Inside the GLP-1 Gold Rush: Eli Lilly CEO on New Breakthroughs, Addiction & Mental Health, Pricing

Summary

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All-In Podcast: Inside the GLP-1 Gold Rush

Episode Summary
Date: September 29, 2025
Guest: Dave Ricks, CEO of Eli Lilly
Hosts: Chamath Palihapitiya, Jason Calacanis, David Sacks, David Friedberg

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Main Theme

This episode dives deep into the meteoric rise of GLP-1 drugs for weight loss and metabolic health, featuring an in-depth interview with Eli Lilly CEO Dave Ricks. The hosts and Ricks explore the origins and impact of GLP-1s, Eli Lilly's business and innovation strategy, pricing and access issues, the implications for mental health and addiction, the challenge of the gray market and IP, the future of research funding, and larger questions about the American health care ecosystem.

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Key Discussion Points and Insights

1. The Journey and Bet on GLP-1 Drugs

Timestamps: 00:04–05:08

• Market Impact: Eli Lilly’s market cap has soared, with a 1000% increase in stock since Ricks became CEO (Dave Ricks at 00:04).
• Origins of GLP-1s: The journey began in 2006 with the first GLP-1 drug as a twice-daily injection for diabetes. Early users reported weight loss as a side effect, seeding future innovation (Dave Ricks at 02:22).
• Breakthrough & Scale: In 2014, Eli Lilly scientists combined GLP-1 with another gut peptide, creating tirzepatide (now Manjaro). Phase 1 trials in Singapore were halted early due to “too much weight loss.” This set off massive investment in scaling supply chains and clinical studies (Dave Ricks at 03:35).
• Results: Manjaro achieved $8.1B in Q2 2025 revenue, making it the best-selling drug ever (Dave Ricks at 03:26).

"We had to stop the study because they were losing too much weight too quickly... From there it was just execution. We knew it was gonna be huge." – Dave Ricks (04:00)

2. Prices, Profits & Moral Imperative

Timestamps: 05:08–09:07

• Cost Dilemma: The high price ($1,000 initially, now down to $499, with ongoing reductions promised) creates both access issues and a wildly profitable business (Dave Ricks at 07:54).
• Host Challenges: Jason and Chamath press Ricks on the moral tension: “Isn’t it a moral imperative to bring this down 50% in price?” (Jason Calacanis at 07:19).
• R&D Funding Justification: Ricks emphasizes balancing price reductions with the need to fund innovation, noting a $14.2B R&D spend (25% of sales) this year.

"If we cut the price to say $100, there will be no more new medicines in this category because we'll have snuffed out essentially the incentive to create...[we] spent 25% of sales on R&D." – Dave Ricks (08:43)

3. GLP-1 Gray Market and IP Challenges

Timestamps: 05:17–06:04; 12:34–15:33

• Gray Market: An active, mostly Chinese-led gray market is emerging with peptide synthesis and copycat drugs, partially driven by lack of insurance coverage in the U.S. (Dave Ricks at 05:38).
• China and Patent Dynamics: China’s rapid, state-subsidized innovation, coupled with aggressive patent “hacking,” is driving global competition and depressing biotech valuations (Dave Ricks at 14:22).

"China's getting very good at patent hacking...they work backwards, sometimes driven by AI algorithms, to define chemical structures that will behave similarly but are outside the patent scope." – Dave Ricks (14:22)

4. Personal Stories & Societal Impact

Timestamps: 01:01–07:02; 16:41–18:33

• Jason’s Weight Loss Story: Jason credits Eli Lilly’s drugs with helping him lose over 40 pounds and dramatically improve his health and outlook, echoing the transformation for millions (Jason Calacanis at 01:01).
• Food Noise & Reset: Drugs act as a “reset,” reducing compulsive eating, with potential life-changing effects (Jason Calacanis at 07:02).
• Broad Pleiotropic Effects: Beyond weight loss, these drugs may aid metabolic health, addiction, mental health, and, in the future, longevity (Dave Ricks at 16:41).

5. Capital Allocation Strategy

Timestamps: 09:07–12:23

• Choices for Surplus: Ricks outlines Lilly’s approach toward organic R&D expansion, huge investment in U.S. manufacturing (six new plants; more to come), and strategic M&A, rather than just returning profits to shareholders.
• Human Capital: “We currently have about 4,200 PhD scientists at Lilly...about the same as MIT and Harvard combined.” (Dave Ricks at 10:27)

6. Biotech Funding Crisis

Timestamps: 12:34–14:13

• VC Pullback: Funding for biotech startups has dropped dramatically as investors chase faster returns in AI and tech; many public biotechs trade below cash value (Dave Ricks at 13:07).
• Crowded IPO Market & China’s Role: Excess biotech IPOs and China’s subsidized swarm model add pressure.

7. Lifestyle, Biohacking, and the Future of Preventive Medicine

Timestamps: 15:33–18:33

• Dave Ricks’ Routine: Focus on sleep, plant-heavy diet, movement, social relationships – not extreme biohacking. He has not (yet) used GLP-1s himself (“yet”).
• Pharma vs. Biohackers: Eli Lilly focuses on rigorously proven disease interventions, not the general “wellness” approach of biohackers, though they observe trends in real time (Dave Ricks at 17:47).
• Forward-Looking: Ricks sees a future where low-dose use of GLP-1s in people over 60 could boost general longevity.

