Transcript

Darren [00:00:02]:

Hi, everyone. Welcome back to another episode of One of one. I’m your host, Darren Gold, CEO of the Trium Group. My guest today is Neel Kumar, co founder and CEO of BridgeBio, a leading biotech company focused on treating rare genetic conditions that largely affect children. Neil is a deeply contrarian thinker and leader. It shows up in his decision 10 years ago to start a company focused on a market that most others ignored, in the unique hub and spoke organizational structure he has built, in the distinctive culture and type of people he attracts, and in the sincere commitment to build a truly generational company. I enjoyed every minute of our conversation, and I’m certain you will too. 

Neal, it’s so good to see you. I’ve been looking forward to having this conversation, and thanks for being on the show.

 

Neil Kumar [00:00:58]:

Thank you. Thanks for having me. It’s great to see you again and look forward to the discussion.

 

Darren [00:01:02]:

Yeah, likewise. So I believe it’s been now a little over a decade since you started this incredible company, Bridge Bio. And I’d love you to describe maybe starting with what was the founding inspiration, what was the big problem you were trying to solve? And there’s something really unique about a decade, which I’d love you to sort of bring us to the present moment as well, after we talk about how this idea came to life.

 

Neil Kumar [00:01:28]:

Yeah. So almost a decade. I was just reflecting on this. I think in six months, it’ll be a decade worth of work at Bridge Bio, but almost two decades now of work in the area that Bridge Bio plays, which is that of rare genetic disorders. And so the company started basically through the observation of the following problem, which was the sequencing of the human genome had allowed us to gain insights that would in turn make beautiful new medicines for mostly children affected with what we call rare genetic disorders. And there was no company or set of companies that wanted to move those ideas forward as quickly as they probably could be moved forward because the marketplaces associated with genetic disease tend to be too small for a large pharmaceutical company. So about a decade ago, myself and several other of my co founders kind of put our heads together and said there’s an opportunity based on all the research that’s happening to really help maybe millions, tens of millions of mostly children affected by these diseases, conditions, and no one’s doing it. So can we put together a company that does it? And that’s what we do. We basically discover, develop, and ultimately commercialize medicines for rare genetic disorders.

 

Darren [00:02:39]:

Yeah. What I love about that is obviously a compelling business opportunity. Right. A reasonably big market. When you add up all of the. I think you call them monogenic diseases, but underserved, given that people don’t think that those markets in any one particular area are big enough. And then this, like, incredible animating mission, you know, to save people’s lives and particularly children. So I’m struck by the powerful combination of both market opportunity and mission. And I imagine that was at the heart of the founding of the company.

 

Neil Kumar [00:03:13]:

Yeah. You know, thank you for saying that. A lot of people think about this space as, like, it’s singles and doubles in terms of a market, or it’s high probability of technical success based on the way we can describe a condition. But the way I really think about it is every time we have the opportunity, and it really is an opportunity or privilege to work on a specific condition, it typically starts by meeting parents, families, and patient advocacy groups. And they give us the gift of understanding the condition, getting to know what type of endpoints we should look at in the clinical trials. And so it’s really a very humane endeavor and one that I’m thankful for even a decade in having the opportunity to work on. And each one of those conditions is. And each one of those children, to have an impact on them is a true privilege. So it’s been a wonderful march forward and backward and forward and backward and sometimes net forward over the course of the last decade.

 

Darren [00:04:09]:

Yeah. Well, I’d love to come back maybe and talk about maybe one of those conditions as an example and bring to life what you just said. But before doing that, walk us through the last nine and a half, almost 10 years, you had this incredible vision. A group of founders. How’s it gone and where are you today?

 

Neil Kumar [00:04:28]:

Yeah, good question. Couple different lenses to understand that question with. I think the first and most meaningful is through our objective function, are we making meaningful new medicines for patients, for the patients that we serve? And we’ve done three approved products. We’ve put 21 new products in the clinic over the course of the decade. I think it, you know, we’re one of the more productive biotechs that’s been around over the last 30 years. So from that standpoint, we’re doing well. From the standpoint of the overall unmet need, there’s still 7,800 monogenic conditions that need their first therapy. So we’re doing poorly, and there’s a lot more work to be done. From the standpoint of our own journey, I’d say we’ve built the capabilities to do this reproducibly and to become a generational company. So we have that now, we have to go execute against that. And from the standpoint of making sure that we’re going to be a reliable engine for the patients that we serve, I think we’ve built those bones. After a couple of near death experiences over the course of the last several years, and tough markets, et cetera, et cetera, I think we have now arrived at kind of the starting line is how I see it for Bridge, where we can pick up more programs. We sort of understand how to structure things from a corporate standpoint effectively, and most importantly, move ideas forward as quickly as possible to the marketplace for patients.

