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Foresite Capital raises $969 million fund to invest in healthcare startups across all stages of growth

Health and life science specialist investment firm Foresite Capital has raised a new fund, its fifth to date, totally $969 million in commitments from LPs. This is the firm’s largest fund to date, and was oversubscribed relative to its original target according to fund CEO and founder Dr. Jim Tananbaum, who told me that while the fundraising process started out slow in the early months of the pandemic, it gained steam quickly starting around last fall and ultimately exceeded expectations.

This latest fund actually makes up two separate investment vehicles, Foresite Capital Fund V, and Foresite Capital Opportunity Fund V, but Tananbaum says that the money will be used to fuel investments in line with its existing approach, which includes companies ranging from early- to late-stage, and everything in between. Foresite’s approach is designed to help it be uniquely positioned to shepherd companies from founding (they also have a company-building incubator) all the way to public market exit – and even beyond. Tananbaum said that they’re also very interested in coming in later to startups they have have missed out on at earlier stages of their growth, however.

Image Credits: Foresite Capital

“We can also come into a later situation that’s competitive with a number of hedge funds, and bring something unique to the table, because we have all these value added resources that we used to start companies,” Tananbaum said. “So we have a competitive advantage for later stage deals, and we have a competitive advantage for early stage deals, by virtue of being able to function at a high level in the capital markets.”

Foresite’s other advantage, according to Tananbaum, is that it has long focused on the intersection of traditional tech business mechanics and biotech. That approach has especially paid off in recent years, he says, since the gap between the two continues to narrow.

“We’ve just had this enormous believe that technology, and tools and data science, machine learning, biotechnology, biology, and genetics – they are going to come together,” he told me. “There hasn’t been an organization out there that really speaks both languages well for entrepreneurs, and knows how to bring that diverse set of people together. So that’s what we specialized i,n and we have a lot of resources and a lot of cross-lingual resources, so that techies that can talk to biotechies, and biotechies can talk to techies.”

Foresite extended this approach to company formation with the creation of Foresite Labs, an incubation platform that it spun up in October 2019 to leverage this experience at the earliest possible stage of startup founding. It’s run by Dr. Vik Bajaj, who was previously co-founder and Chief Science Officer of Alphabet’s Verily health sciences enterprise.

“What’s going on, or last couple decades, is that the innovation cycles are getting faster and faster,” Tananbaum said. “So and then at some point, the people that are having the really big wins on the public side are saying, ‘Well, these really big wins are being driven by innovation, and by quality science, so let’s go a little bit more upstream on the quality science.’”

That has combined with shorter and shorter healthcare product development cycles, he added, aided by general improvements in technology. Tananbaum pointed out that when he began Foresite in 2011, even, the time horizons for returns on healthcare investments were significantly longer, and at the outside edge of the tolerances of venture economics. Now, however, they’re much closer to those found in the general tech startup ecosystem, even in the case of fundamental scientific breakthroughs.

CAMBRIDGE – DECEMBER 1: Stephanie Chandler, Relay Therapeutics Office Manager, demonstrates how she and her fellow co-workers at the company administer their own COVID tests inside the COVID testing room at Relay Therapeutics in Cambridge, MA on Dec. 1, 2021. The cancer treatment development company converted its coat room into a room where employees get tested once a week. All 100+employees have been back in the office as a result of regular testing. Relay is a Foresite portfolio company. (Photo by Jessica Rinaldi/The Boston Globe via Getty Images)

“Basically, you’re seeing people now really look at biotech in general, in the same kind of way that you would look at a tech company,” he said. “There are these tech metrics that now also apply in biotech, about adoption velocity, other other things that may not exactly equate to immediate revenue, but give you all the core material that usually works over time.”

Overall, Foresite’s investment thesis focuses on funding companies in three areas – therapeutics at the clinical stage, infrastructure focused on automation and data generation, and what Tananbaum calls “individualized care.” All three are part of a continuum in the tech-enabled healthcare end state that he envisions, ultimately resulting “a world where we’re able to, at the individual level, help someone understand what their predispositions are to disease development.” That, Tananbaum suggests, will result in a transformation of this kind of targeted care into an everyday consumer experience – in the same way tech in general has taken previously specialist functions and abilities, and made them generally available to the public at large.

Pfizer-BioNTech’s COVID-19 vaccine just got a lot easier to transport and distribute

The COVID-19 vaccine developed by Pfizer and BioNTech now has less stringent and extreme transportation requirements than it debuted with. Originally, the mRNA-based vaccine had to be maintained at ultra-low temperatures throughout the transportation chain in order to remain viable – between -76°F and -112°F. New stability data collected by Pfizer and BioNTech, which has been submitted to the U.S. Food and Drug Administration (FDA) for review, allow it to be stored at temps between 5°F and -13°F – ranges available in standard medical freezers found in most clinics and care facilities.

The vaccine should remain stable for up to two weeks at that temperature, which vastly improves the flexibility of its options for transportation, and last-mile storage in preparation for administration to patients. To date, the vaccine has relied largely on existing “cold-chain” infrastructure to be in place in order for it to be able to reach the areas where it’s being used to inoculate patients. That limitation hasn’t been in place for Moderna’s vaccine, which is stable at even higher, standard refrigerator temperatures for up to a month.

This development is just one example of how work continues on the vaccines that are already being deployed under emergency approvals by health regulators across the U.S. and elsewhere in the world. Pfizer and BioNTech say they’re working on bringing those storage temp requirements down even further, so they could potentially approach the standard set by the Moderna jab.

