A Look at Ascendance Biomedical, Packaging Medical Tourism for Longevity Therapies
Ascendance Biomedical is a fairly new venture, still in the early stages of formalizing its structure and agenda. It is focused on the twofold path of (a) establishing patient-funded trials of potentially useful therapies in the longevity science space, and (b) packaging participation in trials and later purchase of therapies via medical tourism, bundling all of the complications into a single product. The people involved overlap with the principals of the Global Healthspan Policy Institute, and are fairly well connected in our community. The organization is tackling just a few types of therapy to get started, gaining experience in how best to go about this class of project.
Now, I will be the first to say that their initial and current work on trials and medical tourism is in areas that are not all that interesting to me, in that I don't believe they will have any great impact on aging: an established but not widely adopted cancer therapy and a hormone therapy approach to restoring ovarian function in older women. I'm not singling out Ascendance Biomedical in saying this. A number of similar initiatives are taking place in the aging research community, such as the Ambrosia trial for plasma transfusion, the TAME trial for metformin, and the TRIIM trial for thymus rejuvenation. What these all have in common is that if you think that aging is caused by accumulated molecular damage, then little should be expected to emerge from these efforts: these are hormone treatments, supplements, and existing drugs, or new therapies that seem at best to fall into much the same region as first generation stem cell transplants, in that they alter signaling in old tissues in some way that helps a little. They are not damage repair. I think we can do much better than all of this, via the SENS approaches. In any case, the point is not Ascendance Biomedical today, it is the potential Ascendance Biomedical of a few years from now.Ascendance Biomedical
Ascendance Biomedical is a novel corporation founded with an ambitious goal in mind: We want to make it easier for everyone to gain access to life-saving treatments - without the hassle. We are a team of physicians, scientists and entrepreneurs unified in the mission to save and improve lives. Ascendance Biomedical provides products and services which enable our customers to access the most cutting-edge biomedical technologies and treatments in the world. Working with clinics, physicians and scientists all over the world in all regulatory zones, we help you get the care that you need. We not only provide medical care and treatment, we also assist with flights, accommodation, travel instructions, the processing of medical records, direct connection with medical personnel upon arrival, analysis of your case to get you the best price with local physicians and - most importantly - set you up to receive the required treatments and interventions for your condition. Ascendance Biomedical offers not just products, but all-inclusive healthcare solutions for patients worldwide.
Medical tourism for senolytic treatments to clear senescent cells - one of the SENS programs for the treatment of aging - is on the Ascendance Biomedical agenda for the near future, and this is a very plausible exercise given the present state of the science. All of the existing senolytic drugs are very well characterized, new ones are being discovered among compounds easily ordered from chemical suppliers, and thus the costs to set up trials are reasonable when considered in the grand scheme of things. What is needed is an organization that specializes in rolling out such trials and then managing easy access to the therapies via medical tourism thereafter. Once such an organization exists, and is well connected in our community, then all further SENS therapies will have a much more cost-effective path to initial human trials and the clinic as soon as safety is proved. That will be important, as none of us will want to wait around for the ten years it will take someone with deep pockets to fight their way past an uncaring FDA. As for stem cell therapies, that can happen in parallel with public access to treatments outside the US.
When looking at the near future of rejuvenation biotechnology, you have to look beyond the therapies themselves and see the development of an ecosystem of companies sympathetic to the SENS vision for the medical control of aging. The first therapies are not only important for the treatments themselves, but also for the organizations that are created in the process of development, and which continue onward afterwards to take on new challenges. We need companies like Ichor Therapeutics that come attached to an established laboratory service business. We need companies like Oisin Biotechnologies doing the work of building the therapies. We need startup incubators and incubator-like organizations like the Methuselah Foundation is becoming. We need the angels and venture capitalists who think SENS is a great idea. We need the non-profits that help to push the research into readiness, such as the SENS Research Foundation. And of course, we need efforts like Ascendance Biomedical that focus on building a better, smoother, more efficient bridge to the clinic. All of these components in the ecosystem are emerging, piece by piece, thanks to a great deal of hard work beyond the scenes.
