague, and to a certain extent, my sounding board, I don’t want to spend too much time introducing him. As you will see, we spend a great deal of time talking to him, talking about him and talking about what he does. But I will say these two things. Our guest today is Imran Eber of action potential venture capital. The one and I’ll repeat the one and only frickin’ VC fund that explores and invests exclusively in electronic medicines. A fund that I was there at the genesis of had an opportunity to see it evolve in real time. And we will hit on all of that in this episode. Second, if you need to understand more about that portfolio, you must go and listen to the episode that we did with the second partner of the fund one papillomas you will find link to that episode in the episode description. But this conversation is to explore things that we did not talk with Juan Pablo. If Juan Pablo’s chat was a visual stop tour of what APVC does. This is a deep dive into the world of bioelectronic medicine investing. So let’s get to the episode.
Imran Eba 07:06
I’m in currently in an audio platform right so even though we can see each other
Arun Sridhar 07:11
Yeah, yes. Because you requested I will make sure that the video doesn’t get out anywhere.
Imran Eba 07:17
Perfect. I couldn’t you know couldn’t brush my hair or something. Don’t comb my hair this morning but why bother?
Grooming is ever Rated.
Imran Eba 07:25
No Right? One of the nice things which is one
thing grooming me Your hair is looking a little long there buddy.
Imran Eba 07:35
I know you said that where I saw you in Florida as well right. And this is shorter. It’s been a little
No I like it though. It looks good.
Arun Sridhar 07:44
It looks Yeah, this is what it was like last year though.
Imran Eba 07:47
Yeah, so I’ve ever done it. I’ve pulled it back a little bit. Yeah,
Arun Sridhar 07:52
and in cricketing terminology Simran basically had the national hairstyle of Pakistan which is like cricket hair so long hair kind of beard and it’s like if you just want a helmet and if you wear the Pakistani kind of Jersey he’s he could actually just has to be right i mean you want to talk about cricket.
Imran Eba 08:11
I was wondering how long it was gonna click to bring up some cricket in reference as well so love cricket Love cricket? Yeah, but you could you have you had the gentleman, Jarrod Kimber too too?
Arun Sridhar 09:35
Imran Eba 09:36
So that’s a legit turn of Cricket Cricket analyst. Genre
Arun Sridhar 09:39
He is doing so awesome. I mean, he’s just doing like, I mean, I don’t know if you’ve ever paid attention to to anything now that he’s doing. I mean, he is doing amazing stuff. Like he was just starting during COVID Because he was just kind of freelancing and all of his quick info and everything dried up and nobody wanted to employ any any writers or anybody during At the time, because there was no sports activity that was happening at the time. And he basically has his own kind of network substack have close to one and a half million subscribers. Yep, right now. And he basically is just I mean, I don’t know, if you haven’t made it by a beta visitors YouTube channel, he’s coaching now.
Imran Eba 10:20
I will do that sounds really cool. I didn’t really I didn’t realise he was coaching to a judge’s saying, so I thought he was coaching.
Arun Sridhar 10:28
He was part of the coaching team of Scotland, the Scotland cricket team until two years ago, maybe. And then he was part of the analyst team for St. Lucia in the Caribbean Premier League. Yeah, yeah. So it’s interesting. Yeah. So I kind of sent you I mean, look at the format is pretty much spontaneous, that just a normal conversation as you probably have our team’s resume, as I kind of mentioned in the email, and also on the phone, the last time we spoke, this season is entirely focused on bioelectronic medicines, because at least we’re actually experimenting for ourselves to see is this actually going to bring and drive more engagement for the area, and also for for the podcast, as well in a way such that we can possibly start making it to be an exclusive, or probably the first noodle mod slash bioelectronic medicine focus kind of podcast in the future, but this is basically a starting testing ground for us. So as a first step, as soon as you start talking about details and interviews, I think a lot of people just zone out because everybody knows everybody. And they just but I think it’s about just taking the word and kind of spreading it to people who are not experts in the area, or non experts outside of the area, but also, even within the area. And you’ve probably seen many examples where some people are really good at one thing, but they’re they don’t have the expertise in doing the other side. And whether you’re in science or an engineer, or even in the investor community, it requires a lot of education. So the way we have kind of laid out this season is to kind of start laying the groundwork in a way such that the future seasons of the episode or of the podcast can all be that kind of more in depth, or people will actually get it but right now we just want people to actually get what electronic medicines are. And that’s why we kind of made it into a bit of a as you can call it gimmicky or you can call it fun or, or it can be like what Jarrett’s original blog was, which was cricket with balls, right? So it can be something like that, just so that it becomes memorable and people kind of tune in. Because it’s not science, I’m not writing a journal article, it’s about getting people to remember and engage with it, rather than kind of doing it. So that’s a reason. That’s the freedom that we have in terms of experimenting, and we get the answers pretty quickly. Within a week after releasing the episodes, we kind of know whether people hate it or love it. Which is which is great.
Yeah. So it’s yeah. What’s your take what’s so do you feel like you yourself, are now closer to defining what a bioelectronic medicine is? It feels like a conversation 10 years on, we’re still having Right? Like, where do we draw the boundary of what a bioelectronic medicine is? Or isn’t that that I personally I actually don’t care that I find I care less about that, then I was working on a there’s a new publication as well, that’s come out on bio electronic medicines and the list of advisers were sort of talking extensively about what they felt was and wasn’t too bioelectronic medicine. And what would it take to sort of in the audience here was sort of to try to engage more of the pharmaceutical audience as well, like from a BD or urban licencing perspective. But as I haven’t been counting Pharma would particularly care if it’s like electrical stimulation or some other sort of stimulation. I mean, at its core, like it’s, the question is like, what’s the therapy that you’re providing? And what are the what’s the results there? So I find we ourselves have not been true to, you know, a set definition that would buy electronic medicines are so I’ve been curious on this effort that you guys are going on? Exactly where you’re about to end up? And will you once and for all answer the question of what a bio electronic medicine actually is? What we just picked?
Arun Sridhar 14:16
Yeah, it’s a it’s a great question, right? And I’m just going to take a stab and maybe JoJo can add to that, or JoJo, do you want to go first?
No, you go first, and I’m happy to pile on your definition. Or your perspective.
