Biotech can be a breeding ground for jargon, coded language, and outright nonsense, as investors and scientists probe the depths of linguistic absurdity to explain why the thing they do is just that much more special than all the other things out there. We wanted to celebrate this proud tradition — and so, like a canny capitalist repurposing an old drug, we stole an idea.
Ambrose Bierce began “The Devil’s Dictionary” in the late 1800s, creating a satirical lexicon he updated weekly before wandering off to Mexico to die. We sought to replicate at least part of that story — hence, The Biotech Devil’s Dictionary. Entries appear semi-regularly in The Readout, our free daily biotech newsletter. (Shameless plug: Subscribe here!)
Here, in one place, are the entries we’ve compiled so far. If they offend you, just remember that Bierce defined a reporter as “a writer who guesses his way to the truth and dispels it with a tempest of words.” So there’s that.
2.0 (adj.): A largely meaningless modifier one can append to anything meant to sound at once improved but also predictably improvable. Seen as a clever way to compare the frightening world of biology to the more linear space of software engineering.
“Biotech 1.0 is the ‘Hopes And Dreams Model,’ but biotech 2.0 is the ‘Nirvana Model.’” — Credit Suisse analyst Ravi Mehrotra
-able (n.): An increasingly popular suffix one can append to just about any technology to give it a sheen of the cutting edge — even (or especially) if it has existed for years, like “wearables.”
“Patients could soon be issued ‘insideables,’ which are chips planted just under the skin, and ‘ingestibles,’ which will be tiny sensor pills that we swallow.” — Dr. Nicole Sirotin, chief of internal medicine at Cleveland Clinic Abu Dhabi
biobetter (n.): A biologic therapy that is similar to an existing product but is not technically a biosimilar because it’s purportedly better in some way. It is important to note that no regulatory body in the world accepts “biobetters” as actual things because a similar-but-better drug is referred to, simply, as “a new drug.”
“Biosimilars are frankly a transitional product. Biobetters may well eclipse biosimilars in the mAb market.” — Alan Leong, biotech analyst
clearing event (n.): A term analysts use to describe bad news for a company when they want to make it seem like, 1) they saw the whole thing coming, and, 2) the bad thing only clears the way for good things to come. For example, while some might see losing one’s job as bad, others might call it a clearing event for employment opportunities to come.
“The clearing event has occurred, been factored, and growth is on the other side.” — Cowen analyst Ken Cacciatore on a court decision that threatens Allergan’s blockbuster eye drug
clinically meaningful (adj.): A handily hard-to-define term one can use when a drug doesn’t show a statistically significant benefit in a clinical trial but needs to be marketed anyhow.
“Forty-four-month median OS in patients treated with Afinitor compared to 37.7 months for the placebo/crossover arm; not statistically significant but clinically meaningful.” — an ad for a Novartis cancer drug, spotted by Dr. Vinay Prasad
electroceutical (n.): A word used to describe non-drug technologies that can treat disease, presumably invented because “medical device,” which means exactly the same thing, is not as elegant.
“What if electroceuticals could be as effective as drugs? What if electroceuticals could be one-hundredth as effective as drugs? It would mean that electroceuticals are going to change the world.” — Marom Bikson, City College of New York professor
gene therapy (n.): A once-definite phrase that has since nebulously expanded to cover, it seems, all of biotech. That includes CAR-T, modified viruses, and, hey, why not old-fashioned protein therapies?
“First gene therapy — ‘a true living drug’ — on the cusp of FDA approval.” — The Washington Post
Holy Grail (n.): Used in biotech to describe things that would be superlatively lucrative if they actually worked, like oral insulin, disease-modifying Alzheimer’s therapies, and pain pills that can’t be abused.
“Ultra-deep sequencing to detect circulating tumor DNA has the potential to be the Holy Grail for early cancer detection in asymptomatic individuals.” — the press materials from a diagnostics company that one-upped everyone by actually naming itself “Grail“
human capital (n.): An ironically dehumanizing phrase used to liken living, breathing people to business assets, which is either a terrifying glimpse of the future or a clever bit of Marxist commentary.
“Bolstered human capital, technology platform and financial position as we expand our fully integrated organization” — Spark Therapeutics, explaining in an earnings report that it hired a new chief scientific officer.
key opinion leader (n.): Commonly abbreviated “KOL,” the phrase is meant to indicate subject-matter mastery but has been stretched and perverted to mean almost nothing, as there is no qualified governing body to regulate the keyness of one’s opinion leadership.
“On Brilinta, KOLs are mixed on odds of success in diabetic patients with coronary artery disease.” — Cowen analyst note on AstraZeneca
moonshot (n.): A term that originated with the Apollo program and has since been co-opted by Google, the MD Anderson Cancer Center, and, most recently, the vice president of the United States. It is worth noting that man has colonized the moon but has not, to date, invented a flying car or cured cancer.
“On January 12, President Obama at the State of the Union Address announced that Vice President Biden would be head of Mission Control, and the national moonshot initiative was formed.” — Dr. Patrick Soon-Shiong (who later abandoned the term after getting sued)
-ome (n.): A catch-all suffix derived from “genome” and since applied to describe any aspect of biology you want to sound expansive, including the proteome, the microbiome, and the predictome.