 

Darren [00:05:55]:

So we’re at the kind of epicenter, both physically and from a time standpoint, of this tectonic shift that’s happening in technology with AI, generative AI, I imagine that’s impacting your ability to scale this and reproduce the capability you just talked about. But where do you sit in that big kind of paradigm shift and how’s it affecting how you think about your business?

 

Neil Kumar [00:06:22]:

Yeah, it’s an important paradigm shift, but actually the most important paradigm shifts for us probably occurred 15 to 20 years ago, and they’ve only accelerated over the course of the time frame that we’ve been around at Bridge. And they’re really threefold. One is ever cheaper exome and genome sequencing. The second is the availability of large databases, what we call longitudinal databases, that may or may not take advantage of AI, but effectively put in context both genotypic information and phenotypic information, effectively how patients are presenting with conditions. And then the third has been an interesting march toward the development of therapeutic modalities, things like gene therapy or genetic medicines, in concert with traditional modalities like small molecules, to allow us to target those well described monogenic conditions at their source. So those three things, genome sequencing databases and therapeutic modality evolution, really has allowed us to take on many more conditions in this rare genetic disorder space than we were able to even a decade ago. And so you layer on AI on top of that. You know, when I was in graduate school, we were finding one to two disease causing genes a year. Today we’re finding a couple a day. And in large part that has to do with both the technologies I just referenced as well as AI, allowing us to accelerate our understanding of what a mutation is doing in the context of a cell, what is it doing in the context of the shape of a protein and things of that nature. So I see it having impact now, and probably the impact is going to be much broader in five to 10 years.

 

Darren [00:07:56]:

So I want to turn our attention to you as CEO. Were you CEO day one or how did that come about?

 

Neil Kumar [00:08:03]:

Yeah, so I was in venture capital before and looking at each one of these types of conditions and trying to start a separate company around it. So I’d started a company alongside several other founders and folks that put it together in the hypertrophic cardiomyopathy space. We had interest in doing a couple other things, but it was a long process to get it through the investment committee and then set it up. And then it was just one condition. And so the observation was, can we put something together that basically can drive a lot of those ideas forward in parallel and can we sort of put it together with a new type of corporate model? Like I like to say about BridgeBio, think about everything you’ve learned about the pharmaceutical industry and then multiply it by negative one. That’s kind of what we’re seeking to do. You’re not going to see any big buildings or helicopters taking people around. Because we are focused on small marketplaces, we tend to redesign almost every aspect of the discovery and development paradigm. And we couple it with a new type of business model that’s decentralized, that allows us to finance in different ways, including debt and equity. And so around the time I was looking for kind of a new solution to move things forward, I met Andrew Lowe, who’s a professor at mit, and he had hypothesized that the right way to move drug discovery and development forward is a much more decentralized, parallelized type business model. And so he and I put our heads together and came up with the foundation for bridge. And then folks like Charles Homsey, Frank McCormick, Richard Scheller, some of my scientific co founders jumped on and we began our efforts then.

 

Darren [00:09:32]:

So I’ve heard it described as a bit of a hub and spoke. Right where you’ve got.

 

Neil Kumar [00:09:35]:

It’s a hub and spoke.

 

Darren [00:09:36]:

Yeah, yeah. These individual subsidiaries focused on one condition and they’re sharing resources, bring that to life. Because it’s so novel and it is emblematic of the new way you’re trying to disrupt really drug discovery.

 

Neil Kumar [00:09:52]:

Yeah. And really the hub and spoke arrived to us basically trying to solve three different things. One is we wanted centralization of some parts of the platform platform so that we could be hyper efficient, both time efficient and cost efficient. And so often a biotech which is only working on one problem might, you know, get something into the clinic. It doesn’t need its discovery resources anymore. And so then they cut it. And then those discoverers end up at some other company three years later, it’s very inefficient. So we wanted the central platform, gna, manufacturing things of that nature that you could take when you need it and give it back when you don’t. We wanted diversification because we live in a lottery ticket industry. You know, the statistical way we define it is mode negative, expected return positive. But it’s like a card game where you’re mostly losing, but every once in a while you win. So you need diversification in that because you can’t predict the winners. And then the third piece of it though is we want to focus at the level of each effort because the right biology crew to understand condition X is not going to be the same crew for Y or Z. Plus you want incentives at the level of that drug, that medicine that those folks are working on. So how do you do that? You basically create affiliates or the spokes and each one of those spokes is targeted at a condition, but they’re hooked up to a hub that provides both financing and some of those centralized efforts and also cuts down the things that aren’t working and doubles down in areas that are. And really it’s not all that novel when you look across other industries that are mode negative, expected return positive, like oil and gas is financed in this way. Movies are often financed in this way. It’s just we hadn’t seen a lot of it in biotech, which I think is the opportunity here. The hub and spoke model not only should allow for more efficient production of drugs, as I think it has over the last decade, but it also should allow for new types of investors to come into the space. And we’ve seen that through Bridge Bio in terms of attracting private equity debt holders, other sorts of folks like that that don’t traditionally participate in the high risk biotechnology marketplace.

