How will new technologies make age-related diseases a thing of the past?

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It is estimated that sometime before 2020, the global population of individuals aged 65 and older will outnumber children under age five. The health care expenditures could be enormous: the World Economic Forum estimates treating chronic, non-communicable disorders could cost an estimated US$47 trillion from 2010 to 2030.

When life span means health span

By some estimates, we spend about 50 times more as a society managing diseases than we do on research that might prevent those diseases from happening in the first place. New genetic and digital technologies could make aging more sustainable, accelerating the discovery and creation of solutions.

The goal is to use transformative technologies to delay the breakdown of function and extend the health span – the ability to age disease-free. In the near term that means deploying sensors in small wearables to cost-effectively manage known diseases associated with aging.

Longer term, innovations in genetic and regenerative medicine, coupled with cheap computing power, improved analytics and a growing understanding of both human behavior and the biology of aging will evolve treatment to a pre-disease state, where conditions should be cheaper and easier to remedy.

Stepping along the continuum: from disease management to wellness

A range of technologies are needed to move us down the path to lifelong wellness. Ongoing efforts to understand the human genome will be further enhanced by combining genetic data with a range of other data types:

  • Traditional clinical laboratory results
  • So-called “multi-omics” analyses that quantify collections of biological molecules
  • Real-time data generated by wearables and mobile technologies
  • Behavioral data gleaned from social media sites and advocacy organizations

Accelerating this shift to precision health are a range of enabling tools that include third-party clouds for data sharing and artificial intelligence. Software can now be used to identify patterns in extremely large data sets, revealing potential links between specific genes or proteins and disease more rapidly than human counterparts could find them.

The ability to shrink, and sync, sensors and electronics is also important. As we will cover in a forthcoming piece, embedding technology into consumers’ lives in such a fundamental way should reduce the wearable tech fatigue that can limit lasting behavior change.

P-medicine

The pivot from disease management to precision health intersects with another larger trend redefining health care: P-medicine, care that is personalized, precise, preventative, predictive, pharmaco-therapeutic and participatory. At its heart, P-medicine represents a new mindset that emphasizes prevention and greater collaboration between physicians, consumers and other stakeholders in pre-empting and solving health challenges.

By capturing biological, clinical and behavioral outputs, this new approach could refine how providers educate individuals about both disease risk and illness so that behavioral prompts are delivered to the right patient, at the right time, to achieve maximal health.

Shifting business models

As our understanding of the drivers of age-related diseases grows, the demarcation between disease management and disease prevention will blur, leading to earlier disease interception. This means broadening the definition of disease to include susceptibility based on the relationship between biological markers and the development of full-blown symptoms. Driven by new technologies, this shift to prediction and pre-emption will necessitate changes in health care delivery and biopharma business models.

Currently, when attention is given to prevention, it is largely ad hoc and episodic. In a consumer-empowered future, providers will personalize care, moving away from reliance on population-based metrics to individualized risk assessments. Near-term, the greatest opportunity is the development of simple, concierge services that either coordinate care or support wellness by integrating insights from big data with high-touch behavioral tools.

The biopharma equivalent of “An apple a day …”

Biopharmaceutical companies currently invest billions in preclinical R&D to develop expensive products designed to treat the body when disease manifests, or, in some cases, to treat a single or small number of risks. But as wellness and disease interception become the norm, there will be less need for such products, exacerbating pricing and utilization pressures that already limit revenue growth.

Companies will need to develop medicines that deliver smaller interventions safely and affordably. The current model, charging hundreds of thousands of dollars for an anti-cancer drug, won’t be palatable when the intervention counteracts not an actual disease, but a disease risk. The good news is, we already have multiple examples of marketed biopharmaceuticals that intercept disease, such as vaccines, bisphosphonates and statins.

Laying the wellness foundation

The shift from disease management to disease prevention and wellness depends on a number of factors:

  • Regulatory flexibility
    Moving from disease management to disease prevention requires utilizing data in new combinations. Standards are needed that appropriately measure safety and efficacy but adapt rapidly enough to meet the pace of innovation.
  • New reimbursement models
    Even though pay-for-value is gaining traction, the current fee-for-service model incentivizes disease management not disease prevention. To prioritize healthy aging, reimbursement models must prioritize prevention and the coordination of complex care.
  • Making behavioral economics mainstream
    Behavioral economics has been slowly moving into the mainstream. Understanding how cognitive biases affect an individual’s ability to invest in his or her long-term health is essential to help consumers make better health choices.
  • Platform creation
    To truly transform aging and extend the health span, it’s not enough to create point solutions. Partnerships that develop integrated, platform-based offerings that are easy to use and flexible enough to accommodate future innovations will have a cmpetitive advantage.

 

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