Open Door Salon

Paul Uhrig is a healthcare lawyer and digital health executive, formerly Chief Legal and Digital Health Officer at Bassett Healthcare Network and Chief Administrative, Legal and Privacy Officer at Surescripts. Eddie Qureshi is founder and CEO of Rainfall Health, an AI platform that helps hospitals manage Medicare's TEAM model.

They explain what health system executives ask before they buy AI, why so many pilots never reach scale, and why only two or three priorities ever make a C-suite agenda. Then the patient side: people connecting their medical records to ChatGPT and Claude, why that data falls outside HIPAA, the consent screens nobody reads, the 30 days after surgery, and why ambient listening stuck with clinicians.

(00:00) The consent form nobody reads

(01:55) AI, bad actors and the threat closer to home

(04:13) Cybersecurity and the 100% landing rule

(07:14) What executives ask before they buy AI

(09:00) Why pilots fail to scale

(10:31) Pitch versus pain point

(14:54) Is every health system the same?

(16:56) Patients bring AI to the exam room

(20:19) Patient data in consumer AI tools

(23:29) HIPAA, the FTC and who educates patients

(26:56) The 30 days after surgery

(31:21) 85% of health systems use AI

(32:02) Why ambient listening stuck

(35:43) What inspired their career paths

(39:01) The hardest decision or challenge

Phil Vanek, PhD, is Chief Commercialization Officer of the International Society for Cell & Gene Therapy (ISCT), chair of the CGT Catapult Technology Advisory Board and founder of Redline Bioadvisors. David H. Crean, PhD, MBA, is founder and managing partner of Cardiff Advisory and the author of Dual Fluency.

They explain what a cell and gene therapy founder has to show before an investor conversation goes anywhere: a de-risked asset, evidence the biology is real, and a manufacturing plan that is not left to the appendix. They argue for writing the target product profile first, rank capital, reimbursement and manufacturing cost, compare how the US, the UK and Europe pay for advanced therapies, and explain why deals announced at JPM start many months earlier.

(00:00) What founders have to show before the conversation starts

(05:12) Target product profile: write the label first

(09:53) Show me the data: AI, fabricated evidence, and the three pillars ranked

(14:37) Who pays: reimbursement in the US, UK and Europe

(19:16) The four-legged stool and the aducanumab lesson

(25:10) Should you build to be acquired? Who really picks the asset

(31:40) Why JPM deals start nine months earlier

(36:06) Hardening the supply chain, and why science needs capital fluency

(40:56) Career lessons, and killing a program that works

(46:02) Mentorship and advice for emerging founders

Retired Air Force Brigadier General Chad Raduege spent 29 years in communications, IT and cyber operations, commanded the White House Communications Agency, and finished his career as Director of C4/Cyber and CIO for U.S. European Command. Today he is President of Cyber, Data & Communications at Elara Nova.

He explains why he sees biopharma data as a national security matter, how ransomware differs from espionage by advanced persistent threats, and why the CEO owns cyber risk at a 40-person biotech with no CISO. He describes what an adversary could learn from a venture firm's due diligence files, how he reads the summer's incidents at Amgen, Boston Scientific and McKesson, and why the industry should build security in and share what it learns.

(00:00) First to market, first breached, and meet Chad Raduege

(05:36) Taking the Oval Office anywhere: the White House Communications Agency

(09:45) EUCOM: Afghanistan, COVID and Russia's invasion of Ukraine

(14:24) Where biopharma sits on a nation-state target list

(19:17) Ransomware vs. espionage, and the 40-person biotech with no CISO

(25:50) VC diligence files, accountability and crown jewels

(33:14) Amgen, Boston Scientific, McKesson: an adversary mapping the industry

(37:40) Build it in, don't strap it on, and the path to 29 years

(43:59) Stop casting stones: ISACs and learning together

AI arrived in drug development carrying a very large promise. Nindhana Paranthaman, Vice President of Early Clinical Development at Bicara Therapeutics, and Paul Agapow, Chief Scientific Officer at Bayezian, work on opposite sides of that promise and agree on more than the marketing would suggest.

Paranthaman names the gains that actually arrived, all of them operational, and the one that did not: more drugs advancing into the clinic. Agapow explains why a trial completed inside a year is marketing, takes the digital twin apart on logical rather than technical grounds, and estimates that about a third of what the industry is building today will still be standing in five years. They close on target herding and what an investor should ask an AI-first company.

