3 ms·

CRISPR is coming. I seriously think with CRISPR we could see several trillion dollar companies. From cancer and aids cures to fundamentally altering what it mea

by cellis 9y ago

CRISPR is coming. I seriously think with CRISPR we could see several trillion dollar companies. From cancer and aids cures to fundamentally altering what it means to be human, this is all within the near grasp of CRISPR ( if what i've been reading is to be believed ).

adventured 9y ago
Gilead managed to demonstrate how curing a major disease does not result in such a spectacular outcome (of the trillion dollar scale). They did very well by curing HepC, briefly, and now they're eroding back down after just a few boom years. The same would occur with curing HIV/AIDS. There would be a brief boom derived from sales in some developed nations (most nations would receive the cure extremely inexpensively, as with HepC). It might get a company to a couple hundred billion market cap short-term, nowhere near a trillion dollar outcome however. Further, attempting to charge a lot for the HIV/AIDS cure (such that you could get to a trillion dollar market cap), would result in a far worse PR outcome than what Gilead & Co. saw with HepC drugs; calls for nationalization would be overwhelming. Nations such as India and China would simply ignore all patents and proceed to copying the cure - few would support any economic counter/consequence against that move. It is often said that companies would intentionally prefer not to cure major diseases. Then Gilead (Pharmasset), goes ahead and does so, while charging less for the cure than the cost of healthcare for living with HepC (much less all that is lost from HepC, including quality of life and economic contribution) - and for doing so, they were treated as a villain due to what they charged. For such reasons, I doubt we'll ever see drug prices high enough to deliver trillion dollar outcomes. Throw on top of this, that the last bastion of crazy drug prices - the US - is nearing an end on its tolerance for such.
- trhway 9y ago
  what you describe just shows that the old business model - pill in exchange for money - starts to show its limitations in the globalized world. Facebook would never get where it is now if it charged $10/year in Africa and $100/year in US. The pharma company who figures out that new business model would become that trillion dollar company.
  - adventured 9y ago
    There is no new business model that will derive a lot more money. There's a finite amount of global income available in a given year and it's not expanding at a rapid clip. The very specific problem is the rest of the world will never pay it, and the US is aiming to stop paying it (exorbitant prices). Nothing is going to change that, it's a fact of life when resources such as income and wealth are inherently limited and expand fairly slowly overall. If you come up with something spectacular that is very valuable, they're still not going to pay it - it was demonstrated overwhelmingly by the HepC cure (and has been demonstrated by vaccines as another for decades; what's more life saving than vaccinations? and yet the developing world simply will not - and frequently can't - pay high prices for such). Vaccines have saved hundreds of millions of lives. Give me an example of something that is going to beat that. Now take a look at the extraordinarily unspectacular financial outcome for the vaccination market (particularly compared to the trillion dollar premise being discussed). Why would anyone by default believe something amazing that comes out of CRISPR, would produce a dramatically superior financial outcome versus what vaccines have produced?
    - kanzure 9y ago
      Perhaps I am up too late and don't completely understand where your question is coming from... but there's a lot of hope available in biology because DNA is one of the most successfully widely deployed technologies of the last 4 billion years. It's had hundreds of trillions of years being battletested in production environments. It's cheap to copy, replicate and eventually it will be cheap to modify and write. Literally everyone is (badly?) programmed with DNA-- and CRISPR isn't the last word on genome engineering. There will absolutely be changes that large chunks of the population will demand, far and beyond the demand for vaccines.
- maxerickson 9y ago
  How are you controlling for competition? https://en.wikipedia.org/wiki/Elbasvir/grazoprevir https://en.wikipedia.org/wiki/Elbasvir/grazoprevir
- a_imho 9y ago
  Well said, I would only disagree with the treatment of Gilead and pharma in general. The moral outrage is against greed. Even when the cost-benefit relation works to other (similarly overpriced) treatments, their margins are way too excessive from the patients' pov imo, because 1. manufacturing cost next to nothing 2. pharma spends way more on marketing than r&d [1] [1] http://www.randalolson.com/2015/03/01/design-critique-putting-big-pharma-spending-in-perspective/ http://www.randalolson.com/2015/03/01/design-critique-puttin...
mac01021 9y ago
For each trillion dollars of company, you'll need a billion people to pay $1k each. I'm not sure current demographics allows for more than one such company in any given sector, and it would need to have a virtual monopoly on whatever it were selling.
- cellis 9y ago
  100 million paying 10k is much more likely. And 1 trillion is in market value, not revenue. Imagine if you could sell a therapy such as a seasonal cure for "common cancer". Drugs can be insanely profitable and there are already several drug makers in the hundreds of billions of market cap.
  - Turing_Machine 9y ago
    "100 million paying 10k is much more likely." 10K is already well within the range people spend on births (currently about $8k including prenatal and postnatal care). Not to mention the cost involved in raising the child to adulthood. :-) You might even be able to charge $50k or $100k, if it actually got to the point of design-to-order (which, granted, would be orders of magnitude more difficult than simply removing one bad gene). How much would a parent pay to have a kid with the mind of Richard Feynman and the body/appearance of David Beckham, or the mind of Marie Curie and the body/appearance of Kiira Korpi? Quite a lot, I'd imagine.
    - bluGill 9y ago
      How much would an insurance company pay to fix high cholesterol, diabetes, cancer etc? I know people spending close $10,000 a year on cholesterol medication. Diabetics' insulin can cost $500 (I don't know how long this lasts), plus the other blood monitoring costs and costs of other complications. Cancer treatment is not cheap but I don't know how to look up the costs. All of the above costs are mostly covered by insurance, but if you work them out, a $100k treatment can pay off in as little as 10 years. Of course there is a difference between ensuring someone's kids don't have a condition and fixing it in someone who is already alive. Will parents make this choice even if insurance pays for it?
Pulcinella 9y ago
CRISPR likely won't be the ultimate cure you think it is. There are many diseases that aren't linked to a single gene. Even if you could edit the genome through magic, if you don't know what change to make then you can't do anything.