Arun Sridhar 14:30
When when we started at kind of GSK back in 2013. I think everybody was called the whole area using a word right? Which is basically neuromodulation. So which is the act of performing model or the act of modulating nerves? You don’t call pharmaceuticals as as whatever pharmaco modulation or chemical modulation or something? Yeah, it’s I mean, of course, words can actually become kind of names and nouns etc. Over time, the history has shown us that but but because the area of neuro modulation originally had become very much focused on deep brain stimulation and spinal cord stimulation, neuroprosthetics, it was very difficult to kind of get the message out to focus on other things outside the brain and spinal cord, which is basically the focus. So I think that terminology kind of when to buy electronic medicines in a way such that it would make more sense for the pharmaceutical industry to actually say, Okay, you feel bad, you go to the doctor, the doctor writes a prescription, you go to the pharmacy and fill it up. In this case, instead of going to the pharmacy, you basically go to the same doctor, or whoever implants the device, they basically see the prescription that the doctor has written. And then they basically implant the device. And that’s what bioelectronic medicines are, it basically uses electricity, but really to differentiate it from deep brain and spinal cord stimulation, which was invoked and very commercially successful. And to show the potential and show that it was not a flash in the pan beyond just neurological disorders. It was basically started as, as bioelectronic medicines. But now, I think the field in the last kind of nine years, the field has exploded so much. And therefore each person is calling it very differently, right? I mean, I think I’m, I’m not against the term neuro technology. I’m not against the term neuro modulation or other things. But everybody starts using BCI, brain computer interface, neuro technology, and then other things, right. So I think, but everything and again, all of that drives that conversation about what is buy electronic medicine and what’s not. So therefore, we just said, it’s not so much of a definition, it’s about the framework of what potentially constitutes bioelectronic medicine. And then you can actually then see what what would be this is a great time to actually go and refer to the framework that we defined in episode one, you can find the link to the framework in this episode’s description below. So go click on episode description, and open the framework as we talk. And then you can actually then see what what would be placed within a given framework. And if it’s a framework, you can actually expand the framework, or you can shrink the framework but you’re not changing the definition of what it is. It’s the it’s the biology and the technology that ultimately enables modulating nerve that doesn’t involve ingesting of a drug and blood absorption and the traditional pharmacotherapy. That’s the That’s the definition. But ultimately, it should be treating something and, and, and even technology, like I mean, that’s why we did the first episode, which is to actually just say this is a framework of how we will define it because it makes sense from a science perspective, from an engineering perspective and from from an investor perspective, because you can actually define, and that’s something that I want to test drive with you as well, because we said, there are different shades, even though it’s word we call it verticals, these verticals can actually get amalgamated and fused in different ways. And each company will probably have a shade of neuro technology at some point, developing, targeting a therapy, but then they could they may not necessarily be a novel therapeutic, but they might actually have more of a neuro technology focus initially, or they might prove something out in the clinic and then drive the technology development etc. But at any stage of financing of the company, one might be able to define what is the percentage spend on each of those arms from if the company is sure is in the electronic medicine space. So therefore, then it becomes easier to define what they are targeting, and that type of investor. Understanding is also important, I mean, not for you, because you are a very sophisticated investor in this space, but for other new entrants into the space, that should almost be like, Okay, this company currently is a neuro technology company, but potentially targeting a disease condition, in a different case, but where they are right now, with your CDSA funding or seed funding, they need to develop the technology. And they’re going to spend 90% of their time doing this and 10% of the time potentially building up for the therapy development. And then when you raise your CD, say you basically said, Oh, I finished the technology prototyping, I’m going to test it in the clinic. So it’s 50% of my focus in the clinic. 10% 20% is the technology development and the remaining 30% is on something else, maybe defining algorithms or closed loop or data or whatever that is, and then that basically can shifted in different gradations. And it becomes easier to define it. And the investor community currently Sorry, I’m giving you all the answers. You should be talking to me.
Imran Eba 19:47
Yeah, no, no, no, this is interesting. So listen, I mean, I think like as you’re setting out that framework, I think I would agree. I would agree with that. I think one of the things that it’s interesting the way you were describing bio electronic medicines because of course You and I remember those early days in New York, you know, almost a decade ago now, right? When we were sitting down and talking about what kind of medicines and the roadmap to what to buy electronic medicine needs to be. But I think to me like the It’s funny how like I today explain it, maybe I’ll tell you how I explained the genesis of bio electronic medicines, because we obviously started from the same place, and we’ve picked up on through the different elements of how the story works. Yeah, but I’ll tell you this from a vantage also of sort of how GSK was looking at this, right, like a decade ago, right, like, if you remember, like a decade ago, the world of sort of value based medicine was allegedly around the corner, of course, another decade has passed, and it truly hasn’t come to be but at that time, we said, gone are the days of blockbuster drugs, right? Nevermind, you know, billion dollar drugs 500 million, it’s a top amount that you’re going to be able to get. And if you’re going to nevermind, thrive as a pharmaceutical company. But if you’re just going to survive as a pharmaceutical company, when you’re only making $500 million per drug, how many drugs you need to launch every year to be able to to be able to sustain that. And I think I remember the math had been done at GSK. And it was like coming out to like eight new drugs approved every year. And then we look back at the past 15 years since the merger of Glaxo and SmithKline. Beecham, and it was like, three was like the top than it ever happened, right? So kind of the writing was on the wall, right? And we’re like, clearly, we can’t can’t survive this. So to me, the sort of the genesis of bio electronic medicines came from this necessity of broadening out the definition of what a therapeutic is. And I think, to me, if there’s one sort of frustration, I’ll call it frustration for the sake of this, but is that even 10 years on, and I think it’ll probably be for at least another 10 years, that you use the word therapy. And the mind goes to a drug, right, and goes to a pill, because some sort of biologic agent, but it doesn’t think about things beyond that. And that is why we started coming down this path at that time, right? It wasn’t we didn’t have some sort of love with electricity, or that we thought that neuromodulation alone was sort of an untapped field. But we were looking to find other ways to treat disease, which importantly, and this is why I always say that we stopped using the word neuromodulation. was because we wanted it to compete with first line therapies, right. And so existing candidly, IPG systems weren’t going to allow you to do that. And they weren’t going to generate the clinical evidence that would convince the sceptics. So if you can make the devices smaller, and if you could make them wearable, and if you could generate high quality clinical evidence, you would have a bioelectronic medicine, and then everything around that you said as well, which sort of fit into that. But when I when I peel that back and say, well, the original, I mean, I get that we sort of took this down this electrical path, we took this pat down this sort of idea of stimulating nerves to treat disease. But at its root, actually, the question that we were asking is that what are the other, quote unquote, non therapeutic ways to develop therapies, right, these like non drug approaches that worth thinking about? And I think in the evolution of how our fund has sort of developed in the last, especially in the last five years as well, I think that’s the question that we have consistently pushed up against that, what are the assumptions that we made when we set out on this? And are these still correct? And what can we continue to sort of pick that right? And it’s been funny how, like, every, every incremental investment that you can see in our portfolio, I think is reflective of this redefinition of what a bioelectronic medicine is. And so, but it’s interesting to hear sort of how that how that difference of some of the elements that we sort of hone in on is we
Arun Sridhar 23:37
know nothing. That’s that’s absolutely true, because I think, what, it’s interesting that you mentioned that it’s only in the case of everything is what you said is true, except in the field of cardiology, where you the moment you say therapy, people will will actually say that stents bypass or stenting or pacemakers or defibrillators, because that has almost that pharmacotherapy and device therapy has almost kind of amalgamated or fused into one such that the same physicians who are prescribing the medicines can also do stuff over time if they are properly trained. And I think the field and I think what we’re trying to do with the area of electronic medicines is to kind of make every field or every therapeutic area into a cardiology space, that ultimately where physicians can get us or have options. Physicians have options, payers have options. And ultimately, patients have options because they get to choose what they want, when they are prescribed the options on table by the physicians in the first place.
