Goldman Sachs analysts asked “Is curing patients a sustainable business model?” analysts ask in an April 10 report entitled “The Genome Revolution.” Goldman was addressing the question of gene therapies that provide complete cures with one treatment.
“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.
Gilead Sciences’ treatments can cure more than 90 percent of hepatitis C patients. Gilead hepatitis C treatments peaked at $12.5 billion in 2015 but are now less than $4 billion in 2018.
Curing infectious diseases (like Hep C) also decreases the number of carriers able to transmit the virus to new patients so complete success means the elimination of the disease. However, cancer has a more constant rate of new patients with the disease that are not based upon infection in almost all cases.
Company Strategy Suggestions from the Goldman Analysts
1. Target large markets: Hemophilia is a $9-10 billion worldwide market (hemophilia A, B) is growing at ~6-7% annually.
2. Address disorders with high incidence: Spinal muscular atrophy (SMA) affects the cells (neurons) in the spinal cord, impacting the ability to walk, eat, or breathe.
3. Constant innovation and portfolio expansion: There are hundreds of inherited retinal diseases (genetics forms of blindness). The pace of innovation will also play a role as future programs can offset the declining revenue trajectory of prior assets.
Nextbigfuture notes that some biotech companies have a powerful platform for generating many cures. Companies working on RNA interference have a model of rapidly being able to adjust their curing system for the next in a series of diseases. This is similar to the constant innovation but is more systematic.
This problem would not exist for biotech companies focused upon extreme longevity. There would be the need to constantly repeat antiaging treatments as new aging damage is created.
Powerful medicine should be in the age of disease cures instead of the age of slight mitigation or symptom reduction. However, beyond the age of curing heart disease, cancer and other diseases is comprehensive repair of aging damage.