E35: Biogen's controversial Alzheimer's drug approval, the billionaire space race, real estate, Bitcoin & more

Key elements of Friedberg’s prediction have not materialized by the forecast horizon (mid‑2023) or even by late 2025:

1. “Many” new drugs on the market within a couple of years
   • As of mid‑2023, the only new disease‑modifying monoclonal antibodies approved for Alzheimer’s in the U.S. were aducanumab (Aduhelm, 2021) and lecanemab (Leqembi, accelerated approval Jan 6, 2023; traditional approval July 6, 2023).(alz.org)
   • The next major antibody, donanemab (Kisunla), was not FDA‑approved until July 2024.(depts.washington.edu)
   • Including older symptomatic drugs (donepezil, rivastigmine, galantamine, memantine) doesn’t change that there were not “ten things approved” in the couple of years after June 2021—only one controversial new drug (Aduhelm) plus Leqembi right at the end of that window.

2. “Everyone’s going to be taking an Alzheimer’s drug in a couple of years” (near‑universal use)
   • Real‑world data show very low uptake of the new antibodies. A JAMA Network Open study of Medicare fee‑for‑service beneficiaries found 1,725 lecanemab users among 842,192 patients with diagnosed Alzheimer’s or MCI between July 2023 and March 2024—uptake well under 1%.(medicalxpress.com)
   • Earlier U.S. work on symptomatic drugs (cholinesterase inhibitors and memantine) found that only about 33–56% of dementia patients ever received an approved antidementia drug, not “effectively everyone.”(pubmed.ncbi.nlm.nih.gov)
   • Globally, care gaps are huge: a Yale‑linked global study reports that around one in five people with dementia receive no care at all, even counting non‑drug support, implying far less than universal medication use.(ysph.yale.edu)
   → The “everyone is taking an Alzheimer’s drug” part of the prediction is clearly false.

3. “Maybe 10% of people get cured, 90% don’t”
   • No approved Alzheimer’s drug is described by regulators or major medical organizations as a cure. The Alzheimer’s Association explicitly calls Leqembi “not a cure,” saying it only slows progression in early disease.(prnewswire.com)
   • News and medical coverage of Leqembi and similar drugs consistently state they “modestly” or “moderately” slow cognitive decline, not that they cure any subset of patients.(cbsnews.com)
   • There is no evidence that ~10% of all treated Alzheimer’s patients are cured in the ordinary sense (disease eradicated or permanently halted).
   → The cure‑rate claim is not supported by current data.

4. Per‑patient cost “on the order of millions of dollars”
   • List prices for the key disease‑modifying antibodies are high but orders of magnitude below “millions” per patient:

   • Leqembi (lecanemab): about $26,500 per year in the U.S.(prnewswire.com)
   • Donanemab (Kisunla): roughly $32,000 per year.(news.northeastern.edu)
   • Aducanumab (Aduhelm): initially $56,000 per year, later cut roughly in half before discontinuation.(grandviewresearch.com)
     • Analyses that include required MRI/PET imaging and monitoring estimate total per‑patient annual costs around $33,000–$34,000 for Leqembi, not millions.(kffhealthnews.org)
     • Over many years of continuous treatment, some patients could approach low six‑figure totals, but “millions of dollars per person” is well above current real‑world or modeled course‑of‑treatment costs.

5. “Very high system‑wide healthcare spending”
   • On this narrower point, projections do show substantial potential spending: JAMA Internal Medicine modeling estimates that broad Medicare coverage of Leqembi could add $2–5 billion per year in Medicare costs alone.(pmc.ncbi.nlm.nih.gov)
   • However, because uptake has remained limited so far (e.g., a few thousand users relative to millions of U.S. patients with Alzheimer’s), actual realized spending through 2025 is far below the worst‑case projections.

Overall assessment
The central quantitative and qualitative claims—many new drugs within ~2 years, near‑universal treatment, ~10% cures, and per‑patient costs in the millions—are all inconsistent with what has actually happened by mid‑2023 or even by late 2025. While the general direction (new expensive drugs creating significant aggregate spending with modest benefit) has some truth, the forecast was far too aggressive in scale, timing, uptake, and clinical effect.

Therefore, the prediction is best classified as wrong.

Available evidence shows Jeff Bezos has never become CEO of Blue Origin, nor announced that he would work on it full time for the rest of his career.