(01:24) What AI actually delivered in clinical development

(05:24) Whether a one-year trial is marketing spin

(10:30) Digital twins, and why a twin cannot replace a patient

(16:39) What survives five years, and the breakdown

(18:48) Protocols, amendments and the unglamorous gold

(29:29) Why biology breaks AI: discovered, not invented

(36:35) Target herding and the hundredth me-too drug

(39:09) Advice for VCs, family offices and private equity

Six hundred investable opportunities in a year. Five investments. Christian Schubert, Vice President and Global Head of AbbVie Ventures, walks Lori Ellis through where the other 595 fall out, and almost none of it is about pitch quality.

Mike Goguen joins him from the other end of the market. He spent twenty years as a general partner at Sequoia Capital before founding Two Bear Capital in 2019, and has served on more than eighty company boards.

Two investors, two entirely different mandates, one table. They cover what separates a funded biotech pitch from a passed one, what loses a pitch inside the first twenty minutes, whether warm introductions still move a founder to the front of the line, why the amount raised early was almost inversely correlated with success in Goguen's own look back at the data, and what makes a rejection useful instead of vague.

(00:40) Out of 600 opportunities, five investments

(02:46) The five to ten percent in the middle, where the work is

(03:31) Is the problem big enough? Why biotech is not tech

(07:04) Passion, resilience, and the North Star nobody else believes yet

(09:58) Sequoia in 1996: should we ever do life sciences again?

(11:53) The capital gap corporate venture is stepping into

(14:04) What is the fastest pitch you have ever lost?

(16:34) What loses a pitch in the first twenty minutes

(18:07) How much diligence goes into the team, not just the founder

(20:42) Social worker and fireman: what early stage leadership actually is

(26:50) When a founder should step aside, and who says it out loud

(28:08) Do warm introductions still move you to the front of the line?

(31:05) Why raising less money early correlates with bigger outcomes

(35:13) Groupthink: the biggest fallacy in venture capital

(38:31) What a fundable company looks like in 2027 and 2028

(43:58) The anatomy of a useful no

(49:24) The fund dynamics hiding behind a rejection

(53:48) The hardest questions: a random walk into venture

(56:38) Three billion lines of code in every cell

(01:00:30) The choice that lingers

(01:02:26) Venture capitalist, philanthropist, first responder. Pick one.

Mike Goguen is Founder and Managing Partner of Two Bear Capital.

https://www.linkedin.com/in/michael-goguen-23314/

Christian Schubert is Vice President and Global Head of AbbVie Ventures.

https://www.linkedin.com/in/crs79/

Episode page: https://opendoorsalon.com/what-gets-a-biotech-pitch-funded/

David Esposito has built biotechs to exit and taken biotechs into bankruptcy. Pavel Khrimian spent most of 2026 winding down the company he co-founded, after a pharma collaboration collapsed at the diligence stage. They talk about what the last ninety days actually look like, the three questions that separate a pivot from a closure, and the obligation to patients that outlives the company.

Lori asks about the ninety days before the decision rather than the day of it, and both answers land in the same place: the data was there earlier, and it did not arrive labeled. A manufacturing delay. A term sheet that was supposed to be a hundred million, drops to eighty, then oversubscribes to a hundred and twenty five. A program that is performing but is no longer the priority.

Khrimian reduces the closure decision to three questions. Do you have a credible hypothesis or asset. Do you have the cash to test it. Do you have the time and money to reach a realistic value inflection. Two answers of no and you are closing rather than pivoting. Esposito's version is structural: after a couple of rounds of capital a company has often prioritized itself into one swim lane, and the data then makes the decision for it.

Neither treats the people as a footnote. Patients on therapy have to stay on therapy, which turns a wind-down into an operational problem of narrowing sites and continuing to ship drug. Employees who did nothing wrong need somewhere to land.

(00:00) Why founders are drawn back to biotech

(00:38) How this sponsored episode worked

(02:04) Exits, launches, and companies taken into bankruptcy

(03:37) Letting go of the obsession with control

(06:04) Reading a new data point and deciding whether to pivot

(07:35) Pay attention to every data point, not just your own

(10:26) Build a base case, then watch it move

(11:26) The acute study, and the pivot to chronic indications

(12:31) Why it is always about the team

(16:06) Healthy tension between science, finance and strategy

(17:47) Doing everything right and still losing

(19:05) A word from Lab Thread

(19:28) The ninety days before the decision

(21:21) When a pharma collaboration collapses in diligence

(23:31) Optimism as a gear, measured against cash

(25:05) Pivot or close: the three questions

(26:54) The binary swim lane, and the calls that are never clear

(29:21) What the CAR-T pivot into autoimmune teaches

(30:52) You are not rewarded for a platform anymore

(31:57) Carrying the news

(33:14) Two hundred grand in the bank and no January calendar

(34:42) Investors, patients, and your team at the same time

(35:42) Take your own shoes off first

(36:42) The obligation to patients still on therapy

(39:20) Helping your team land somewhere good

(40:17) What inspired you to take this path

(44:12) The hardest decision you have had to make

(47:10) Thank yous

David Esposito is President and Chief Executive Officer of ONL Therapeutics.

https://www.linkedin.com/in/davidesposito2/

Pavel Khrimian is Co-founder and Chief Business Officer of Deka Biosciences.

https://www.linkedin.com/in/pavel-khrimian-3219935/

This episode was made possible by Lab Thread.