"Over time, I think we're going to get to a point where taking pretty low doses for most people, say over 60, 58, is not a terrible idea and it may help you live longer." – Dave Ricks (17:10)

8. GLP-1s, Mental Health, and Addiction

Timestamps: 18:33–20:13

• Unexpected Effects: Clinical trials show that GLP-1 drugs reduce smoking, gambling, compulsive shopping, and possibly symptoms of mental health disorders like bipolar and major depression.
• New Therapeutics: Eli Lilly is developing GLP-1 variants with stronger neuropsychiatric benefits, targeting depression and bipolar disorder (Dave Ricks at 19:35).

"When we started doing these studies at scale, it was immediately obvious people stopped smoking. Like—a lot of people stopped smoking." – Dave Ricks (19:01)

9. Food System, Health Policy, and the Spread of Obesity

Timestamps: 20:13–21:50

• Root Cause: The American processed food system is a major driver of obesity and metabolic ill health ("We are the least healthy metabolic big country... it's the food we feed ourselves." – Dave Ricks at 20:26).
• Diet Dogma: The anti-fat, high-carb dogma (“carb thing”) of recent decades contributed heavily to today’s crisis.

10. Drug Advertising, Media, and Public Trust

Timestamps: 21:50–23:57

• Advertising Controversy: Drug companies like Lilly spend heavily on consumer advertising; Ricks is candid, saying he’d prefer less advertising and more R&D, but regulation and competitive pressure lock everyone in (“mutually assured destruction”).
• Media Conflicts: Hosts raise questions about the influence pharma ad dollars have on mainstream media coverage.

"I'd be for a system where we don't have nearly as much drug advertising, to be clear. The ads annoy people. They're poorly constructed, owing to regulation built for magazine print advertisements." – Dave Ricks (22:25)

11. AI, ChatGPT, and Patient Empowerment

Timestamps: 24:10–25:22

• Rise of LLMs in Health Research: Ricks praises the democratization of medical knowledge via AI tools, saying, “I think it's a huge plus. I do it myself…I also do it just to see what the different models are producing about our drugs” (24:26).
• Consumer Info: Patients can now arrive better informed than their doctors, changing the information dynamic in health care.

12. Public Research Funding & University Role

Timestamps: 25:22–28:02

• NIH Budget Issues: Ricks acknowledges the historic value of NIH-funded research, but questions how grant money is allocated and whether universities are always the best stewards.
• Need for Sunshine: He calls for more transparency and competitiveness in public research funding.

13. PBMs (Pharmacy Benefit Managers) & System Reform

Timestamps: 28:02–29:28

• Declining Value: Ricks suggests PBMs have outlived their original usefulness—“probably we're at the end of that S curve cycle and should get to something else” (28:21).
• Systemic Bloat: Consolidation means PBMs now prioritize their own profit over patients’, adding complexity and opacity to drug pricing for little actual benefit.

14. What’s Next? Future of Breakthrough Rx

Timestamps: 29:28–30:20

• Next Big Thing: Ricks bets the next blockbuster therapeutics will be in brain diseases: depression, dementia, autism—areas of massive unmet need and suffering.

"Part of what we try to do is allocate capital into spaces where there are no drugs, hoping to hit the dartboard... That's how we got obesity drugs." – Dave Ricks (29:29)

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Notable Quotes & Memorable Moments

• "Together, we've lost a Friedberg." – Jason Calacanis on his and Sacks’ weight loss (01:23)
• "Drug development is hard and long and requires a fair amount of failure and discipline, a huge amount of capital." – Dave Ricks (02:22)
• "Once I cycled off it for months and am now on an extremely low dose, the food noise and my discipline has come back. There's something about a certain moment where you get too far over it..." – Jason Calacanis (06:04)
• "I'm all for skepticism of science. That's what scientific process is... But if we restrict access while we're asking these questions, I worry." – Dave Ricks (21:20)
• "If you look at human suffering globally, 40% is brain disease...and what we've had so far has not worked." – Dave Ricks (29:29)
• "Do you supplement? ... Is there anything?" – David Friedberg, teasing out Ricks’ health habits (15:51)

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Timestamps for Key Segments

| Timestamp | Topic | |-----------|--------------------------------------------------------------| | 00:04 | Origins and meteoric rise of Eli Lilly and GLP-1 | | 01:01 | Jason Calacanis’ personal weight loss experience | | 03:26 | Manjaro’s record-breaking global sales | | 05:38 | The GLP-1 gray market and global copycat problem | | 07:19 | Price, profits, and the question of affordable access | | 09:07 | Capital allocation: R&D, CapEx, and buybacks | | 12:34 | The biotech funding crisis and China’s strategic competition | | 14:22 | Patent law and Chinese “patent hacking” | | 16:41 | Use of GLP-1s for longevity, biohacking trends | | 18:33 | GLP-1s for addiction, mental health, and new drug horizons | | 20:13 | American health crisis and the food system | | 21:50 | Role and impact of drug advertising in media | | 24:10 | AI, ChatGPT, and patient empowerment | | 25:22 | The future of public research funding and universities | | 28:02 | The PBM system and potential reforms | | 29:28 | The next big pharma breakthrough: Brain diseases |

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Conclusion

This episode provides an unfiltered look at the business, science, and ethics of pharma’s new frontier—from unprecedented medical breakthroughs to moral and systemic healthcare questions. Dave Ricks is candid about the trade-offs between profit, innovation, and access. The discussion weaves personal stories, public health strategy, and industry disruption into one of the most pressing conversations of the decade.