by cellis 9y ago

adventured 9y ago

Gilead managed to demonstrate how curing a major disease does not result in such a spectacular outcome (of the trillion dollar scale). They did very well by curing HepC, briefly, and now they're eroding back down after just a few boom years. The same would occur with curing HIV/AIDS. There would be a brief boom derived from sales in some developed nations (most nations would receive the cure extremely inexpensively, as with HepC). It might get a company to a couple hundred billion market cap short-term, nowhere near a trillion dollar outcome however. Further, attempting to charge a lot for the HIV/AIDS cure (such that you could get to a trillion dollar market cap), would result in a far worse PR outcome than what Gilead & Co. saw with HepC drugs; calls for nationalization would be overwhelming. Nations such as India and China would simply ignore all patents and proceed to copying the cure - few would support any economic counter/consequence against that move. It is often said that companies would intentionally prefer not to cure major diseases. Then Gilead (Pharmasset), goes ahead and does so, while charging less for the cure than the cost of healthcare for living with HepC (much less all that is lost from HepC, including quality of life and economic contribution) - and for doing so, they were treated as a villain due to what they charged. For such reasons, I doubt we'll ever see drug prices high enough to deliver trillion dollar outcomes. Throw on top of this, that the last bastion of crazy drug prices - the US - is nearing an end on its tolerance for such.

