Podcast Transcript

David Brühlmann [00:00:47]:
Welcome back to the second half of our conversation with Eric Moyal, founder of Project Insulin. If you joined us for part one, you know we’re tackling one of the more stubborn problems in making an essential medicine affordable without cutting corners on the science. In this part, we continue the discussion — from the technical realities of development to the strategy and mission that hold it all together. Let’s pick up where we left off.

I’d like to tap into your expertise a bit more because you have a fundraising background and a nonprofit background. We do have an affordability crisis not only for insulin, but also for many other drugs. That’s a big one. I’m curious, Eric: how does developing a biosimilar as a nonprofit actually change your decision-making and your whole business model?

Eric Moyal [00:02:59]:
The first thing, which we touched on at the beginning, is shareholders versus stakeholders. We don’t have a fiduciary duty to investors. David, if you gave me a million dollars today, I would say thank you and take you out to dinner, but I don’t owe you anything other than ensuring that we make this insulin as affordable as possible. And that creates a kind of freedom.

There is less pressure from investors — or from donors in our case — to stray from the mission of making insulin as affordable as possible. So I think that’s the first piece: we don’t have that pressure. On the other hand, we also don’t have the incentive structure. There’s no ROI incentive.

So if you gave me a million dollars, or if I’m trying to convince you to give me a million dollars, if you don’t passionately care about this mission and the idea that it could change the lives of hundreds of thousands or millions of people, it’s going to be very hard to bring you on board.

And truthfully, a lot of conversations we’ve had with potential donors have gone like this: “Well, if you were a for-profit, I would have invested, no problem.” That’s a simplification that’s easy to say when someone is rejecting us. I don’t actually think they would have invested if we were a for-profit. But I’d say that’s one of the main differences: the investor–donor relationship.

On one hand, we don’t have pressure to generate ROI. On the other hand, we don’t have the incentive — the carrot on the stick — of ROI. That’s the biggest structural difference. Otherwise, it’s the same thing. We’re a life sciences company that happens not to be trying to make a profit.

And I think what trips people up is the idea of nonprofits making money. Yes, of course we have revenue. We will sell insulin at cost. “Cost” is our manufacturing plus operating expenses, divided by the number of vials we sell. Of course, that’s a simplified model, but the principle holds: we have to cover our expenses. Those expenses are also subsidized by donations and grants.

So let’s say in five or six years, when our insulin is on the market and FDA-approved, if our annual expenses are $10 million — just as an example — and we receive a $10 million donation, we can heavily subsidize the price patients pay because we operate at cost. That’s the whole point.

I think that’s another key piece: the ability to subsidize. And the last thing is: it’s different. That’s not a judgment — it’s not better or worse — it’s just different. And a lot of people are uncomfortable with different.

David Brühlmann [00:05:32]:
When you say “different,” especially in biotech, there is often risk aversion or at least some resistance to change. Let me rephrase what you just said, Eric. What I understand is that the funding mechanism is very different — you are addressing a different type of audience, and there is no ROI expectation.

On the other hand, on the cost side, it is very similar to a for-profit model because there is very little room to reduce costs of development and manufacturing. You’re using the same raw materials, the same facilities, working with a CDMO. There is very little room to bring down those costs, right?

Eric Moyal [00:06:20]:
Absolutely. That is 100% correct. There isn’t a lot of room to bring down the cost of manufacturing. The difference is the price we sell it at. So in the U.S., people without insurance coverage can, on average, spend up to $300 per vial of insulin, and you need between two and four vials per month.

The projected manufacturing cost — generally, not for us specifically, but based on a few different papers — is between $2 and $10 to make that vial. So the manufacturing cost is $2 to $10, but it’s being sold at $300. That’s a huge gap, and that’s where we’re going to play. We’re playing in that gap.

Our starting price will be around $30 per vial, and then we’ll slowly bring it down further as we achieve economies of scale and make our manufacturing process more efficient. But I think the “at-cost” model is important. It’s as close to true cost as possible, because if manufacturing is $10, then you also need to add the CDMO’s margin, plus our operating costs, plus shipping. That’s how we get to roughly $30.

But I think manufacturing costs will remain the same or very similar unless we develop some major process innovation — and we do have a strong team — but unless something fundamentally changes, I don’t expect that cost to drop significantly.

And again, the goal of our organization is not to innovate the drug itself — it’s to ensure access. That’s something you have to remind yourself of constantly, because there are always more efficient ways to increase titer, optimize strains, and so on. And that’s great — but that belongs to high R&D organizations, not to someone trying to make a biosimilar accessible.