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Transcript

[Chamath Palihapitiya]

GLP1 drugs have become increasingly popular.

[Dave Ricks]

Eli Lilly coming to save us here has had its market capitalization increase by about 860% since he became CEO. And the stock price is up a little bit more than 1000%.

[Chamath Palihapitiya]

No need for needles.

[Jason Calacanis]

Eli Lilly says it has a pill.

[Dave Ricks]

Eli Lilly's experimental pill appears to work as well as the injected drug. It's everyone's job to move the science. We should always be pushing forward. Ladies and gentlemen, please welcome Eli Lilly CEO Dave Ricks. How are you? Hi, David. Good to see you. Good to see you. How are you? How are you, Dave? All right.

[Jason Calacanis]

You want to say thank you?

[Dave Ricks]

What's happening? I just want to. Dave. Yes.

[Jason Calacanis]

I don't want to make it awkward, but we were sitting here three years ago on this pod, and Chamath was calling me a fat bastard. He wasn't wrong. I was 213 pounds. I'm a svelte 172.

[Dave Ricks]

Right.

[Jason Calacanis]

And it's because of what you've done.

[Dave Ricks]

Thank you.

[Jason Calacanis]

Can I give you a hug?

[Dave Ricks]

You can, yeah. Bring it in here. Bring it in here.

[Jason Calacanis]

I appreciate it.

[Dave Ricks]

Congratulations.

[Jason Calacanis]

Also, sacks lost 20 pounds. So together we've lost a Friedberg, Ben Sachs.

[Dave Ricks]

Give him a hug. Come on. Nice, nice.

[Jason Calacanis]

How much money are you guys printing? My Lord. What do you do with it? You have real barrels. What do you do with it?

[Chamath Palihapitiya]

Can I please start?

[Jason Calacanis]

Yes, go ahead.

[Dave Ricks]

Okay. Sorry.

[Jason Calacanis]

I got four more jokes. I'll get them in.

[Chamath Palihapitiya]

In the end, I mean, you really have built one of the most incredible businesses in America, but you've done it because you took an enormous bet a long time ago.

[Dave Ricks]

Yeah.

[Chamath Palihapitiya]

Do you want to talk us through the journey and the process you had to go through and what you saw early on and how you made the bet on this class of drug?

[Dave Ricks]

Yeah. Great. And thanks for having me here. I'm trying to up my cool factor. That's what they tell me in Midwest I need to do.

[David Friedberg]

Did you get a Tomas Ford suit as well?

[Dave Ricks]

No, I'm actually disappointed in the ties. Like, I don't know. That's not.

[David Friedberg]

You and I are. You and I are.

[Dave Ricks]

I'm a guy who wears ties.

[Jason Calacanis]

Dave, Suit Supply does a great job. Just own it.

[Dave Ricks]

Okay. There we go. Just donate. Okay. So, yeah. GLP1 drugs. We all know about it. It feels like an overnight success. But what. What happened? You know, drug development is hard and long and requires a fair amount of failure and discipline, a huge amount of capital. So, actually, in 2006, we launched the first GLP1 drug. Nobody really knew the name of it. It was a twice a day injection for diabetes. But the COVID of our annual report in 2007 had a lady on it and she said, there's a quote, it says my diabetes is under control and I'm losing a little bit of weight. So that was 18 years ago. I mean, and since that time we're now we've been inventing new versions of that, solving various problems with that twice a day. We wanted to make it more convenient, needed to get the dose up and people tended to lose weight, more weight when you got the dose up. And then Tirzepatide, which you ask how much money we're making. But actually in Q2 we reported global sales which surpassed Keytruda to becoming the best selling drug in the world. Actually the best selling drug in the world of all time. In Q2 this year.

[Jason Calacanis]

How much did it make in Q2?

[Dave Ricks]

$8.1 billion in revenue and just in the quarter growing at 80%. Yeah.

[Jason Calacanis]

And how many people are on a GLP1 globally now?