 

Darren [00:11:52]:

Any drawbacks, things that you’ve struggled with in this sort of novel approach?

 

Neil Kumar [00:11:57]:

Yeah, lots. How much time you got? I mean, I think anytime you’re doing something completely new, there’s a lot of head scratching and that can become very difficult in what we’re in today, which are narrative driven markets. So a couple of things that come to mind. Number one is people like the description of a company as associated with a certain moat that makes sense to them. So it’s like I own this biology platform or I own this set of IP around gene editing, Whereas in a hub and spoke model you’re doing a lot of different things. They all arrive at sort of the same thing. You’re targeting well described genetic conditions at their source. But we do different sizes of markets, different therapeutic areas, different modalities. And so that can be hard for investors to understand and to give credit for. I think second is the levering of a company that’s early stage. You don’t often, often see the amount of debt, you know, that we’ve been able to raise over time associated with company that, you know, up until a year ago didn’t have any revenue. And so that can throw folks off a little bit. And then thirdly, I think for the people that we’re hiring to explain to them, are you at the hub, are you in a spoke? How do those incentives work over time? That, that has been a little bit of a challenge. But I think over time people have, and with some success stories people have arrived at. Okay, like, this is a. This is a pretty interesting model and one that seems to get you through the tough times and allow to drive success in the areas where scientifically we can do something special for patients. So overall, it’s been good, but many drawbacks.

 

Darren [00:13:31]:

Yeah. As I hear you describe all of that, I’m picking up a set of traits, and it just so happened to begin with the letter C. So I’m just going to name them contrarian, courageous, convicted, and confident. And I’m wondering if you would agree that those are traits that are unique to you, and if so, if not, what would you replace them with? And if so, I’m curious to go back in time and really understand, like, where did. Where were these traits formed out of? Like, what experiences gave rise to who you are today?

 

Neil Kumar [00:14:04]:

Well, first of all, thank you. Those are just some of the traits that my wife might associate with me. But our partners are usually our, you.

 

Darren [00:14:14]:

Know, our biggest truth tellers. So I’m. It’s a good validation. Yeah.

 

Neil Kumar [00:14:19]:

You know, I think when I think of those traits, honestly, I think of the parents and patients that we have the opportunity to serve. Not so much me. I honestly feel like I’ve been just so extraordinarily lucky to be in a space where I get to draft off a lot of the courage. And I mean, think about the experience of being a parent and understanding what this thing is and the odyssey of diagnostics and then the odyssey of trying to find a partner that you can work with and spaces where, you know, large pharma is not interested. So I think all of that is maybe just a reflection of where I’m at. The contrarian piece for sure, has been around since I was young. I don’t precisely know where that comes from. To be honest, we look for it, we try to recruit for it. I don’t know if you’ve ever read that. There was an interesting polemic that was written by John Hardwig, I believe, on epistemic independence, long time ago at mit. And he had posited that everyone is on this trajectory of either trying to rederive everything for themselves, but you probably waste your whole life rederiving the theory of gravity. And you know, that’s a waste of time. You should just accept it. And then there are people who accept everything and they’ll never do anything new. And that’s a lot of folks. But most people are in the middle somewhere. And we like to recruit people who are a couple clicks over to rederiving everything themselves, first principles, knickers, whatever it may be. And I think I’ve always been that way since the get go. Maybe it was growing up a little different in, you know, a town where there weren’t a lot of people that looked like me. I don’t know what it was. Maybe loving Bob Dylan from a young age. It’s hard to tell what it is, but definitely we’ve got that streak here at Bridge, and I have it myself.

 

Darren [00:15:52]:

How do you assess for that trait in other people when you’re interviewing really smart, talented people?