Imran Eba 24:48
i Yeah, completely agree with that. I mean, I think that that model is not right now. They’re not outside of cardiology. That’s
Arun Sridhar 24:55
exactly the point. That’s where we want to get to right yeah.
Imran Eba 24:59
I I think they are going to get there, though, right. And I mean, I think like anything I think it is going to take, it always takes longer. But the trend line over even the decade that we’ve all been working in this space as well, that you’ve only seen sort of a continuous improvement of ideas and a continuous improvement in the quality data that’s allowing you to do that. I think what I what I’m saying is, let’s not, let’s not sort of become dogmatic in our own views, you know, just like, even just like how, perhaps, you know, when you’re having conversations with more classic drug folks, they think that the solution to every ill you know, every illness is a drug, right, this sort of mindset that, you know, I don’t know if this is appropriate, as an appropriate reference here. But I remember, early on in our time, when we were looking at, when we started looking at this field to buy electronic medicines, you know, the area of ablation was a little bit outside of what we were looking to invest in, but we had come across this company, in the respiratory space, right? We can edit out the name if that’s but there’s not a whole lot. So you’re gonna figure it out anyways, but Nuvera, which is not a company we invested in, but we’re really intrigued by the idea of using ablation as a one time procedure to target the, you know, the bronchus and ablate, the nerves to open up for COPD, sort of open up deep airways, and really be able to, as a one time procedure, treat COPD. And I remember sort of thinking back to all the time at GSK, because I used to be in business development at GSK and supporting the respiratory franchise for a period of time. And that was like the the question, right? How were we going to improve compliance with drugs? And I remember taking this idea to a senior member at GSK. Not because I had that to say that we were looking at this, but just to say, Hey, this is an interesting idea. What do you think about this? And I was like, I remember this individual sort of looking at this and saying, like, I don’t Why would anyone use Why would anyone have this procedure done? Right? Like, why would someone have this 30 minute procedure done, which once he did it, arguably, you were cured of your COPD? They could not understand that. Because and sort of finally reconciled it after sort of hemming and hawing about it for a little bit to said, I guess, a patient who has lost the functioning of their arms, for example, if they’re a paraplegic, and cannot pick up a visit dilator or cannot pick up some sort of inhaler product and place it that’s the patient who would be using for that patient. This would make sense, right?
Arun Sridhar 27:27
It almost targets the most worst of the worst patients.
Imran Eba 27:30
But it’s also driven from this. Yeah, this sort of, we can’t even think about the idea that something other than a drug could be providing therapeutic benefit. But I think we also need to be careful not to adopt our own dogma of exactly what it means to be what about electronic medicine needs to be right, we only set on this path to find non drug based therapies. So I think that’s the challenge that I sort of look at us as well as to make sure that we are thinking about what exactly is a non drug sort of approach that we’re we’re looking at. And as an investor, I think when we are evaluating opportunities, and even as a biotech fund that’s focused on bio electronic medicines, I would say that even we are not, it’s not so much that we’re purist about, oh, this has to stimulate this nerve, and it has to be on nerve. And that nerve has to be a, you know, has to be an autonomic nervous thing. All those things are ultimately secondary to what is the market this is going after? What are the you know, what are the options that are available for patients today as a standard of care? And how do we think this this idea that this, you know, this company or this individual is developing? How is that going to stack up in that world? And that question is the question that needs to be answered before, you know, we think about how in with the pure or not something might be in play electronically.
Sorry, but you you said something really interesting, though, about focusing on a non drug therapy? It? Are you did you just close the door on combo therapies? Is that out of the question? No,
Imran Eba 29:03
I actually, actually, I think combo therapy is actually is a really, really interesting area where some of our more recent sort of focus has been shifting in that area. So this may be another sort of another topic to sort of develop on right. I think one of the when you look back sort of on the decade that we’ve been doing this as well, we used to talk about this idea of what is the future of reimbursement look like, you know, ultimately, these these have to be commercially viable stories that we’re looking to invest in. And I think that reimbursement has been one of the biggest frustrations in this process, unfortunately, has not gotten any better. You know, last year, you know, the NCAA T the MC guidance that have come out was sort of the first thing that had ever happened that we were excited about a long, long time. And, you know, unfortunately that too, that too was repealed. We’ll see what what it replaces but it sort of sets this sort of invite womenswear reimbursement continues to be a really tough story, I think sort of coupled with a regulatory perspective, which also tends to be a little difficult. And as we talk today, you’re seeing sort of the back and forth that’s happening between nevro and Medtronic on their, you know, new indication approval. And peripheral diabetic neuropathy as well that never ran this study was able to get approval, Medtronic comes and gets approval on the same indication, based on a couple of very small studies that they had done back in 2014. And that, you know, invariably that sort of makes a very difficult environment. So, judge a long winded way to answer your question, I actually think that in some ways, the the path that appeals is a path that actually takes us through a drug pathway as well. And an interesting idea that we’ve we’ve been exploring more recently, is looking at conventional drugs, right, but saying that this drug alone has moderate efficacy. But if we were to combine this drug with some sort of electrical or other means of delivering energy to the body, that could the combination of those two actually provide a better therapeutic outcome than the drug alone? And if we could do that, could we then build a story around the drug itself and use a reimbursement pathway that is more, you know, the more traditional sort of pharmacy benefits or medical benefits approach that you’d be seeing on the drug side? I think that that is, you know, I think you guys know, and you’ve talked about one of the companies in our portfolio that’s sort of exploring that idea as well. And more recently, I’ve been looking at a couple of others in that space, which I think are of interest.
I like the idea of, of, of using a combination therapy as a as a way of getting through some of the payer hurdles. And I guess the big question is, you know, how do you eat a whale? Well, one bite at a time. So the other bite that could be taken that could launch us significantly forward is if we find one device, one bioelectronic medicine device, however, we choose to define it, that can and will become a first line therapy. So the same trial and and the Magnus medical results that they got, and the FDA shutting down their study saying it’s, it’s inhumane to deny or withhold this treatment from people, I think if we can get one or two of those big wins, not only on regulatory clearance, but then to push that through to the payer side, then that that is, is a big chunk out of that giant whale that we have to eat
Arun Sridhar 32:36
on the Magnus medical episode is episode two of the season. And you can find the link to that episode in the episode description as well.