David Brühlmann [00:07:57]:
How will your distribution model look like? Because the reason I’m asking is that even for currently approved insulin options, the manufacturing cost is not actually that high. So from what I understand, the high price — the $300 — mainly comes from distribution and middlemen. So what is your approach to avoiding middlemen and getting directly to the patient?

Eric Moyal [00:08:23]:
That’s another case where timing played a role. We started during COVID, and at that time the idea of a mail-order pharmacy already existed, but it was really taking shape and scaling. So our idea is a mail-order pharmacy model. You put your prescription in, and we ship it directly to you.

That way, there is no traditional middleman. The only intermediary is UPS or another logistics provider. It’s not a chain of insurance companies, pharmacies, wholesalers, and so on. It would go straight to the patient through our website.

Now, there are additional ways to optimize this. For example, instead of shipping to individuals, we could ship in bulk to centralized locations — larger shipments of insulin — which would reduce the per-vial shipping cost.

Another layer would be partnering with local and federal healthcare clinics. Some already provide free or low-cost care for patients who are struggling. So over the next few years, instead of sending Joe three vials a month, we would be sending a clinic 100,000 vials at a time. That again brings the cost down per patient in the long term.

We are actively working on those partnerships. There are also global opportunities. For countries with limited access to insulin, distribution could go through organizations like UNICEF or the UN. So instead of shipping directly to individuals in those countries, we would ship to an organization that already has distribution infrastructure in place. Of course, we would need to win those contracts.

But that’s another way to keep costs low while still ensuring access for the people who need it most. So our distribution model is generally:

1. Direct-to-patient via mail-order pharmacy

2. Partnerships with clinics and healthcare providers

3. Global partnerships with large organizations that already have distribution systems

Our guiding principle is not to reinvent the wheel. We work very hard to avoid building unnecessary infrastructure, because that adds cost, delays, and complexity that are not central to the mission.

David Brühlmann [00:10:21]:
What are the potential roadblocks you’re facing in significantly changing the distribution model?

Eric Moyal [00:10:28]:
You’re absolutely right that the biggest challenge is not actually drug development. On the development side, the main question is: can we raise the money? The bigger challenge is distribution — how do you actually get the product to patients? So building the right partnerships is critical, and that takes time. It will likely take a few years to establish those relationships properly.

We are fortunate that drug development itself also takes time, but we still need those partnerships in place by the time we receive FDA approval. We are effectively on a timer. Another important piece is ensuring we have a strong relationship with the FDA.

Our fill-finish site will be in the U.S., which should also help with supply chain and distribution. So supply chain could have been a major bottleneck, but having domestic fill-finish should help mitigate that. The biggest challenge overall is still building those partnerships and deciding whether we build our own mail-order pharmacy or partner with an existing one.

There is a very interesting nonprofit in St. Louis, Missouri, that already operates a nationwide mail-order pharmacy, shipping to all 50 U.S. states. Being centrally located in the U.S. makes them strong for distribution, so partnering with them could be a major advantage. In any case, these relationships need to be secured before we complete Phase 1 — essentially in time to support rollout planning. So I’d say the biggest challenge is building the partnership ecosystem and ensuring we have the infrastructure in place to track and deliver insulin nationwide efficiently.

David Brühlmann [00:11:53]:
For a founder or scientist listening who would also like to solve affordability issues or challenges, what is the most important thing they should understand before starting and going down a similar path?

Eric Moyal [00:12:07]:
Like you said, there are many ways to do this. The first thing is that my expertise is in fundraising, so I went the nonprofit route because that is what I know and what I’m comfortable with.

I don’t think you have to go the nonprofit route. There are public benefit corporations, there are S-corps, and other corporate structures that can be used to support accessibility and affordability. You can also make a profit while still aligning with that mission. So that’s one piece.

But then, for a scientist, raising money is hard. And when you’re building a generic or biosimilar drug company, it’s not always seen as particularly “sexy” from an investment perspective. So it can be difficult to raise capital. In that sense, I do think the nonprofit model was the right route — not just for me, but for this specific problem — because it affects so many people and is such a large, well-known issue. For other medications, that might not be the case.

With insulin, I get a lot of leeway when introducing our organization because everyone knows how expensive insulin is, and almost everyone knows someone with diabetes. The last thing I would say is: make sure you are really in it, because it is not a short process.

We’re five and a half years in, and as of this recording, we are signing our contract with our CDMO — which means we are starting drug development in July. That took five and a half years just to reach the starting line. As a scientist, it’s different — you may have a bench, early experiments, proof-of-concept work, and so on. But in this case, it takes time. Be patient, and make sure you are truly committed, because it is hard and it can be lonely. You are often the only person doing exactly what you are doing.

David Brühlmann [00:13:49]:
Looking back on the journey so far, what is the biggest lesson you have learned?

