Dr. S (@drsprs) header
Dr. S (@drsprs) profile picture

Plastic & Reconstructive Surgeon. Hand & Microsurgeon. Random musings on medicine and investing.

Joined August 2010
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Healthcare also. Hitting the lowest paid workers first. For ex just today, did surgery on a lady last week, she applied for disability coverage, AI agent called my office, my nurse answers, AI agent had all pt info, interacted with nurse over phone, then generated a confirmation fax, sent fax to me to sign, I signed it, faxed back. Disability coverage approved. AI replaced an office worker at the medical disability co. So much back office medical staff going to be deleted due to AI. Will still need some but far fewer.
Microsoft offering 60k employees buyouts... AI's impact on the labor market is going to be a big topic next year. Crazy that the Fed's September SEP forecasts steady (4.1%) unemployment through 2028.
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Re-tried "Ask Doximity AI tool" recently and it is quite good. As good or better than OpenEvidence. Good for researching less common operations/consultations. Not good for market based research since the AI models for both are not set up on latest press releases from biotechs. $DOCS
Replying to @WaterworldCapi1
OpenEvidence already killing off $DOCS first. Already uninstalled Doximity app. Had it for years. Little to no use now.
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It was trash in January but now 10 months later vastly improved. Maybe all these AI tools are going to commoditize.
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Really good mouse data after pivoting to GalNAc delivery from prior whiff using LNP. But up 30% on 🐁 data is a bit much. A therapy to watch in the future. No position. $KRRO
New preclinical data for KRRO-111 reduced pathogenic Z-AAT in the liver by up to 95%, supporting its potential to address both lung and liver manifestations of #AATD. Regulatory submission expected in H1 2027. Learn more: bit.ly/4yDFEjt $KRRO
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Nice tuck in acquisition. $PCRX sales have been pretty mature and stable despite Federal and state opiate initiatives. We currently pay about $220 a bottle for Exparel, I just hope Viatris doesn't jack up the prices after the buyout. Good for tummy tucks, etc. Competition from Zynrelef never materialized $HRTX. Probably because of the gooey sticky consistency. Didn't trust it if I use drains, used in most plastic surgery procedures.
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One thing I have noticed since getting back into active investing in 2020: thematic based market trends significantly overshoot and undershoot your expectations. COVID vaccine, post COVID opening trash, GLP winners/losers, and now AI drug discovery ($TWST is the best example). At the end of all of these thematic trades, the tickers broaden out to lower quality names (e.g. $DNA). Calling a top or bottom is difficult in real time, but some catalyst always marks a change in sentiment.
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Do as you wish with this contra data: $IOVA $IBRX 🧐
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Grail Adcom briefing docs are up. No time to analyze it this morning but the stock is ripping $GRAL Voting Question 1: Is there reasonable assurance that Galleri is safe for patients who meet the criteria specified in the proposed indication? Voting Question 2: Is there reasonable assurance that Galleri is effective for use in patients who meet the criteria specified in the proposed indication? Voting Question 3: Do the benefits of Galleri outweigh the risks for use in patients who meet the criteria specified in the proposed indication?
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$GRAL 2 best trial data: Pathfinder was observational design, NHS RCT.
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For buy+hold guy at heart, $XENE posed problems for me. I played the FOS readout in March, but sold right after since the MDD/BPD readouts were super high risk (coin flip odds). It didn't even pop that much for the FOS success (mostly priced in, but made decent $). Prob FDA approval baked in for FOS as well (likely flat on approval imo). So, now the MDD program zeroed out for random safety issue, would the stock trade down again on a MDD fail in 1/2027? Also, commercial launch is murky since so many damn generics in this space.
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Long story short, it has been a trading stock, not a holding stock. $XENE
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Rezatapopt data looks excellent for $PMVP. IMO an approvable drug. My main concerns are small market for this Y220C mutation, this is like 250-350 pts/yr in USA. Assuming usual pricing, about $30M/yr. Need to find other indications. Short term have predatory offering terms and long term won't be profitable with this run rate.
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Typo, meant quarterly sales, not annual.
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Just talked to this surgeon in the lounge. Bro hasn't sold a share of $TSM and is up 3.5X. No plans to sell either. Taiwanese legend. 4.5 million now.
Replying to @drsprs
In my opinion doctors are not reliable contras since some are good investors. Some bad. 2021 - surgeon I know sold a second house for 1M gain. He took that 1M and put it all on $TSM. No comment on that trade, might end up fine in 10 years. Down now. Am I your contra? 😂
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Wife response after I explained my next biotech binary thesis to her. 😵‍💫😵‍💫 $XBI
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Some concerns RE: solana:87kdzhXBsdQdc7S9WfvWYvXsesGeRwhEDF7XSLXBpump -> Ambros 1. Generic bisphosphonates readily available and already used off label for CRPS with mixed success. 2. Post op CRPS is a weird condition and trials have to be super strict on inclusion criteria. AKA this is frequency misdiagnosed even by BC hand surgeons. 3. Multiple past trial failures: neridronate (NCT03530345, NCT03560986) and oral zoledronate (NCT02504008) were terminated for futility after interim analyses.
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Looking at the bioprocessing logistics for intismeran autogene (MRNA-4157), this is definitely workable for most community based practices. Assuming the numbers hold up as clinically meaningful, I don't see a scenario where this is not adopted as standard of care along with Keytruda for stage 2B-4 melanoma. Manageable side effect profile and minimal downside risk. After surgical resection receive the IM injection 6 to 8 weeks later in office. Most patients are going to opt for it and payors forced to pay since it's oncology. Caveat is we need to see the actual numerical benefit. Doing the math on this and assumed pricing, $MRNA stock does look stretched on this move though.
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