Tomorrow's Medicine, Ep. 9: Business Development in Healthcare - Nicolas Duhem

With Dr. Nicolas Duhem, Healthcare Business Development Expert. Hosted by Arseniy Arsentyev. Published November 26, 2025.

https://aarsentyev.com/podcast/ep9-nicolas-duhem

Machine-transcribed and lightly edited: filler words and false starts are removed, and the wording is otherwise as spoken. Where the two differ, the recording is the record. Times are minutes into the recording. Not medical advice.

[0:00] Arseniy Arsentyev: So hello, Dr. Duhem. Could you please tell us more what you're doing and who you are?

[0:05] Dr. Nicolas Duhem: Hey, thank you for inviting me to share my experience here. Originally, I'm from Belgium. I currently work in the US. As a professional background, I'm a PharmD, PhD and MBA. I've worked in the pharmaceutical industry across big organizations and then I worked at McKinsey in strategy consulting. I currently work for a biotech company in strategy and business development.

[0:36] Arseniy Arsentyev: All right. And anyone who's not familiar with the business aspects of the healthcare business struggles with the definition of what the business development and especially strategic business development is. So could you please provide some kind of a definition or example of work you do?

[0:55] Dr. Nicolas Duhem: I would say strategy and business development, they encompass two pieces. One, that's the strategic planning of the organization. So that means what are the big key questions that needs to be answered over the next couple of years to make sure that we can attain a vision that is preset and defined. So that could be anything. The vision is already something that the core leaders of the organization are going to define. For example, that could be commercialize five drugs by 2035. That could be being number one or number two leaders in key therapeutic areas. So it's really up to the management of a company to decide.

[1:45] Attached to that, there are key questions. And it's basically establishing the roadmap to achieve the ambition of the company. In terms of business development, it's a bit narrower. It's really about how do you drive innovation internally and externally, and how you make sure that your pipeline in your enterprise remains up to date, remains very innovative. As you may know, the life cycle of a drug is very constrained. That means that once you've done the clinical trial, you have 10 years to commercialize the drug, then there is a patent cliff and you lose all your revenues because generic makers are entering. So you need to make sure that you constantly have an innovation engine that produces innovative drugs so that you remain competitive in the marketplace.

[2:43] So BD will effectively try to source the latest innovation, and you're basically placing bets across a couple of technologies where you believe you would have a competitive edge.

[2:58] Arseniy Arsentyev: Okay, and what makes business development in healthcare particularly interesting, and how is it different?

[3:06] Dr. Nicolas Duhem: I would say the main difference in healthcare is that you need a hundred compounds to get one successful drug. So the ability to pick the winners in terms of the ecosystem, emerging biotech is very difficult, and it takes a lot of skills, it takes a lot of data, it takes a lot of experience. That makes it pretty unique. Usually those are complex deals, so you can either invest in a platform that will produce, for example, antibodies for a set of disease, or you can invest into a specific disease. So one drug, one disease.

[3:51] And then attached to that, there are economics, a contract that you sign with a partner. And there is usually an upfront payment. So something that you pay immediately. Milestones payments. So once you initiate a clinical trial, you need to pay a certain amount of money. And then there are like royalties that you pay to your partner once the drug is commercialized. So the complexity is a bit probably higher than in other industries. And the risk associated to it too. You need to have a portfolio of companies where you place your bets.

[4:31] Arseniy Arsentyev: And when you taught me about this placing bets on the potential drugs, could you share approximately at a typical firm, how many people are actually making this decision to choose drugs from a various set and place a financial bet on it? How many people do make those decisions in business development?

[4:58] Dr. Nicolas Duhem: So that would depend on the size of the organization. If you have a big pharma like Pfizer, AbbVie, Johnson & Johnson, Novartis, it's probably close to 100 people in that type of organization. And then you have certain tiering in terms of decision making. So for a deal below, let's say, $25 million, there is no review by the CEO or the CFO. And then if you reach a certain amount of money, then there is a transaction committee and the CEO needs to give his approval or the CFO.

[5:41] And then once we are talking about billion-dollar type of transaction, usually the entire board is also involved. So yeah, that's a bit the framework. For smaller companies, think of $20 billion of market cap, that's small in the pharma world. Then you have like in the dozens, so 10, 20 people max working on that. And they usually work on alliance management. So the partners that they've chosen to commercialize a certain drug in a certain geographies and then sourcing and evaluating new assets and then managing those contracts and relationships.