[Dave Ricks]

I'd estimate around 20 million take prescription GLP1s. Some unknown amount of people take non prescription. But anyway, so that would be compounding. Compounded or synthetic. Yeah. Or just like not for human use. We can talk about all that. Yeah. So anyway, 2014 comes along. Four scientists at Lilly decided to combine GLP1 with another peptide that your stomach produces when you eat. That's appetite suppressing. They made the single molecule called Tirzepatide. That's what's Manjaro now. But that happened in 2014, 2016. I was named a CEO and I got a call that fall and one of our chief scientists called me and said, hey, we have to stop an early phase study for Tirzepatide. That's usually a bad call. So I'm like, oh, like this is the follow up to our second gen version of the GLP1. He said, no, no, it's actually good news. We were running this study in Singapore with healthy male volunteers. You can imagine what a healthy male Singaporean looks like at baseline, right? Not gcal, they're not overweight. And we had to stop the study because they were losing too much weight too quickly. They're basically not eating. So scientists like, actually it's good news. We can tune the dose down, we can work with this. And from there it was kind of just execution. We knew it was gonna be huge and we started building out supply chain, building out factories, running a massive clinical program. We currently have over 100 clinical studies with the medicine going on for all kinds of other uses as well, not just slowing down.

[Chamath Palihapitiya]

We're going to go there in one sec, but I just want to go back to this. So the problem now, and maybe you can comment on this, is you have this enormous success.

[Dave Ricks]

Yeah.

[Chamath Palihapitiya]

There is a very active gray market, particularly in China, peptide synthesis that are producing drugs that are basically the equivalent of your drug, working around copies. Talk to us about that. How do you deal with that and what do you do about that and what should people do about that and when they encounter it?

[Dave Ricks]

Yeah, it's an unusual situation. I think there's always been counterfeit medicines. We're not used to it in the United States because we one have a, for most people, a pretty good system to subsidize some of the benefit via the insurance markets. So there's not a lot of incentive to go outside the system. That's different for these drugs because insurance quality is poor. I don't know if you bought out of your own pocket, but most people have. And so did you pay out of pocket?

[Jason Calacanis]

Interestingly, when I first got it four years ago, I had this revelation when I was in Forta de Mar and I had heard Tim Ferriss talk about it on his podcast with a friend of mine, Kevin Rose. And I went to my doctor and I said, hey, I want to get on this. He said, what is that? He said, oh, no, you don't need that. That's for people who are diabetic. You're not even pre diabetic. I said, I want to do it for weight loss. It's off market. He said, I don't know if I can do that. I said, I'm going to get a different doctor if you don't. And he said, let me try. And he got it on prescription after I lost 20 pounds and my BMI got below 30, which really, I mean, I don't want to get emotional, but I got three daughters. I want to stick around. And it really changed my life incredibly. And in many ways I was embarrassed that I couldn't have the discipline to do it. And then I realized there was a food noise that I had that was constantly screaming. And once I cycled off of it for many months and now I'm on extremely low dose, the food noise and my discipline has come back. There's something about a certain moment where you get too far over it. So now I do have to pay for.

[Dave Ricks]

It's kind of a reset drug.

[Jason Calacanis]

Yes.

[Chamath Palihapitiya]

You've always bought his brand of drug.

[Jason Calacanis]

And I Think the question I have for you about this big picture is there's a lot of demand for it. It is still a bit too expensive. You're wildly profitable. This is going to be a pill format. I think you're.

[Dave Ricks]

Yeah, that's ours. That's yours. That's coming next year.

[Jason Calacanis]

So is there some thinking when your head hits the pillow, hey, I'm having such a profound impact on so many people's lives. All of the diseases we have are downstream of obesity. We know that this thing is helping with many other things. Do you have a moral imperative to bring this down 50% in price? I would think that must weigh on your conscience, that it's too expensive and you're too profitable in a way and there are shareholders who want you to print money. But there are lives at stake here and there's longevity and there's health spend. So maybe unpack that.

[Dave Ricks]

Yeah, we're committed to bringing the pricing down. And I want to come back to the supply situation because that led to some of the compounding but also affects pricing. You know, we've led in reducing the out of pocket costs. But from it was originally $1,000. Now it's 499 from us. We'll push that down further with new medicines like orals.

[Jason Calacanis]

What's the goal for orals?

[Dave Ricks]

The main goal is to get it reimbursed. Why is it we pay for antihypertensive drugs that the moment you stop taking them, you have the same exact risk as before? But we don't pay for anti obesity drugs. That makes no sense to me. Why do we pay for surgeries that don't work but we don't pay for these?

[Jason Calacanis]

What's the number on the pill? What's the target? You can tell us.

[Dave Ricks]

Yeah, I don't have a target in my mind, but lowers the direction two, three. We've told the street expect single digit deflation in this category over time.

[Jason Calacanis]

5% a year it goes down or more.

[David Friedberg]

Yeah, or more.

[Dave Ricks]

10%.

[Jason Calacanis]

So you get it down from 5.

[Dave Ricks]

But here's the risk, Jason, is if we cut the price to say, I don't know, $100, there will be no more new medicines in this category because we'll have snuffed out essentially the incentive to create new, the next thing R and D. So we have to balance that. We want to create the next better medicine. We spent 25% of sales on R and D this year. That'll be $14.2 billion. Wow. That has to get paid for, of course. And we pay for it through revenue.

