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A decade ago, I had pegged gene and cell therapies as the next frontier. As an investment banker, I was sure they would someday change how patients were treated. But a question from a biotech CEO started me thinking about not only how to pay for them, but how to offer guarantees for these therapies to payers who rightfully wanted reassurances that they were paying for something that works for their beneficiaries.

In the spring of 2013, I had just visited a lab focused on gene and cell therapies at Baylor College of Medicine. Bluebird Bio, which would soon launch a successful IPO, had licensed its technology from the same lab and was about to announce a major collaboration with Celgene and Baylor.


I sent a presentation on one of the Baylor programs to the CEO of an immunotherapy company I banked at the time. I thought his company should license and develop the technology. On a call, he came out of the gate with this: “I just have two questions for you, Emad. One, do you think this will really work? And two, if it does work, how the hell am I ever going to get paid?”

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