[6:31] Arseniy Arsentyev: That's interesting. Let's dive a little deeper into the structure. Can you take a second and outline kind of department, maybe some other structural hierarchy of a typical consulting firm?

[6:47] Dr. Nicolas Duhem: So consulting is a different business.

[6:52] Arseniy Arsentyev: Okay, but consulting in healthcare, let me be precise.

[6:55] Dr. Nicolas Duhem: Okay. So consulting in healthcare, I would say, if I take my, past experience at McKinsey, we usually have one core team serving one client. So that means you would have a senior partner who is the top of the client service team. So the senior partner manages a relationship with the executives in the client. So a big pharma, a mid-sized pharma, a biotech, whomever is the client. Underneath the senior partner, you have the partners. And usually you have three or four of them. They manage different types of, let's say, clients.

[7:45] Let's say clients. So some are more specialized into research, some are more specialized into commercial, some are more specialized into operations. And then underneath that you have associate partners and they are the one managing the projects on the ground. Usually they manage two or three projects at the same time. And underneath them you have the engagement manager who is the project manager. So one project, one team, one topic. They are responsible for making sure the analyses are being driven appropriately, timely.

[8:22] And underneath the engagement manager you have the analysts. So whether the associates or the business analysts and they are the one running specific analysis or specific production of material that can be interviews or synthesizing insights from market research, things like that.

[8:47] Arseniy Arsentyev: Okay. And what are the skills that differentiate consultants and make them want to pursue a career specialization in healthcare and medicine?

[8:59] Dr. Nicolas Duhem: Usually you need to have some sort of a passion for life sciences. If you choose a career in research, I would say you probably need to have a scientific background, whether it's a PharmD, PhD, MD. But you need to understand the science, basically. Otherwise, it's really, really difficult to follow conversations and to go deep into certain topics. On the commercial side, you probably don't need MD or PharmD or a PhD. But you certainly need a business background. And you also need to have a basic understanding on science because you need to be knowledgeable about certain data, clinical trial data, real-world evidence, and then making sure that you go through the reimbursement process. So you need to get a grasp on what the disease state is, the current standard of care and economics around it.

[10:07] But you also need to understand how to market the drug. So marketing, sales, market access.

[10:14] Arseniy Arsentyev: And do you know people who transition from pure business consulting, like classical consulting, to the healthcare consulting by learning, as you said, basic science?

[10:27] Dr. Nicolas Duhem: So that can happen. Usually when you choose one consulting company, you stay in it. There are probably less than 5% of movements between consulting companies because there is some sort of loyalty of whom you pick at the beginning. So if you start with McKinsey, it's not so common that you see folks going to BCG or Bain and vice versa. Because there is a cultural aspect of it, which makes it a bit harder for folks coming from, let's say, BCG to integrate into McKinsey.

[11:10] And vice versa.

[11:11] Arseniy Arsentyev: Okay, great. Thanks for your answer. Let's talk about pharmaceutical developments. And also during a pre-call, we discussed preliminary topics such as US expansion for healthcare companies. And let's build the foundation. First of all, can you outline some troubles that are usually arising in pharmaceutical industries and in industries that produce or research drugs?

[11:39] Dr. Nicolas Duhem: The main challenge for any pharmaceutical company is the productivity of research and development. So that's where there is the most waste in the industry. It takes a lot of resources to develop one successful treatment. And by successful, I mean able to show meaningful improvement for patients in terms of efficacy, safety or convenience. Today, models estimate that to bring a drug on the market, it takes approximately $2 billion. That's a very, very huge number. And there are no other industry where you have such a hurdle.

[12:30] So the main hurdle is really about producing a drug that is effective, safe and good to go for physicians and patients. The other challenge is actually around reimbursement. You may have a drug that has established a certain level of efficacy and safety, but that may not be always sufficient for it to be reimbursed. And that will depend on the geography you play in. So in the US versus the UK versus Germany versus Japan, they have very different criteria to assess that. So that means that sometimes you're very successful at developing a drug, but the drug is not reimbursed or usable by physicians or providers, and that doesn't make it a commercial success. So I would say those are the two main barriers today in the industry.

[13:28] Arseniy Arsentyev: And as I understand, FDA plays a huge role, not especially, primarily in the US market. And can you describe the role that FDA approval processes, these reimbursements play in strategy, in business strategy?

