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Neil Kumar

Neil Kumar

CEO of BridgeBio Pharma, Inc.

Aug 14, 2026

29:10
If tomorrow morning you're the new head of a new regulatory body, what kind of rules would you want to create that would make it ensure that there's proper oversight of prediction markets, but be able to operate in this industry for whoever wants to see it grow?
29:26
Yeah, it's a really great question.
29:28
And one, you know, look, we're a global prediction market because we're based on a blockchain.
29:32
And so we go where the internet goes.
29:36
And You know, that means we're constantly interacting with different regulatory authorities.
29:43
It's a very important conversations and that's across the globe.
29:48
And one thing you learn, no matter how much you want to try and say this is the one way to do things, you're never going to get there.

7 MINS LATER

36:55
And what do you think of the current mechanisms that we have in place and how do you think this is gonna evolve?
19:47
And you mentioned a couple examples, but can you describe kind of the company model you sort of did, but like the hub and spoke model or portfolio approach? How does that work?
20:05
Yeah, so basically when we were starting the company, we were trying to solve for five things at the same time.
20:10
And to solve for all of them, we had to go up and spoke.
20:13
So there's a lot of – I mean there weren't a lot.
20:15
It was really just us and Roivant at the time that were exploring this model.
20:18
But even us versus Roivant, I think we were exploring the model for – separate reasons and with separate design criteria in mind.
20:29
So for us, the first and foremost is, I believe, the picking of the right project, which may sound kind of obvious, but the picking of the right disease and the right medicine to work on is probably the most important thing we do as a team.

14 MINS LATER

34:37
And can you rewind to like, what was it about that disease? What did the landscape look like? And what gave you the conviction to think we should place an early bet here?
10:30
Tell us more about your thinking with that.
10:32
Yeah, it was really a striking readout, to be honest.
10:35
When you look at the natural history of the condition, and again, these are small data sets, but we had not thought we would be able to demonstrate functional improvement as early as one year.
10:46
Of course, a therapeutic had never really been tested, and certainly a therapeutic with this type of strength um you know biochemically what we look at is glycosylation of something called the alpha distroglycan complex and in some cases we were able to normalize that for patients that they start well below normal and we were also looking at a ck which is a function a functional measure of muscle damage And there again, we were able to return people between one and two times of what's normal.
11:16
But again, we weren't sure whether or not that would translate into better ambulation and better breathing at the 12-month time period, which is why we were running that three-year trial and continue to run it in a nested trial design.
11:27
But very hearteningly, we were able to see two things really that I thought was striking.
11:31
One, on the placebo arm, we saw uniform decline in breathing and ambulation.

7 MINS LATER

18:09
Looking back, what are some of the lessons that you've learned from that? Did it all work out like you anticipated? Yeah.
17:39
I'm wondering whether it's that question or something similar, just asking you, like 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.
17:53
Yeah, I think Zero to One was published right around the time that The Bridge was starting, maybe a year after.
17:58
But we always used to hand it out alongside T.S. Eliot's Four Quartets for anyone who starts.
18:04
Because the stuff he talks about in there, and I will answer the question, on definite optimism and secret finding and sort of feeling like you're part of a cult, but that's directed towards something productive.
18:16
All of that is really fundamental to our culture today.
18:19
The difference, I think, is although we aspire to be an engineering-like company, you know, probability of technical success is still well below 50%.
18:27
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 in the context of trying to find success? 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.

11 MINS LATER

29:39
Can you give us an example of that that might bring this central part of what you're doing to life?
Angelica Peebles
Angelica PeeblesCORRESPONDENT
34:59
So how do you see that competitive landscape looking?
35:01
Yeah, so Pfizer's done a wonderful job of building this market out over the last five years.
35:05
But what they have is sort of a semi-potent glue, if you will, gluing that tetramer back together or protein back together.
35:11
We have a super glue, if you will, the only compound with near complete stabilization on its label.
35:17
And what we're seeing as a product of that is impact of the drug as early as three months.
35:21
We've never seen that before in this space.
35:23
and a 42% reduction in cardiovascular hospitalization and death at 30 months.
Angelica Peebles
Angelica PeeblesCORRESPONDENT
35:46
So what's your outlook for the sector?

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