[David Friedberg]

So with the cash flow that the business is generating, is that how you think about capital allocation? Some percent to R&D, some percent I'm assuming to CapEx and supply chain durability, some percent maybe to buybacks. I mean, how do you think about where the capital should be allocated? And maybe on the R and D side you can tell us a little bit about diversification and how else you think about deploying capital?

[Dave Ricks]

Yeah, well, I think we've had this totally asymmetric success. So what do we do with it? I think one version of it is to sort of play out the cash flow game, return it to shareholders and return at some future date, remembering that in pharma we have no enduring franchise. Everything we make goes to zero because of the patent system. So in 2030 something Manjaro will go to zero. Yeah. And so should we think about our company as one that will just return to the previous baseline, send all that money back to our shareholders who took that risk over 15, 20 years with us and paid them back? That's a little bit like, I don't know how kind of Apple is running their company, right?

[Chamath Palihapitiya]

Yeah.

[Dave Ricks]

And that's viable. That's great for shareholders. At Lilly, we think about our job a little differently. We want to create a solution to some other problem people have and we think we're good at that and can uniquely do it. So we should try, we should not try to no end. That's wasteful. You can just bury all that money. And that's sort of the history of the industry is people have found success, wasted money, they go back to the baseline anyway, but the shareholders don't get rewarded. So we're running this experiment now. We're betting a lot on organic RD build out. We currently have about 4200 PhD scientists at Lilly, by the way. It's about the same as MIT and Harvard combined. So the scale of the science enterprise is huge.

[Chamath Palihapitiya]

Dave, how do you push people on the risk spectrum? There's a tragedy of riches that can happen because you're so successful. There's this one drug. There could be some emergent scientist in your organization who wants to take a long shot but then just doesn't feel motivated because it's just like this is not going to do anything. How do you get that person unlocked so that they go for the big moonshot?

[Dave Ricks]

You mean that their idea isn't big enough to matter?

[Chamath Palihapitiya]

They think that, but they may not know. They may stumble in a different path.

[Dave Ricks]

I don't Think that's our bigger problem. I think in big companies in general, and pharma companies maybe in particular, the bigger problem is people thinking they have a big idea but having no way to advance it. So I'm trying to work on that side, which is if you think you have something that could be big, how does it become easier to advance your idea in our company versus leaving us and raising money in venture? We can talk about venture and biotech in a second because it's totally, totally broken. Broken right now. But anyway, back to David's question. So first priority, invest in organic R and D. Secondly, build out the supply chain. What's different about Manjaro and the follow on drugs is they're injectable drugs. These are very capital intensive, technically difficult things to scale. We've committed with President Trump to build all that in the US we're currently constructing six plants. We're going to announce four more in the next six months. I was hoping to be able to announce one today, but that'll come in a few weeks. So yeah, this is creating 20,000 construction jobs in this period and ultimately five or six, 6,000 manufacturing jobs. And so we'll become a net exporter at scale for these. And unless some Chinese state owned enterprise gets in this business, it'll be very hard for others to build that out and follow.

[Jason Calacanis]

Well, they're doing it in the car.

[Dave Ricks]

Business, so yeah, if they're determined they might. But then the final is actually to buy external innovation where it makes sense to tuck it in and maybe that leads us to marketplaces.

[Chamath Palihapitiya]

You bought that gene therapy, right?

[Dave Ricks]

Yeah, we recently bought a gene therapy company in June. We can talk about that. But we're doing a big deal about every two weeks. Most of them are smallish. Biotech funding right now is a dumpster fire. Peak got to about 20 billion in new checks a year into biotech. We're now around five.

[David Friedberg]

Just walk the audience through the dynamics. Why is biotech cratered? Why is it so hard for capital to flow back in? What are the dynamics that are driving this market condition right now?

[Dave Ricks]

There's many factors, but the first one is competition for other venture ideas driven by the industry you guys are in. Right? So there's just a crowd out going on with AI and other things that if your cycle time to return is just more visible or faster. Biotech is hard and slow. Secondly, I think too many biotechs IPO'd in the last decade and so the liquidity market has sort of collapsed because there's a lot of investors deeply underwater. Half of biotech that's publicly traded is trading at or below cash. So investors look at that and say, what's my future here? Unless you can really analyze the technology and take a differentiated bet on the drugs they're working on, I think general investors don't want to participate in that. And then you have China, which is the other factor. Right. So China is investing heavily like they do every other state owned thing. They're subsidizing their own companies. They have like a swarm model here where they'll subsidize many small things really against follow on ideas, betting they can execute faster than us. It's a national priority for a long time.

[David Friedberg]

Can you talk about the patent issue there? The patent and IP issue. So in the us you know, when we make a filing and what goes on with the.

[Jason Calacanis]

They just don't respect any of our ip, do they?