Imran Eba 32:44
Yeah, I agree. I mean, I think that it’ll be interesting to see. I mean, I think one of the, I remember speaking with some of the investors at the beginning, the the name of the company right now, but neuro Tronic, the TMS company, that you know, the public TMS company that had some of the earliest data on the value of TMS in major depressive disorder. And this is an investor who sort of has since shifted over to more on the biotech biotech pharma side as well. But they’re saying that, you know, we had this great data in depression. And we went and showed it to physicians, and we in without telling them what the modality was, of this therapy, and people were like, This is crazy. This can’t be this is like, we’ve never seen anything like this. And when they revealed that this was actually, you know, transcranial magnetic stimulation, they’re like, oh, nevermind, like that’s, that’s not gonna work. Right. Like immediately, that sort of shifted, shifted that sort of mindset back into that both. Yeah. It’s so much friction against biassing. And so but I think that, like, yeah, if you if you bring that idea. So I think what Magnussen with TMS, with the same study has shown I think, is intriguing. It’s but it is ultimately still transcranial magnetic stimulation. Right. And so I think that today, that is better than it used to be. But this question of, could you, you know, could you actually could you actually enhance the outcome of a drug when you combine it with TMS, whether it’s st or otherwise, you know, approach, I think can be an interesting one. And if you can do that, could you then sort of couple the, could you then sort of build a reimbursement story around the drug, as opposed to necessarily around the device, which might be a path for some of the early bioelectronic kind of successes that we want to continue that we may want to build?
Arun Sridhar 34:35
I think just going back to one of the points that you raised at the beginning there and Ron, you kind of mentioned that the strategy has repeatedly been looked at in terms of what is about electronic medicine and how should the investments in the area for action potential venture capital should potentially change over time, which I think you’ve done a phenomenal job of to paint a bit more colour around the fact that how this transformation has happened, and going from electricity as medicine, to kind of what I think Juan Pablo, the last time he was on, I think he was mentioning that it’s something that EPBC kind of starts approaching things as energy as medicine, which is something that we actually adopted when we spoke of in our first episode. And it was interesting that I kind of did all the transcript for the script, and we recorded everything. And then I shared with you what this was. And I think we were both kind of going back and forth was exactly the same points that we raised in episode one. So it was a, it was a very pleasant accident for me. And I was mentioning this to Jojo, and she was elated at the time, but but paint a bit more colour about how that transition has happened,
as don’t call it electrosurgical.
Arun Sridhar 35:53
i And how, what were the hurdles when you actually, were making the transformations both internally for you and Juan Pablo as partners, the Investment Committee to potentially kind of the wider area. And also I’m assuming that with a BBC being an evergreen corporate fund, there is also a sense of perception as well. So can you just address these points with a bit more detail for
Imran Eba 36:25
us? Yeah. Tell me what you mean by sense of perception.
Arun Sridhar 36:29
Sense of perception is that, I mean, I think my impression, and maybe this is clouded by my view of being inside GSK, while a PVC has been outside of it, and I think you’re aware of it. I mean, we’ve had conversations about it, which is that you always have this sense of or you always have discussions about how we are being perceived by the outside world, and therefore, how should we actually what we’re doing? Is that going to be reflected in the perception of how others might actually talk about it, etc? I’m assuming that you probably face a sense of that, in a way. And by the way, if there’s anything we can always edit out, so don’t worry about it. Just
Imran Eba 37:14
yeah, no, absolutely no. So no. So I think, let me make sure I can cover all the questions. But I think the evolution at the fund level that’s happened in this definition that used to be remember, like we said, when we when we put up our billboard said, Hey, we’re at we’re asking potential, we said, we’re looking at implanted devices, stimulating autonomic nerves to treat chronic diseases that target nerves that are below the neck. Right? That was, we were like, essentially, let’s invest in setpoint. That is the definition of the the only company that was sort of fitting that definition, right? And then we’re like, Okay, well, like, how do we sort of change from that? Now, the benefit of being a venture fund, as opposed to being a corporate entity that is made a massive investment in a device of a particular type or an indication is that you can come in on a Monday, and you can re ask yourself that question that is this, what we still want to keep doing? Or should we be thinking about something else? Right. And so it wasn’t that we were deliberately, you know, every every week or every month coming back and questioning what we were seeing, but the Vantage that you have, as a fund that’s focused exclusively on bio electronic medicines, is that a we were comfortably seeing 19th. And consistently, I would say, 95% of the opportunities, we just have line of sight, we know what’s sort of going on, we know what what sort of the commonalities of those themes are, we’re seeing some of the emerging trends as well. And so every time we would sort of sit down, and it’s almost, it’s where it has one problem would have sort of his deal flow and his or his opportunities coming to him, I would be having my conversations. And it’s funny how you would see these sort of industry trends that were happening, right detail, I just saw this sort of idea. And so that’s interesting. I just saw this sort of idea. And they’re all sort of kind of shifting in that sort of direction. And so a little bit from what it wasn’t so much that we we put a stake in the ground said this is we will not move from here. We just said let’s go with where things are going. Right. And I think that let’s make sure that we’re always investing in ideas that we think have big, you know, a big unmet need, where we think that if we can generate good clinical evidence that we will be able to win. And let’s not be held up by any sort of other view. And as a result of that. So we made investments in sort of wearable therapies, we’ve been exploring that idea. We went with more sort of traditional canon lead devices as well, where they were thinking about novel applications. And now you’ve seen some, some ultrasound plays that we’ve made as well. And I think that that has always been a very, I mean, when you ask a question, it’s like, I can’t think of a time when we sat down and said, We need to change something or we need to be able to redefine something. And I think that, you know, GSK is credited as well as sort of our corporate sponsor in this as well, that they recognised that that was the value of the venture fund right there. It’s the flip But what having your own own group internally would be, which is you guys should be doing the things that we can’t do? Because you guys, can you guys can move faster, right? You guys aren’t sort of aren’t sort of fixed to any one view. So go and explore what’s going on. I mean, to their credit, like every time we’ve brought these opportunities, that’s the questions are asking, right, like, what’s the unmet need here? Why do you think that this particular opportunity would win? As opposed to saying, no, no, this is this, this is the area that we need to be investing in. So I think that that is, you know, I think that that has worked nicely. And I think your your question around sort of perception and how, how that seen? I mean, I don’t think anything I would say here needs to be censored. I mean, I think that, you know, you know, our view has been, it’s up that we said, look, we’re the leaders in this space, come follow us, I think we’ve wanted to be open and active members of a community that’s tried to shape what bio electronic medicines can be. And so we’ve played our part, you’ll see the companies we’re investing in, I think that allows sort of indirects a certain level of focus we’re involved in in, you know, as you know, speaking, speaking publicly on these things as well. But we’re just part of that community. Right, we’re not. And I think that the things that we focus on, I think, hopefully, is it sort of elevates all the discussions. And I think, you know, I think it’s, it’s a separate topic in terms of sort of how active or vocal Galvani has been over over that period of time. But from our perspective, I think it’s always been that we should be, we should be showing people what we’re thinking about and how we’re thinking, thinking about and see what other people do in that space as well.
