Monday, April 30, 2018

Eradicating Disease – Healthcare Industry’s Worst Nightmare?


Take just one pervasive disease, diabetes. The American Diabetes Assn. notes that: “The American Diabetes Association… released new research on March 6, 2013 estimating the total costs of diagnosed diabetes have risen to $245 billion in 2012 from $174 billion in 2007, when the cost was last examined… This figure represents a 41 percent increase over a five year period.” And the number keeps rising as Americans put on the pounds (type 2). MedScape.com adds: “Researchers using a simulation model have put a price on the direct medical costs of treating diabetes and its complications, during a lifetime, in the United States. The figure ranges from around $55,000 to $130,000, depending on age at diagnosis and sex, with the average being $85,200.” Plus the downtime and productivity losses.
You just have to look at the TV ads for treatment options, noting how much money pharmas make from everything from injectable insulin, insulin monitors, needles and the varying forms of lesser treatments. Plus the loss of digits and limbs, pain treatment, vision loss and the host of complications, direct and indirect like those from increased susceptibility to other ailments (e.g., heart disease).  For many endocrinologists, treating and monitoring one form of diabetes or another has become the bulk of their medical practices.
Cure diabetes, and all this stops. That the U.S. government is dramatically cutting back on supporting scientific and medical research has to come as good news for all those healthcare suppliers and professionals. I mean, if diabetes and all the suffering it causes can be eradicated, what is going to replace those treatment revenues for all those totally dependent on the assumed incurability of diabetes. That there are clear signs from European researchers that they really believe that diabetes can be cured with a bit more research. You can bet that there is a huge contingent of medical sectors that never want to see that happen.
Indeed, as we begin to embrace an entirely new approach to chronic ailments, based gene modification and splicing, we are increasingly likely to be able to cure some of the most expensive diseases with a single genetic treatment. While that treatment might not come cheap, most believe that it will be increasingly less expensive than the lifetime regimens needed to treat so many of these diseases today… a lot less expensive.
You’d think that given the statements of so many in politics and the medical profession, seeking a path to universal healthcare… or at least for now dramatically reducing healthcare costs… that this is tremendously good news. But if you lift the curtain slightly, you just might shocked at how hard some elements of the healthcare sector want to work to crush such developments. The economic impact on those in the healthcare field who are dedicated to such lifetime treatments is obviously devastating.  So kill the research. Make the FDA drag its feet for extra years if necessary, but make sure that they do not lose that income stream!!!
Perhaps this excerpt from the April 13th Daily Kos (coincidentally Friday the 13th) might shed some light on how financial analysts look at this subject:
On April 10 in the year of our Lord, 2018, analysts at Goldman Sachs allegedly released a report titled “The Genome Revolution.” According to numerous news reports, the report delved into a pretty awkward subject—cures.
"The potential to deliver 'one shot cures' is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies," analyst Salveen Richter wrote in the note to clients Tuesday. "While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow."
It isn’t “good business,” to be absolutely frank. We all know it isn’t. There are entire fringe worlds of conspiracy that continue to exist based on this one single kernel of truth. Why is this news now? Because science and medicine are getting very close to big and meaningful breakthroughs on diseases and maladies that were once only somewhat treatable with very expensive routines of medications. Gene therapy breakthroughs have been a big part of this, with the FDA approving promising gene therapy trials, and even more exciting results coming in from around the world. But as CNBC reports, solving serious problems for the public doesn’t mean you get to keep buying mega-yachts. Goldman Sachs analyst Salveen Richter has some bad news for our current “free market” system:
Richter cited Gilead Sciences' treatments for hepatitis C, which achieved cure rates of more than 90 percent. The company's U.S. sales for these hepatitis C treatments peaked at $12.5 billion in 2015, but have been falling ever since. Goldman estimates the U.S. sales for these treatments will be less than $4 billion this year, according to a table in the report.
"GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients," the analyst wrote. "In the case of infectious diseases such as hepatitis C, curing existing patients also decreases the number of carriers able to transmit the virus to new patients, thus the incident pool also declines … Where an incident pool remains stable (eg, in cancer) the potential for a cure poses less risk to the sustainability of a franchise."
One of the very reasons government needs to spearhead such research is to avoid this very obvious conflict of interest between private industry and the needs of the general public. Unfortunately, the Trump administration is completely committed to the profitability of the private sector, so as long as that is our priority, don’t hold your breath on any hope of containing healthcare costs or providing great economically affordable access to the healthcare system. Then again, there is an election later this year where your vote could make a difference.
I’m Peter Dekom, and I guess in the long run, we get what we vote for!!!

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