• In September 2023, Blue Origin announced that Bob Smith, then CEO, would step down and be replaced not by Bezos but by Dave Limp, an Amazon executive, as CEO of Blue Origin. Bezos is described as the company’s founder and funder, not its incoming CEO. (washingtonpost.com)
• Biographical and news sources list Dave Limp as the sitting CEO of Blue Origin as of 2024, with no indication that Bezos has held the CEO title at any point. (en.wikipedia.org)
• Separate reporting in 2025 notes that Bezos’ first return to an executive role since leaving the Amazon CEO job is as co‑CEO of the AI startup Project Prometheus, not of Blue Origin. (en.wikipedia.org)

Across major news outlets and reference sources, there is no public announcement of Bezos becoming Blue Origin’s CEO or declaring he will work on it full time for the rest of his career. Instead, Blue Origin’s CEO role has been held by Smith and then Limp, while Bezos has taken an executive role elsewhere. Therefore, Friedberg’s prediction did not come true.

The prediction mixed several claims:

1. Office utilization falls but offices are not “destroyed”.
   Evidence supports this. U.S. office vacancy reached about 19–20% in 2024, the highest in at least 40 years, while access‑control data show average office occupancy in major U.S. cities stabilizing around ~50–55% of pre‑Covid levels—far below 2019, but clearly not zero. (fortune.com) In 2025, more obsolete office space is being demolished or converted than new space is being built, but a large office sector still operates. (nypost.com) This part of Chamath’s view is broadly accurate.

2. Companies move toward smaller, more flexible footprints.
   Surveys of U.S. office occupiers by CBRE in 2023–24 found that more than half of large tenants planned to reduce their office space, with demand concentrating in higher‑quality, more efficient buildings; CBRE’s 2025 mid‑year outlook notes smaller occupiers as key drivers of leasing and a persistent “flight to quality.” (cbre.com) This fits his expectation that firms would "get much smarter about getting smaller spaces and having flex spaces."

3. "Things like WeWork do better" than pre‑pandemic.
   This is clearly wrong for WeWork, the specific example he named. WeWork’s losses and lease obligations remained so severe that it filed for Chapter 11 bankruptcy in November 2023, after accumulating more than $10 billion in losses and seeing its equity value fall over 99% from its peak. (forbes.com) The company only exited Chapter 11 in mid‑2024 after eliminating over $4 billion of debt and shedding roughly a third of its locations and a large share of future rent obligations—hardly “doing better” than its pre‑Covid condition as a high‑growth private unicorn. (reuters.com)

   The flex‑space sector overall has benefited from hybrid work—rival IWG (Regus/Spaces) has reported record revenues and significantly higher profits in 2023–24 and continued expansion and revenue growth in 2025. (reuters.com) But Chamath’s formulation tied the thesis specifically to "things like WeWork," and WeWork’s business performance has deteriorated dramatically relative to pre‑pandemic conditions.

Because the core causal claim that flexible‑space providers "such as WeWork" would perform better than before Covid has not come true for WeWork itself—even though enough time has passed to judge—this prediction is best classified as wrong overall, despite being partly right about lower office utilization and the structural shift toward smaller, more flexible offices.

Chamath framed post‑COVID inflation as a “head fake” that would prove transitory, implying only a brief spike before settling back near the pre‑pandemic norm and not becoming a serious, multi‑year problem. In reality, U.S. CPI inflation ran well above the Fed’s 2% target for four straight years: about 4.7% in 2021, 8.0% in 2022, 4.1% in 2023, and 2.9% in 2024, with 2025 still around the mid‑2% range—meaning elevated inflation persisted for several years after COVID rather than being a short blip. (usinflationcalculator.com)

The severity and duration of the surge forced the Fed into its most aggressive hiking cycle since the early 1980s, after which Chair Jerome Powell explicitly retired the word “transitory” for inflation and described the earlier framing as inappropriate. (cnbc.com) Financial and economic commentary now generally describes this as a multi‑year high‑inflation episode and even a shift toward an above‑2% inflation regime, not a mere head fake, with articles in late 2024–25 referring to “high inflation entering its fifth year” and the Fed projecting inflation above target for years to come. (investopedia.com) That contradicts the prediction that long‑term inflation would turn out not to be a serious issue.

On the narrower point about market expectations: 10‑year breakeven inflation did spike toward ~3% in 2021–22 but subsequently fell back to roughly 2.2–2.3% by late 2025, close to its historical median of about 2.2%. (fred.stlouisfed.org) So it is fair to say long‑run market expectations remained anchored. But that outcome coexisted with several years of realized inflation far above target and continued policy concern, so it does not validate the broader “head fake / no real inflation problem” thesis.