[13:45] Dr. Nicolas Duhem: So the FDA and the reimbursement process are two separate processes and very different. FDA is only responsible for the assessment of the efficacy and the safety of the clinical trials that were run. It's a very important organization. Usually, the pharmaceutical company has a relationship very early on with the FDA, with certain bodies of the FDA, to make sure that they comply with the requirements to develop a clinical trial, from the phase one, which assesses, in healthy volunteers or a certain type of patients, mainly the safety and the proof of concept in human beings, through the phase two, which is assessing the efficacy and the safety in a broader set of population, sick patients, and then the phase three, which is usually a confirmatory trial.

[14:57] The FDA is very important to understand what are the endpoints that are going to be required to make sure that the FDA can assess effectively the efficacy and the safety of the drug. So you need to have that constant dialogue with them to make sure that you do not have any surprises as you go through the process. The reimbursement is then... There's a one-on-one negotiation with payers. The payer system in the US is very scattered. It will depend if it's a competitive arena or not. It will depend if it's a specialty drug or not. It will depend if it's a drug that's infused or taken by the patient itself. So it's a very complex process.

[15:49] Arseniy Arsentyev: What mistakes do you see European companies or maybe non-European companies face when entering the US market?

[15:58] Dr. Nicolas Duhem: By entering the US market, do you mean interacting with the FDA?

[16:01] Arseniy Arsentyev: I mean selling products on the US market. So, for example, I have a hypothetical company that is in Belgium and I want to grow my market and start selling products on the US. What are the common mistakes that CEOs, the senior executives makes?

[16:22] Dr. Nicolas Duhem: So, usually a company based in Europe developing a drug would have interacted with the FDA through the development process. So, before the commercialization. Because the clinical trial needs to be set up in terms of endpoints for both regulatory bodies, both European and American, so that they can achieve both standards at the same time. So, usually they have a certain idea of what it is to bring the drug in the market. In terms of the main challenge, I would say the number one is the healthcare system. If it's a de novo company that has no experience with the US healthcare system, it's a very different system versus any European country.

[17:18] You have a breadth of payers and a way to contract with them that is going to require a really big market access organization. Usually you need to engage with those six months ahead of your regulatory approval by the FDA. And then you have very different sets of payers. For example, you have closed payers like Kaiser. They are providing the healthcare services and also reimbursement the drug in a closed system. So, think of it's probably the closer system that you can have versus European countries. And then you have like the commercial payers that are Cigna or United Healthcare or CVS.

[18:14] They have what we call PBMs, so pharmacy benefit organizations. And those organizations are going to negotiate the pricing and formulary placement of a drug on behalf of their clients. And their clients are usually the employers. But that means that you need to engage with them. They have different requirements. They have different interests. And underneath that, you have multiple formularies where you can have multiple sets of economics that are going to be appealing or not for certain employers or customers.

[18:55] Arseniy Arsentyev: I've already started to take notes. Such a complex system. Do you see it simplifying in the future? Do you see a way to make this R&D process, process pushing product to market, less complex and less painful?

[19:12] Dr. Nicolas Duhem: So, the R&D process is different than the market access process. The R&D process, I don't think there is a meaning.

[19:20] Arseniy Arsentyev: Sorry to interrupt, but I think they are both not optimized. Market pushing and research process are both not the best state that can be. It's my personal opinion.

[19:33] Dr. Nicolas Duhem: Yes, but they are not for very different reasons.

[19:38] Arseniy Arsentyev: Oh, wow. Interesting.

[19:40] Dr. Nicolas Duhem: The R&D process, which is the FDA and EMA process. In terms of setting up endpoints, setting up safety standards and collaboration, it's a pretty well-oiled process. The main issue there is that you need a lot of trial and errors to have a successful drug. And to fix that, the promise is basically to use advanced analytics, machine learning, artificial intelligence, so that we can identify early on a target and a compound that are going to interact very well in silico, so that once you go in vivo and in human trials, you have less waste. And you can identify a drug that's very successful very early on.

[20:43] So the regulatory process itself is not really an issue. It's more about the productivity of the research that's the barrier for the pharmaceutical industry. In the payer and the commercial sphere, the main issue there is that any healthcare system on the planet is under pressure because of aging population, increase of chronic diseases, etc. And that innovative drugs today are bringing an added benefit, but healthcare systems are under pressure. So that's the first thing. So the willingness to reimburse is not the same across countries, and there is no harmonization across the different payers to determine what that would be. In the US, the payer system is very scattered, and that's the main reason why there is a certain level of complexity there.

[21:54] Do I think that it's going to evolve over the next 10 years? Probably. Do I think it's going to be a single payer system like in Europe? Probably not. So, that's my point of view there, but the solution there is just to make sure that you interact with payers early on, you understand what's driving their decision making once the drug is approved.