Roivant Sciences is “mapping the drugome, or mapping the universe of drug candidates that have already been discovered for various purposes.” — Vivek Ramaswamy, CEO of said company
optionality (n.): Execspeak used to describe a deal in which what is being acquired could potentially be more valuable in the future. But because that applies to pretty much everything, it is difficult to imagine an event with no optionality, except perhaps death, though that of course depends on your personal philosophy.
“I think the better way to think about it is our shareholders will own 44 percent of the leading biopharmaceutical company with tremendous future optionality for growth and value creation.” — Brent Saunders, CEO of Allergan, discussing a merger with Pfizer whose optionality was later destroyed by the U.S. Treasury
OS (n.): Short for “operating system,” used by biotech executives to make investors think their biology, which is unpredictable and terrifying, is akin to tech platforms, which are scalable and predictable. See: 2.0.
“Think about him as the leader of our mRNA OS.” — Stéphane Bancel, CEO of Moderna Therapeutics, which is trying to trademark that very phrase
precision (adj.): A term whose popularity as a descriptor of “medicine” has made it a catch-all for anything that could use a futuristic sprucing up, including agriculture, dating, and shoplifting.
“EPVantage has already trademarked ‘precision journalism,’ so don’t even think about it.” — Jacob Plieth, who is (hopefully) joking
probability of success (n.): A term sell-side analysts use to guess at how likely clinical trials are to meet their goals; their estimates generally range between bullish and can’t-miss, odds-on, buy-this-stock-right-now-or-you-deserve-to-be-jailed positive.
“Investor consensus remains at a coin flip, but we maintain our conviction of 60 percent-plus probability of success.” — Cowen analyst Ritu Baral on Sage Therapeutics’ treatment for a rare seizure disorder, a drug that later proved virtually indecipherable from placebo
solve (v.): An innocuous mathematics term that has recently (and wincingly) been appropriated to apply to things that are not equations and thus don’t have discrete solutions, like, say, cancer or health care.
“I’m not saying that cancer will cease to exist. But once you manage it — once you know how to control it — it’s a solved problem.” — Jasmin Fisher, senior researcher at Microsoft
transformational (adj.) and unmet need (n.): A pair of phrases one can weave into really any sentence about a new drug, as literally no one in the history of biopharma has touted its milquetoast pipeline of treatments for diseases that are perfectly well served already.
“Addressing the significant unmet need in fibrotic diseases is a key part of Bristol-Myers Squibb’s strategy to build a sustainable and diversified portfolio of transformational medicines.” — Francis Cuss, chief scientific officer of Bristol-Myers Squibb
undruggable (adj.): A word meant to describe biological targets that cannot be reached by medicine, it is used almost exclusively by people at companies working on medicines for exactly those targets, thereby negating their “undruggability” and turning the phrase into nonsense on the order of “idiot-proof.”
“In truth, I hate the term ‘undruggable,’ because it hamstrings the creative mindset necessary to hit a previously unaccessible target.” — Dr. Jay Bradner, head of the Novartis Institutes for Biomedical Research
unlock value (v.): A bit of corporate argot used to describe the process of making money, implying that “value” has been cloistered away by some dastardly villain or is perhaps buried under sediment and thus in need of biotech’s answer to fracking.
“While M&A remains Sanofi’s top priority in 2017, we performed a sum-of-the-parts analysis to determine if there’s value to be unlocked from the company’s separate business units.” — Leerink analyst Seamus Fernandez
Biotech Devil's Dictionary
I think you’ve misunderstood “clinically meaningful”. Clinically meaningful refers to the magnitude of a change in a measure of efficacy that most physicians/patients/regulators would consider to be a “meaningful” improvement for the patient.
While hard to define it’s not meaningless. Importantly, it’s very possible to show statistically significant “improvement” that is not clinically meaningful.
The “meaningful” v. “significant” distinction is occasionally a problem in clinical trials, but is a HUGE problem in epidemiology and social science.
Good piece. Another term. If you are in Pharma R&D you will quickly learn that all of your clinical trials are on the “critical path”. This statement is enough to infuse one with paranoid anxiety for 3-4 years, and if you don’t suffer a nervous breakdown before FDA Judgement Day you will be made to feel at the very least that you are single handedly responsible for each day’s delay in approval or its rejection.
When my boss asked me for the probability of success of my clinical program I always pulled a number from the place where the sun don’t shine. It was always at least 90% or he would give it the thumbs down.
Another 6.5 months of “clinically meaningful” existence could be important to those greedy grandchildren who make sure they squeeze every last nickel out of Grampy’s will.
And every biotech company is a “world leader” in whatever it does. How can they all be world leaders? It is like in Lake Wobegon, but worse. 🙂
You don’t address WHY these terms exist. They exist because pharma and biotech are fields where failure is a common and inherent part of the process. But we can’t admit that, so the flacks must describe failure as if it were success.
This is great! I hope to seem more installments in the future!
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