In this episode, Niklas Anzinger sits down with Stephen Martin, U.S. Lead at Infinita and Operations Lead of the Montana Experimental Treatment Review Board (ETRB), to explore what could become a new model for biotech development and patient access in the United States.

Montana SB 535, is a new framework allowing eligible post-Phase 1 experimental treatments to reach patients under regulated oversight with special clinic licenses and an expert review board. Stephen explains why traditional Right-to-Try and expanded access programs have struggled to scale, and how Montana could change the economics by allowing biotechs to generate real-world evidence, treat patients, and create revenue earlier in the development process.

They discuss how the pathway works in practice, who qualifies, opportunities for biotech companies and physicians, the relationship between state and federal regulation, the FDA’s role, and whether Montana could ultimately provide a blueprint for accelerating drug development across the United States.

More on this topic:

* Scott Alexander on the Aduhelm Approval

* Jared Rhoads on X

Reason, co-founder and CEO of Repair Biotechnologies and a longevity industry veteran with a background in astrophysics, joins us to talk about what it actually takes to test a therapy on humans, and why the system built to protect patients often keeps the best evidence hidden.

He breaks down why investors backing gene and cell therapies care more about a drug’s earning potential than whether it works, and why treatments already in use could be quietly adding years to human lifespan without anyone confirming it. Drawing on his own experience as a trial participant in Roatán, he also explains why Australia has become a faster, cheaper alternative for clinical trials, and how much of that gap comes down to culture rather than actual safety.

More about Reason’s work:

* Fight Aging!

Tim Urban, creator of Wait But Why and the mind behind one of the most-watched TED Talks of all time, joins us to talk about why progress does not happen automatically.

In this episode, he discusses the Space Race, longevity, AI safety, startup cities, and the social conditions that allow new ideas to survive. Tim explains why some technologies move fast while others stall for decades, why the best communities treat ideas like experiments, and why the future may depend less on prediction and more on building better environments for progress.

More about Tim Urban’s work:

* Tim Urban’s X

* What’s Our Problem?: A Self-Help Book for Societies