[Dave Ricks]

Well, I think right now they are okay amongst. So if I have a patent and I file and launch a product, I don't see immediate copies because it's in their interest to have a patent system right now for the reason you're raising. So we changed the patent laws in the US in 2011. I think the American Events act, where it's first to file used to be first to invent. And all the patent litigation we had was all about whose lab notebook said January 5th versus January 4th on this invention. That was the case. Not did you file it in a reasonable time, but did you invent it first? Now it's first to file. So there's no question about we don't care who invented it first, it's just who got into the patent office as a consequence of that. Our biotech companies and big companies like Lilly, Pfizer, et cetera, we file as soon as we can because we don't get beat on first to file. What does that do? A patent exposes the invention to the world. China's getting very good at patent hacking. So what they do is they look at that chemical structure. They work backwards, sometimes driven by AI algorithms define chemical structures that will behave similarly but are outside the patent scope and they go fast. So they're really quite a derivative biotech market. But that is also hurting biotech valuations in a significant way. Dave, how old are you?

[Jason Calacanis]

How old are you?

[Dave Ricks]

I'm 58.

[Jason Calacanis]

You're 58? You look great.

[Dave Ricks]

Thank you.

[Jason Calacanis]

You look like 40. What do you want?

[Dave Ricks]

Are you hitting on me?

[Jason Calacanis]

I'm off the menu. Come on. You look great. You got some off the Menu stuff going on. What do you got? You're on the Wolverine. You on BPC1?

[David Friedberg]

It's actually an interesting question. What is your lifestyle routine like? Do you supplement? Is there anything el.

[Dave Ricks]

Do you have Brian Johnson coming? Okay. I follow him on X. I'm not doing the Brian Johnson.

[Jason Calacanis]

He's the opposite of you. He looks like he's dying. You're handsome. That guy looks like he's turning into Lestat. That's a vampire.

[Dave Ricks]

There's another Brian Johnson, the Liver King. I don't know if you ever followed him. Yeah, both of these guys are taking it too far. But seriously, I get up early, I work out, I read, try to go to bed early.

[Jason Calacanis]

Sleep is important.

[Dave Ricks]

Sleep. Okay. There's like four things in life that I think really matter where there's evidence. Sleep, eating, healthy foods, mostly plants, movement and social relationships. I think those are the things that over time. Because that's how weird.

[Jason Calacanis]

Because I got a meditation app if you got a beat.

[Dave Ricks]

My wife tried to get me to do that. My wife tried. I haven't tried yours.

[Chamath Palihapitiya]

Have you been motivated to try some of these drugs prophylactically?

[Dave Ricks]

You know, people ask me if I've used the GLP1 drugs. I haven't, but yet is my answer. Because what's happening? As with all medicine technologies, you start with the sickest and most extreme cases and you work your way as you prove safety to general use. I think what we're seeing now with the broad benefits, everything from metabolic disease, less drinking, lower inflammation. Our competitor Novo's gonna read out a study in a few months on dementia risk. It probably won't be positive, that's my guess, but it will probably be in the right direction. So you have these sort of general, what scientists would say pleiotropic effect, like broad based, positive things. I think we're going to get to a point where taking pretty low doses for most people, say over 60, 58, is not a terrible idea and it may help you live longer.

[Jason Calacanis]

I just want to follow up on this one specifically. These peptides are becoming quite the rage in the biohacking space. Have you been tracking the Wolverine Protocol, BPC157 and the tremendous impact people are reporting from it.

[Dave Ricks]

There's lots of communities like this trying different things we don't ever recommend because we live in a world of clinical studies and FDA approvals.

[Jason Calacanis]

But you watch it, of course.

[Dave Ricks]

Yeah.

[Jason Calacanis]

And what do you think of those specifically? Are you pursuing them?

[Dave Ricks]

There are broad. Well, we're pursuing them in the path we do, which is taking those disease states or people with the pre disease state, like pre diabetes. And then we study it and we prove an outcome. So we did that with Manjaro and showed a 93% reduction in conversion from prediabetes to diabetes. That's kind of how we work is like slicing the medical stack. These guys are coming at it the other way, which is sort of saying, I'm already healthy. Can I generally stay healthier with small doses or other regimens, supplements? That's not our game, but we watch it.

[Chamath Palihapitiya]

There's a handful of drugs that I would say are epidemically prescribed in America. Probably at the top of the list would be SSRIs and antidepressants. And there's a lot of anecdotal evidence that GLPS and this class of drug actually is quite helpful with just the psychological health of an individual. Can you talk to us about that? Like, what's ongoing? What is a readout that you think could be transformational in that space?

[Dave Ricks]

Yeah, this is interesting. I mean, sometimes we engineer a medicine to do something like we did glp, gip, tirzepatite to reduce body weight, lower blood sugar and lipids. And then sometimes along the way, you discover an effect you didn't predict. So one of those is like smoking cessation. When we started doing these studies at scale, it was immediately obvious people stopped smoking. Like a lot of people stopped smoking.

[Jason Calacanis]

Also gambling.

[Dave Ricks]

Gambling and online shopping, all kinds of problems.

[Jason Calacanis]

This is why on it. Because he was stuck in the game.

[Chamath Palihapitiya]

Poker is not gambling. But go on.

[Jason Calacanis]

So anyway, anyway, I was talking about craps.