 

Neil Kumar [00:15:58]:

Well, I don’t want to give away all the secrets, but we ask a series of questions that I think pretty reliably have gotten us there. We do always ask, given your experiences, what’s one thing you look at and you see the world doing it in this way, and you just think, that’s idiotic. Why do they do it that way? So we ask that question and the best of our recruits have, like, an answer that immediately strikes everyone. So it’s like, ah, yes, thank you for asking that. We ask a couple different types of questions in and around where a chip on your shoulder might come from. Because I think having a chip on your shoulder allows you to be a bit contrarian at times. That arises from all sorts of different backgrounds. But yeah, and then we try to assess people’s understanding of theories. Like, it could be any theory. Like, we’ll often ask, like, what’s your favorite theory and why? And what we’re looking for there is that they have thought deeply about how humanity organizes or why we organize as a company or some theory that has to do with biology or physics. And then they’ve noticed it’s applicability in certain cases and the absence of its applicability in other cases. And you can see Them really struggling with. Yeah, just how predictable this, this world is or isn’t. And most people who are deeply thoughtful about that answer, you know, tend to, tend to be a bit contrarian. I don’t know why, but like, yeah, I’m getting this.

 

Darren [00:17:21]:

The sense that Bridge Bio maybe was born out of the implicit answering of those questions, you know, could have been, in part.

 

Neil Kumar [00:17:28]:

Yeah. That’s interesting.

 

Darren [00:17:29]:

And Peter Thiel has this famous question, interview question where he says, what’s the one belief that you strongly hold that very, very few people would otherwise agree with? I’m wondering whether it’s that question or something similar. Just asking you whether it’s something that was the basis of founding the company or something that you’re holding now that is just different than the rest of the world sees it.

 

Neil Kumar [00:17:53]:

Yeah, I think Zero to One was published right around the time that the Bridge was starting, maybe a year after. But we always used to hand it out along inside T.S. eliot’s four quartets for anyone who starts, because the stuff he talks about in there. And I will answer the question on definite optimism and secret finding and feeling like you’re part of a cult, but that’s directed towards something productive. All of that is really fundamental to our culture. The difference I think is although we aspire to be an engineering like company, probability of technical success is still well below 50%. So how do you keep the definite optimism, but pair that with an understanding that most of everything that you’re going to do is failure. Failure in the context of trying to find something that you swallow, transit the gut, gets into the blood, finds the right cell, reliably binds the right target and then changes human behavior at a P value of less than 0.05 that you can measure in the clinic. That’s hard stuff to do and generally it takes a long time and it’s generally laden with failure. So the T.S. eliot book is about how do you deal with that failure and get into the mindset, almost the eastern mindset of divorcing yourself, divorcing process from results. But I think for us the contrarian mindset is sort of many fold. It really starts with the fact that to do this right and this means to start from an early idea and to make a medicine that really matters for patients that is a super long 10 plus year, super capitally intensive and super high risk business. And so the fact is most people are not cut out for that. Even most people in biotech are not cut out for that. And so they sort of subdivide the industry and they just try to get in and get out at a higher price point. And so it could be venture that gets in early and tries to IPO or sell something. It could be a hedge fund investor that gets in as the thing, IPOs along the middle ground. But there are very few people who are focused on the NPV of the asset, like the overall economic value and what it could do, especially in these small markets. So that was the first thing that we thought of is like, look, there may be stuff that we’re working on that is never popular for big pharma. And you know, our proposal is not to sell it. Our proposal is to build a generational business, but it’s going to take some time for us to do it. So that’s, that’s one set of contrarian beliefs that has to do with what, what is the fundamental value of a program. Another set of contrarian beliefs has to do with how do you organize? You know, we, we have a concept of a minimum viable team, minimum viable process. We have to do that because the marketplaces we’re going after are small. But we do it also because small groups of individuals can accomplish a lot and have a lot more fun doing it than I think, the large bureaucratic types of organizations you see traditionally in biopharma. And so we have, on average, much younger teams. We have teams that pair sort of young all stars with very experienced R and D practitioners. And we have a totally different mindset in terms of every minute matters and how hard we want to charge it, individual problems. So that’s another contrarian belief we have. It’s just how we organize. The third is how we finance. You know, as I mentioned earlier, that the capability and the wherewithal to really try to lower your cost of capital aggressively. That’s not something that most people do most because they don’t think about economic value. They just want to raise enough money to ultimately sell the company. And all of it comes back to we want to be in this space that is mostly overlooked for a long period of time in a sustainable way. And that’s just not the objective function for most folks. So I think, yeah, there’s a lot of contrariness built in here.