[22:27] Arseniy Arsentyev: And what is a typical timeline for producing some treatment and actually putting it on the market? Say, for example, some science division of my hypothetical company finds promising data that supports a certain chemical might, I don't know, improve your cardiovascular health. How long and how much would I need to spend time and money to put the product onto the market?

[22:59] Dr. Nicolas Duhem: So I would say that to get one asset to be entered in phase one. So that means optimizing that asset so that it can reach the right target so that there is no off target side effects that are identifiable early on. I would say you probably need three years or something like that, or four years, and that will take a couple of compounds, so let's say 10 to 20 to get there. Then once we are in phase one, usually you have like a backup compound if the phase one doesn't work, or two.

[23:47] From the phase one through the phase three, that can take up to five or seven, eight years. It really depends on the therapeutic area. In the blood thinner compounds, for example, you need to have 50,000 patients recruited for the new generation of blood thinners. So that takes a lot of time to recruit all of those patients. If you have rare diseases, if you have rare diseases for whom there are a couple of thousands of patients worldwide, the requirements from the regulatory authorities is way less stricter. So you will need a couple of dozens or a hundred patients for those specialty or rare diseases. So, and that can decrease the time you need to produce the clinical results you need to get to the regulatory body.

[24:49] So all in, it can take from seven to 10, 12 years. Seven is if you're extremely lucky, or if you are a me too compound, a fast follower compound, with a proven mode of action, basically.

[25:07] Arseniy Arsentyev: And are we talking about billions of dollars to go through all the stages?

[25:12] Dr. Nicolas Duhem: Sorry, could you repeat the question?

[25:14] Arseniy Arsentyev: Are we talking about billions of dollars that are required to put these medications onto the market?

[25:21] Dr. Nicolas Duhem: Yes. On average, you need $2 billion to get one drug approved by a regulatory body.

[25:27] Arseniy Arsentyev: $2 billion, one drug?

[25:28] Dr. Nicolas Duhem: Yeah.

[25:30] Arseniy Arsentyev: Wow. Okay, and the last question on this topic is, do you need to have your boots in the U.S.? And how important is it to be actually present as a European company if you want to work on the U.S. market?

[25:48] Dr. Nicolas Duhem: So, the U.S. market represents probably 60% of the market worldwide. It's a very important market for different reasons. It's probably the most innovative market in the world in terms of producing new technology, because access to capital market is very different than in Europe, because the ecosystem is a bit more centralized than it is in Europe. And regarding the importance to have a physical office in the U.S., I think it's a very critical, it's critical actually to be either in Boston or San Francisco or New Jersey.

[26:33] Those are the main hubs. You have San Diego too, and to a certain extent, New York. But those are very important decisions that need to be taken early on. You cannot run a clinical trial without having sites for recruiting patients in the U.S., because you need to establish those relationships early on with physicians with your drug of interest. Otherwise, once you commercialize, they're going to ask you, why didn't you come to me so that we could better understand the development process early on?

[27:13] Arseniy Arsentyev: You said Boston, San Francisco, New York. What's, in your opinion, the best city to have this networking?

[27:21] Dr. Nicolas Duhem: I would say Boston and San Francisco are the strongest. And then New York, New Jersey are more pharma-driven versus biotech-driven. So probably San Francisco and Boston.

[27:39] Arseniy Arsentyev: All right, let's proceed to the career-oriented section that probably will help some of my younger audience. And the first question for you is, what background skills should a young person obtain in order to be an expert and in order to be a professional in the field of healthcare consulting? And business development, of course, if we're talking about it.

[28:06] Dr. Nicolas Duhem: Yeah, I would say to have a medical degree helps. Even if you work in commercial functions. And it can be a scientific degree: biology or veterinary, life sciences. It's really about having some sort of understanding of biology. And then what I did is to couple that with an MBA. So having that ability to understand financial decision frameworks is really useful because then you can combine both. And given a drug needs two billion dollars to be put to the market. It's very important to understand how resource allocation works at some point.

[29:04] And also to have the ability to say we need to cut our losses and cancel the program and stop the program, even if it's very painful. So I would say having a dual background is really helpful because you are then able to understand the scientists and also the commercial and financial folks from a pharmaceutical or biotechnology organization.

[29:26] Arseniy Arsentyev: So you need to be kind of a translator between two worlds, the world of business and the world of science. Is that a correct statement?