Taken together with another fresh development, study results from Israeli researchers that found just one shot of the ordinarily two-shot Pfizer-BioNTech vaccine could be as high as 85 percent effective on its own, this is a major development for global inoculation programs. The new requirements open up participation to a whole host of potential new players in supporting delivery and distribution – including ride-hailing and on-demand delivery players with large networks like Amazon, which has offered the President Biden’s administration its support, and Uber, which is already teamed up with Moderna on vaccine education programs.

This also opens the door for participation from a range of startups and smaller companies in both the logistics and the care delivery space that don’t have the scale or the specialized equipment to be able to offer extreme ‘cold-chain’ storage. Technical barriers have been a blocker for some who have been looking for ways to assist, but lacked the necessary hardware and expertise to do so effectively.

Toronto’s UHN launches a study to see if Apple Watch can spot worsening heart failure

A new study underway at Toronto’s University Health Network (UHN), a group of working research hospitals in the city, could shift our approach to treatment in an area of growing concern in human health. The study, led by Dr. Heather Ross, will investigate whether the Apple Watch can provide early warnings about potentially worsening health for patients following incidents of heart failure.

The study, which is aiming to eventually span around 200 patients, and which already has a number of participants enrolled spanning ages from 25 to 90, and various demographics, will use the Apple Watch Series 6 and its onboard sensors to monitor signals including heart rate, blood oxygen, general activity levels, overall performance during a six minute walk test and more. Researchers led by Ross will compare this data to measurements taken from the more formal clinical tests currently used by physicians to monitor the recovery of heart failure patients during routine, periodic check-ups.

The hope is that Ross and her team will be able to identify correlations between signs they’re seeing from the Apple Watch data, and the information gathered from the proven medical diagnostic and monitoring equipment. If they can verify that the Apple Watch accurately reflects what’s happening with a heart failure patient’s health, it has tremendous potential for treatment and care.

“In the US, there are about six-and-a-half million adults with heart failure,” Ross told me in an interview. “About one in five people in North America over the age of 40 will develop heart failure. And the average life expectancy [following heart failure] is still measured at around 2.1 years, at a tremendous impact to quality of life.”

The stats point to heart failure as a “growing epidemic,” says Ross, at a cost of some “$30 billion a year at present in the U.S.” to the healthcare system. A significant portion of that cost can come from the care required when conditions worsen due to preventable causes – ones that can be avoided by changes in patient behavior, if only implemented at the right time. Ross told me that currently, the paradigm of care for heat failure patients is “episodic” – meaning it happens in three- or six-month intervals, when patients go into a physician’s office or clinic for a bevy of tests using expensive equipment that must be monitored by a trained professional, like a nurse practitioner.

“If you think about the paradigm to a certain degree, we’ve kind of got it backwards,” Ross said. “So in our thinking, the idea really is how do we provide a continuous style monitoring of patients in a relatively unobtrusive way that will allow us to detect a change in a patient status before they end up actually coming into hospital. So this is where the opportunity with Apple is tremendous.”

Ross said that current estimates suggest nearly 50% of hospitalizations could be avoided altogether through steps taken by patients including better self-care, like adhering to prescribed medicinal regimens, accurate symptom monitoring, monitoring dietary intake and more. Apple Vice President of Health Dr. Sumbul Desai echoed the sentiment that proactivity is one of the key ingredients to better standards of care, and better long-term outcomes.

“A lot of health, in the world of medicine, has been focused on reactive responses to situations,” she said in an interview. “The idea to get a little more proactive in the way we think about our own health is really empowering and we’re really excited about where that could take us. We think starting with these studies to really ground us in the science is critical but, really, the potential for it is something that we look forward to tackling.”

Desai, has led Apple’s Health initiatives for just under four years, and also spent much of her career prior to that at Stanford (where she remains an associate professor) working on both the academic and clinical side. She knows first-hand the value of continuous care, and said that this study is representative of the potential the company sees in Apple Watch’s role in the daily health of individuals.

“The ability to have that snapshot of an individual as they’re living their everyday life is extremely useful,” she said. “As a physician, part of your conversation is ‘tell me what’s going on when you’re not in the clinic.’ To be able to have some of that data at your fingertips and have that part of your conversation really enhances your engagement with your patients as well. We believe that can provide insight in ways that has not been done before and we’re really excited to see what more we’re learning in this specific realm but we already hearing from both users and physicians how valuable that is.”

Both Ross and Desai highlighted the value of Apple Watch as a consumer-friendly device that’s easy to set up and learn, and that serves a number of different purposes beyond health and fitness, as being key ingredients to its potential in a continuous care paradigm.

“We really believe that people should be able to play a more active role in managing their well-being and Apple Watch in particular, we find to be — and are really proud of — a powerful health and wellness tool because the same device that you can connect with loved ones and check messages also supports safety, motivates you to stay healthy by moving more and provides important information on your overall wellness,” Desai said.

“This is a powerful health care tool bundled into a device that people just love for all the reasons Sumbul has said,” Ross added. “But this is a powerful diagnostic tool, too. So it is that consumer platform that I think will make this potentially an unstoppable tool, if we can evaluate it properly, which we’re doing in this partnership.”

The study, which is targeting 200 participants as mentioned, and enrolling more every day, will span three months of active monitoring, followed by a two-year follow up to investigate the data collected relative to patient outcomes. All data collected is stored in a fully encrypted form (Ross pointed to Apple’s privacy track record as another benefit of having it as a partner) and anyone taking part can opt-out at any point during the course of the research.

Even once the results are in, it’ll just be the first step in a larger process of validation, but Ross said that the hope is to ultimately “to improve access and equitable care,” by changing the fundamental approach to how we think about heart failure and treatment.