[Dave Ricks]

So then there have been reports and there's a big VA study that read out. And we know our veterans suffer from a lot of mental health. Yeah. And there were pretty dramatic reductions for those that were using GLP1s who had diabetes. So we are now, right now, starting studies in bipolar disorder and major depressive disorder, along with these addictive hedonic pathways where you're sort of self medicating with a new GLP one, a different one that probably has a little less weight loss but a little more brain activity, really so dialed in for these uses. So we'll get that drug in three or four years if it works. And I think it could really change some of these terrible mental health conditions.

[Chamath Palihapitiya]

Well, can you take a step back maybe and jump off from SSRIs? Give us a description of the landscape of the American human health, the MAHA movement. You know what Bobby and his team are now doing at hhs.

[Dave Ricks]

Yeah, long overdue. I mean, I think the, the food system in particular, you're working on this, but could be changed in a much more positive way. I think we are the least healthy metabolic big country and probably the reason for that is the food we feed ourselves. Processed food chemicals, highly processed food chemicals. This whole carb thing that went on for 30 years, which has been totally debunked. And food companies have a lot of influence and they've.

[David Friedberg]

You're saying the antique carpenter, the low.

[Dave Ricks]

Carb or no carb thing, the anti fat, high carb diets, which we were feeding people for 30 years. And I think most people don't believe in that anymore, but it led to a big part of the obesity curve, glycemic index kind of thing. So I'm all for all that and I think we should reform that and find ways to make quality food cheaper and more accessible.

[Jason Calacanis]

You'll probably like that. He's shaking it up.

[Dave Ricks]

It's a big cartoon part to Bobby Kennedy. I think that part I think we have a lot of alignment on. I worry about. I'm all for skepticism of science. That's what scientific process is. It's questioning and challenging. I worry about some of the stuff going on with vaccines right now because I don't see why we're asking these questions, but it's okay to ask them. But if we restrict access while we're asking them, I worry about that. That hasn't really affected the medicine world. We don't make vaccines. But at least recently we have.

[Jason Calacanis]

Let me ask you a hard question.

[Dave Ricks]

Yeah.

[Jason Calacanis]

The mainstream media in many cases make 25, 50% of their revenue off of advertising from companies like yours?

[Dave Ricks]

Yes.

[Jason Calacanis]

We allow you to advertise. Should we allow you to advertise and have you captured that mainstream media, Is that the intent when Anderson Cooper makes double digits of his money from your firms?

[Dave Ricks]

Well, I would be for a system where we don't have nearly as much drug advertising, to be clear. Yeah, yeah.

[Jason Calacanis]

That's paradoxical. How do you then you just want to rise based on your reputation.

[Dave Ricks]

Mutually assured destruction. Right? The ads annoy people. They're poorly constructed. Why? Because of regulation built. Believe it or not, if you read the regulation. 1992 FDA published a regulation on advertising built for magazine print advertisements.

[Jason Calacanis]

Yes.

[Dave Ricks]

And now we have to follow that regulation for TV advertisements, which is why you have the scrolling side effects as if they were printed on the back of the ad. That's literally how we're here. So the ads are poor. They don't represent the patients we're serving, et cetera. By the way, more than half of our consumer spending to reach consumers is not on tv. Does it work for you?

[Jason Calacanis]

Does it move the needle when you do a big ad buy?

[Dave Ricks]

It does, unfortunately. That's why people keep doing it. Of course, the productivity of that is debased when your competitor does it. But then everyone wants to go up above the next prisoner's dilemma. Yeah, a little bit. So I would be for a system where that got reduced.

[Jason Calacanis]

Okay.

[Dave Ricks]

There's been a lot of legal actions that said that were fought over this through the years. And it's pretty clear under First Amendment we can do it. It's hard to regulate. There's been some efforts in Congress to tax it differently. I'm okay with that. Yeah, it doesn't move my needle at all.

[Jason Calacanis]

You'd rather see that money go into R and D? I would.

[Dave Ricks]

R and D or legitimate ways to reach patients. I think consumers need to play a bigger role in their health care. I think that's part of what Maha is about, is a reaction to the system hasn't served me. The experts haven't served me. So I think people need better information. It could come from us. That's great. I just think on TV probably, yeah.

[David Friedberg]

You'Re not going to know what's available off the shelf on the Dr. Shelf of TU without any sort of knowledge or information.

[Dave Ricks]

Truth is, most primary care doctors are way too busy to even attend a continuing education, even know what's happening.

[Jason Calacanis]

What do you think people think of people? What do you think of people using ChatGPT and large language models to do their research and then they come to their doctors, sometimes with much deeper research than the doctor's aware of. Is this a plus or a minus? Do you trust it? Do you do it yourself?

[Dave Ricks]

I think it's a huge plus, I would say. And I do do it myself. I also do it just to see what the different models are producing about our drugs. Yeah, it's like an audit, but mostly it's accurate. And they've. It's gotten better over the last two years, I'd say substantially better. And many, including Google to their credit, have a way to sort of click through and check the facts directly, which is a useful thing. They've served that up a little more proactively. That's good.

[Jason Calacanis]

Do you want directly with them for.

[Dave Ricks]

Consumers owning their health and for more.

