US Senator Everett Dirksen (1896-1969) was quoted as having said, “A billion here, a billion there, pretty soon it adds up to real money.” In a half-century, it seems that what a billion once was, so a trillion now is. The US National Debt is twenty trillion and rising at thousands of dollars per second. The largest budget item for the US Federal Government, before Social Security or National defense, is Medicare/Medicaid at over one trillion per year. The United States National Healthcare Expenditure grew to $3.2 trillion in 2015 according to Centers for Medicare & Medicaid Services. That is equal to $9,980 per person and accounts for 17.8% of the United States Gross Domestic Product (GDP). Where there is money, there is a market.
591,686 people died of cancer in the United States in 2014 according to the Centers for Disease Control and Prevention. Also in 2014, the median monthly cost of cancer drugs at the time of FDA approval was over $10,000. Kymriah, Novaritis’ new immune therapy for acute lymphoblastic leukemia, is priced at $475,000 for one treatment. Lung cancer took the lives of 155,610 United States citizens in 2014 when Keytruda, Merck’s treatment for the most common form of lung cancer, was approved by the FDA, and priced at $12,500 per month.
The “Law of Supply and Demand” states that the price of a product moves up in a time of increased demand and decreased supply. In a free market then, rarity determines monetary value of a product or service. Nothing is rarer than a cure for cancer, nothing either in greater demand for those who have received the dreaded diagnosis. When faced with the prospect of being consumed from the inside out by ones own rapidly mutating cells whose only agenda is their own survival, most cancer patients would have an upper spending limit that exceeds their potential lifetime earnings. What could be more valuable than another day of life?
As Daniel Keyes writes in Flowers for Algernon, “There is no greater joy than the burst of solution to a problem… This is beauty, love, and truth all rolled into one. This is joy.” Mr. Lefkofsky has made a career of solving problems with “big data.” Some of the problems that Mr. Lefkofsky has solved include connecting companies with customers through marketing campaigns (Innerworkings, IPO 2006), providing efficient transport of products (Echo Global Logistics, IPO 2009), and making discounted goods and services available to consumers (Groupon, IPO 2011). Now the only problem Mr. Lefkofsky wants to solve is how to efficiently connect cancer patients with the most effective treatment, backed by the most up-to-date research, for their individual cases. Mr. Lefkofsky “can’t seem to think about anything else,” but the data to be wrestled in this contest is a much more formidable beast.
Tempus, Eric Lefkofsky’s co-founded private company, provides genome sequencing for its network partners, gathers clinical data via electronic healthcare records, and assists doctors in digitizing their patient notes. Tempus intends to build the largest medical library of molecular and clinical data. This is an undertaking with no historic precedent. One genome sequence takes up about 200 gigabytes of data storage. For statistical significance, at least 100,000 human genomes must be sequenced; about 15,000 have been completed so far. When that goal is achieved, storing one digital copy will require 20 petabytes (20,000,000,000,000,000 bytes) of hard drive space. The Amazon “Snowmobile,” an 18-wheeler hauling a hard drive, could carry five copies, and those five copies would arrive at their destination over twenty years earlier than if they were transferred over the internet. But that’s just the molecular data. Tempus is also gathering electronic medical records from collaborative partners like Knight Cancer Institute (OHSU), The Cleveland Clinic, and The University of Michigan. That clinical data will be stored along with molecular data, so as to begin the massive search for effective cancer treatments to be matched with specific cancer cases. Imagine caravans of autonomous data-hauling 18-wheelers moving across the country like the giant sandworms of Dune.
Once gathered, the data must be analyzed using the latest developments in artificial intelligence and machine learning, looking for patterns in the genomic data, and matching those patterns to successful treatments on living human patients. Comparisons devolve in the construction phase when trying to comprehend a dataset of this heretofore unimagined size. All of this data gathering and number crunching has one goal—to deliver real-time information on effective treatments to oncologists of cancer patients.
Eric Lefkofsky believes that by bringing big data to healthcare, “we can reduce mortalities by well over 50% in the next 25 years” and reduce by $1 trillion the waste within the United States healthcare system. With that trillion the US could increase the education budget by 20%, double the crime budget, eliminate poverty, budget for retirement of the $20 trillion national debt, and still have $400 billion leftover. Those educational, social and economic improvements would add one million productive Americans to a more educated society with less crime and no poverty. One could then assume enough lift to the GDP from those improvements to more than return the investment of the original waste-reduction savings. Mr. Lefkofsky believes the potential rewards are worth the risk, and with Tempus, has put his money on the line.
For Eric Lefkofsky, “the elephant in the room is cancer (and other diseases) that endlessly consume our resources…” The death of a cancer patient is a failure to deliver effective treatment in a timely manner. Getting the right treatment to the cancer patient is a matter of efficiency, and efficiency is what Eric Lefkofsky does. Saving the cancer patient in the hospital is similar to saving the wounded soldier on the battlefield; time is of the essence. “It’s time to double down. It’s time to focus. Because as you can see, if we win this battle, we win the entire war.”
Read more about Eric Lefkofsky and his foundation here.