Lawrence W. Abrams

My counterfactual to assumption economic institutions can't keep pace with Tranformational AI: Full Stack Inference Providers : @baseten , @modal , @FireworksAI_HQ and others My Taglines: "Turning stateless workflows into stateful capital" "Creating competition for the frontier lab duopoly" "Greatly reducing procurement transaction costs via marketplaces" #econtwitter @econD47

Post from 4 years ago. Small independent pharmacies have a better chance now with the elimination of spread pricing and death of 12,000 sq ft combined front store and Rx fill in back. Retail Rx needs to get paid more for fill as now more than ever in the age of AI, there is value-added when real people are there to answer questions. Plans and government need to mandate that #PBMs pay more for Rx fill !!!

Expect $CVS to sell Pharmacy Unit to PE similar to Walgreens sale to PE Sycamore Partners -- about $10-$12 B in cash plus DAR (Divested Assets Rights) to sale of mail order to a big Rx distributor. Two questions remaining: (1) what retailers are there left who will pay for customer Rx records these days? $WMT ? regional grocery chains? (2) how will PE get rid of long term leases on 1000s of 12,000 sq ft. stores? ( calling all Dollar Trees, Dollar General, Family Dollar Store and 99 Cents Only Store :(

Competition senses $CVS management will be preoccupied with divestiture over the next two years. Caremark (and ESI ) #PBMs vulnerable to BCBSs finally ending contracts for adjucation, rebate management and mail order in the next 2 years. BCBSs, not small startups, biggest threat to PBM 80% market share over the next 2 years.

Post from 4 months ago. $CVS will sell retail business to private equity who will close 12,000 ft stores and move Rx retail to small 3000 ft stores.

Smart move by $CVS. Retail and mail order Rx fill margins no longer covering front store losses. My napkin estimates of value unlocked. Market cap before $100B = $120 B Aetna #PBMs Caremark, but - $20B Pharmacy. Market cap after $120B Aetna / PBM and give away pharmacy to PE who will sell mail order to Rx distributors and declare bankruptcy for retail like Rite Aid

Ads like these from the leading full stack inference provider @baseten will do more to blunt the pricing power of the frontier lab duopoly than the @FTC or the @dojphofficial Yea, startup AI infra market makers

$EVGN worth 10-20x just for its accumulated data to be used to fine-tune other LLM drug discovery models of well funded US startups and public Pharma. Witness $GOOG buying bankrupt Spirit Airlines just for its data. Could also split data buyout into drug discovery and ag chemical discovery . Easily data alone worth 20x current valuation

Markets and price signals deter AI monopolization. It is startup inference providers with LLM price transparent choice routers, not the Chinese, who have turned inference into a commodity, calling into question the sustainability of @AnthropicAI @OpenAI 60% -80% margins. Kudos to @baseten @modal @FireworksAI_HQ @daytonaio With 10+ fast followers, only moat how deep the stack - router, harness, post-training.. cloud sandboxes and VM. Example below of @daytona sandbox pricing

Suggestion for DtC cash pay healthcare: more emphasize on low cost - walk in UTI urine test, followed by fast Dr. video and appropriate antibiotic Rx if positive

Entrepreneurial alert: massive shortage nationwide of Estradiol due to FDA reduced side effects in black box warning that has greatly increasing demand.

#econtwitter There is starting to emerge within economists circles two schools of thought on the ability of economic institutions to adapt to transformative AI (TAI) - what I call “The Stanford School” and “The Hayek School” Below is lede to @DigEconLab recent post announcing new monograph. Here is my reply A counterfactual to @DigEconLab @erikbryn premise that “TAI advances faster than economic institutions can adapt”>> rapid rise in startups success of @OpenRouter @baseten offering auction market design routers-harnesses-post-training low transaction cost competition between frontier LLMs and open weight LLM.

A counterfactual to @DigEconLab @erikbryn premise that “TAI advances faster than economic institutions can adapt”>> rapid rise in startups success of @OpenRouter @baseten offering auction market design routers-harnesses-post-training low transaction cost competition between frontier LLMs and open weight LLM.

A big frustration of users of GLP-1 and other self-injectables is having to refrigerate continually when traveling. The Big 3 #PBMs have no solution. @heyepic is likely to solve that with recently announced Prescription Marketplace via Rx fill routing and re-routing in MyChart at Point of Phone (PoP) See my mock-up>>>

Two sided agentic AI wars in healthcare - PA, upcoding/ downcoding - are about exploiting Grossman - Hart incomplete contracts of a hard to measure granular property rights of a good - healhcare. Is only endgame vertical integration or maybe preserve market but with different goverance — an Ostrom like private collaboration? $UNH #AI #PA #HealthcareAI

My take on @HeyEpic announced Prescription Marketplace: another step toward patient directed healthcare at the Point of Care (PoC) and Point of Phone (PoP) - no question competition for both the Big 3 #PBMs at Point of Sale and @Google Health in ChatGBT @OpenAI @AnthropicAI at PoP