How should we pay for the work that makes a treatment possible?

In the previous issue, we examined investment in the work needed to take discoveries into experiments and practical use. This issue brings the next question into view: what can a company receive in return for taking on that work? Previous issue’s insight ↗

Hansa, which is developing a pretreatment for gene therapy, signed an agreement providing not only for sales of its own drug but also for royalties on gene therapies made accessible through that pretreatment. Without owning the gene therapy itself, the company sought to connect its contribution to revenue if the treatment succeeded. Hansa–Sarepta agreement ↗

The important point is that payment is not based solely on the amount of work performed. Beyond hours worked or measurements taken, the contract attempts to recognise the value of a treatment that might not have been possible without the supporting technology.

We can ask the same question of AI that supports clinical trials.

If a company performs an existing task more cheaply, its payment is likely to be framed as a service fee. But if it makes an acceptable trial design possible in a field where too few patients previously made a trial impractical, its contribution goes beyond efficiency. It may change whether a drug can be developed at all.

That value does not, however, automatically translate into rights to the drug. SURPASS does not grant drug rights uniformly to participating AI companies. Costs, responsibilities, permitted uses of data and any share of success would need to be agreed separately. ARPA-H submission FAQs ↗

Our hypothesis is that the growth potential of research support companies depends not only on how much work they can automate, but also on whether they can make previously impractical development programmes possible.

Not every company needs to own rights to a drug. Providing services to multiple customers without taking on the risk of drug development failure may be the more suitable business.

What matters is understanding what a company's technology has made possible and choosing compensation that reflects that contribution. The commercial work does not end in the laboratory. Deciding how to recognise that value in a contract is also part of building the business.