Nobody went into science for the admin. Lab Thread is the integrated lab management platform that scientists actually enjoy; Built to fit the way you work, from first idea to final report. Everything connected. Nothing lost. Never in your way.

Visit labthread.com to learn more, or book a demo

Episode page: https://opendoorsalon.com/biotech-wind-down-pivot-or-close/

Newsletter: https://opendoorsalon.substack.com/

An AI fabricated a scientific citation. When Raphaël Ognar pushed back, it apologized, saying it had not wanted to fall short by giving him an unsatisfactory answer. He told it that "I don't know" would have been better than lying, and stopped using it that day.

That anecdote opens a conversation that escalates. Ryan Cawood pastes in a DNA sequence he already knows the answer to and gets a confident, wrong one back. A cell line takes nine months to build and fails at the door of a GMP facility because a chain-of-custody record has a hole in it. And the FDA does not care where your data came from: submit it, and you own it.

Ryan Cawood, PhD, is Co-Founder and CEO of Lab Thread. Raphaël Ognar is President, CEO, Co-Founder and Chairman of NKILT Therapeutics, and carried two small molecules through to approval inside big pharma before leaving to build his own company.

Both run companies with AI in the workflow. Neither will put it in the pitch deck.

(00:00) "I don't know" is a good answer

(00:24) What happens when AI goes wrong in drug discovery

(01:40) The publication that did not exist

(03:41) The AI apologized for not wanting to disappoint

(05:02) The DNA sequence it read confidently and wrong

(06:51) Who is liable when the model is wrong

(10:01) What a mistake actually looks like in a lab

(12:06) Build checkpoints into the prompt, not just at the end

(14:47) Flawed data in, confident answer out

(16:29) Failure at big pharma versus failure at a small biotech

(21:01) Trials are designed for approval, not for the real world

(25:16) When you cannot show where the answer came from

(27:25) Nine months of chain of custody, recorded on paper

(30:20) Confidence is not accuracy

(32:34) Integrating AI instead of renting it

(35:24) Greed versus outcome in the AI bubble

(37:04) Who is really paying for your AI subscription

(39:33) The energy and water nobody prices in

(41:28) AI for AI's sake, and the colleague who rewrites your email

(43:31) The pitch deck with no mention of AI

(46:07) What inspired you to take this path

(50:20) The hardest decision

The A, B, C round path that funded biotech for thirty years is not currently available. Sara Jane Demy has just come out of her own Biotech CEO Summit, where that was the main topic. Jeremy Levin, who ran Teva Pharmaceutical Industries and sat on the executive committee at Bristol-Myers Squibb, has a specific answer about where the money went instead.

Host Lori Ellis asks them where biotech capital actually is now, why chief executives have changed their minds about Chinese clinical data, and what each of them regards as the hardest decision of their career. Levin's answer to that last question involves a resignation written on a napkin.

(00:00) There's no other industry like this

(00:30) Introduction

(01:17) The troops without supplies

(04:04) What the war does to the industry

(05:59) Hormuz: plastics, fertilizer and food security

(09:45) Is China gaining from the war?

(10:25) Why CEOs now trust Chinese clinical data

(12:58) The question isn't if China leads, it's when

(14:52) What disruption did to the US innovation engine

(17:13) Innovation won't stop, it will migrate

(19:57) What gets repaired and what doesn't

(23:05) The A-B-C round model isn't there anymore

(26:49) Back to basics: be fearless

(28:50) Advice for people still inside government

(33:52) Is the foundation still standing?

(35:33) The hardest decision of your career

(39:47) The resignation written on a napkin

Sara Jane Demy is Founder and CEO of Demy-Colton, which runs Biotech Showcase, BioFuture and the Biotech CEO Summit.

Jeremy Levin is co-founder and Executive Chairman of Ovid Therapeutics, the former President and CEO of Teva Pharmaceutical Industries, and a former chairman of the Biotechnology Innovation Organization.