Arun Sridhar 41:37
Yeah, no, I think it’s a very insightful answer there. I’m Ron. And it’s also your portfolio is also more from from being very much focused towards the vision that you kind of outlined, which is it has to look fundamentally different to the existing hockey puck size devices, or IPG is to something that’s a bit more smaller. The early investments that you made with respect to setpoint, and calla etc, are fitting into that. And then you kind of moved from there into expanding into other disease conditions beyond just what was out there. And almost defining that in the way of axon therapies have investment in and then moving. I mean, that’s one example. I’m just coding examples of my top of my head to defining more of a platform technology for the type of devices that you’re looking or you’re looking to fit into the vision that you have, like news better, as an example, to now looking more at expanding the definition out from what the original series of investments was to now looking at energy as medicine with kind of seeding of alphas medical and all the great things that we actually that Alpheus is doing and other people are doing. And it’s also interesting that you mentioned, action potential venture capital, because when we spoke with with Hubert Lim and Chris polio and McHale, Shapiro, they actually mentioned that we kind of it was interesting, the conversation was just going and then they kind of mentioned as a complete tangential question, we need to have a chat with him, Ron, because why are they still call action potential? Technically, you don’t need to create an action potential to produce neuro modulation. And I think we were just joking that a PVC probably needs to have a name change at some point.
Imran Eba 43:24
branding exercise. Yeah. I mean, I think that, you know, how many I would say only obviously, a broader audience doesn’t always even pick up on how geeky The name was action potential, right? Is this the, you know, the word action and potential and in their own right, have have a certain sort of, I don’t know, like excitement to them, I guess. But that’s like, it’s always funny to hear that people. But now that’s a more even more sort of a criticism of the name saying that you don’t give maximum potential to evoke therapy, which is, which is true. But
you got to have something and stick with it. I don’t think a name changes, is it all appropriate? I think you guys have done a great job. And you’re, you’re going to be sort of remembered as, as the first man on the moon in the in the VC space for bioelectronic medicine, but you have adapted from electricity to energy, you have adapted from nerve targets, and broadening that I know, some of the organ targets are coming up. What about any shift from starting below the neck? Is there any willingness then to move up above and move into BCIs?
Imran Eba 44:37
I think everything is fair game. So but I would, I would so look at sort of going above the neck, that sort of two separate doesn’t necessarily mean that it needs to go to BCI. But I think that, you know, we sort of avoided I think this sort of this distinction and of course central and peripheral nervous system is a little random anyways. Right? So I think that we, if the data suggests and if there’s a case to be made I think that there’s definitely scope to look at therapies north and north of the north of the neck and even things like occipital nerve stimulation, right, which is still a cranial nerve, but above the neck, and it’s from a migraine perspective, I think there’s some really nice companies out there that have generated some interesting data to support sort of justification that I think it’s a separate conversation altogether on, you know, brain, brain computer interfaces and therapies in that space. I think that it is certainly a very interesting idea. I think that there’s obviously, if you if you had no concern for sort of time horizon from an investment perspective, I would say that, yeah, for sure, this could be a really interesting area, but from an investor perspective, where you’re looking to make returns over, you know, sort of, even as early stage investors, we’re still trying to make sure that we can make a return within seven to 10 years. I think that when you look at that sort of time horizon, that’s about as far as you can make it even in that horizon. I think that’s where I would say, as of today, that we look at those opportunities. And we’re like, Yeah, this is interesting, but I think I need to see more more of it develop. But that’s specific to BCI. More in terms of, you know, the sort of clinical data you can generate, I think the invasiveness of the procedure, I think in terms of the patient population that you can target and how you can sort of build that case. So I think those are the sort of questions but there’s nothing stopping us from looking above the neck. In fact, I think we actively actively continue to do so.
Arun Sridhar 46:34
We hope you’re enjoying the chat with Imran. But before we go any further, I want to give a big thank you to our two sponsors, core tech, neuro and Ser tech medical, without whose help we would not be able to bring these episodes to you. Because production of these episodes, especially the ones that we’ve done before, has taken a lot of time and effort and resources. So we really thank our sponsors, please check out both their suite of preclinical and clinical devices and neural interfaces that is available through the respective website. That’s cortex iphon neuro.com. And SirTex. Website is tech med.com. Thank you. Let’s get back to the chat with Imran.
But I had a follow up question then on on BCIs. Not not even necessarily from a PVCs investment standpoint, but as the field as a whole, which is, as BCIs get more attention because they are just media clickbait everybody loves it. Everybody loves talking about Elon Musk and how the cyborgs are gonna take over and Elans gonna help blah, blah, blah, blah, blah. Truth and fiction of all of that aside, the I see a huge risk that we’re facing of this hyperbole sort of tainting the rest of the field. And if we’re not careful about how we address it as a community, that the public perception, driven by, you know, people trying to get clicks and use Elon Musk’s name as a way to get people readers, a little bit of hysteria has a chance of negatively impacting everyone, whether it’s a cervical vagus implant, or if it’s a wearable, especially anything close to the brain. How do you I’m sure you get some people who who ask what you do, and you answer and they’re like, oh, my gosh, you’re the one putting the robots in my vaccine. How do you respond to that?
Imran Eba 48:42
Thankfully, we haven’t had that conversation. We haven’t had that conversation with anyone, thankfully. But yeah, I mean, I think the I think Georgia to some extent, it’s, it’s inevitable, right? I mean, I think that that’s how some people will see the news, and that’s how they’re going to perceive it. There’s there will be, you know, even more than that sort of scenario in which people talk about, you know, cyber taking over the world, which may well happen. But even more immediate than that is to me, you know, companies that I think the greater disservice that we have in bio electronic medicines is a continuation of companies committed to to cheap science and not doing the right thing, right. And it’s a system that allows them to get away with that, be able to get approval and be able to commercialise that ultimately dissuades, you know, credible investment and credible sort of people or more credible investors and more citation that but you know, the the attracting people to that, I think that is where we are paying a bigger price. And I think that we can’t do anything about the end. I don’t you know, to give you an analogy of another industry where I think this is happening as well and has happened in the past and will continue to happen. This quantum computing, right when you look at quantum computing and The power of quantum in the future as well, like it’s ridiculous like what it can do, right? So now you’ve started up a company today and you can say whatever you want about what this company is about to do in the future. And some people will do that, and investors will sort of pile money into that, but then you and then you know, that hype will rise. And then inevitably, when people fail to deliver on those sort of timelines that people are looking at things will crash. So I think we may, we may suffer some of that consequences as well. That’s, you know, I think, unfortunately, the nature, the nature of what we’re doing, but I don’t know if that’s something that we can ultimately, ultimately control or if we even necessarily need to control because I think that that aspect of it is a cyclical nature, it does talk to this huge promise. But like I said, I think to me, like the bigger focus, and what we can probably have more control over is this community, elevating the companies that we know are sort of doing good work and making sure that we’re not elevating those for whom, you know, who haven’t made that sort of same commitment or who are trying to find, you know, some of their shortcuts, which I think ultimately is a disservice to the industry that we’re all trying to develop and nurture.