Eric Moyal [00:13:56]:
It’s interesting — last night I went out for drinks with my girlfriend because we were celebrating the start of drug development. We were reflecting on the last five years: the biggest pitfalls, the biggest successes, and what we’re most excited about moving forward. I think beyond all the science I’ve learned — I now know what a reverse-phase cleavage step is, I know what a plasmid is — all of these things I never thought I would learn in my lifetime. But the biggest lesson is how important it is to get the right people around you.

In the early days, nonprofits require a board of directors to start, which is not the same as for-profit companies. My original board was my partner, my girlfriend, and a friend of mine who is a lawyer. That was it. In those early conversations, they often told me “no” — a lot. No, we can’t do this. No, we shouldn’t do that. At the time, I hated it. Every board meeting, I was nervous and worried they would reject my ideas. But in hindsight, those first two years had no real stakes. No one knew who we were, and we had no money. Hearing “no” forced me to come back with better, more thoughtful proposals. It shaped how I think and how I operate.

So when things became serious later, I wasn’t asking for vague or unrealistic things — I was asking for concrete, well-developed decisions. I think the biggest lesson is that founders often have an ego around their idea: “this is my vision, I’m making this happen, if you disagree you just don’t understand.” Letting go of that — at least partially — and learning to listen to the people you trust is critical. If you surround yourself with the right people, you can trust them when they say something is wrong or shouldn’t be done. I have many stories that reinforce that, but I think the point is clear.

David Brühlmann [00:16:10]:
How will the next five years look for Project Insulin?

Eric Moyal [00:16:14]:
Oh, man. There’s the version where, in five years, we’re FDA-approved and the drug is on the market. There’s the version where we’ve completed our preclinical work and submitted our pre-IND package to the FDA. And then there’s the version where it doesn’t happen at all. And that’s all part of the reality of fundraising being our main driver. Depending on how fundraising goes, any one of those three outcomes is possible.

What I think is most likely is that we will have hired a few more staff to support the scientific work, and we will have completed our pre-IND package and submitted it to the FDA. We’ll also be preparing to start Phase 1 clinical trials. That’s probably the most realistic scenario over the next five years. It’s a more conservative view, but it reflects the realities of the process. Could it happen faster? Absolutely. As a nonprofit, the pressure is not to achieve ROI as quickly as possible — it’s to give ourselves the best possible chance of FDA approval. So if it takes five years to get through pre-IND, that’s fine by me. I have nothing but time.

David Brühlmann [00:17:15]:
Fantastic. We’ve covered a lot of ground today. What is the most important takeaway from our conversation?

Eric Moyal [00:17:24]:
First and foremost, Project Insulin is here to stay. We are growing — an ambitious nonprofit building insulin for everyone who needs it. But I think the bigger takeaway is that this problem is not going away, and that generic drugs, in general, are part of a much larger conversation beyond insulin.

Generic medicines should be affordable. The original idea behind the patent system was to incentivize innovation: companies develop new drugs, recoup their investment, make a profit, and then once patents expire, those drugs become affordable and widely accessible. That was the implicit deal made when modern patent laws were established in the 1960s or 1970s. We have moved away from that balance.

So the takeaway is that generic drugs should be accessible and affordable to anyone who needs them. We are one step in that process. We won’t be the only ones — and we can’t be the only ones — but we are part of a broader push toward more affordable medicines, especially in the generic space.

David Brühlmann [00:18:28]:
Where can people connect with you and support Project Insulin?

Eric Moyal [00:18:33]:
Absolutely, and thank you. You can find us at projectinsulin.org — that’s our website. On social media, we are @ProjectInsulin on most platforms, or Project.Insulin. The best way to support us is to join our newsletter. That’s where we share updates when something meaningful happens. We don’t send emails often, but we do when there’s important news.

David Brühlmann [00:18:57]:
You got it, smart biotech scientists — I will leave all the information in the show notes. Please reach out to Eric Moyal and learn how you can contribute to more affordable insulin. Well, this has been great, Eric. Thank you so much for taking the path less traveled with a nonprofit approach to solving such a big problem. It’s been a wonderful interview. Thank you for being on the show today.

Eric Moyal [00:19:22]:
Absolutely. Thank you, David, and thank you for taking the time to interview me and share the work we’re doing.

David Brühlmann [00:19:28]:
Building a biosimilar as a nonprofit means measuring success in patient health rather than margins. And as Eric reminded us, that reframes nearly every decision along the way. Whether you’re a founder, a scientist, or simply someone who cares about access, his story shows that technical rigor and mission can advance together. Please leave a review on Apple Podcasts or your favorite platform — and thank you so much for tuning in.