After a personal journey and interest in Alzheimer's Disease (AD) by Bill Gates, Gates Ventures set out to find the best way to accelerate innovation in the field of AD. In partnership with the Alzheimer's Drug Discovery Foundation, Gates Ventures created the Diagnostics Accelerator (DxA) to fund innovations as a venture philanthropy fund. The AD field had seen rapid advances in therapeutics, and as such, large corporations were hesitant to take venture funding which meant potentially losing control and having other opinions on the Board. Instead, these companies were turning to other non-dilutive sources of funding. The DxA, and GV, sat at a crossroads and needed to determine where to go next to fulfill their mission.

In early 2024, Ruth Jones, head of digital banking at Signa Bank, a (fictitious) European consumer bank, was thinking about how to best incorporate GenAI capabilities to improve efficiencies and create new ways to improve the customer experience. Where were the biggest opportunities? How could the bank incorporate GenAI to better personalize the customer experience? And what were the most effective strategies to mitigate the number of product and enterprise risks that would arise? Jones needed to ensure that as the technology was increasingly embedded and incorporated across the bank's operating systems, that there would be no negative fallout on its consumers or its reputation.

Supplements the (A) case, 824020. Following on the negotiations detailed in the Miracle Therapeutics (A) case, Beth Sharp and Jennifer Brilliant from Miracle Therapeutics face new challenges with their company's funding and intellectual property (IP) after several missteps. The company and its young CEO are at a crossroads and must solve the challenges faced by many early-stage life science companies. The case follows how they navigate these issues to set Miracle on the right course.

In 2019, Moderna faced long odds of survival having failed to develop a successful clinical program out of the vast platform technology they had built around mRNA. Nearly overnight, the company skyrocketed to success with a vaccine for COVID-19, leading to an extremely fast ramp-up in manufacturing relying heavily on contract manufacturing organizations (CMOs) to produce hundreds of millions of doses of a single vaccine. However, on the heels of Moderna's COVID success, the company had more than 40 clinical programs in the pipeline, and as they moved towards personalized vaccines, had to determine what the future of manufacturing would look like for a company that needed to produce massive amounts of certain products and a handful of doses of others.

Born out of a desire to bring technological advances in enterprise software into the healthcare vertical, Peter Gassner and Matt Wallach founded Veeva to bring life sciences companies into the digital age for data management in both the commercial and R&D sectors. Over the course of years of growth, the company expanded to take a commanding share of the market and become the nearly-uniform "operating system" for life sciences companies. Veeva also became the first Public Benefits Corporation (PBC) in the U.S. to enshrine their objectives for the industry within their business model and as one of five stakeholders, along with shareholders, as a for-profit company. Veeva is now at a crossroads and must decide where to go to ensure compliance with their objectives as a PBC, continue their growth and expansion, and ensure they maintain market share. What should the company do?

After pivoting from a focus on hardware to a focus on scientific data, TetraScience, led by veteran SaaS executive, Patrick Grady and Founder Spin Wang, has embarked on a journey from nearly cash-out to a player in the scientific data management space. This case focuses on challenges within the scientific data space today, including TetraScience's approach to building a two-sided network, and how the company plans to utilize the pivot as a way to address one or both sides of that network and build upon their desired new business model. Where should TetraScience look to expand their total addressable market (TAM) and capture market share in an industry where companies know they have a need to solve their data issues, but have a ton of inertia holding the industry within the status quo?

After publicly declaring that they would not enter the contract research organization (CRO) business in 2017, Thermo Fisher purchased Pharmaceutical Product Development (PPD), one of the biggest players in the CRO space, in 2021. Much had changed in the intervening years, but questions still remained concerning the strategic about-face. Thermo Fisher, often referred to as the 800lb gorilla in the room, was already nearly a one-stop-shop for biotech and pharma companies. Now, with the acquisition complete, Thermo Fisher and its customers faced a bit of a reckoning, with many potential paths forward. What would the right path for Thermo Fisher and its customers be?

Catalent's newly appointed CEO, Alessandro Maselli, experienced the highs of the pharmaceutical contract development manufacturing (CDMO) space during COVID-19 while helping Moderna and others bring vaccines to market quickly and safely. After rushing to add capacity to help deal with the pandemic, demand for CDMO services dried up post-pandemic, leaving Maselli and Catalent to pick up the pieces. Once considered as an acquisition target by other industry giants, Catalent dealt with several struggles, including a departing CFO, several issues with plants, and declining demand. How can Maselli turn the ship around and drive Catalent to even higher heights moving forward?

After selling the PerkinElmer name and several ancillary business units, Prahlad Singh (CEO) and his team at the newly christened Revvity faced a challenge on how best to capitalize on the opportunities ahead for the business and emerge as winners within the Life Sciences and Diagnostics industries. Would the focus on Life Sciences and Diagnostics allow Singh to capture the value in the market that eluded him when PerkinElmer was saddled with other non-core businesses, or would challenges persist by trading at lower multiples than their peers? Singh and the company had a clean slate, and needed to craft a corporate strategy that focused on core strengths and showcased the unpolished gems that Revvity had acquired and polished into a global stable of respected brands.

