Speaking at a Startup Health fireside chat on the future of health on Tuesday, billionaire venture capitalist Vinod Khosla jettisoned moderator Unity Stoakes' suggestion that the vaccine research and development efforts could teach health tech a thing or two about collaborating with industry incumbents.
Stoakes referred specifically to the development of the coronavirus vaccines made by Moderna and Pfizer-BioNTech, both of which have demonstrated the greater medical research field's ability to accelerate drug research and development to a pace quicker than ever thought possible. The two vaccines were authorized less than a year after development started.
Moderna's vaccine was developed in partnership with the National Institutes of Health, and although the Pfizer-BioNTech vaccine was developed outside the federal government, the Trump Administration's Operation Warp Speed has purchased 200 million doses to date.
"I can give you the politically correct answer, but the real answer is collaboration is generally BS–with some exceptions," Khosla replied, before walking his comment back with a "Let me be more nuanced."
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There's a time and a place to work with entrenched industry players
Khosla's namesake firm, Khosla Ventures, is a kingmaker among highly technical healthcare startups, particularly in biotech. The Sun Microsystems cofounder has continued to make big bets in healthcare through Khosla Ventures, including Viome, a microbiome startup that's raised $60 million, and heavily funded IPO candidate Oscar Health.
In his eyes, collaboration works only when companies scale, not in the innovation stage. In fact, the Pfizer-BioNTech partnership resembled a similar model, with the pharmaceutical giant stepping in to assist with mass production and distribution after the vaccine had been developed by BioNTech.
"The experts would have slowed this down, leaving aside the political factors," Kholsa said. "Pfizer obviously helped scale a vaccine, but if the first innovation had been done with Pfizer's experts, it would have slowed down."
Although Khosla acknowledged the role of Pfizer's vaccine research "experts" in scaling, he attributed the success of the pharma giant's vaccine to entrepreneurs, particularly the German married couple behind BioNTech. BioNTech's CEO, Dr. Ugur Sahin, cofounded the firm with his wife, Dr. Özlem Türeci, who is the chief medical officer, and BioNTech is their second company.
"When you need real out-of the-box thinking, you can't rely on experts in an area," he said. Khosla hedged this by adding that entrepreneurs get "extreme value" by taking into account expert points of view early–all while maintaining their radically different perspective. Kholsa did not elaborate on who he considers an expert, but his response indicates he does not include many entrepreneurs in that group.
Collaboration, in his eyes, is more important for scaling up. In a hypothetical situation with Tesla, Khosla asked listeners to imagine if the electric car company had taken advice from General Motors.
"They would have ended up with the EV1," Khosla said, referring to GM's failed electric car from the late 90s. "If we take advice from healthcare providers in radical innovations, we're going to end up with the EV1 equivalent."
In the wake of the pandemic's disruptions in the industry, Khosla also said he believes that the healthcare system has become more flexible and "open to experimentation," citing the now-disproven experimentation with the malarial drug hydroxychloroquine.
"Every manner of info has been done to solve this catastrophic problem," he said. "The culture of experimentation will stay with us."
