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Rightful accolades to Moderna and Pfizer/BioNTech for the Covid-19 vaccines they created and developed in less than a year, along with plans to use their technologies to fight other infectious diseases, such as AIDS, and even to treat cancer, have renewed enthusiasm for complex therapies. But I believe that complex therapies, for all their wonders, represent only part of the future of medicine.

Modern medicines are split into two big families: biologics and small-molecule drugs.


Complex biologic drugs are isolated from natural sources (human, animal, or microbial cells), and are generally delivered by injection. In addition to the Covid-19 mRNA vaccines, biologics include therapies that activate the immune system, replace dysfunctional enzymes, and supply essential molecules the body has stopped making, like insulin. They’re big business: In 2021, companies developing biologic drugs received more than $20 billion in new funding, a stunning 250% increase over the previous year.

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