What kind of board does a development-stage biotech actually need? How should we allocate the board’s time? This article is an exploration of how an biotech should utilize its board as a resource, conserve directors’ time for what matters most, and get the best out of its board, especially its investor-directors, in the process.

Which rare disease treatments make it to patients? "The hidden kingmaker is not the drug company, it’s insurance," writes CNBC anchor Becky Quick, in setting up her conversation with RA Capital Managing Partner Peter Kolchinsky and Aradigm Health CEO Will Shrank at the network's Cures Summit last week.

Planetary health investing and biotech investing are more alike than most practitioners in either camp realize. Yet the two ecosystems have largely evolved in parallel, developing their own governance norms, financing conventions, and public-market strategies. That separation is a missed opportunity. 

China is well positioned to fill the biotech innovation gaps in the global economy that the United States leaves behind. America’s “most-favored nation” drug pricing policies will present China with the opportunity to serve the world’s need for innovative medicines if the US continues to isolate itself. With that isolation will eventually come higher domestic prices for the R&D and medicines Americans rely on until the American public demands that we, too, buy our innovative meds from China. Alternatively, the US could continue to work with China to accelerate global R&D while requiring that supply chains ensure against geopolitical disruption through domestic manufacturing of our medical standards of care. Meanwhile, to get other countries to pay their fair share for medicines, the US should rely on trade pressure, not MFN. 

In this year’s Semper Maior report, in addition to the usual analysis of how Core Biotech performed, we’ll review the biotech M&A landscape over the past several years, best practices for preparing for M&A, and tips for executing on a deal if and when the time comes. We’ll examine the crucial roles various advisors may play along the way. We’ll take stock of who’s buying, what they’re buying, and why. We’ll share some advice we’ve gleaned from some of the smartest and most connected dealmakers in biotech. A small mistake can be worth an astounding amount considering the many years of value creation that leads up to an exit.

The GLOBE and GUARD mandatory Medicare drug pricing models proposed by CMS on December 19th shift the rebates companies pay CMS from “don’t raise prices faster than inflation” to “don’t raise prices higher than the rest of the developed world, on a GDP/capita-adjusted basis.” This will be damaging to biopharma innovation if implemented broadly.

As we break for the holidays and begin to look forward to 2026, we're also taking a beat to look back on what most drew our readers' attention in 2025. 

With CMS set to announce this week the “maximum fair prices” for 2027’s cohort of drugs under the IRA’s “negotiation” program and the recent the three-year anniversary of that law’s passage, it seemed a good time to take stock of just how the law is influencing the biopharma investors’ and innovators’ collective drug development choices. A collection of empirical evidence.

I learned in Cuba that the CDC’s strength is not in politics but in its people and their integrity. That lesson is as urgent today as it was in 1993. If we drain its strength, the price will be paid not in headlines, but in actual lives.

In an effort to encourage continued discussion between and within our biopharmaceutical community and the regulatory bodies we collaborate with, RA Capital Management has submitted several recommendations to the US Department of Health and Human Services and the Food and Drug Administration to help the agencies as they continue to modernize their processes to benefit the American public.

In Washington, senators and representatives usually fight for their states’ economic interests. Why then, when it comes to the biopharmaceutical industry that is so important to Massachusetts, are we such an outlier? This article examines the origins of this Massachusetts Paradox, what kinds of biopharma-related policies the state’s voters and politicians should logically support, and proposes a new approach to rallying our neighbors to support those policies. This campaign is rooted in a kind of engaging storytelling that all of us in the biopharma ecosystem, from startup to pharma and from investor to banker, can and should contribute to.

This article is one in a series seeking to give a face to some of the folks at RA Capital Management toiling away tirelessly and passionately to bring the next generation of medicines to patients. 

RA Capital is incredibly proud to have a number of women in senior positions and a deep bench of female biotech and investment leaders. In this piece, Sarah Reed, RA Capital’s general counsel, spoke with just three of the many phenomenal women here who have been involved in some of our recent high-profile exits.

A New York Times article gives our economist Richard Xie an excuse to reflect on the nuances of family and community spillover of the benefits of certain medicines, and our industry’s inability or reluctance to try to measure them.

We believe the FDA’s new COVID vaccine guidelines are too narrow, leaving young children vulnerable. If it were up to us and we were deciding on how to best use boosters, we would have approved and recommended them for healthy children under 5 years of age and to pregnant women (which protects infants under 6 months who are ineligible for vaccination due to their immature immune systems).

Despite our best efforts, clinical trial execution remains stubbornly unpredictable, with delays and budget overruns threatening even the most promising programs. But biotech leaders can now access a proven framework for tackling this universal challenge through RA Capital's Gateway platform and RA Capital’s website.

