Alex Telford
Writes about the biotech industry, drug development and forecasting — “I write to learn, mostly about biotech.”
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What they believe
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The West has not yet internalised that China is a source of genuinely new drugs, not just a maker of ingredients and copies.
I don’t think many in the West have yet fully internalized a mental model of China as a source of genuine innovation.
atelfo.github.ioSaid 20 Dec 2024This on korrents
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A computational discovery platform does not make a biotech fast, because the thousand other steps of drug development are still the bottleneck.
Another challenge for Class II biotechs is that even if you have a nifty computational drug discovery platform, you are still often bottlenecked by the rest of the drug development process. It takes 1,000 (or more!) small steps to advance a drug through discovery, development, and past the regulators.
atelfo.github.ioSaid 17 Sept 2024This on korrents
The bold line is korrents’ wording; the quote is theirs. These 2: what they wrote before what they said aloud, one per source, newest first.
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As its own page →Hiding
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29 December 2025
7 December 2025
28 September 2025
18 September 2025
3 August 2025
20 December 2024
From one piece Will all our drugs come from China? 2 beliefs · atelfo.github.io
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korrents.com
China now starts about a quarter of the world's new clinical trials, more than Europe does.Their words
Chinese companies are now responsible for about a quarter of new trial starts — more than Europe.
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Their words
I don’t think many in the West have yet fully internalized a mental model of China as a source of genuine innovation.
17 September 2024
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Their words
Another challenge for Class II biotechs is that even if you have a nifty computational drug discovery platform, you are still often bottlenecked by the rest of the drug development process. It takes 1,000 (or more!) small steps to advance a drug through discovery, development, and past the regulators.
1 April 2024
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Readrcmnd.app
The Success EquationTheir words
In his book "The Success Equation", Michael Mauboussin introduces the luck:skill continuum: the tendency for activities to fall on a spectrum from pure skill to pure luck.
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Readrcmnd.app
Where Futures ConvergeTheir words
The book "Where Futures Converge" claims that the early adoption of regulations ("the ordinance") governing the use of recombinant DNA in Cambridge helped establish Kendall Square as a centre of biotech innovation:
23 December 2023
From one piece The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it 9 beliefs · atelfo.github.io
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korrents.com
Regulatory and social tolerance for drug risk falls over time, and the ratchet is almost never loosened.Their words
it seems to be broadly true that regulatory and societal tolerance for risk declines with time
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Their words
it will take time for deep learning systems and training data to mature enough to be useful for the truly value-adding task of predicting safety and efficacy in humans
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Their words
Because patents have fixed term lengths, with small extensions to compensate for the year or so when the drug is under regulatory review, drug developers are incentivized to go after conditions where clinical trials can be completed quickly, all else being equal.
+ 6 more
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korrents.com
Clinical trials cost what they do because they are complex, bureaucratic and reliant on highly skilled labour.Their words
Clinical trials are expensive because they are complex, bureaucratic, and reliant on highly skilled labour.
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Their words
Biology is unpredictable, especially when the immune system is involved, and there is no guarantee that a drug that appears safe in animals will be safe in humans.
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Their words
The most significant factor preventing us from taking better molecules into clinical trials is not our ability to design arbitrary molecules, but our (lack of) understanding of underlying disease biology. In other words, we often know how to make something, but not what to make.
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Their words
The cost to discover and develop a drug today is orders of magnitude higher than in the 1950s. Despite this, the probability that a drug entering clinical trials will eventually reach the market has hardly improved in the intervening years.
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Their words
In reality, the productivity crisis in the pharmaceutical industry is the culmination of decades of just about every aspect of drug discovery and development getting gradually harder and more expensive.
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Their words
Such prolificacy is unlikely to be repeated any time soon; if current trends hold, a drug discovery scientist starting their career today is likely to retire without ever having worked on a single drug that makes it to market.
17 November 2023
11 October 2023
24 August 2023
17 May 2023
Nothing matches.
Beliefs
Korrents What they believe 12 beliefs — each backed by an exact quote.
Each is a — compiled by korrents.com, not by them: the one-line wordings are korrents', the quotes are theirs.
Recent
The West has not yet internalised that China is a source of genuinely new drugs, not just a maker of ingredients and copies.