Arun Sridhar 51:14
Yeah, I think it’s an open kind of invitation. You don’t need invitation and Ron, but but especially to me and JoJo here, because we, you kind of know me, as another brand brother here anyway, use us and use the SKRAPS platform to kind of what I think we always say and it just so organically just came out when we were doing our previous documentary series, which is also kind of filtered into this one, which is we want to use craps as a as a way not just to do interesting interviews, because everybody does it. But we just want to use the platform to inform educate and engage people on on important things that matter. And I think we are here to help for this is to everybody, I think SKRAPS exists only for that reason. And it is basically kind of a philanthropic effort, because we spend our time doing it in our in our spare time in the evenings and weekends to make this happen. But at the same time, we are so committed to making this happen between the two of us so so it’s an it’s an open invitation for you and everybody else in the area to kind of use SKRAPS as a medium to kind of get get the information out there, get the right factual information out there, etc. So now, I think thank you so much for that really insightful comments on the strategy both of APCs as well as of your opinions about how things are kind of morphing to and what we should be guarding against. Another interesting thing, which is, which is not so evident when people just look at the companies on your website, but but someone like me, who has actually had a bit of an insight into the companies, the people that have invested in and also about the thinking over time, you’ve invested, you and Juan Pablo have invested in in entrepreneurs at various stages of the carrier cycle. So you’re basically, of course, ideas are important, and ideas are great. And that’s what you invest in, because that’s what becomes companies and products at the end of the day. But there is also a very interesting kind of diversity in the type of entrepreneurs that you’ve invested at EPBC as well. So you don’t just prefer entrepreneurs who are established serial entrepreneurs, you’ve done that I mean that with Howard and mark on axon therapies, and is one great example of that. But you have also seeded ideas from scratch. Some ideas may not have worked out, some ideas are going well. And then you have others who are a bit more established. And Michael Ackerman is another great example right with Him doing oak leaf and then proceed you as a second company of an established entrepreneur. And now you’ve also taken kind of chances with, with more what for lack of a better term rookie entrepreneurs with with terms of alphas and potentially other aspects there and more often established CEO types like with Milton Morris, of newspaper, etc. So tell us about what goes into the thinking in a venture firm, especially EPBC when you think about the entrepreneurs who actually formed the company and how you go about doing this, because I don’t think there’s any one secret sauce here. But I just want to kind of get your understanding on how you add one obligor and go about doing it.
Imran Eba 54:44
Yeah. And I think for myself this journey and I think Arun, you’ve had sort of a, you’ve had a little bit of a front seat to some of watching me learn this as well because I will tell you that when I started in 2013 in this space, and you know Certainly I had been doing business development and investing in fund of funds and doing all that sort of stuff before that, but people would say this, and you must have heard this all the time. It’s all about the people. It’s all about the people, you invest in people, everything else is secondary. And I used to hear that. And of course, why would I say that’s not true, but at some level, I think I was willing to accept that that wasn’t true. And that if you had, if you had a seedling of a really, really good idea, like a really phenomenal idea, then I was willing to put in the effort that was needed to make that idea succeed. Because my sort of assumption, whether I said it explicitly or not, when people said it’s all about the people was that, well, you’re being lazy, because you don’t want to work with the more difficult or the, you know, the story that needs a little bit more nurturing, before it can be successful. Yeah. And so I will prove you wrong by putting in the work necessary to take, you know, some ridiculous idea, and really show it showing the backing work. And if there’s anything that I’ve learned, and you know, the, if, of course, that is, like, I cannot say it enough times, it is all about the people, right? It is all about the people, and it’s all about the people. And so, you know, the funny thing here like, and I think when you and I were talking about this before as well, I think you’d use this sort of this, you know, the expression herding cats so to speak, is it feels like, you know, like, how do you sort of manage a portfolio of CEOs. But in fact, I think as I was thinking about that, I think nothing about this is herding cats. I think that what I’ve learned today is that my job as a board member, and it doesn’t matter what stage of company I’m investing in, or how I’m investing, but my job as an investor is to find the right person and support that right person to be able to thrive. Because if you’re not the right person, that is, it is I would say an impossibility to get people who don’t get it to start getting it right. And so that doesn’t mean that you need to know everything when we invest in you. And you know, because you I know you’ve had Vijay Agarwal on our call on your podcast for the series as well, right in the company, we invested in Alpheus medical. And Vijay comes from, you know, Vijay, sort of, I hope he won’t be I know, he won’t be offended me sort of describing as this but you know, people often caution you against sort of first time entrepreneurs, don’t invest in physician entrepreneurs. And if and on top of the list of physician entrepreneurs is neurosurgeons right, neurosurgeons work in a world where everyone tells them that they’re right, they need to be the ones who are
Arun Sridhar 57:40
right. They believe that they are God. No kidding.
Imran Eba 57:45
Yeah. Right. I mean, in some ways, you need that, right? You need them in a surgical suite. That’s exactly how they don’t need to be convincing you that what they’re doing is right or wrong, they you need to listen to what they’re asking to do. So here comes a person who sort of fits the the exact, you know, the exact characteristics of someone who wants shouldn’t be investing in. But what is the sort of commonality between the CEOs that we’ve seen succeed and the CEOs that we try to back is it doesn’t actually matter what sort of the stage of development is, but it is this sort of it’s, you know, this ability to sort of be able to listen and learn, right. And I think that even if you’re a first time CEO, this idea that you can hear from other people, what they’re saying, be able to digest that present a vision of what you are trying to do, and how you can bring other people along in that journey. I think that if you can demonstrate that it’s that allows other people to that allows us as investors just sort of back that. I think when investors are dealing with or dealing with CEOs or founders who, who are unable to do that, right, where they are sort of are antagonised by the things that you may be saying, are not willing to feel like they have all the right answers. And they’re the only ones with the right answers, if they feel that any of these sort of things that people feel because they know one thing very, very well, right, inevitably people know one thing very, very well. And if they’re not willing to acknowledge that actually, well, there’s a whole host of things, I don’t know, anytime you come down that path, there is no truly I don’t think there’s anything that us as investors can tell people, to get them to stop thinking like that and start demonstrating that you can think more broadly. So. So long story short, I think to me, the investing in people means looking for people who exhibit that sort of characteristic. And so then Vijay, for example, when we started speaking with Vijay, and despite all these sort of character characteristics, and we said are all these qualities that we said would be you know, the aspects that would be high risk, there was a person who was like, I don’t know how to do these things. I want to know about how to, you know, how do I think about this helped me and you know, and open to being thrown handed by and learning from the people that they’re surrounded by. And when you have that, I think, then sort of the upward potential is who is used there.
Quick question just because I know of two companies or about to be companies that are looking for CEOs, because they’re both started by academics, that for two reasons, and for both of them, they don’t want to be a CEO. And they know they’re not the right CEO. So in a nascent field like this, and it’s the chicken and the egg, you know, you gotta have money to get a CEO on board. Sometimes you can engage or entice somebody to act as a CEO with some sweat equity up front. But you got to move pretty quickly, in order to retain top talent in a really risky field. So how are we identifying, grooming, attracting enticing, inducing whatever you want to call it, new business talent into a field where we know where the promise is? We know where the the expectations are. But we need to bring some some lay people, strong business background, a little bit of scientific background, and a lot of passion. How do we how do we get them? How do we find them and bring them over to our side of the fence?
