Two recent news items are a reminder that, for want of a better term, the “Ozempic shift” continues.
In the last year or so, we seem to be seeing a wave of developments in the pharmaceutical world, including the launch of GLP-1 agonists such as Ozempic, that offer the promise of longer, healthier lives in ways that once might have been hard to believe.
And so to those news items.
The world’s most popular weight-loss and diabetes drugs are linked to a powerful new possible benefit: better outcomes for cancer patients.
A suite of four new studies suggest that people taking so-called GLP-1 drugs like Novo Nordisk’s Ozempic and Eli Lilly’s Mounjaro saw reductions in tumor progression, lower overall chance of death and less risk of developing breast cancer. . . .
A cancer impact would add to the health benefits that researchers credit to GLP-1 drugs. In addition to reducing blood sugar and spurring weight loss, the medicines are approved for reducing the risk of heart attacks and strokes, and in testing for helping with sleep apnea and dampening addictive behaviors. The drugs have also turned Novo Nordisk and Eli Lilly, their makers, into two of the world’s most valuable drug companies
In a small, preliminary study, an experimental gene-editing treatment dramatically lowered cholesterol levels, perhaps permanently, after just one infusion, scientists reported on Monday.
If confirmed in larger studies, researchers hope the findings may lead to a one-and-done way to prevent heart disease in large numbers of people. Most gene therapies target rare diseases, but cardiovascular disease kills nearly 800,000 Americans a year. . . .
It is unusual for The New England Journal of Medicine to publish such a preliminary result. But “it looks like it works pretty well,” said Dr. Eric Rubin, the editor in chief. Moreover, he noted, the trial is an ambitious attempt to apply cutting-edge gene therapy to the leading cause of death in the United States.
Early days, but interesting, and, obviously, encouraging.
There are good reasons to be skeptical about some of the wilder claims about the size of AI’s potential bounty, but this from The Economist in faraway 2024 is, I think worth noting:
Approximately 86% of all drug candidates developed between 2000 and 2015 failed to meet their primary endpoints in clinical trials. Some argue that drug development has picked off most of biology’s low-hanging fruit, leaving diseases which are intractable and drug targets that are “undruggable.”
The next few years will demonstrate conclusively if AI is able to materially shift that picture. If it offers merely incremental improvements that could still be a real boon. If it allows biology to be deciphered in a whole new way, as the most boosterish suggest, it could make the whole process far more successful and efficient—and drug the undruggable very rapidly indeed. The analysts at BCG see signs of a fast-approaching AI-enabled wave of new drugs.
I would have felt bad (well, not really) about mentioning the economic implications of this, but The Wall Street Journal, naturally, got there first. After describing the widening range of benefits attributed to GLP-1s, its writer added that “heavy demand [for GLP-1s] has stressed companies and governments that have to cover the costs.”
It’s not a simple equation. Quite a few benefits delivered by GLP-1s (longer, healthier lives) are back-end loaded, but the costs are payable up front. It is easy enough to envisage much of the cost of treatment being borne by private insurance, while most of the savings (less need for medical care in old age) benefit Medicare, at least until the final lap.
Of course, Medicare, facing a crisis earlyish next decade, needs all the help it can get, as does Social Security. I am sure that its administrators wish Americans nothing but the longest of lives. But in their darkest moments some of them must occasionally think of the brief old days when the Grim Reaper moved at a brisker pace. When Social Security was first introduced, the retirement age (65) was beyond the reach of most aging Americans.
As I noted in a Capital Letter last year, that has changed:
Today, average life expectancy is 76 and 81 for American men and women respectively, but Social Security’s retirement age has barely moved, only reaching 67 for those born in 1960.
I suspect that, in this country anyway, the demographic “crisis” has been somewhat exaggerated. More on that topic to come. Nevertheless, the number of over-65s has been growing faster than the working-age population for some time now and will continue to do so for the foreseeable future. If spicing up blue plate specials with hemlock is out of the question, a partial answer is to increase the retirement age (and to encourage post-retirement-age working), something made easier if healthy life expectancy increases. That change is already taking place, but if a new wave of pharmaceutical innovation can speed up, so much the better.