EP 168 - Alasdair Milton: The Innovation Inflection Point: Why 70% of Cures Never Reach Patients

Breakthrough science has never been stronger — yet patients still miss life-saving therapies.Despite decades of innovation, most precision medicines fail at the last mile of healthcare delivery.The problem isn’t discovery. It’s how science, capital, and systems are aligned — or not.Possessing elite science is no longer enough to win in the multi-trillion-dollar biopharma ecosystem.As innovation shifts from West to East and from treatment to prevention, leadership teams struggle to bridge scientific depth with incentives, execution, and real-world delivery. Capital follows speed and scale — not intention — and healthcare systems built decades ago are failing to keep up.In this episode, Alasdair Milton, Principal at KPMG, explains where innovation actually breaks — and what must change for cures to reach patients at scale. From diagnostics and data silos to capital allocation and prevention models, this conversation reframes the next decade of precision medicine.💡 What You’ll Learn in This Episode1️⃣ Why only a fraction of eligible patients receive precision therapies2️⃣ How delivery systems — not science — kill innovation outcomes3️⃣ Why prevention is the next major value shift in healthcare4️⃣ How capital allocation decisions quietly determine patient access5️⃣ What leaders must change now to compete in the next biopharma cycle👤 About Alasdair MiltonAlasdair Milton is a Principal at KPMG advising global biopharma leaders on strategy, transactions, and innovation models. With a PhD in cancer biology and two decades at the intersection of science and capital, he works with executives navigating precision medicine, prevention, and large-scale healthcare transformation.💬 Quotes That Reframe the Debate(01:00:20) “Great science only creates value when translated into clear commercial decisions.”(01:37:24) “Power has swung decisively to pharma, with biotechs now starved for capital and leverage.”(01:36:10) “Markets shift fast, but leverage always follows capital, data, and disciplined execution.”(02:26:30) “Life sciences must move from treating sickness to predicting risk and sustaining lifelong wellness.”(01:46:24) “China is catching up fast, and by the 2030s, truly innovative molecules may originate there.”🧭 Timestamps(00:04:04) Shifting from treating disease to preventing it(00:05:32) Turbulent markets, steady scientific progress(00:07:03) In-vivo CAR-T and the next leap in cellular medicine(00:11:00) From chronic disease management to functional cures(00:20:20) Bridging specialized science with corporate strategy(00:21:55) Translating lab precision into business language(00:22:07) Bridging scientific depth to business acumen(00:57:40) Turning complex science into decisive commercial implications(01:08:46) Why in-person collaboration still drives leadership and learning(01:11:48) Navigating the $200B biopharma patent cliff through M&A(01:17:25) Capital concentrates on de-risked teams with proven leadership(01:18:17) Interpreting the biotech market recovery and tailwinds(01:28:26) Long-term capital returns as pharma reclaims deal leverage(01:38:03) Navigating IRA impacts and macro headwinds(01:43:39) China’s rapid ascent in the global monoclonal pipeline(01:46:24) China accelerates the eastward shift in global innovation(02:07:31) Precision medicine redefines individualized healthcare outcomes(02:09:03) Standardized data transforms healthcare delivery(02:16:57) AI across the precision medicine continuum(02:26:30) From reactive treatment to proactive lifelong wellness Send us Fan Mail Join Christian Soschner for expert coaching. 50% Off - With 35+ years in deep tech, startups/scaleups, and public companies, Christian offers power video sessions. Elevate strategy, execution, and leadership. Book Now.Support the showJoin the Podcast Newsletter: Link