Imran Eba 1:01:22
Yeah, yeah. That’s a good question. And I think that maybe the the assumption in that question, in terms of that CEO is that that is the singular, one person that would start a story from an academic story through to what would be the successful outcome. And I would say that that person rarely exists, right? The person who would be willing to engage that early and take the story that far out. So I think, for the sort of company in Georgia that you’re talking about, in this case, if they have sort of academic ideas that are in that nascent stage, what you need to do is fine, you know, you do need to have a network of people that are looking for people who’ve had experience in this space, looking for people who, who, who have sort of more of a business centric mind or more sort of thinking about how something can be commercialised or how something can be clinic, you know, the clinical development and finding people, they don’t need to have done it, they don’t need to have done all that. But they have sort of some of those those critical ingredients, and set an expectation that in this moment, let’s move together and take this thing forward. And we don’t actually know what the what that long term future will be. But in this moment, let’s do like the next. That’s the next right thing and build the story out and see if we can get that traction. And I think that where I find sometimes companies have tripped up a little bit is when they’ve sort of made these long term commitments to, you know, to anyone, you know, in terms of what that story might look like, or where that story needs to go. And I think, you know, a good leader also, if you can find that person to, I’m trying to think of the examples that you’re presenting, you have an early idea, maybe in academia, you may have some promise here, the question is, well, okay, well, what things do I need to be able to do to secure the first meaningful random financing, right? And so who’s that sort of person who can help you do that? And how you can do that. But I think that how you take that story forward, and what what depends a little bit on not necessarily looking for that person forever. So I want to make sure that that is sort of the question you’re asking Jojo, because I think that that is to me one of the one of the questions that one needs to, you know, think when we look at our companies as well, in our portfolio, some of the early stage companies were, you know, recently last year, we brought on a CEO for axon that, that Arun was mentioning, as well, right. And the new CEO that we brought on, this is still a company running on their Series A. And so if you only said, Look, we can only bring in the like, you know, the Nadine yards in the people who’ve done this before and are successful, and all that sort of stuff, or, you know, the Andrew Cleveland, everything is sort of like let’s get Andrew, to convince him to come and do this. That’s not going to work. Right. And if we can’t keep going back to the same five people and saying that, how can they do that? But I think it’s identifying the people who are, you know, as I’ve seen in my previous, you know, the previous question as well that sort of exhibit those qualities and show that they can actually they can lead the story and allow them and support them to be able to sort of develop towards it as well. I think it’s how
Arun Sridhar 1:04:27
it’s how I would one last follow up if the overall kind of APC portfolio and I’m sure you get asked this from time to time. So we cover people to talk talk about just to recap everything about the key messages, which is, which is people should when you think about therapy, people should actually the goal is to make bioelectronic medicines almost on par with the molecular medicines and that’s what the overall vision is and that vision is has stayed constant, but the ways in which you execute to that vision has possibly changed. With the times and over the years for a PVC, from strictly going for electricity minimally invasive kind of procedures to kind of potentially looking at interesting closed loop and platform technologies to, to moving into energy as medicine kind of, kind of areas. So that’s all great. And I think all of your companies have had really or most of them who are in the clinical stages have had some really good clinical data. So far, all the way from setpoint. To colour to, to axon in their in their kind of pilot study, six cetera, to new spatter and everything else. Right. So which is which is wonderful. What does beyond just how well the companies are currently performing? What does success look for a PVC?
Imran Eba 1:05:53
I mean, they, as a venture investor, the, you know, ultimately financial returns is the is the driver for that. But are you looking beyond that as a question in terms of what what?
Arun Sridhar 1:06:02
It can be financial, and it can be non financial, right. So the bosses, the investment committees and the the corporate strategy from which EPBC kind of potentially reports into and might be interested in the financial returns, of course, but as as partners in the Fund for you, and Juan Pablo, what does success look like beyond the financial return?
Imran Eba 1:06:23
What is Yeah, yeah, I think it actually your summary, Arun actually really captures that. Right? I think that if we had if we had conviction, in a belief 10 years ago, that there should be there’s got to be a way to treat disease that doesn’t involve a molecular biological, you know, drug entity. I think we have only, you know, only more conviction in that belief today. Right? I think it is. I think it is one of the greatest services that we do as humanity, that every time we think about an illness that we think the mind automatically goes, like, automatically shifts into well, what drug can we sort of developed it to think about how we can solve this and you look at this, what, you know, the, you know, the sort of the the behaviour, which is that we we make a mistake using a drug? And then we were like, well, let’s try it again, and do the exact same thing over again. And let’s make that same mistake over and over, over again. Right, Georgia, you were talking about earlier about sort of like thinking about brain centric, or, you know, above the next sort of therapies, I think one of the biggest areas where bioelectronic medicines is going to win is an Alzheimer’s and dementia. Right? I think that this assumption that therapies, and I say that within my broader definition of what a bioelectronic medicine is this assumption that we’re going to have drugs, you can see sort of how that story with Biogen more recently sort of evolving as well, but this sort of desperation for finding a drug that can do this thing, which maybe a drug will never be able to do. And why is it that as soon as we think about how we’re going to solve any disease, we’re always thinking about it from a drug. So I would say, Arun, to your question, and what at its core, let’s put the financial returns and all that stuff to the side, at its core, if we can contribute in some way to start shifting the discussion so that people do not immediately think about drugs, as is the problem to all to all illnesses. I think we’re making progress, right? I think that’s where we are doing something and we’ve contributed something. So finding these companies, and you know, you know them, right, and, you know, these companies in new sparrow medical with, you know, antimuscarinic with all the side effects and anti muscarinic Sabbe. If you had a minimally invasive approach to overactive bladder to kalah. I mean, Cal is a great example of essential tremor, right, and deep brain stimulation works. And then you’ve got benzodiazepines and you’ve got like, ridiculous cocktail of drugs that you would take and say, Why am I taking this this, you know, and then you’ve got a risk one device, and I can solve this as well. So every company that we look at, and that we’ve invested in is going after a problem today that we don’t even think twice about prescribing these horrific drugs to people and saying, Well, that’s the classic taking this drug, and this side effect that you’re going to feel right is, is is is insanity. So to me, that is success is for bioelectronics. And for our find is to change that mentality and to be able to contribute to that. I think that’s where
Arun Sridhar 1:09:23
plus other answers a huge, huge, huge factor, right? Because when you have an implanted device, you don’t have to think twice unless you have to actually have to manually switch it on and if it’s something as debilitating as sleep apnea or something where it affects your mood the next morning, your cognition the next morning, etc. People will turn it on. But I think you and I have been in that situation before been part of the analysis in the early days. And this is probably true of every pharmaceutical company that’s out there you can and I think the classic poster child for this is diabetes so you can get an anti diabetic drug to the market. You can get it you can all the payers will pay for it. And then at the end of 12 months, close to 60% of the people will basically stop taking the new medication. Not because it’s too expensive, it’s because of the fact that they just can’t be bothered to take medication every single day. It’s the adherence and the compliance which the devices if it’s as good and it’s able to generate the data that it’s as good as, as the standard of care currently, or even better, in some cases, then you’re basically taking the compliance and the other aspect out from from the patient’s
Imran Eba 1:10:32
if you’re having an impact on the quality of life of a patient, because the diabetic and the patient with hypertension isn’t actually feeling their hypertension, right, it is hard to get patients to comply. And I you would not solve that problem by having a wearable device replacing a pill, right, you would just introduce a new problem for them. And I completely agree for, especially for for conditions where a patient isn’t going to experience a quality of life improvement in a meaningful period of time those patients having that’s the added benefit of sort of a device that does it for you, and you don’t have to think about it, I think for anything, where you where you do have a benefit, or the patient will know that they’re having a benefit. The reason why compliance often struggles is because of those side effects, right? Like, I’ll take this drug, but man, this drug makes me feel lousy, right. So I know I’m able to like this aspect of my depression, I feel better about but these are all the long list of side effects that I now need to contend with. But if you can show that you can solve for that as well, I think you’re definitely going to see a greater level of compliance. It’s, you know, I think they’ve sort of human human behaviour. But I think that, you know, I think that to me, I find myself correcting people used to sort of, like ignored before and to say that this is just the way that people use this language, right? Like, well, I often work with other will talk to other investors and they’ll say, Oh, we’re we invest in therapeutics, we don’t invest in devices. And I’m like, you can do that. But devices also worth therapeutics, they just want you to know that the definition should be capturing all what you’re saying, is that you are you investing in drugs, right? Like, I get it, that’s, that’s, that’s what you do. But, but, uh, you know, device can also provide therapy. So, yeah.