trhway 9y ago
what you describe just shows that the old business model - pill in exchange for money - starts to show its limitations in the globalized world. Facebook would never get where it is now if it charged $10/year in Africa and $100/year in US. The pharma company who figures out that new business model would become that trillion dollar company.
- adventured 9y ago
  There is no new business model that will derive a lot more money. There's a finite amount of global income available in a given year and it's not expanding at a rapid clip. The very specific problem is the rest of the world will never pay it, and the US is aiming to stop paying it (exorbitant prices). Nothing is going to change that, it's a fact of life when resources such as income and wealth are inherently limited and expand fairly slowly overall. If you come up with something spectacular that is very valuable, they're still not going to pay it - it was demonstrated overwhelmingly by the HepC cure (and has been demonstrated by vaccines as another for decades; what's more life saving than vaccinations? and yet the developing world simply will not - and frequently can't - pay high prices for such). Vaccines have saved hundreds of millions of lives. Give me an example of something that is going to beat that. Now take a look at the extraordinarily unspectacular financial outcome for the vaccination market (particularly compared to the trillion dollar premise being discussed). Why would anyone by default believe something amazing that comes out of CRISPR, would produce a dramatically superior financial outcome versus what vaccines have produced?
  - kanzure 9y ago
    Perhaps I am up too late and don't completely understand where your question is coming from... but there's a lot of hope available in biology because DNA is one of the most successfully widely deployed technologies of the last 4 billion years. It's had hundreds of trillions of years being battletested in production environments. It's cheap to copy, replicate and eventually it will be cheap to modify and write. Literally everyone is (badly?) programmed with DNA-- and CRISPR isn't the last word on genome engineering. There will absolutely be changes that large chunks of the population will demand, far and beyond the demand for vaccines.
maxerickson 9y ago
How are you controlling for competition? https://en.wikipedia.org/wiki/Elbasvir/grazoprevir https://en.wikipedia.org/wiki/Elbasvir/grazoprevir
a_imho 9y ago
Well said, I would only disagree with the treatment of Gilead and pharma in general. The moral outrage is against greed. Even when the cost-benefit relation works to other (similarly overpriced) treatments, their margins are way too excessive from the patients' pov imo, because 1. manufacturing cost next to nothing 2. pharma spends way more on marketing than r&d [1] [1] http://www.randalolson.com/2015/03/01/design-critique-putting-big-pharma-spending-in-perspective/ http://www.randalolson.com/2015/03/01/design-critique-puttin...

mac01021 9y ago

For each trillion dollars of company, you'll need a billion people to pay $1k each. I'm not sure current demographics allows for more than one such company in any given sector, and it would need to have a virtual monopoly on whatever it were selling.

cellis 9y ago
100 million paying 10k is much more likely. And 1 trillion is in market value, not revenue. Imagine if you could sell a therapy such as a seasonal cure for "common cancer". Drugs can be insanely profitable and there are already several drug makers in the hundreds of billions of market cap.
- Turing_Machine 9y ago
  "100 million paying 10k is much more likely." 10K is already well within the range people spend on births (currently about $8k including prenatal and postnatal care). Not to mention the cost involved in raising the child to adulthood. :-) You might even be able to charge $50k or $100k, if it actually got to the point of design-to-order (which, granted, would be orders of magnitude more difficult than simply removing one bad gene). How much would a parent pay to have a kid with the mind of Richard Feynman and the body/appearance of David Beckham, or the mind of Marie Curie and the body/appearance of Kiira Korpi? Quite a lot, I'd imagine.
  - bluGill 9y ago
    How much would an insurance company pay to fix high cholesterol, diabetes, cancer etc? I know people spending close $10,000 a year on cholesterol medication. Diabetics' insulin can cost $500 (I don't know how long this lasts), plus the other blood monitoring costs and costs of other complications. Cancer treatment is not cheap but I don't know how to look up the costs. All of the above costs are mostly covered by insurance, but if you work them out, a $100k treatment can pay off in as little as 10 years. Of course there is a difference between ensuring someone's kids don't have a condition and fixing it in someone who is already alive. Will parents make this choice even if insurance pays for it?

Pulcinella 9y ago

CRISPR likely won't be the ultimate cure you think it is. There are many diseases that aren't linked to a single gene. Even if you could edit the genome through magic, if you don't know what change to make then you can't do anything.