 

Darren [00:21:26]:

Yeah. Let’s turn our focus to you as CEO. And I’d love to if you were to describe in narrative form what the evolution has been for you in that particular role as leading the company. How would you describe it last nine and a half years? What have been the big evolutions or shifts or learnings along the way?

 

Neil Kumar [00:21:47]:

Good Question. I think when you start, regardless of how much TS Eliot you read or Power of Now or whatever, it’s like you are so personally wrapped up in trying to put a dent into a universe. I mean, no startup is asked for. So part of it, it’s like you see this unmet need, but if people were asking for it, someone else would have done it. So you’re really propelling it forward. And that energy can be, you know, it’s intoxicating, it’s exciting, it’s pretty hardcore. You push people in ways that, again, are, I think, energizing, but also insanely tough. And that’s kind of chapter one of it, right? You’re bringing it to life. You’re all the time, you’ve got a small group of individuals who believe passionately in this idea that may not be taking form in a way that’s like super popular in the world, but you’re pushing and you’re pushing and then you start to see a little bit of success, and then you get even more hyperactive and tough, and then failure occurs inevitably, or at least it did for us. And then I think the second chapter of my leadership journey was at once persevering through that, knowing that we were building something important still, but trying to divorce that terrible setback from my own person and trying to understand how I could come to peace with kind of where I was at when my motto is family and excellence, and the excellence falls out and you’re going home every day and you’re just. It’s tough and you’re losing colleagues and all of that. And I think that second chapter taught me a lot, but that was definitely a distinct chapter in the book. And now the third chapter, I think, is. I don’t know how I would frame it, but it’s a bit like trying to take what worked in the first chapter and pairing it with the second chapter and also acknowledging that lots of different languages are being spoken at this company. Now, unlike the first chapter that all have to work in concert. We’ve got commercial, we’ve got manufacturing, we’ve got development, we have early stage discovery, we have various financial voices. And how do you kind of keep all of that together with a coherent view? And still that strength of putting patients first, every minute matters for the patients that we serve, but do it in a way that you feel ultimately will build the bedrock for a generational firm. So I’m just learning that this is what I’m working with Andrew on. But yeah, those are kind of the three chapters, I think about writ large.

 

Darren [00:24:17]:

I think one of the things I find founders and CEOs struggling with is talent, particularly in companies that are you would define as generational. Right. Where you’re trying to do something fundamentally different and it’s significant and it’s big and it’s hard. You by definition are asking people to do insanely difficult things and when they fall short or you’re recognizing that you need new people, it can be disruptive and tough. And I’m just wondering how you’ve dealt with what I imagine has been a recurring phenomenon for you, which is just making sure you’ve got the very best people and demanding the most out of them.

 

Neil Kumar [00:24:54]:

Yeah, I think it’s an important point because the sustainable competitive advantage at Bridge is really a people and a process. That’s all it is. It’s not I own distribution to cardiologists. It’s not I own the IP for a specific gene editor, as we discussed earlier. So how do you maintain that people in that process is something that we think a lot about. And it actually, it’s been ingrained at this company since, since we got going. So, you know, we have a lot of turnover. We have a pretty strict, I’d say, review system every year. We’ve done a lot of work and I’ve personally done a lot of work to make that completely non emotional because I think actually people who come and they enjoy it and they stay here, have a good time, there are people who come, don’t enjoy it, and they go off and do great, great things. So I’m very proud of our alumni network as well. So I view it as a place where you can learn, but it may not be for everyone for a long period of time. And I think we were able to have those conversations pretty openly with our employees. And that actually has unlimited talent. And I would say that that has improved our ability to get. You know, I was at a conference the other day and someone gave us the compliment. It’s like this firm bleeds talent. Hopefully that didn’t mean that we just bleed it out and everyone else is grabbing it. But I think we have done a good job of showing that there’s a variety of different career paths that are available to people who are very smart and hardworking. And therefore we are able to attract a lot of people who are like that. You got to remember when I joined the biotech scene, it was smaller, maybe 2009, 2010, but there weren’t a lot of career paths for young hungry folk. It was like, just do your time for 20 years and then maybe you’ll become a senior director of something. Not to say that there’s anything wrong with that career path, but I think it’s not for everyone. So I think we’ve been able to turn that on its head a little bit and get good talent because of it. But yes, it can be a severe culture in that you’re giving feedback a lot and feedback is a gift and we try to practice all of that, but I think it works.