Episode page: https://opendoorsalon.com/where-biotech-money-goes-venture-capital/

Newsletter: https://opendoorsalon.substack.com/

Alzheimer's science is finally moving. Two disease-modifying drugs are approved. Two blood

tests are approved. Biogen has taken an anti-tau drug into Phase 3. And early-stage

neuroscience companies still cannot raise money.

Lori Ellis sits down with two investors who fund brain health from opposite ends of the

capital stack and asks the question founders actually need answered: what has to be true

before you write the check?

They do not entirely agree, and that is the useful part. One says the caution was earned by

a track record of failure. The other says the ecosystem has already turned. Both are

specific about what they need to see, and blunt about what kills a deal.

Karen Harris is Executive Director of Mission-Related Investing and Finance at the

Alzheimer's Drug Discovery Foundation, where she leads the ADDF's venture-based investment

strategy. She came to the nonprofit world after more than two decades in finance, including

Global COO of global equity capital markets at UBS and investment banker at Merrill Lynch.

Mahesh Narayanan is Managing Partner and Founder of Neuvation Ventures, a Baltimore-based

seed fund backing deep tech, medtech, diagnostics and biotech innovation in brain health.

He spent fifteen years running life-sciences startups with two exits, and started investing

after his niece was diagnosed on the autism spectrum in March 2020.

(00:00) I can tell who's going to be a good CEO

(00:45) Why neuroscience became the hardest early-stage money to raise

(04:21) What changed: approvals, payer literacy, and neuroscientists becoming investors

(07:56) The payer and prescriber conversation founders start far too late

(12:48) Anthem covers a blood-based biomarker, and why that matters

(14:21) NIH, DARPA, ARPA-H, and the dual-use advantage in brain health

(18:07) Where private equity actually fits, and where it does not

(20:11) Venture philanthropy and venture capital: convergence and divergence

(25:04) What each investor needs to see from a founder

(30:02) Red flags: part-time CEOs and founders who will not be coached

(35:05) The caddie test

(38:24) What neuro founders should be doing right now and are not

(42:03) What inspired this career path

(46:56) The hardest decision

Watch the full conversation: https://opendoorsalon.com/why-alzheimers-startups-struggle-to-raise-money/

Karen Harris: https://opendoorsalon.com/honored-guests/karen-harris/

Mahesh Narayanan: https://opendoorsalon.com/honored-guests/mahesh-narayanan/

Most biotech CEOs assume nation-state hackers are a big-pharma problem. Raja Mikkili and Anne Elise Herold Li explain why the opposite is true: the small and mid-size companies doing the innovative R&D are the more interesting target, because they are the R&D labs the big companies shop from.

Continuing the conversation that started at BIO, they break down what a nation state actually wants from a biotech (the roadmap, not the ransom), why the West Pharmaceutical breach should have been an industry wake-up call, how far down the supply chain you now have to audit, what AI-versus-AI attack recon looks like, and the four-sentence clause buried in collaboration agreements that quietly gives your data away.

Raja Mikkili is Vice President, Core Technologies and Security at Arcutis Biotherapeutics, where he leads cybersecurity strategy, data analytics, AI, and technology initiatives. His 20-plus-year career spans aerospace and defense, pharmaceuticals, private equity, and construction, including DoD- and FDA-compliant security programs at EaglePicher Technologies and Zydus Pharmaceuticals.

Anne Elise Herold Li is Managing Partner of the New York office and Shareholder at Brownstein Hyatt Farber Schreck. A Chambers-ranked, first-chair IP trial lawyer focused on biotech, pharma, and medical devices, she holds an M.P.H. from Emory, teaches biotechnology law at Fordham, and is admitted to the U.S. Supreme Court.

CHAPTERS

00:00 The vulnerability no one reads

01:33 What nation states actually target in biotech

06:23 Why small biotechs are the bigger prize

10:23 The West Pharmaceutical wake-up call

14:51 Auditing your supply chain down to the roots

19:19 Honeypots, dummy data, and vendor firewalls

23:14 AI attacking AI: recon at machine speed

27:56 The new Cold War: China and the BIOSECURE Act

31:06 The COINS Act and who gets audited

32:54 Why anonymized data is exactly what they want

35:34 Career paths and hardest challenges

42:11 Data ownership: the four-sentence vulnerability

Open Door Salon is where global healthcare is discussed by the people who build, fund, and fight for it. Hosted by Lori Ellis.

Newsletter (seven key takeaways for every episode): https://opendoorsalon.substack.com/

Website: https://opendoorsalon.com/

LinkedIn: https://www.linkedin.com/company/opendoorsalon

Raja Mikkili: https://www.linkedin.com/in/rmikkili/

Anne Elise Herold Li: https://www.linkedin.com/in/anneeliseli/