I don’t think many in the West have yet fully internalized a mental model of China as a source of genuine innovation.
Will all our drugs come from China? Said 20 Dec 2024
China now starts about a quarter of the world's new clinical trials, more than Europe does.
Chinese companies are now responsible for about a quarter of new trial starts — more than Europe.
Will all our drugs come from China? Said 20 Dec 2024
A computational discovery platform does not make a biotech fast, because the thousand other steps of drug development are still the bottleneck.
Another challenge for Class II biotechs is that even if you have a nifty computational drug discovery platform, you are still often bottlenecked by the rest of the drug development process. It takes 1,000 (or more!) small steps to advance a drug through discovery, development, and past the regulators.
A new breed of biotech Said 17 Sept 2024
Show 9 more
A drug discovery scientist starting today will probably retire without ever having worked on a drug that reached the market.
Such prolificacy is unlikely to be repeated any time soon; if current trends hold, a drug discovery scientist starting their career today is likely to retire without ever having worked on a single drug that makes it to market.
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
The pharmaceutical productivity crisis has no single villain: nearly every part of discovery and development got gradually harder and more expensive at once.
In reality, the productivity crisis in the pharmaceutical industry is the culmination of decades of just about every aspect of drug discovery and development getting gradually harder and more expensive.
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
Pharmaceutical R&D productivity has fallen for decades: far more money spent per drug, with no matching improvement in the odds a candidate reaches the market.
The cost to discover and develop a drug today is orders of magnitude higher than in the 1950s. Despite this, the probability that a drug entering clinical trials will eventually reach the market has hardly improved in the intervening years.
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
The hard part of drug discovery is knowing what to make - which target is worth drugging - not designing the molecule.
The most significant factor preventing us from taking better molecules into clinical trials is not our ability to design arbitrary molecules, but our (lack of) understanding of underlying disease biology. In other words, we often know how to make something, but not what to make.
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
No amount of animal testing can guarantee a drug is safe in humans, so human volunteers must carry some irreducible risk for medicine to advance.
Biology is unpredictable, especially when the immune system is involved, and there is no guarantee that a drug that appears safe in animals will be safe in humans.
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
Clinical trials cost what they do because they are complex, bureaucratic and reliant on highly skilled labour.
Clinical trials are expensive because they are complex, bureaucratic, and reliant on highly skilled labour.
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
How long a trial takes decides which diseases get drugs at all, because capital flows to the indications whose endpoints can be measured quickly.
Because patents have fixed term lengths, with small extensions to compensate for the year or so when the drug is under regulatory review, drug developers are incentivized to go after conditions where clinical trials can be completed quickly, all else being equal.
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
Deep learning is not yet ready for the task that would actually add value in drug development: predicting safety and efficacy in humans.
it will take time for deep learning systems and training data to mature enough to be useful for the truly value-adding task of predicting safety and efficacy in humans
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
Regulatory and social tolerance for drug risk falls over time, and the ratchet is almost never loosened.
it seems to be broadly true that regulatory and societal tolerance for risk declines with time
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
Beliefs others hold too
Pharmaceutical R&D productivity has fallen for decades: far more money spent per drug, with no matching improvement in the odds a candidate reaches the market. 2 hold this
The cost to discover and develop a drug today is orders of magnitude higher than in the 1950s. Despite this, the probability that a drug entering clinical trials will eventually reach the market has hardly improved in the intervening years.
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
The hard part of drug discovery is knowing what to make - which target is worth drugging - not designing the molecule. 2 hold this
The most significant factor preventing us from taking better molecules into clinical trials is not our ability to design arbitrary molecules, but our (lack of) understanding of underlying disease biology. In other words, we often know how to make something, but not what to make.
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
How long a trial takes decides which diseases get drugs at all, because capital flows to the indications whose endpoints can be measured quickly. 2 hold this
Because patents have fixed term lengths, with small extensions to compensate for the year or so when the drug is under regulatory review, drug developers are incentivized to go after conditions where clinical trials can be completed quickly, all else being equal.
The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it Said 23 Dec 2023
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Recommends rcmnd
rcmnd What they recommend 8 things — each backed by an exact quote.
Compiled by rcmnd.app, not by them: the quotes are theirs, and each links to the post it was copied from.