 

Darren [00:26:53]:

Yeah, this is something that I think is a pattern I see over and over again. I want to just maybe play back to you and see if you agree with it. And I think you, by what you just said you do, is if you are trying to build a truly breakthrough or generational company, it’s not only okay to have a culture that may not be right for everyone, it’s a fundamental element. It should be distasteful to a meaningful percentage of people because that by definition means you’re building something distinctive. And to build something great, you need to be distinctive. And I find that the founders and CEOs that embrace that, don’t misuse it, but use it as a strength, are the ones that finally kind of figure out this talent issue and problem that vexes a lot of people.

 

Neil Kumar [00:27:39]:

Yeah, I agree. And there’s something. I used the word intoxicating earlier, but there is something intoxicating about being around a bunch of like minded, hungry individuals all with distinct talents. Because drug discovery and development is a crazy team sport. Like when we started, we didn’t even want an org chart. It was just a swarm of people because I don’t know how to do CMC in China and that person doesn’t know how to do this specific western blot assay for TTR stabilization. And all of us together though, when you’re hard charging, you’re really questioning everything, first principles, thinking. And you’re all together on a Sunday night, working hard. There’s something really fun about that. And it’s not for everyone, but for those people that it is, yes, I think it’s really great.

 

Darren [00:28:23]:

And maybe to return to the families and the parents and the children who sit at the center of everything. In some ways when you think about them and what’s at stake afford to not demand that level of performance from each other. So I’m sure there’s a really virtuous cycle in all of that.

 

Neil Kumar [00:28:42]:

And one of the things is our first value at the company is put patients first. And that’s if you go to almost any Biotech, there’s some version of put patients first. And what I always try to tell people is that a value is nothing until it comes in conflict with something else that’s somewhat valuable in your life. So putting patients first means not putting your colleagues feelings first, or your team first, or sometimes even your honeymoon first or your home. Unfortunately, it requires sacrifice and I’ve seen it time and time again from the individuals that have contributed mightily at bridges. Like they’ve made those sacrifices to put patients first. And I think there’s a lot of firms that say it, but I don’t see the trade offs here. We try to live that.

 

Darren [00:29:26]:

Yeah. So I promise to come back to a condition and to have you describe what is it like at the early stages of defining, unpicking a certain area, meeting parents and children. Can you give us an example of that that might bring this central part of what you’re doing to life?

 

Neil Kumar [00:29:45]:

Yeah, you know, I’ll talk about the first product that we had approved, which is one that the marketplace didn’t pay so much attention to because it only affects 150 children or so in the United States and Europe. But it’s a devastating condition called molybdenum cofactor deficiency, type A. And like all of the conditions that we try to make medicines for, the bad news is it strikes with devastating consequence. None of the children with this disease will live past three years old, absent of therapy. But the good news is it’s very well described biologically. Every single piece of the pathology arises from a specific mutation in a gene we know well called MLCS1. And so when we got involved with this condition, we actually met two parties. One was a clinical investigator who thought he had a good idea for how you could actually cure this condition or target the well described disease at its source to do something profound for kids. And then we met the parent advocates of which there were maybe 20, 20 families that were together and a few of them had already lost their children, but they were so courageous and still wanting to sort of pay forward the learnings that they had and hopefully the pushing forward this idea of what could be a medicine. And so we met with them, understood profoundly what the unmet need was, understood that there was this opportunity for us to help these kiddos. And although it wasn’t, you know, NPV huge, it was NPV positive because we were so efficient with how we ran that clinical trial. And you know, today, maybe six months ago, I had the opportunity to meet one of the young boys on our medicine now, six and a half years old, meeting most of his development milestones with this medicine that basically puts back what’s missing here, which is a monophosphate in the brain. So a beautiful story. And really the idea came to us from the clinical investigator, the courage from the patient community, and then we just did the rest and took it to the marketplace. So that, I think is a great story and emblematic of the type of work that we do. We’ve got small, small conditions like Canavan disease. These are diseases that most people have not heard of. And then we have some larger ones like ATTR cardiomyopathy, which is a good chunk of heart failure with preserved ejection fraction, or achondroplasia, which is the most common form of dwarfism. So we work in big and small when it’s genetically defined, but all of it comes together to allow us to serve patients across the board, I think, in pretty profound ways when it works.

 

Darren [00:32:16]:

Yeah. Incredible story. And is that process of picking the next condition area a centralized process, or can anyone in the company sort of come up with an idea and have autonomy to pursue it?