The second leg of the prediction—that once inflation fears faded, U.S. homebuilders would “rip in the capital” and housing supply would “pick back up really aggressively” from pandemic‑era lows—also did not materialize in the way implied. Housing starts did rise above late‑2010s levels in 2021–22 (about 1.60 million starts in 2021 and 1.55 million in 2022 vs. 1.29 million in 2019), but then declined to 1.42 million in 2023 and 1.37 million in 2024, with overall construction in 2025 dropping to its lowest level in roughly five years amid high mortgage rates and tariff‑driven costs. (ipropertymanagement.com) Multiple analyses in 2023–24 still find a structural housing shortfall on the order of 2.5–3.8 million or more homes nationally, and broader housing‑crisis work cites a 4–7 million unit shortage as of 2024, indicating that new construction has not closed the gap and that supply remains constrained rather than having surged enough to normalize the market. (realtor.com)

Taken together, the core narrative—that post‑COVID inflation would mostly be a brief head fake and thus clear the way for an aggressive, sustained homebuilding boom that sharply alleviates U.S. housing scarcity—has not played out. Inflation proved prolonged and policy‑significant, and although building increased somewhat, it fell back and left a large, widely‑documented housing shortage. Therefore the prediction is best classified as wrong.

By 2025, both main outcomes Jason described have effectively occurred, even though multiple forces (remote work, taxes, general housing under‑building, high post‑2022 mortgage rates) contributed alongside institutional homebuying.

• Significant net migration from high‑regulation states (CA, NY) to pro‑development states (esp. TX): From 2021–2024, California and New York had the worst net domestic migration in the U.S., while Texas repeatedly had the highest net domestic in‑migration. Census‑based estimates show California’s net domestic outflow at about −408k in 2021, −342k in 2022, and still strongly negative afterward, widely described as a “California exodus.”(en.wikipedia.org) Texas, meanwhile, added hundreds of thousands of residents annually, with domestic migration alone bringing roughly 193k people in 2021 and about 231k in 2022, and Texas ranking #1 nationally for net domestic migration in 2023 and 2024.(comptroller.texas.gov) This is consistent with Jason’s “massive movement” out of California/New York to states like Texas.

• High‑regulation states relaxing zoning and development rules (including in and around Sacramento): Since 2021, California has passed multiple laws that materially weaken local NIMBY zoning. SB 9 (the California HOME Act), effective 2022, creates a statewide, by‑right process for duplexes and lot splits on most single‑family parcels, limiting cities’ ability to block such projects.(en.wikipedia.org) Sacramento went further, becoming an early city to end exclusive single‑family zoning and, in 2024, adopting a “Missing Middle Housing” ordinance that allows multi‑unit housing (up to 8–10 unit cottage courts, four‑plexes, etc.) in every former single‑family neighborhood.(sd11.senate.ca.gov) Other California cities such as Berkeley have also voted to end single‑family zoning in most of the city, explicitly to allow more duplexes and similar “middle housing.”(sfgate.com) Additional statewide reforms (SB 4 on faith‑based/higher‑ed land, CEQA streamlining) further tilt policy toward more building in exactly the kind of high‑regulation markets Jason referenced.(en.wikipedia.org)

• Political backlash to institutional buyers of single‑family homes: While not a single, unified national crackdown, there has been clear, sustained political backlash: federal “Stop Wall Street Landlords” bills in 2022 and 2024 aimed at curbing tax benefits and access to federally backed financing for large investors in single‑family homes; state‑level proposals (e.g., Nebraska’s bill to bar out‑of‑state corporations from buying single‑family houses; New York’s 2025 proposal to delay and penalize hedge‑fund purchases); and widespread rhetoric from officials blaming “Wall Street landlords” and “shadowy private equity giants” for driving up housing costs.(khanna.house.gov) These moves are a direct response to institutional investors’ growing share of home purchases—around 15–25% of single‑family sales in recent years according to NAR/Redfin summaries.(nasdaq.com)

Netting this together: over the several years after mid‑2021, there was a large, measurable migration from high‑regulation states like California and New York to pro‑growth Sun Belt states such as Texas, and high‑regulation California in particular has implemented unusually aggressive zoning and permitting liberalization. Causality is overdetermined, but the specific future Jason painted—backlash to institutional accumulation of single‑family homes coinciding with either mass migration to places like Texas or a break in NIMBY zoning in places like Sacramento—matches the broad trajectory that actually unfolded. Hence the prediction is best judged as right in outcome, even if his suggested mechanism wasn’t the only driver.

Jason predicted that in the coming years the U.S. would (1) force people to publish their tax records and (2) impose some kind of minimum/wealth tax on large asset holders.