Abraham Heifets and his co-founder, Izhar Wallach, had founded Atomwise to develop i) an AI engine to transform drug discovery by creating better medicines faster, and ii) a machine learning-based discovery engine that combined the power of convolutional neural networks with massive chemical libraries to discover new small molecule medicines. Computational chemists employed at big pharmaceutical companies were interested in trying these engines and associated tools on their projects. On the other hand, Atomwise could keep its tools for itself if it were to become a pharmaceutical company on its own. These options would chart very different courses for Atomwise. The case articulates the dilemma facing Heifets and Wallach, as they contemplated committing to a business model that would leverage the strengths of the technology to deliver value for patients and for investors.

Constellation Pharmaceuticals was a company focused on epigenetic therapies for cancer patients. Despite a promising start and an early deal with a leading biopharma company, the company weathered twin setbacks in the end of a major research collaboration and the decision by the same company to let an option to acquire the company lapse. In a difficult capital market, the company had begun a reboot, but needed to figure out how to weave together key corporate development threads. New CEO and returning Constellation team member Jigar Raythatha wondered if Constellation could capitalize on the current portfolio and make the run to be a fully-integrated biopharmaceutical company selling its own products in the United States. He realized it would take a combination of clear goal setting, capital markets, and potentially partnering to balance this goal and returns for longtime shareholders. His background and training provide a playbook that might not apply-Constellation might not be able to secure another big pharma partnership and might instead need to put together a series of deals to secure needed capital and capabilities without trading away too much of the company's future.

The success or failure of Dicerna Pharmaceuticals (Dicerna) as an emerging pharmaceutical company would likely hinge on its lead drug candidate Nedosiran and the company's ability to see it successfully through clinical development. Ralf Rosskamp, Chief Medical Officer, had an ambitious clinical development plan that leveraged novel technology and a dynamic regulatory strategy to rapidly accelerate Nedosiran's development as a treatment for a rare disease. The case elaborates on Rosskamp's plan to design, operationalize and execute the clinical development plan, with a limited staff and an aggressive time line.

Jake Becraft, a PhD student at MIT disillusioned in pursuit of his dreams of becoming an academic, serendipitously finds himself discussing the potential commercial applications of his work with Tasuku Kitada, his former postdoctoral research mentor. The two decide to alter the course of both of their lives, join forces, and begin down an entrepreneurial road to found Strand Therapeutics. The journey features the genesis of Becraft's ideas, the pursuit of those ideas, the path to entrepreneurship and the associated challenges, including many bumps, twists and turns along the way.

Andrew Kress (CEO and founder) and his team had built a promising marketplace business at HealthVerity serving its core market in healthcare, with a focus on pharmaceutical R&D and services. Thus far, HealthVerity's products had been unique to the pharma and pharma services customer segment. However, there was a real opportunity to apply the underlying technology across multiple industries, for which some investors strongly advocated. The company was grappling with questions of whether to increase revenues by expanding to other verticals beyond healthcare or by going deep with its current customer base and providing end-user analytics-based applications on top of their marketplace offerings. The company believed they had a unique understanding of a technically-challenging market in healthcare, and wondered how the model would scale. Kress wondered if there were ways in which the company could focus on specific analytics solutions or end-user applications (and which ones, specifically?), and if so, would that be worth the effort and risk, or did the approach need to be all or nothing? And was he limiting his thinking about the risk and opportunity to enter adjacent markets solely because of lack of familiarity or was there a real chance to serve other customer segments well if better understood and resourced, and how quickly could the company figure out the answer to that question without risking excessive time and capital?

Beth Sharp and Jennifer Brilliant founded Miracle Therapeutics based on intellectual property developed by Brilliant and her post-doctoral student, John Supreme, in Brilliant's lab at Elite University (EU). Miracle will have to obtain a license from EU to the Brilliant patent rights and other technology, and the founders want this license to be exclusive. With venture funding waiting in the wings, Sharp and Brilliant set up a meeting with EU's Technology License Office (TLO) to discuss the terms of the license. The TLO's licensing manager, Susie Deal-maker has provided them with a licensing term sheet template for review prior to negotiating the key terms. The case explores the components of a technology/IP license and the process of negotiating a deal with a University.

Coming out of the COVID-19 pandemic, Moderna was riding the successes of developing a vaccine in record time and helping stem the tide of the crisis. However, the company had grown at an incredible rate, more than doubled its number of employees, and had to put on hold desired projects to push the company to continue to innovate and push the boundaries as a digital-first biotech company. The retirement of CTO and Moderna's digital architect, Marcello Damiano, prompted the company to reevaluate how best to proceed. The choice for who would replace him loomed large over many aspects of the company's strategy moving forward, and could potentially reshape its future.

Nora Khaldi had built a technology "to unlock the power of nature" in the service of extending human lifespan and improving health, and now in April 2020 was debating telling her Board of Directors she wanted to put on ice some of her discoveries. Nuritas, the company she founded in 2014, leveraged artificial intelligence (AI) to find specific peptides―short chains of amino acids―among the trillions that exist in nature and target them for preventing or treating the onset of disease and preserving health for longer. Khaldi worried that getting certain products to market was taking too long and about the potential distraction caused by doing too many projects to serve very distinct industries. Underlying this was her concern that cash would run short if they tried to do it all. She weighed shutting down Nuritas's promising early-stage pharmaceutical projects―including one aimed at treating Glioblastoma, an aggressive brain cancer―to focus on consumer-oriented approaches, like a supplement to improve muscle health and reduce the physical signs of aging. Khaldi contemplated telling her team to cease most of their pharmaceutical work, at least for the time being, and eliminate roles linked to that part of the business.