Recent
Read Where Futures Converge
The book "Where Futures Converge" claims that the early adoption of regulations ("the ordinance") governing the use of recombinant DNA in Cambridge helped establish Kendall Square as a centre of biotech innovation:
atelfo.github.io 1 Apr 2024
Read The Success Equation
In his book "The Success Equation", Michael Mauboussin introduces the luck:skill continuum: the tendency for activities to fall on a spectrum from pure skill to pure luck.
atelfo.github.io 1 Apr 2024
Liked Contingency and Convergence: Toward a Cosmic Biology of Body and Mind
"Contingency and Convergence: Toward a Cosmic Biology of Body and Mind" by Russell Powell
atelfo.github.io 14 Sept 2022
What others say about Contingency and Convergence: Toward a Cosmic Biology of Body and Mind →
Show 5 more
Liked Good Enough: The Tolerance for Mediocrity in Nature and Society
"Good Enough: The Tolerance for Mediocrity in Nature and Society" by Daniel Milo
atelfo.github.io 14 Sept 2022
What others say about Good Enough: The Tolerance for Mediocrity in Nature and Society →
Liked The Innovator's Dilemma
"The Innovator's Dilemma" by Clayton Christensen
atelfo.github.io 14 Sept 2022
Liked Why Greatness Cannot be Planned: The Myth of the Objective
"Why Greatness Cannot be Planned: The Myth of the Objective" by Kenneth O. Stanley and Joel Lehman
atelfo.github.io 14 Sept 2022
What others say about Why Greatness Cannot be Planned: The Myth of the Objective →
Recommends Energy and Civilization
For a history of energy, I recommend Vaclav Smil's Energy and Civilization
atelfo.github.io 14 Sept 2022
Liked Nature: an economic history
Books that heavily influenced this post: "Nature: an economic history" by Geerat J. Vermeij
atelfo.github.io 14 Sept 2022
Where they publish
Blog Alex's blog His blog on biotech, medicine and forecasting. Has a feed.
Recent
- Going direct: notes on Eli Lilly at a trillion 7 Dec 2025
- Thoughts on the future of software development as a non-developer 3 Aug 2025
- Will all our drugs come from China? 20 Dec 2024
Show 7 more
- A new breed of biotech 17 Sept 2024
- Some questions about biotech that I find interesting 1 Apr 2024
- The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it 23 Dec 2023
- Latent optima 17 Nov 2023 All data is the result of some selection process. The first order manifestation of this is bias: a failure to select a representative sample of the real underlying thing the data is describing. But selection operates at…
- Concepts of health and disease as a barrier to progress 11 Oct 2023 This essay was the runner-up in the Homeworld Ideas writing contest. To read it on the Homeworld website, click here.
- An Enhertu innovation map 24 Aug 2023
- Intelligence as efficient model building 17 May 2023
Link verified 20 Sept 2026. Recent items update automatically from the channel.
x.com @Atelfo Their X account.
Recent
- We've significantly improved the preclinical and China coverage of our free drug pipeline tracker in the past week or so. If you're in biopharma corp dev or investing check it out and let us know what you think! (link in quoted post) 21 Sept 2026
- We ran an experiment to see if LLMs could help map, identify, and prioritize unmet medical needs across thousands of diseases. I've found it pretty educational to browse through; I've worked in biopharma for a while now and there are still so many big problems I've never heard of 12 May 2026
- There's no guarantee that Kendall square is going to remain a biotech hub. Every 20-30 years or so a new industry has replaced the previously dominant one; before biotech it was AI, before that it was minicomputers, hard candy, and soap 29 Dec 2025
Show 3 more
- Dave Ricks on @stripe's podcast is the best pharma exec interview I've listened to in a good while. My notes on the conversation, Lilly's DTC strategy, and how they're using the capital influx from GLP-1s to build a new type of pharma business model: 7 Dec 2025 atelfo.github.io
- Thinking about this paper again today as I try to get GPT-5 to clean up some overwrought code 28 Sept 2025
- Monoclonal antibodies are still underrated as a drug technology and will likely be the next modality after small molecules to scale globally and make an impact on long-standing scourges like malaria and snakebite 18 Sept 2025
Link verified 23 Sept 2026. Recent items update automatically from the channel.
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