So I really like your connection to Alzheimer’s in particular, because that is a network problem, right. And if you think like, standard networking, illustration would be a computer network that’s full of wires and electricity, and everything has to be timed as right and the communication goes into more in into multiple outputs in different directions, different timing, whereas a biologic is more like a flood. And, and it covers the entire body and you don’t want to miss a flood. You don’t you don’t flood a network. That I mean, bringing, bringing in a cascade of water biological changes to an electrical network doesn’t fix the problem. All it does is sort of change the flow of energy temporarily. And it’s not going to fix anything. You need electricity to fix electricity. However, you’re generating it, whether it’s whether it’s electrical, optical stimulation, whatever, you know, we’ll leave that. That part to the side. But nope, opening a dam to fix the network doesn’t work. Yeah,
Imran Eba 1:13:23
yeah. I completely agree with that. Yeah, that’s true. I mean, I think that’s true. It’s certainly true of Alzheimer’s. Yeah. Alzheimer’s, dementia, but earlier to depression and any sort of mental health disorder, this sort of led it’s led the brain with some neurotransmitter in the hopes that we’ll have some sort of long lasting, it’s like, almost seems counterintuitive as to why you would even think that that would be the case. But but no one questions that right, because it is how, like, the ease with which people will take SSRIs and not think twice about it is is impressive, in some ways, right. And yet, well, you know, device like a, you know, companies that have developed even these non invasive like dorsal lateral prefrontal cortex stimulation devices using transcranial direct stimulation, like, yeah, like maybe not enough energy is being delivered to the target location, we can think about how to improve that. But the idea of selectively sort of picking a location as opposed to bathing the brain talks to what you’re talking about judger, which is that the brain is connected, right. And so if I’m having an effect here, it should have this sort of a cascade as opposed to let me just, yeah, let me just bait everything in a drug and see what you know, hopefully the area where I want to elicit a response gets one so but yeah, very much agree with that.
Arun Sridhar 1:14:39
Yeah. I think we covered it all. I think if there’s any follow up or something I will let you know in Ron, but I think we’ve kind of covered everything on and kind of stayed out of controversy as well. We did I deliberately try to craft questions in a way such that it wasn’t explicit or or it was it kind of
why you would Stop now. No,
Arun Sridhar 1:15:03
there’s no need. You’re
taking on NIH
Imran Eba 1:15:06
you’re taking? Yeah, I’m happy to say,
Arun Sridhar 1:15:09
Yeah, this is all coming out of the edits, by the way that this conversation is coming out in the edits. I
Imran Eba 1:15:14
was gonna call you out on that, by the way, the but your criticism of the NIH is innovation prize or the what do they call it? needlebook price. Yeah. Then you’re on my prize. Yeah. So your, your criticism, but I actually compared to what GSK had done, I actually give this particular programme. Obviously, it’s a bigger check. But it’s actually trying to push the story. Clinically, right, the innovation prize that GSK had launched, was very much about early, you know, early preclinical studies and how we can get, you know, how we can get a device that’s going to help that preclinical studies, we made an assumption that we needed to do that. And to do that would be opening up the world to buy electronic medicines, I think what we’ve been able to show is actually, you can do all that, and it doesn’t really matter, you need to show that this works clinically. Yeah. And so, you know, you can skip over that. So you know, but yeah, since you’re picking a fight with everyone anyways, there’s like a little room
Arun Sridhar 1:16:11
for anything, any fights.
Imran Eba 1:16:14
But I’m happy to say anything controversial if you if there was something controversial to say, but, I mean, I think that you and I talk, you know, my views on these things, but you hopefully can sense where my passion and sort of the areas that are more important, more important to us as well.
Arun Sridhar 1:16:32
No, yeah, and you know, me, I’m not gonna… I’m not controversial. I just tend to have opinions that sometimes can be misinterpreted as controversial. Yes. Always another’s. No kidding.
Imran Eba 1:16:42
Yeah. No, yeah. ruin your Yeah, you’re the both of you guys. I mean, honestly, this. This, the fact this effort that you’re doing, I saw what you did on the on the psychedelic site as well. But the effort that you’re doing here, hopefully this will will pay off. This is exactly the sort of thing that we need to be doing to it’s a long journey. Right. I think that if anyone had a hope that we would, you know, start this until years later, we would have sort of reached the summit, I think is is naive, right? So we’re not we’re nowhere close to being done here. There’s a lot of work to be done. But this sort of stuff. Absolutely helps with that. So thank you so much for your for your service. Thanks.
Arun Sridhar 1:17:21
Thank you. Thank you so much. All right. So that was a conversation we had with Imran Eber of action potential venture capital partner at GlaxoSmithKline. It’s a venture fund that exclusively focuses on bioelectronic medicines. Hope you appreciated the nuances and the personal side of what investors are sound like and appreciate. Hope you got to know an investor personally through this conversation EPBC as action potential venture capital is known, and the partners in Ron EBA and Juan Pablo are very patient listeners, and do incorporate learnings in a very agile way than any other venture fund or partner that that I have interacted with. Go check out their website. Link is in the episode description. If you want to hear more about their investments, you need to go check out Juan Pablos episode that is available from season two, same time last year. Finally, a huge thanks to our sponsors, codec Nero and SirTex medical for their support of a production Mr. Swaminathan ThiruGnanaSambandam. Among them was our sound engineer who performed the mixing, mastering and sound design for the episode. If you liked what you heard, please go and check out the other episodes this season. And please shout from your LinkedIn or Twitter rooftops and please tag us to help us spread the word. We do this for you