Brian Naughton // Mon 11 September 2017 // Filed under biotech // Tags biotech vc

Y Combinator recently announced that they want to do more biotech, specifically "health and synthetic biologies". This seems like a good thing in general, since there aren't too many incubators for biotech out there. IndieBio is the biggest, but they are completely focused on biotech, even providing lab space.

So what are YC actually investing in? Here are the biotech companies from the 2017 Winter and Summer batches (data from techcrunch: 1 2 3 4):

  • Darmiyan: Alzheimer's diagnostic
    We definitely need better Alzheimer's diagnostics, so this seems like a great thing. Usually these diagnostics are designed to help enroll prodromal patients in clinical trials (e.g., Avid), but this one seems to be for screening too, at least according to techcrunch. It's unclear to me what their technology is, though it appears to be MRI-based.
  • HelpWear: heart attack-detecting wearable
    This watch monitors heart palpitations, arrhythmias and heart attacks. I'd buy one if I were at risk... It will enter clinical trials in the "near future."
  • Oncobox: cancer genetic test
    This test appears to match cancer drugs to patients, so I guess it's similar to Foundation Medicine, though with "full DNA and RNA profiles". Usually, it's pretty expensive to do anything novel like this, since you have to convince doctors that it makes sense. So you need to fund a trial, or ten.
  • Forever Labs: autologous stem cells
    Pretty cool, but reminiscent of the whole cord blood thing. It also reminds me of the companies you can send your surplus teeth to (there are several!), which is an odd, but noninvasive, way to get stem cells from kids.
  • Cambridge Cancer Genomics: "next gen liquid biopsy, AI, smart genomics"
    This is quite a few buzzwords, especially for a British company. They say they are "applying our proprietary analysis to a tumour's genomic features", to help guide treatment. The team certainly looks solid, but similarly to Oncobox, they will likely need a bunch of money to prove this works.
  • Modern fertility: at-home fertility test
    These guys appear to be packaging a panel of useful fertility tests for home use. I don't think they have to invent anything new here, which is probably a good thing. It's "physician-ordered", which avoids FDA involvement (and is also a good phrase to search for in "DTC" genetic tests...)
  • BillionToOne: NIPT for developing countries
    (Disclaimer: I know these guys). This one makes sense to me. NIPT is a great technology that should be brought to every country.
  • PreDxion: blood test for the ER
    This appears to be a POC blood test. I don't doubt the need for new tests like this, but they'll need to go through FDA, which is a long road.
  • Clear Genetics: automated genetic counseling
    Automating genetic counseling is necessary because there are only a couple of thousand genetic counselors in the US and the tests are getting more common and more complex. It's a bit hard to believe genetic counseling is a $5B market in the US though, since that implies $2M+ revenue per genetic counselor.
  • Delee: a circulating tumor cell diagnostic
    I thought CTCs were done after On-Q-Ity but it's been a while and there's probably something new and interesting to do here. They've completed a small trial already, which is great.
  • AlemHealth: radiology imaging diagnostic
    Like BillionToOne, AlemHealth is bringing a known-useful technology to emerging markets. Perhaps surprisingly, I believe this kind of global radiology outsourcing is already common in the US (one large healthcare system sends images to Brazil and India, apparently).
  • Indee: CRISPR research tool
    This is apparently for "developing and manufacturing" cell therapies by gene editing. It sounds novel, cell therapies are here for the long-term, and there are dozens of CAR-T companies around to pay for it, so it could be cool.
  • InnaMed: home blood-testing device
    This seems to be a cartridge-based blood diagnostic, kind of like Cepheid, except for home use. I don't know if doctors like to bill for these visits or not, which can kill adoption, but if InnaMed can pull it off it seems like a great thing... Like PreDxion, they'll need FDA clearance.
  • Volt Health: electrical stimulation medical device
    This seems to be a topical neurostimulation device to treat incontinence. It looks like one of those electrical muscle stimulation belts for your abs. I instinctively like this because incontinence is one of those massive problems nobody wants to work on. Maybe the trial will be inexpensive too, since the risks seem low.

My sole criterion for a company to make the list was that it may involve FDA, CLIA/CAP, or similar. There may be omissions! — I just skimmed through the techcrunch articles.

In 2015, 18 out of 108 YC companies were labeled "biomedical". My criteria are stricter, and I count 14 out of 210 companies from 2017 as "biotech". This appears to be lower than — or at least not significantly higher than — the number in 2015, somewhat contradicting the YC quote.

Interestingly, the 2015 batch were also much more computation- and therapeutics-focused, including 20n, atomwise, Transcriptic and Notable Labs. Synbio leader Ginkgo was funded in 2014. 11 of the 14 biotechs from 2017 are diagnostics (including Clear Genetics), one is a therapy / medical device (Volt), one a research tool (Indee), and one a service I can't classify (Forever Labs).

It's a curious set of companies, surprisingly light on computation- or data-driven companies, which you'd think would be YC's strength. Also notably, I don't see any synthetic biology companies (arguably Indee?) and only Volt Health is therapeutic. By contrast, IndieBio has many (at least half?) synthetic biology companies, and several therapeutics.

Because the list is so diagnostics-focused, many of the companies on this list will need expensive trials to properly enter their markets. Perhaps the YC program is setting them up for a raise from traditional biotech VCs? I don't yet see what YC wants to do in biotech, but their statement about doing more is only a few months old, so it will be interesting to see what happens in 2018.


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