Amazon, Dr. Gupta, Lilly and Other Thoughts

i dont know about subtitles. the title should be good enough, right?

Amazon’s Q1 call. It still fascinates me that the company has had negative free cash flow for the last two years yet is worth $1T. I’m not saying I disagree with the valuation. It’s just not what one is used to as a securities analyst!

Amazon unveiled “Tranium” and “Bedrock” among other LLM tools and reminded me of their launch on the earnings call. I will try them when they’re available and report back. When asked about ML/DL, Jassy had largely the same answer as Google and Meta: “we’ve been doing this all along!”. He did have the more honest addition that “these models have gotten a lot more interesting in the last six to nine months”.

You can tell who can iterate and introduce product quickly when new technologies arrive. The Amazons, Googles and Metas of the world are the dinosaurs of ten or twenty years ago: Oracle, SAP, IBM. Today’s OpenAI, HuggingFace and perhaps a few more players we’ve yet to meet (Character.ai?) will outfox our new troglodytes. A few of them will survive the sea change, but if history is any guide, this will be bloody.

Interesting excerpt from Jassy on the call:

“And if you look at the experience that's been the case for the last several decades, we're going to have a hard time convincing our grandkids that it used to be the case to get a primary care appointment, you had to call ahead of time, a month ahead to schedule an appointment and drive 20 minutes to the doctor and park and get into the facility and wait 20 minutes in reception. And you get into an exam room, you wait 10 minutes for the doctor to come in. The doctor talks to you for five minutes and then prescribes you medicine where you drive 20 minutes to go get the medicine. And that experience just doesn't make sense and won't be the case.”

I couldn’t agree more. But real disruption isn’t just copy-pasting the old healthcare supply chain together more efficiently. We need a real sea change to fix healthcare. Speaking of…

Dr. Gupta (www.drgupta.ai)

The feedback from Dr. Gupta has been overwhelmingly positive. Thank you! We’ve received two indications of interest for nationwide deployment. Most countries are struggling with healthcare costs. Some poorer countries have virtually no healthcare in rural areas. But most importantly, access to health information is a predictor of health outcomes. LLMs are a revolutionary way to query and traverse complex information that clearly outperforms search engines. Imagine being someone in the media who wants to marginalize or stop access to a tool which could help, say, rural Iranians healthcare. Thankfully only the blindest sheep still visit outfits like Gizmodo.

Our newest feature has launched: “Dr. Gupta’s Library” will now deposit medical journal articles related to your conversation with Dr. Gupta. Most people don’t even know the medical journal system exists. Try searching for ‘epilepsy’ or ‘diabetes’ on Pubmed. You will quickly leave as you realize you’re not sure how to navigate this mess. For example, there is no useful sorting by relevance that would actually yield something useful unless you’re an expert.

Lilly

Mounjaro, wow. $569m in the fourth quarter of launch. I made a partial list of blockbuster launches available at https://github.com/martinshkreli/models/blob/main/Biopharma.xlsx.

A couple of examples worth pointing out: Gardasil hit $365m in its fourth quarter. Vaccines tend to peak early as ACIP recommendations rule there. Januvia family of products hit $243m before peaking around $6B in annualized sales. Tremfya, Cymbalta, Darzalex and Zytiga all were in the $150-170m range in their first fourth quarter. Anything could happen to Mounjaro, but I don’t think anyone has considered that the product could possibly do $40B in revenue.

Miscellaneous

I have a financial product coming out soon. Not Godel, which will be out later in the summer.

Altman is right: the only way out of the national debt is AI/AGI. What do we spend the most on? Healthcare.

Vice bankruptcy is a sign of the times: social media and AI media will unspool the news media world. Tucker Carlson is an example of defecting to the former. The Hollywood strike will create more of the same creator economy usurping their would-be proprietors.

I bought the Gizmodo journalist’s domain name and will chronicle their stupidity. Journalists don’t like it when someone investigates them.