NashBio is a company that makes complex healthcare data easy to use. From idea to execution, the company leverages real-world clinical, genomic, and imaging data to advance the discovery and development of new therapeutics and diagnostics. Pulse 2.0 interviewed NashBio CEO and co-founder Leeland Ekstrom, PhD, to learn more about the company.
Dr. Ekstrom’s Background
Could you tell me more about your background? Dr. Ekstrom said:
“I grew up in Canada and came to the US to complete a PhD in biomedical engineering at MIT, focused on neuroscience. After grad school, I joined McKinsey & Co. and consulted primarily in the pharmaceuticals practice, working on a wide range of topics related to innovation and particularly genomics and precision medicine. A place like McKinsey is fantastic for starting your career, especially as a life-long learner – you are exposed to so many different organizations, topics, working styles, etc. From there, I was recruited to Vanderbilt University Medical Center (VUMC) to write a business plan to deploy large scale real world data and genomic assets to support commercial life science R&D – NashBio grew out of that effort. My prior experiences were excellent preparation for the fusion of cutting edge science /technology and business building /innovation that I’ve experienced at NashBio.”
Formation Of The Company
How did the idea for the company come together? Dr. Ekstrom shared:
“In the early 2000’s, VUMC created the BioVU biobank by linking together and deidentifying deep, longitudinal clinical phenotype data derived from its electronic health record with genomic data generated by analyzing residual blood specimens collected with consent after providing clinical care. This combination of data provides an incredible platform for understanding the role of genes in human disease and the discovery of new treatments and diagnostics to care for those disease. The idea for NashBio came together in response to extensive market interest from life science companies to use these data in their R&D programs. NashBio was launched to create a streamlined, customer-oriented organization to service these requests and ultimately have as broad impact as possible improving human health.”
Favorite Memory
What has been your favorite memory working for the company so far? Dr. Ekstrom reflected:
“I have been working on/for NashBio for almost 10 years so have accumulated a number of special memories. Several big commercial milestones really stand out – our very first customer contract (I remember quite clearly where I was when we found out – sitting on a plane at Nashville’s airport), our first large contract (on the last day of fiscal year 2020 in the midst of the pandemic) and the completion of the Alliance for Genomic Discovery contracts (on the last day of fiscal year 2023).”
“The other set of memories that is quite salient is the hiring our early employees, my leadership team and really the whole team that has participated in this journey and especially watching many of these people grow with the business and take on new and expanding roles as the company scales up.”
Core Products
What are the company’s core products and features? Dr. Ekstrom explained:
“Our mission is to make complex health data easy to use. We work with real-world healthcare data derived from electronic health records and germline genomic data generated from residual biospecimens, both of which are de-identified.”
“We use this data to support our clients conduct a wide range of life science R&D applications, such as the discovery or characterization of new drug targets, the stratification of patients within different disease populations to better understand why some may not respond to treatment or progress in their disease, and the study of how certain drugs or treatments are used in the real world setting (as opposed to clinical trials). Some of the features that differentiate our offerings are the multi-modality, depth and longitudinality of the datasets we leverage, and the diversity of ancestries, ages and diseases represented in the underlying subject cohort these data are derived from.”
Challenges Faced
Have you faced any challenges in your sector of work recently? Dr. Ekstrom acknowledged:
“We are in a fast-moving space, both in terms of the types and amounts of healthcare data generated and the possible uses of those data for R&D. Some of the data types, particularly multi-omic data such as genomics, proteomics, and epigenomics, are also quite costly to generate at scale, so we need to be quite thoughtful about which directions we are going to pursue and which we are going to pass or hold on, to avoid bringing a lemon to market. There is no substitute for voice of customer in this regard – we are constantly asking our customers what they need now, and what they anticipate needing in 3+ years.”
“Selling into biotech companies has also been a challenge for the past couple of years, as many of the smaller companies have been grappling with a difficult funding environment. To balance that, we’ve been working more closely with large pharma companies recently, but ultimately, we’d like to return to a balance between large and small life science companies.”
Evolution Of The Company’s Technology
How has the company’s technology evolved since launching? Dr. Ekstrom noted:
“We’ve always been a cloud-native organization – our CTO has built our tech stack from the ground up with that orientation. We started as a services focused company – our clients would come to us for a specific project and we would help build/analyze the required dataset for that problem.”
“With that approach, all our technology was oriented inward – we built tools for our internal teams to use, but didn’t have to worry about customer experience or anything in that domain. We are now transforming from that project-focused organization into one that blends data, technology and services to offer data as a service experience. Specifically, what that means is we are standing up a secure research platform that would enable our clients to interact directly with our entire dataset and then building an ecosystem of data products that modularly sit on top of that platform.”