 

Neil Kumar [00:32:29]:

Anyone in the company can come up with the idea, but it has to go through what we call the investment committee. And the reason for that, by the way, is. And this is a little odd, but it’s very idiosyncratic to biotech. Traditionally, biotechs get started with, or oftentimes they will get started, okay, we have gene therapy for the brain, but now what disease should we go after? And so the disease is almost an afterthought. Whereas my supposition in starting Bridge was the most important thing we’re going to do is choose which problems to work on. That means the science has to be beautiful. That means we have to have the ability to target the condition at its source. And we could go through all the different diligence details that overlay those two assertions. But it’s really important because I’ve seen great teams in this industry do not so well because they’re just working on a problem that’s too challenging or not well thought out. And I’ve seen some poor teams actually do all right because they’re working on a well described condition. And the glory of human genetics, especially in this genetic disease or Mendelian disease landscape, is that it allows you to pick the right problems to work on. So we think a lot about that and it is centralized the way we choose those problems.

 

Darren [00:33:34]:

If I were somebody thinking about founding a business and disclaimer I’m not.

 

Neil Kumar [00:33:40]:

Well, you’re running a business.

 

Darren [00:33:41]:

I’m running a business and helping people that are founding businesses. I mean, I’d be pulling out so many gems from this conversation, particularly around being contrarian. The importance of mission, the power of a distinctive culture. There’s so much clarity in the idea that you had and the business that you’ve built. I’m also wondering, is there anything else if you’ve got that person that’s either thinking about or has founded a business but early on, Any lessons from your decade now that you’d offer or is there one in particular that would come to the top?

 

Neil Kumar [00:34:18]:

There are several, but maybe I’ll just say one that I was thinking about earlier this morning, which is I was trying to describe to a founder because he was talking about doing a series of meetings that he didn’t think were going to result in much. And as the glory of, of doing a startup or working on a company like ours is the low yield, high impact work is where it all happens. And so unlike, you know, when I worked at a big firm or a big consultancy, it was like, let’s target these guys because there’s a higher probability that it could work and blah, blah, blah, we sell the business. The secret finding the, you know, the bumping up against the ecosystem and like surprising to the upside. All of that stuff is low yield build work, but it’s work well worth doing. And so like, that would be like one thing that I would want to leave. There’s a lot of like conversation these days about like, oh, like you spent your time doing this. That’s a time trade off. Like, like we’re not running out of time. Most people are not running out of time. You know, I was like, you still have another hour in the day, two hours in the day, three hours. You can keep stretching, you can keep going, but doing that work, doing that, you know, probability of 1% activity, I find it can be very, very important in a biotech or any type of startup. And when you have a lot of people doing that, you’re going to get a break. It’s kind of like financing too. Everyone asks me, like, what’s your financing strategy? Well, if you’re lucky enough to have a financing strategy, like I can now because I have a little bit of a reputation. You know, Bridge has a reputation. But when I started, there was no financing strategy. It was just, you ask everyone for money and you. I could have never predicted who our first investors were going to be. But we got lucky. But we also built a muscle for the financial downturn our own downturn. There was no circumstance under which I didn’t feel like we were going to be able to go get ourselves the liquidity to keep doing the important work that we need to do for patients. So you build muscles in doing that low yield work also that I think most people just simply don’t. And you can see it now. And biotech’s been in a three year downturn. Management teams that have never really experienced how to to be hungry and scour the entirety of the landscape are failing. So yep, that’s another idea I think I would leave with people.

 

Darren [00:36:26]:

Yeah. Being a founder and CEO is an all consuming business. Your second chapter has been beginning to separate your own identity from the success of the business. But they’re so integrally tied and I’m curious to hear life outside of Bridge Bio to the extent that even makes sense to you. You’re a family man, you have interests. What does your life look like? Where do you spend your time? What brings you joy?

 

Neil Kumar [00:36:55]:

I do go back to the family and excellence piece. I think family is a big part of it. I have two younger daughters and it brings me a great deal of joy to just be at home and hanging out watching basketball with them or playing tennis or whatever. So I’d say being a father, being a husband is a big part of it. I’ve been trying to work in as much balances as possible. I read a ton. I love the page, you know, obviously not as good at talking as I am at reading or at least so I like to do that and you know, like everyone else try to try to stay active but I don’t know. I was talking to Andrew about this the other day. I think like I grew up in some circumstance where I just had a lot of time to like I love music, I adore it and like a new album just came out from Bon Iver or whatever. I’ve just been listening to it constantly and just walking around the block or whatever, taking time times to do that. Just think about stuff and that’s what reading allows you to do too. Helps me balance out and honestly it’s a fundamental part of my life. So it’s not a lot of productivity outside of work. Hopefully it’s productive at work and then I go home and I’m just hanging out or thinking or listening to good music. Yeah, but that’s important.

