Longevity/Biotechnologyback to investment strategy
Several recent research reports have this startling message: we are about to experience an exponential rise in life expectancy over the next 10 years. Not only will we live much longer, but we will also feel younger while living longer. Eye-opening facts and predictions from these reports include:
“The research in aging mechanisms will get us an exponential increase in life expectancy. For example, in 2020, age 60 was equivalent of age 40 in 1980. By 2030, 90 will be new 40.” —Dr. Michael Roizen, Chief Wellness Officer of the Cleveland Clinic.
Life expectancy in 2020-2030 will mark a single decade, exponential increase of up to 30 years. Even if there is debate about whether this number will be 10, 20 or 30, it is still impressive. Compare this to every decade between 1850-2020, which limited us to linear increases of about 2.5 years on average.
“I now think there is a 50% chance that we will reach longevity escape velocity by 2036. After that point (the “Methuselarity”), those who regularly receive the latest rejuvenation therapies will never suffer from age-related ill-health at any age.” —Aubrey de Grey, Strategies for Engineered Negligible Senescence (SENS), a leading voice for antiaging, aging reversal, and aging damage repair.
We see a signiﬁcant market opportunity for genome medicines that will disrupt existing biopharma markets. Today, most chronic disorders require lifelong treatment. For example, severe hemophiliacs require 50+ infusions a year. In contrast, gene and cell therapies targeting diseases at the genetic level have the potential to be “one shot cures” or at the very least less-frequent treatments. At the moment, they are being tested (and proven effective) as treatments of “last resort”. However, the next step for these therapies could be to move into earlier stages of disease progression, which would disrupt existing therapeutic markets.
The global cumulative TAM for genome medicine across all disease areas based on the current generation of technology platforms (gene therapy, editing and cell therapy) could reach USD 4.8 trillion. This total is largely driven by oncology (> USD 1 trillion), neurology (> USD 1.5 trillion) and eye disorders (> USD 0.5 trillion). By comparison, annual global prescription sales are projected to be USD 1.01 trillion in 2022 (source: EvaluatePharma).
We see two drivers of commercial opportunity. The first is the creation of new proﬁt pools, e.g., orphan disorders. The second is the disruption to current therapies/markets, e.g., cancer, heart, neurology, and viral infections. We note that a signiﬁcant proportion (USD 3.6 trillion) of our estimated revenue pool is derived from prevalent patients. These are patients who already have the condition. Once they are treated, they are essentially “cured”. Therefore, in the long term, the primary driver of recurring sales will be disease incidence, i.e., the number of new patients born with or developing the disease with oncology (USD 1.2 trillion) as the largest source. In addition, this scenario is also contingent on the continued optimization of gene therapy efﬁcacy/safety, movement to earlier stages in cancer, and standardization and successful scaling of manufacturing of viral vectors to meet commercial demand.
In our view, the current generation of genome medicine is the “ﬁrst wave“. We anticipate that a new generation of optimized therapies will emerge in the coming years with better efﬁcacy, safety, targeting, and speciﬁcity. We believe these improvements will expand the range of addressable diseases to include solid tumors, multigenic disorders, and others. We see about USD 3.5 trillion in upside from new TAMs of diseases with no existing treatments, but which become treatable by next-generation genome medicines.
We have made the following investments in genome therapy segment :
is a biopharmaceutical company using ribonucleic acid interference (RNAi) to develop medicines that silence genes that cause disease.
is a biopharmaceutical company that develops medicine against rare eating disorders.
is a clinical-stage US biopharmaceutical company developing new generation messenger RNA (mRNA) based vaccines to save human lives. The company’s approach is to instruct cells in the body to make specific proteins that then produce an immune response. mRNA-based therapeutics are used by established COVID-19 vaccine manufacturers such as Pfizer, BioNTech, and Moderna. The key factor behind the success of mRNA technology is that it “turns on” sleeping genes.
is pharmaceutical company focusing on developing treatments for orphan indications for a child’s central nervous system (CNS). The company’s lead product, FINTEPLA (low-dose fenfluramine) succeeded in two phase III studies in Dravet Syndrome, a serious and rare genetic form of epilepsy. The drug is also being assessed as a treatment for Lennox-Gastaut Syndrome (another rare epilepsy) in a phase III study. The drug’s tolerability and safety profile have been favorable to date.