[Jason Calacanis]

Information, do you work directly with them? Do you have an ARM that will go to Grok, go to Gemini and say, hey, we did These searches. Here's some things you need to improve.

[Dave Ricks]

So we've pointed things out. When there are mistakes, it does feel a little bit like we're lobbying into a black hole. And maybe that's a capacity issue on their end or maybe it's a they're taking the point of view that our model's just trained on the Internet, the corpus of information, Reddit. Yeah, right. And it is what it is.

[Chamath Palihapitiya]

We don't want to own the bastion of intellectual.

[Dave Ricks]

We don't want to own the outcome of Reddit.

[David Friedberg]

Before we run out of time, I just want to get your view on research funding in this country. The NIH budget cuts have been proposed. What will the follow on effect be? Are these cuts going to be to low roi, research programs that ultimately wouldn't have translated into the clinic and into improving lives? Or are you worried about NIH funding cuts and what they're going to do to the pipeline of therapeutics in America? When will we realize the effects of that?

[Dave Ricks]

Yeah, great question. I don't think anyone knows the answers to those. It's not obvious, let me put it that way. No doubt that the NIH over its history has done some landmark things that no market could do. And I'm for more of that mapping the human genome megaproject that could only be done by government and undoubtedly produced a ton of good and economic value for the country. I think if you look at the first of all, NIH total budget is a little over $40 billion. Most of that is extramural. They're granting that to institutions in smaller checks, sometimes very small checks. I personally kind of wonder what the impact of that. Is it sort of a VC model where we spread a ton of bets and a few of those will bloom into giant successes? Or is it just sort of filtered out without a strategy? I think that's a question that should be asked and maybe Jay's asking that. I think the other problem with the NIH granting is as you do that like any government mechanism, it gets influenced by the people who are making the grants. Who are those people? People receiving grants. So there was a little bit of a back scratching issue here and I think exposing some sunshine onto that to sort of say what is that process? Is it truly competitive and is it truly pursuing ideas that the market can't solve itself?

[David Friedberg]

And should it be done at universities? Let me just ask you this. Are universities the right research institutions today? And going forward? We've got two university leads tomorrow that we're going to have a conversation with about this topic amongst others. But what's your view when you look around the world at how research is done? Ex us. What's the right model? Is this the right model?

[Dave Ricks]

Probably too much that way. I'm on the board of an R1 university so I have to. I'm a little biased maybe myself, but I think a lot of good things have happened in universities but we should not exclude that to other applicants. I think there could be a place for other participants.

[Chamath Palihapitiya]

Dave, tomorrow we're going to have Mark Cuban.

[Dave Ricks]

Yeah, great.

[Chamath Palihapitiya]

And we're going to talk about PBMs.

[Dave Ricks]

Yeah.

[Chamath Palihapitiya]

And one of the big.

[Dave Ricks]

He's on fire.

[Chamath Palihapitiya]

Well, one of the big boogeymen in health care are these PBMs. Can you just explain quickly, 30 seconds. What do they do and what's your view on whether they should even exist in American healthcare?

[Dave Ricks]

Probably we're at the end of that S cycle and we should get to something else. We actually owned a PBM in the 90s. Why did they exist? Two reasons to match up claims. So you can go into any pharmacy in the country with a card that says here's my benefit and that benefit can be adjudicated to you. That was a big IT problem in 1993. It's not really a big IT problem now. And there's dozens of these so called transparent or light PBMs. Actually our company is moving to one off of one of the mainline ones because it's in our business interest. But also their service is better. The other thing is negotiate like bulk discounts. So gather up a bunch of employers or plans, go to the drug companies, get a lower deal. I think that's fine. I'm for that too. What happened is, you know the like any consolidated terminal state of an industry. What's the term the insecuration of their service is they just, they just become. So every action they make is about their benefit, not the customer. And that's what's happened. That's why everybody hates them. Sachs GLP has kind of came out of nowhere as this big category. If you had to guess what do you think the next big surprise category.

[David Friedberg]

Would be that we're not thinking about?

[Dave Ricks]

It's hard to predict that, but I would say probably a brain disease. I think if you look at human suffering globally, 40% is brain diseases. And it's so broad we could spend a whole panel talking about them. And what we've had so far has not worked. You know when Bobby's raising the question why do we have so much autism? That's a great question. What's causing it? Depression rates despite the advent of, I mean, we invented Prozac. So many drugs, people are aided but it's not solved. We still have lots of depression in this country and maybe it's growing in youth. So these are huge problems as our population ages. Dementia and brain, you know, these. So I'd bet there. Part of what we try to do is allocate capital into spaces where there are no drugs, hoping, you know, to hit the dartboard where there isn't a competitor. That's how we got obesity drugs. We're working on that, but it'll be hard to. It's hard to predict.

[Chamath Palihapitiya]

Ladies and gentlemen, please.

[Dave Ricks]

Yeah, thank you.

[David Friedberg]

David Ricks. David, Rick.

[Chamath Palihapitiya]

Thanks, bro.

[Dave Ricks]

Great to see you. Okay, great. Thank you, David. Yeah, thanks, David. I appreciate it. Congratulations, my man. I appreciate it.