1. Public disclosure of individual tax information
Federal law still treats individual tax returns as strictly confidential under Internal Revenue Code §6103, and IRS guidance emphasizes that returns and return information may not be disclosed except in narrow, codified circumstances. The Freedom of Information Act and other open‑government rules explicitly do not override these protections. (irs.gov)
Recent developments reinforce privacy rather than moving toward public release: in 2025 a federal court ruling highlighted that tax data remain highly protected and rejected broader sharing of IRS information, underscoring the importance of confidentiality. (washingtonpost.com)
No federal statute or regulation has been enacted since 2021 that mandates public disclosure of ordinary individuals’ tax returns or even high‑level summaries. State-level attempts have been narrow (e.g., California’s law conditioning candidate ballot access on releasing tax returns, parts of which were struck down) and do not create general public disclosure for taxpayers. (en.wikipedia.org)
Net effect: U.S. policy has not moved toward forcing taxpayers in general to publish their tax records; if anything, legal and judicial actions have reaffirmed confidentiality.

2. Minimum tax / wealth tax on individuals with large holdings
The U.S. still has no federal wealth tax—there is no ongoing annual tax on individuals’ net worth. Major tax-policy summaries as of 2025 explicitly state that the United States does not impose a federal wealth tax, and no state currently levies a recurring net‑wealth tax on individuals either. (taxpolicycenter.org)
There have been proposals aimed at very wealthy individuals—e.g., the Ultra‑Millionaire Tax Act of 2021 (a true wealth tax) and the Biden administration’s “Billionaire Minimum Income Tax,” which would apply a minimum rate on very high‑wealth households including unrealized gains—but these remain proposals, not enacted law. (en.wikipedia.org)
At the same time, Congress has moved in the opposite direction on some wealth-related taxes, such as advancing legislation to keep or raise very high estate‑tax exemptions, which eases taxation of large inheritances rather than tightening it. (washingtonpost.com)
Some states, like Washington, have floated wealth‑tax bills, but as of late 2025 these remain proposals and have not established an operative wealth tax regime. (apnews.com)

Conclusion
More than four years after the June 2021 podcast, the U.S. has not begun forcing public disclosure of individuals’ tax records, nor has it adopted any form of federal wealth tax or mandatory minimum tax specifically targeting individuals’ net worth. Policy discussion has occurred, but the concrete legal changes Jason predicted have not materialized, and in some respects policy has moved the other way. Therefore, the prediction is wrong.

Key observable outcomes since mid‑2021 contradict the prediction that Bitcoin toxicity would cause a death spiral, deter participation, and materially undermine Bitcoin’s long‑term success relative to the rest of crypto:

1. Bitcoin dominance and relative performance rose, not fell.

   • CoinGecko data show Bitcoin’s average market‑cap dominance was ~47.6% in 2021, dipped in 2022, but then climbed to 51.9% in 2024 and about 59.3% in 2025, with daily dominance surpassing 60% for the first time in four years in April 2025.
   • By 2025 this resurgence is explicitly linked to mainstream legitimacy and institutional adoption, while Ether’s market share has shrunk from ~13% to ~7% over the same period, indicating Bitcoin has strengthened relative to most of the crypto ecosystem, not weakened. (coingecko.com)

2. Participation and on‑chain adoption kept climbing.

   • Glassnode‑based analytics show addresses with a non‑zero BTC balance hit an all‑time high of ~38.8M in late 2021, then ~40M by early 2022, and continued rising to over 44M by early 2023 and about 52.5M+ by May 2024, with further growth beyond 53M later in 2024. This is sustained user growth, not a collapse in willingness to participate. (dailyhodl.com)

3. Price and institutional adoption reached record levels.

   • After the 2021 drawdown, Bitcoin not only recovered but set successive all‑time highs: breaking $70,000 in March 2024 and then exceeding $110,000–$120,000+ multiple times in 2025, with peaks reported around $118k–$125k and a market cap near $2.2–2.5 trillion. (forbes.com)
   • U.S. spot Bitcoin ETFs, launched in January 2024, amassed over $100–125B+ in assets within about a year, holding more than 6% of Bitcoin’s supply and ranking among the fastest‑growing ETFs in history—strong evidence of new mainstream and institutional participation rather than people avoiding Bitcoin. (cointelegraph.com)

4. Crypto as a whole grew, but Bitcoin remained the centerpiece.

   • By mid‑to‑late 2025, the total crypto market cap is in the ~$3.8–4T+ range, with Bitcoin alone around $2.2T or more—roughly 55–60% of total value. Even as altcoins and stablecoins boomed, analysis from financial and industry outlets repeatedly frames Bitcoin as the benchmark digital asset at the core of the ecosystem, not a project in “collapse.” (investopedia.com)

"Bitcoin toxicity" and maximalist culture are real discussion topics, but the prediction here was much stronger: that such toxicity would collapse the project and put Bitcoin into a "death spiral" by driving people away and causing it to underperform the broader crypto space. Four years of data show the opposite: Bitcoin’s user base, price, institutional integration, and market share have all grown markedly. On that basis, the prediction is wrong.