4 ms·

The issue is that preventing it doesn’t really cost. Lifestyle change isn’t something VCs can make a big return on. Whole population groups prevent it without t

by mfer 4y ago

The issue is that preventing it doesn’t really cost. Lifestyle change isn’t something VCs can make a big return on. Whole population groups prevent it without taking any drugs. Where is the money to be made? Whole population groups around the world get it in a really limited capacity and only at extremely old age if they do. We know how they live and what they eat. Groups have been studied in the US who are similar and they get really low rates of Alzheimer’s compared to the surrounding population. The changes people need to make for this just aren’t those you can get a high rate of return on.

alwillis 4y ago
> Where is the money to be made? Drugs are the most obvious. I'm personally familiar with the drug Gleevec, the multi-billion dollar blockbuster drug for Chronic Myelogenous Leukemia, which only about 4–5,000 people get in the US each year. Compared to heart disease and the more well-known cancers (breast, lung, colon), this is a rounding error. When it launched, the cost was $10,000 for a 30-day supply in the US. Novartis' annual revenue for Gleevec was $4.7 billion dollars before it became a generic drug after patent expiration [1]. The number of people in the US who get CML per year is 5,000; the number who get Alzheimer’s is 100 times that—500,000. I'm not suggesting revenue of 100x of $4.7 billion to a comparable drug for Alzheimer’s; but 10x isn't out of the question. Due to the COVID pandemic, Alzheimer's disease dropped from the sixth to the seventh-leading cause of death across all ages in the United States. This is big market. > Lifestyle change isn’t something VCs can make a big return on. It's much more complicated: Having at least one APOE e4 gene increases your risk of developing Alzheimer's disease two- to threefold. If you have two APOE e4 genes, your risk is even higher, approximately eight- to twelvefold. But not everyone who has one or even two APOE e4 genes develops Alzheimer's disease. Sure, there are lifestyle issues at play, combined with genetics. At some point, this will get figured out and there will certainly be a way for investors to make a lot of money on "the cure", testing, diagnostics and the required intellectual property. If these blood tests pan out, the next step will be wearable devices (like glucose monitors) to test for Alzheimer’s markers or including that tech in a future Apple Watch or other future device. As an example, Apple has already bought several health-tech startups [3]; if a startup develops Alzheimer’s tech Apple can incorporate into it's ecosystem, they'd be ripe for an acquisition. > Whole population groups around the world get it in a really limited capacity and only at extremely old age if they do. False—the rate of Alzheimer's is growing globally. It's 50 million people now; at current rates, it will exceed 152 million by 2050 [2]. Like many diseases of old age, people are getting it at increasingly earlier ages. For example, we used to call Type 2 Diabetes "adult onset Diabetes"; that term is quickly fading in relevance since children get Type 2 Diabetes pretty often these days. The theory from David Sinclair that diseases of old age, including Alzheimer’s, are the result of a lifestyle the promotes premature aging, people who are genetically at increased risk for Alzheimer’s (by having at least one APOE e4 gene) will continue to get it at earlier ages. [1]: https://en.wikipedia.org/wiki/Imatinib#Economics https://en.wikipedia.org/wiki/Imatinib#Economics [2]: https://www.brightfocus.org/alzheimers/article/alzheimers-disease-facts-figures#:~:text=Alzheimer%27s%20is%20on,related%20dementia.21 https://www.brightfocus.org/alzheimers/article/alzheimers-di... [3]: https://www.beckershospitalreview.com/healthcare-information-technology/apple-s-health-it-acquisitions-a-timeline.html https://www.beckershospitalreview.com/healthcare-information...

by mfer 4y ago

alwillis 4y ago

> Where is the money to be made? Drugs are the most obvious. I'm personally familiar with the drug Gleevec, the multi-billion dollar blockbuster drug for Chronic Myelogenous Leukemia, which only about 4–5,000 people get in the US each year. Compared to heart disease and the more well-known cancers (breast, lung, colon), this is a rounding error. When it launched, the cost was $10,000 for a 30-day supply in the US. Novartis' annual revenue for Gleevec was $4.7 billion dollars before it became a generic drug after patent expiration [1]. The number of people in the US who get CML per year is 5,000; the number who get Alzheimer’s is 100 times that—500,000. I'm not suggesting revenue of 100x of $4.7 billion to a comparable drug for Alzheimer’s; but 10x isn't out of the question. Due to the COVID pandemic, Alzheimer's disease dropped from the sixth to the seventh-leading cause of death across all ages in the United States. This is big market. > Lifestyle change isn’t something VCs can make a big return on. It's much more complicated: Having at least one APOE e4 gene increases your risk of developing Alzheimer's disease two- to threefold. If you have two APOE e4 genes, your risk is even higher, approximately eight- to twelvefold. But not everyone who has one or even two APOE e4 genes develops Alzheimer's disease. Sure, there are lifestyle issues at play, combined with genetics. At some point, this will get figured out and there will certainly be a way for investors to make a lot of money on "the cure", testing, diagnostics and the required intellectual property. If these blood tests pan out, the next step will be wearable devices (like glucose monitors) to test for Alzheimer’s markers or including that tech in a future Apple Watch or other future device. As an example, Apple has already bought several health-tech startups [3]; if a startup develops Alzheimer’s tech Apple can incorporate into it's ecosystem, they'd be ripe for an acquisition. > Whole population groups around the world get it in a really limited capacity and only at extremely old age if they do. False—the rate of Alzheimer's is growing globally. It's 50 million people now; at current rates, it will exceed 152 million by 2050 [2]. Like many diseases of old age, people are getting it at increasingly earlier ages. For example, we used to call Type 2 Diabetes "adult onset Diabetes"; that term is quickly fading in relevance since children get Type 2 Diabetes pretty often these days. The theory from David Sinclair that diseases of old age, including Alzheimer’s, are the result of a lifestyle the promotes premature aging, people who are genetically at increased risk for Alzheimer’s (by having at least one APOE e4 gene) will continue to get it at earlier ages. [1]: https://en.wikipedia.org/wiki/Imatinib#Economics https://en.wikipedia.org/wiki/Imatinib#Economics [2]: https://www.brightfocus.org/alzheimers/article/alzheimers-disease-facts-figures#:~:text=Alzheimer%27s%20is%20on,related%20dementia.21 https://www.brightfocus.org/alzheimers/article/alzheimers-di... [3]: https://www.beckershospitalreview.com/healthcare-information-technology/apple-s-health-it-acquisitions-a-timeline.html https://www.beckershospitalreview.com/healthcare-information...