§ 03.5 ── HEALTHTECH / BIOTECH ── IN DEVELOPMENT
IN DEVELOPMENT · v0.0

For funds where clinical evidence and regulatory pathway determine outcome.

The Healthtech overlay is in design. Our work on the live Impact engagement already exercises some of the underlying primitives because that engagement intersects clinical evidence. We're looking for our first dedicated Healthtech engagement to formalize the segment-specific overlay.

CLINICALevidenceREGULATORYpathwayREIMBURSEaccessHEALTHTECH / BIOoverlay v0.0── DRAFT · v0.0 ──

FIG. 01 ── HEALTHTECH SIGIL · CLINICAL · REGULATORY · REIMBURSE

§ 03.5.1 ── CHALLENGE

Three things every Healthtech fund deals with.

κ 0.85–0.90 · COUNTER-EVIDENCE THRESHOLDCLAIM ───→100%01 · EFFICACYclaim 96%lit 62%02 · MOAclaim 88%lit 54%03 · DOSINGclaim 82%lit 66%04 · SAFETYclaim 92%lit 71%05 · ENDPOINTSclaim 86%lit 48%05 LANESASYMMETRY ZONE — COUNTER-EVIDENCE @ 0.85–0.90 κAUDIT-CHAIN PRESERVED

FIG. 02 ── EVIDENCE ASYMMETRY · CLAIM vs LITERATURE · κ 0.85–0.90

01

CLINICAL EVIDENCE ASYMMETRY

Founders' decks claim clinical efficacy. The underlying literature is partial, contested, or non-existent. The cost of accepting weak evidence is multi-year, multi-million-euro. Counter-evidence search at the 0.85–0.90 confidence band catches most asymmetries. The audit chain preserves the rigor for every claim.

02

REGULATORY PATHWAY UNCERTAINTY

FDA, EMA, MHRA, BfArM pathways diverge by product class. Software-as-a-Medical-Device (SaMD) regulatory posture is still evolving. Reimbursement pathways diverge further. Funds without rigor on pathway assessment over-invest in unwinnable regulatory positions.

03

REIMBURSEMENT RISK COMPOUNDED

Even when regulation clears, reimbursement may not. CMS · NICE · G-BA · HAS each have different evidence thresholds. Phase 3 trial design that satisfies regulation may not satisfy reimbursement. The overlay tracks both pathways in parallel.

§ 03.5.2 ── OVERLAY ── IN DESIGN

What we're designing.

01 · REGULATORY RAILFDA · EMA · MHRA · BfArMFDA 510(k)1976 pathPMAclass IIIDe Novonovel low/modEMA centralizedEU-wideMHRA · BfArMpost-Brexit · DEPHASE 3 ENDPOINT DESIGNassessed against both rails — in parallelCPT · HCPCS · DRGCMSQALY thresholdNICE TAadded benefitG-BA AMNOGSMR · ASMRHAS HTA02 · REIMBURSEMENT RAILCMS · NICE · G-BA · HAS

FIG. 03 ── DUAL-PATHWAY BLUEPRINT · REGULATORY ∥ REIMBURSEMENT

01

CLINICALTRIALS · PUBMED · COCHRANE · NICE

Real-time integration. Counter-evidence search auto-triggered. Replication-status weighting. Mechanism-of-action documentation requirements. Partner-defined source weighting (pharma-funded studies vs independent).

02

REGULATORY PATHWAY TRACKING

FDA 510(k) · PMA · De Novo · breakthrough designation. EMA centralized · decentralized · mutual recognition. SaMD-specific (FDA Pre-Cert · MDR class IIa/IIb/III). MHRA, BfArM, HAS posture tracked per portco.

03

REIMBURSEMENT RISK MODELING

CMS coding (CPT, HCPCS, DRG). NICE technology appraisal track record. G-BA AMNOG assessment patterns. HAS HTA outcomes. Phase 3 endpoint design assessed against reimbursement evidence requirements, not just regulatory.

04

MECHANISM OF ACTION DOCUMENTATION

Founder claims about MOA traced to underlying biology. Where MOA is novel, overlay flags additional rigor requirements. Where MOA is established, prior reference data becomes evidence weight.

05

PHASE PROGRESSION ANALYTICS

Series A through commercialization. Phase 1/2/3 progression rates by therapeutic area. Cohort-context retrieval ("how do dementia digital therapeutics typically progress through Phase 3?").

§ 03.5.3 ── KPIs · ADAPTED

Same eight KPIs. Healthtech calibration.

INBOUND≤30 MINDECISION≤10 MINCLINICAL≥0.85INTER-RATER κ≥95%EVIDENCE≤14 DPATHWAY LEAD100%AUDIT+50%TIME FREEDNOWTARGET

FIG. 04 ── KPI BAND · NOW → TARGET · HEALTHTECH-CALIBRATED

INBOUND TRIAGE

vs partner baseline · therapeutic area routing

DECISION TURNAROUND

≤ 30 min

including evidence-asymmetry flag

CLINICAL SCORE

≤ 10 min

full evidence stack with counter-search

INTER-RATER κ

≥ 0.85

Cohen's κ weighted · across partners · clinical judgment

EVIDENCE COVERAGE

≥ 95%

verified · counter-evidence checked

PATHWAY LEAD TIME

≤ 14 days

regulatory shift flagged before material

AUDIT COVERAGE

100%

clinical claims + pathway + reimbursement

PARTNER TIME FREED

+ 50%

time on founder + clinical engagement

§ 03.5.4 ── FIRST HEALTHTECH ENGAGEMENT

Co-design terms.

First-engagement funds in a new segment get co-design pricing and naming-as-reference rights (if mutually beneficial). Phase 0 remains free (10 working days, framework + synthetic-data PoC). Phase 1 scope reflects co-design. All artifacts — including the Healthtech overlay v0.1 — yours unconditionally regardless of gate outcome.

§ END ── FIRST HEALTHTECH FUND

If your fund is Healthtech or Biotech and you'd consider being our first Healthtech engagement — let's talk.