“Our services then become a possible add-on for those clients who need that level of support, as opposed to the sole access channel. With this technology transformation, we are having to think a lot more prospectively about what we develop (i.e., will the customer actually want this), and whether we should build, buy or partner to achieve the outcome. The end result, however, should be a more scalable organization.”
Significant Milestones
What have been some of the company’s most significant milestones? Dr. Ekstrom cited:
“These probably coincide closely with some of my favorite memories that I mentioned previously. We launched the company in early 2018, although a lot of the foundational work that enabled our launch took place as much as a decade earlier when VUMC first started building the biobank. As a services focused company, we were revenue generating right from launch, and achieved profitability within our first couple of years – that was a rewarding milestone.”
“The launch of the Alliance for Genomic Discovery (with Illumina in 2022, with multiple pharma members in 2023) is NashBio’s most significant accomplishment to date. It was a complex transaction that built on the years of customer service we had provided up to that point, and will be transformational for both the company and the broader field of real world genomics that we operate in.”
Customer Success Stories
Can you share any specific customer success stories? Dr. Ekstrom highlighted:
“Given the customers we work with and the early stage of research we are supporting, we often don’t learn too much about how our customers use the data we provide – they tend to hold those results pretty closely. However, customer return is one proxy we use for success. Six of the eight pharmas that joined the Alliance for Genomic Discovery had previously worked with us in some fashion, so that was a pretty cool endorsement. We’ve also had a number of ‘super-fans’ emerge over the years – they worked with us while at one company, and then pulled us along when they move to a new organization, in some cases through multiple transitions. We view that as another indication of customer success.”
Revenue
When asking Dr. Ekstrom about the company’s revenue details, he revealed:
“We are privately held – we were capitalized at launch and have since grown organically on the basis of our operations. In terms of revenue, we have operated for several years in the low eight figure range. With our ongoing business transformation that I described above, we believe we are building a more scalable foundation to continue that revenue growth.”
Total Addressable Market
What total addressable market (TAM) size is the company pursuing? Dr. Ekstrom assessed:
“There are lots of different ways to define TAM for us, depending on the exact combination of use cases that one includes. Pharma use of real world data for R&D is the strictest definition – when we’ve built that bottoms-up, we estimate a couple billion dollar TAM, which is indicative of a fairly specialized B2B market. If you start expanding that to the full extent of pharma use of real world data (e.g., moving into commercial & marketing use cases) and to other life sciences companies outside pharma, the TAM gets 10-50x larger according to some of the sources we’ve seen, but building to address that whole market is a long term project.”
Differentiation From The Competition
What differentiates the company from its competition? Dr. Ekstrom affirmed:
“There are two parts to answering that question. The first part is the differentiators that come from the data assets we deploy. The dataset is a curated and normalized real world dataset, so we’ve already done a lot to refine it and make it R&D ready compared to other EHR-derived datasets. It is multi-modal (i.e., contains a wide range of clinical data subtypes in both structured and unstructured format) and multi-omic (i.e., primarily genomic, but we are moving into proteomics and other omic layers).”
“The depth and longitudinality of the clinical data are also important factors – one of our Board members always compares it to a high-definition movie, as opposed to a one-time snapshot. Our last data differentiator is the demographic diversity we can access – the dataset has a wide range of age, disease, ancestral and site of care diversity, which expands the number of use cases it can support. The second set of differentiators comes from our team and how we work with our clients to navigate this data. We are domain experts – our scientific, clinical and technical teams are deeply versed in both the capabilities and limitations of real world data. We also put a real premium on customer-orientation – we insist on delivering a product that our customer will be able to use.”
Future Company Goals
What are some of the company’s future goals? Dr. Ekstrom emphasized:
“Our vision over the mid-to-long term is to be the indispensable source of real world multi-omic data for life science R&D. To deliver on that vision, we are actively working through the transformation I described above to create a more scalable business. Once that is complete, we believe our new foundation will be pretty attractive to continue to expand and diversify our data assets, whether that is bringing online other specialty clinical data types or multi-omic layers that increase our depth or other sources of data. As always, our focus will be on making these data assets easy for our customers to use – the science they conduct is hard enough, so any and all data munging that we can do first will make them more likely to succeed.”
Additional Thoughts
Any other topics you would like to discuss? Dr. Ekstrom concluded:
“I am a strong believer in the importance of basic science and investing appropriately in it. Our biomedical ecosystem here in the US is one of our economy’s crown jewels and has produced countless innovations that have improved human health, but those applied breakthroughs were often not clear when the foundational research that led to them was first started. With the growth of technology and analytics that we are currently observing (e.g., AI/ML), we are on the cusp of many waves of new innovation. Pulling back from basic science in the name of efficiency is not going to help us realize those waves – basic science is not efficient.”