President Trump’s recent “most-favored nation” proposal seeks to compel companies to charge the same prices in the US as they do elsewhere. But the price controls sought by MFN override market negotiation and threaten to backfire by drastically reducing spending on R&D that drives tomorrow’s treatments and cures. That would undermine the return on investment America has been getting – financially and in terms of better health. Instead of price-controlling in the US, we must convince other countries to pay their fair share for novel medicines. This is an intractable trade puzzle that the US should begin trying to solve. And to end other countries’ freeriding, first we need to examine the extent of it.

To truly appreciate the advances offered by GCEA, there's nothing as illustrative as getting in there and running the numbers yourself. However, building a de-novo cost-effectiveness model can be a daunting task. 

Well, not to worry! Just in time for the ISPOR Annual Meeting 2025, we've released an easy-to-use GCEA calculator that allows you to explore and appreciate the societal value of innovative medicines, and underpin the key value drivers without building a full-on model. The GCEA calculator offers an interactive user interface that lets you customize your own GCEA. 

Stylus, a Raven company that emerged from stealth this week with funding from RA Capital and others, is positioned to overcome the existing limitations of genetic medicines with its suite of engineered recombinases that are designed to recognize a safe harbor site in the human genome and introduce a therapeutic payload with high specificity and integrity.

Understanding how investors use NPV to value drugs at various stages of drug development explains what CBO's and other analyses miss.

The public has taken a renewed interest in discussing vaccines, with many people asking to be convinced that vaccines are safe and effective enough to be used as widely as modern medicine recommends. In the hope of reaching some more people seeking answers to common questions, we’ve prepared this Q&A document. Medicine is complicated, and the current discourse is noisy, but it’s possible to bridge the gap between experts and patients by breaking down the jargon. We’ll try to do that here. We wrote this with our own friends and families in mind because we believe that everyone should be able to get clear answers to their questions. We hope it is useful to you.

Big pharma once again showed up for the Superbowl, or their ads did at least. But those pricey spots, while didn’t connect the dots to inspire the American public with their role in getting important therapies to the patients that need them. Were they moving? Sure. But will they move the needle where it really counts? Probably not.

Since the original version of this article was published in 2023, the market has continued to be tight for biotech investment. New companies continue to form and get funding, but overall, investors are reducing risk with an increasing preference for companies with clinical data – or at a minimum validation in animal studies – before follow-on investments are attractive. 

One of our guiding principals here at RApport and RA Capital is that we learn collaboratively; not just internally, but with the rest of our community as well. RApport is an important part of that (and as always, we encourage you to reach out with questions, comments, and op-ed ideas: rapport@racap.com), but RA University – in which many of our readers are already enrolled – is another. Recently, we’ve been rolling out RAU’s newest, on-demand course: Biotech Unveiled: Understanding the U.S. Biomedical Innovation Marketplace and its Global Role.

Wouldn’t it be better if everyone in our ecosystem were candid with one another?

After all, within companies it’s common to encourage everyone to speak their minds. If you see a problem, call it out; give honest feedback; feedback is a gift; people have a duty to dissent if they disagree with something. So, what stops this corporate if-you-see-something-say-something from going beyond managers and employees? If we normalized candor, we could learn more from one another, cross-pollinate best practices, and correct misunderstandings.

As we break for the holidays and begin to look forward to 2025, we're also taking a beat to look back on what most drew our readers' attention in 2024. 

On the occasion of a documentary about living with cystic fibrosis and the drug that turned his life around, Gunnar Esiason reflects on his personal struggle, the roles of patients and their caregivers in drug development, and the scientific struggle we so rarely see publicly depicted.

On RA Capital's Gateway, Peter Kolchinsky, Managing Partner at RA Capital Management, and Travis Wilson, Partner at Gurnet Point Capital, delve into how biotech companies can achieve more with lean, strategically staffed teams. Small, agile teams of versatile professionals who leverage external expertise when needed lets companies maintain operational efficiency and financial discipline.

Unlike our healthcare spending that goes to services and should be considered an expense, the mere 8% we spend on novel medicines doesn’t just pay for the same things year over year – it’s an investment in progress. Surprised it’s such a small fraction? Most people are.

Hear from our cast of biotech executives and board members on Gateway as they discuss how they utilize the investors on their boards.

Last week’s publication in the Forum for Health Economics and Policy of Valuing the Societal Impact of Medicines and Other Health Technologies: A User Guide to Current Best Practices is a watershed moment for the field of health economics and outcomes research.