[29:34] Dr. Nicolas Duhem: That's right. You can learn the business piece while you work. So that's also totally possible. It really depends. If you have a broader interest in understanding macroeconomy, microeconomy, then having a dual background is useful.

[29:54] Arseniy Arsentyev: And what do you personally wish you learned earlier? Was there any topic that you stumbled upon?

[30:02] Dr. Nicolas Duhem: I would say that's probably how a corporation works and how the decision making within a corporation is taken. When you are studying, it's usually pretty straightforward. You take your class, you learn, and then you pass an exam. You get a basic understanding on how a concept is developed, etc. Once you work in a real organization, decision is not taken as rapidly as it would be when you study. So that would be one, making sure that you have the ability to work cross-functionally and to bring people as a team so that you produce an outcome that is the most optimized with the most information you can get at a certain point of time.

[31:14] Arseniy Arsentyev: And the common problem and the common thing that is not usually taught during the podcast is the problem of credibility. Because healthcare and medicine is a space that requires yourself to present you as a caring professional person. There is so much impact of having a good versus a bad reputation in the field. And how do you navigate it? And what do you suggest how to do proper, credible networking? That's the question.

[31:56] Dr. Nicolas Duhem: Well, I would say, to quote Warren Buffett, reputation is like virginity. You lose it one time. I think reputation is important in any field, whether you're a professional or your personal field. What I would say is that making sure that you listen and you ask questions is going to be important to build your credibility early on. So once you get out of school, usually you have the urge to answer all the questions because you've studied so much and you put so much effort into your studies. Having a more humble approach and listening to folks, asking the right or asking the questions, even if those questions look dummy in a way, I think is a way to approach your career in a good way.

[32:57] I would say that would be my biggest advice. Never be afraid of asking questions. And the other piece is sometimes it's more important to know what you don't know than to know what you know. And that comes also with the humility, because once you know that you don't know and that you need to take a decision with 60 or 70 percent of information that is available, then you do not approach the decision with the same perspective.

[33:32] Arseniy Arsentyev: That's a great answer. During my episodes, closer to the end, with every guest, I begin the discussion on the main topic of my show, which is Tomorrow's Medicine. It's some amount of time that we speculate on possible directions that our current world is emerging, that our current world is changing. Do you have your vision for Tomorrow's Medicine, say in 10 to 15 years? What do you think will change and what do you want to change?

[34:07] Dr. Nicolas Duhem: In terms of the forces at play, China is going to become a way bigger producer of innovative medicines. That's what we already see today. 60 or, I don't know if it's 40 or 60 percent of the deals year to date are somehow related to Chinese innovation. So there is something that's being pushed there and where basically Europe, similar to many other fields, is going to need to raise standards to remain competitive with its research. So that's one major force. The second force I see is the impact of artificial intelligence. If those technologies mature enough, the computing power that we will have at our disposal to better design drugs, to better understand targets, to better understand diseases is going to be phenomenal.

[35:14] And completely out of our understanding: we need to be at ease with the fact that machines are way more powerful and, quote-unquote, intelligent — it really depends on how you define intelligence — than what we can get out of our brain. So that means that companies will need to invest a lot of money into those new technologies so that they remain competitive too. I see healthcare, the pressure on healthcare to continue. The average cost, I believe in Western countries, excluding the US, for taking care of a 70-year-old is four times higher than the cost of taking care of 50 or 60-year-old. So that means that the budgets that will need to be allocated to healthcare is going to increase, irrespective of drugs. I'm talking about the totality of healthcare.

[36:23] That's going to be in competition with other priorities. As you see geopolitical tensions rising, you have military budgets going on. So there will be a lot of trade-off that needs to occur. How is it going to impact healthcare? I'm not sure yet. But that's going to be a major point of tension. Those are like the three major forces that I see. The rise of China innovation, the rise of AI and quantum physics in drug discovery. And then healthcare systems being put under pressure even more and in competition with other priorities at the state level.

[37:04] Arseniy Arsentyev: All right. I'm just amazed that you mentioned China. It's such a niche topic that I'm not usually talking with guests about. And can we dive a little more into this? Because it's really interesting. What can you tell us more about Chinese pharmaceutical market? You said already that it is advancing at an enormous rate. And can you maybe mention some differences in culture, in some business relations? So how Chinese healthcare market is different from the US one or maybe European?

[37:43] Dr. Nicolas Duhem: So I would mainly focus on the innovation ecosystem. I'm not such an expert on the reimbursement in China. It's quite complex.

[37:54] Arseniy Arsentyev: Sure. Let's talk about innovation.