 

Darren [00:38:08]:

Yeah. You’ve mentioned books now a few times, specific titles. Any one in particular that you haven’t mentioned that you might say like God, if I were to name one book that was formative. It would be this one. Curious. I’m a big book reader too, so I love hearing the answers to these questions.

 

Neil Kumar [00:38:27]:

Yeah. I mean so many it’s hard to. Hard to choose from. You know, one that, that speaks to the founder experience that, that I relate people to. Or maybe two. One is Shoe Dog, which I know you’ve read.

 

Darren [00:38:39]:

It’s right behind me actually.

 

Neil Kumar [00:38:40]:

Yeah, I can see it. It’s. I didn’t appreciate to what extent Nike was Phil and the reflection. There’s a beautiful story he tells about what is Nike. It’s the person standing under the lamplight cheering the last person to cross the marathon finish line. I mean the ethos of that company is so him and how he came up. So I love that. Another book on CEOs that I really admire is called Outsiders. Eight CEOs that really live the whole I’m going to drive this business in the way that I think is theoretically right. ROICG and wac. It was across a variety of industries, but quite enlightening. And then the other book that has profoundly affected maybe three books that have profoundly affected. And I’ll stop there. The way that we built this firm is Scale by Jeffrey West. How things in a decentralized or centralized way can grow or will fail to grow. Another is called Swarm by Mark Moffat. Jeff Just how different creatures come together to solve complicated problems. And long story short, it’s not always hierarchical with one person on high telling everyone what to do. So I think there’s organizational structures that don’t serve us well when we’re trying to solve complicated things. And then the last is Strategy by Lawrence Friedman. It’s sort of a bid for the high shelves, huge book, but it’s on the history of strategy. And the best sort of takeaway that I can come to from that book is that that strategy writ large, like a ten year strategy, makes very little sense. The right strategy is to define what your core principles and values are and then react to an ever changing playing field by trying to apply it in the best and most opportunistic way. And I see science as that. I mean I don’t wake up tomorrow and say I’m only going to work on this type of therapeutic area. I’m only going to work with this type of modality. I try to stay responsive to whatever opportunities come about that helped me to help as many patients as possible. So those are the books that I. That I think about a lot, at least.

 

Darren [00:40:36]:

Wonderful. More gems. Thank you, Neil. Yeah. As we come to Close. Anything else that. That we haven’t covered that you’d want to share or maybe something we have that you’d want to maybe add to or put a finer point on?

 

Neil Kumar [00:40:51]:

I mean, I guess one thing that I was reflecting on the other day with one of my mentors is how, like, when you’re starting a company, how all the different inputs you’ve had over the course of your life sort of integrate into the thing. And I’ve been very lucky to have a great series of mentors starting in my undergraduate years on the scientific side. But I was reflecting on the fact that the co founder I was talking about earlier, Andrew Lowe, who’s a professor of economics at MIT, I met him because during my PhD at MIT, I was trying to model the way self care move and it turns out to be an autocorrelated stochastic random walk. And he just happened to be the expert in that because that’s how stocks move. So I met him 20 years ago and then 20 years later I attended one of his lectures and said, hey, we should try to apply some of your principles to starting a biotechnology firm. And likewise, my mentors from 3rd Rock are all co founders with me here and I continue to work with them. My graduate advisor, his input it in a lot of different ways to some of the science that we do, and all the way back to early albums that I listen to from Dylan, making their way into every board memo and all of that. So don’t discard anything that you sort of come through. All of it can come together in a nice way as you put together a company and make it your own. So I’ve always been struck by that. It’s kind of crazy just how many different ingredients there are that all get mixed up ultimately in making a company.

 

Darren [00:42:24]:

Yeah, it’s pretty magical. When I meet and work with founders, there’s always usually at least one thing that stands out as being really distinctive. And what I’m taking away from our conversation, having known you a bit before Neil, is there’s something really, really coherent about you and the company. Its founding, its story, its promise to the world that is particularly unique. And I imagine people listening to this conversation are picking up on that. But I just wanted to play that back for you and share that observation. It’s been incredible to sort of catch up through this conversation and to hear about this incredible company and the story behind it and your animating force in bringing it to life and sustaining it and growing it into what I. That I’m. I’m going to guess is going to be a really generational company. So thank you for your time.

 

Neil Kumar [00:43:18]:

Thank you. Appreciate the time and great to catch up again.

 

Darren [00:43:21]:

Likewise. 

It’s hard not to be deeply moved by Neil’s commitment to such an important mission and convinced of his steadfast commitment to making that mission a reality. I look forward to being with you you on the next episode of one of one. Until then, I hope you live and lead with courage, wisdom, and above all, with love.