Goldman Sachs asks in biotech Report: Is curing patients a sustainable business? (2018)

If a person dies from a disorder in their 20s, they'll never buy your heart medication in their 70s. Today's patient is tomorrow's patient.

The issue with that logic there is those basic drugs are mostly generic now. That money is less, and goes to the PBM and generic manufacturers in India.

The longer someone lives, the more potential value they can contribute to a society. The opportunity cost is something we've figured out from a medical perspective, but shareholders want returns today, not returns fifty years from now.

That is what we need to address.

They could use profit in 50 years, but it will possibly be someone else's profit.

Treat vs cure. You treat them so you can go on treating them. If you cure them, maybe you’ll treat them later and or maybe you won’t - but that’s outside the current bonus cycle / opportunity window.

The longer someone lives, the more potential value can be squeezed.

This is how they should think.

>The longer someone lives, the more potential value they can contribute to a society.

This is a function of how old the sick person is, as well as how severe their sickness and hence recovery will be. The data says, for the most part, healthcare is needed when one is close in age to exhausting their body’s capability anyway.

The FDA needs to declare death a disease that patentable drugs can be developed against. All of a sudden the flood gates get opened to encouraging drug research on anything that keeps people alive longer.

If the executive lives longer it is their profit.

>The longer someone lives, the more potential value they can contribute to a society.

This is questionable. Highly populous countries have worse living conditions than moderately populous ones, currently.

Better living conditions cost more money per family, which leads to less children.

I don't like the squeezing mindset but if people contribute to their health insurance and don't use those services because they're healthy it could be seen as squeezing those patients but it really isn't, it's just how insurance should work.

Highly populous countries were colonized and robbed off their resources until recently.

I quite like this concept. Did you come up with it?

It’s odd because many other industries like wineries, nut orchards, etc. do all play the long term game successfully.

Even medical drugs take a while to develop but somehow the sales has to be “right now”.

The government says that people can stop contributing to society when they reach 67. Some governments completely block you from continuing working.

Some governments recognize that the longer people life, the more pensions / social security / healthcare resources need to be paid to that person.

its much cheaper for governments for people to just die when they retire, tax their wealth at 40% and then free up resources (housing or healthcare) for the next generation.

No, it is a common trope in futurism circles.

Because death is not technically a disease, right now if a company came up with a literal immortality pill they wouldn't be able to get it patented or get FDA approval for it.

> Highly populous countries have worse living conditions than moderately populous ones, currently.

https://ourworldindata.org/grapher/population-density-vs-pro...

There does not look to be a strong correlation between population density and income, at least on a log-log scale across countries. But I would guess that these numbers hide a trend for cities to be richer than rural areas (subsistence farming etc).

Yeah, maybe not cure them as such, maybe just get them to a healthy-enough state to go back to functioning but still needing The Medication.

It could be a different company's profit.

That is not the alternative to curing disease that is being proposed. The choice is between healing for good or keep on continued medication.

Or more bluntly: sell a product or sell a subscription

No, again because of secondary effects, which of course the government keeps track of both implicitly and explicitly.

I'm not sure I agree, when we humans only lived for 50 years there were no time to develop any range of other diseases that we are experiencing now in later life, so even if you cure A there will definitely be many many opportunities to treat anywhere from B-Z.

It's a common trope but also wrong.

If you invent a pill that gives old people the mental and physical vigor of 25 year olds, you don't need to patent or trial it as an immortality pill. Just pick one of the many medical conditions associated with advancing age, like osteoporosis or male pattern baldness, and prove that it safely and effectively treats that condition. If the pill cures baldness and also gives patients improved muscle tone and working memory as a side effect, the FDA won't complain about those beneficial side effects.

Once the drug is approved for treating baldness it can be prescribed off-label for other conditions and/or the manufacturer can progressively run trials for treating additional conditions, similar to how GLP-1 drugs originally developed for diabetes treatment have now been tested and approved for treating obesity.

Can you elaborate on the secondary effects?

> Just pick one of the many medical conditions associated with advancing age, like osteoporosis or male pattern baldness,

A drug that maintained telomere length doesn't treat anything directly.

A drug that slows down metabolism and extends life by 20% on average, not patentable.

Why can't you patent a drug that maintains teleomere length? Or one that slows down metabolism? The FDA does not control the patent office, merely what drugs can be sold in the US. And neither of these inventions seem like they would fall under the limited patentability exclusions.

So invent it here, patent it everywhere, and sell it in the countries that allow it to be sold.

The point I was trying to make is that most pharma companies have many products for many disorders and diseases. Curing one of those diseases will make a few life-long patients for some of your non-curing treatments.