[37:58] Dr. Nicolas Duhem: So the innovative landscape, I would say 10 or 15 years ago, China was seen as a copycat maker, basically. With some organization doing copycats of well-known drugs like Enbrel or Humira. But not so much. And they were seen as an API, so active pharmaceutical ingredients producer for generic companies. So your painkillers or your medicines for arthritis, etc. A lot of the compounds are made in China. So they were seen more as the factory of the pharmaceutical industry. That has shifted for the past three years, I would say. There has been a big push from the central government to spur innovation and to bring China into an innovative economy versus being the factory of the world. So that's a broader push from the China government across many disciplines.

[39:07] What you've seen also is more flexibility in terms of regulatory pathways. So there is something which is called physician-led clinical trials. So that means that a physician can decide to initiate a clinical trial and to test a drug on a small population size to get early results and to understand if there is a signal for efficacy or for safety. That path doesn't exist in the U.S., nor in Europe. So that brings a lot of flexibility on testing a lot of compounds very early on, very rapidly.

[39:51] And that's the early stage of the drug development. What Chinese companies are doing now is partnering with European or American companies once they have established some sort of proof of concept so that they can advance those drugs into the phase two, the phase three. And the way that they are doing that is usually to sell the rights of the drug to other geographies. So the Chinese company would keep the Chinese rights to commercialize the drug in China. And then they would sell the rights to commercialize the drug in the U.S. and/or in Europe to a big established company, because clinical trial is still very expensive.

[40:44] What you've seen over the past couple of years is that there has been a big push in quote-unquote well-known therapeutic areas. So in obesity, in cholesterol, in cancer, PD-1/VEGF is one famous example. And they have been able to produce results that are pretty interesting and pretty good to the surprise of some Western companies. And that shows that they have improved their innovation engine from manufacturing generics compound, basically, or API for generic compounds or just being a factory to producing new innovative drugs. So they have AI slash quantum companies like XtalPi, which is pretty well known with dozens of collaborations traded in Hong Kong. So the capital market is also a bit more flexible to welcome this type of innovation and to take more risk to fund those type of innovation.

[42:03] Arseniy Arsentyev: Great. And final question for you. Where do you see the doctors are going? Are they going anywhere? In your vision of tomorrow's medicine and the medicine in 10 to 15 years, what will doctors do? And to what extent will they be replaced by AI or maybe by surgical robots?

[42:25] Dr. Nicolas Duhem: So I would say for technology, any technology, the short-term impact is usually overestimated. The long-term impact is usually underestimated. Where AI is going to go, my personal belief, and it's a belief, is that we are not going to replace physician by robots. If you look at radiology, for example, AI or machine learning software have been able to get very accurate data and analysis for quite some time now. You haven't seen radiologists being fired all over the place in the US because the machine was able to produce a more accurate diagnosis, etc. What you've seen is that there is more time for those radiologists to study the disease, to spend their time with patients. So that's one example on what has been the impact of technology, robotics, and machine learning on physicians.

[43:43] When it comes to surgery, there are already a bunch of robots being in place, like the da Vinci robots. There is also the Johnson & Johnson has also a bunch of robots being developed. Those are used by surgeons, but I don't see a world where you would have a robot being run with no human oversight. The same way that a plane is mainly electronics today and, quote-unquote, on autopilots, you wouldn't see a plane flying without any pilots. That would be pretty tensuous, I would say.

[44:31] I would say that the future is going to be enhanced in healthcare with those type of technology. But I don't think that neither you nor I wants to be fully treated end-to-end by a robot. You still need a human touch because when you announce a cancer diagnosis, when you are asking your patient, how is your diabetes being managed? Why aren't you able to comply with a diet? Those are very rational questions, and you can have a very rational question, but we are human beings. And there is a lot of emotion in what we do and how we decide. And I do not think a robot or AI or AGI, whatever comes next, will be able to handle that the same way that a human would be able to.

[45:30] Arseniy Arsentyev: Okay. Thank you very much, Dr. Duhem, for participating in my show. I am absolutely confident that the information you provided will be important, will be heard. And, yep, thanks for your time.

[45:44] Dr. Nicolas Duhem: Absolutely. Thank you for the opportunity, and I hope it was a helpful context for your listeners.

[45:51] Arseniy Arsentyev: Yep, everyone, the best thing you can do to support my show is to subscribe to my channel and share my episodes with your friends. Let's wait for the 10th anniversary episode of Tomorrow's Medicine. Bye-bye to everyone.

[46:05] Dr. Nicolas Duhem: Thank you.