The medical tourism industry has only grown since stem cell therapies first became available, and since the regulatory burden in the US and Europe continues to increase. More regulation means more costly medicine, and worse medicine - the gap between what is possible and what is allowed continues to grow as it takes ever longer for research to be approved by the FDA and other regulatory bodies. Yet in many ways the medical tourism industry is very immature. There is little in the way of service organizations, reviewers, independent assessors and standards bodies. When you choose medical tourism, you must undertake a lot of work yourself, and will probably find yourself wishing that someone just offered simple, sensible packaged products for therapies of interest. This lack of market maturity may be a consequence of the fact that, in the grand scheme of things, very few people actually purchase any given therapy on any given day. The healthy, or at least those not in very dire straits, vastly outnumber the sick and the damaged. The advent of therapies like senescent cell clearance using senolytic drugs changes the whole economic picture here, however. This is a product that can be sold to everyone over the age of 40, once every few years. The pool of potential customers is far, far greater than that for a therapy for any given age-related disease, and the economics mean that yes, we should absolutely see the emergence of a competitive marketplace for packaged services like those offered by Ascendance Biomedical.
There was a great series of articles by a British journalist, Alexander Masters, who tried to get patient funded trials going for an oncolytic virus for neuroendocrine cancer after his friend was diagnosed. Neuroendocrine cancer is the kind that finished Steve Jobs.
I'm guessing that Reason has very little time for ethics in medicine, but I think they are important in this situation to deflect the criticism that these treatments are only for the rich. Politics do unfortunately have an effect on science, and should be managed rather than ignored.
"The biggest complaint about your scheme is going to be that it means rich people are getting treatment and poor people aren't. But you've dealt with that by ensuring benefits go to people who can't afford the treatment."
"The second complaint Savulescu thinks people will make against my Dating Agency proposal is that it's going to exploit rich people's desperation and make them throw their money away.
I have several responses to this.
One is, "So?"
The main force that would make the Dating Agency work is clearly desperation; that's what's powerful about it. The sick, wealthy or otherwise, are desperate to find new treatments. They know that traditional therapies like chemotherapy and radiotherapy can be both savage and futile; they want something fresh, scientifically decent and ready to be injected when that day of despair arrives. Doctors like to say we mustn't play on patient desperation, but that desperation never goes away just because doctors are pompous about it. The Dating Agency provides a way to guide this enveloping terror towards things that might actually help, from responsible sources; it stops good money being wasted on quack ideas."
"O'Connor shook his head, unsatisfied. "Once you introduce an uneven monetary relationship, it's warped the vision of trials as the social spread of risk." But the point was more theoretical than critical, so he dropped it and introduced another possible complaint: "The question you'll get asked is, 'Is the rich person dictating the research agenda?' People won't like that, even though the rich have done that since time began. Think of Bill Gates determining the priorities of the World Health Organization."
"But the wealthy person is not commissioning new research. He's picking up established, peer-reviewed research into his disease that has not managed to get funding from the usual sources because there's not enough money to go round, even though it is good research. The Dating Agency simply helps things along. It says, 'Well, we have these university departments where they have various promising things and these peer-reviewed papers to back up the work, and do you want to fund any of them?'""
"O'Connor's next objection had not occurred to me at all: "What happens if the drug works?"
"Splendid. He's bought back his life and the lives of 20 others, for a measly £2 million."
"And he's going to want to go on having access to the drug. Very few trials are for a drug that might cure you outright. Most are to treat chronic conditions, like cancer or diabetes or HIV."
"But then he'll have to provide it for all the other patients who'd been on the trial too, otherwise they'll die."
In short, the wealthy individual gives £2 million, returns home triumphant from the hospital, and finds a bill for another £10 million lying on his doormat because he's now got to fund the drug in perpetuity for every other patient who shared in the risk of the trial in order to let him have access to it. In fact, as O'Connor pointed out, it would not be a lifelong commitment because there is well-established etiquette on this matter. A lot of drug companies say, "If you're on this trial and it works, we will pay for you to have the drug for the next two years." Within these two years other sources of funds will have been easy to find, because everybody loves a drug that works.
But then, added O'Connor, there's the adjusted problem: what happens if the drug works for some of the people on the trial, but not for the donor? He still finds a £10 million bill on his doormat, only this time he's come home knowing he's about to die. "I suppose that's just the risk of doing business in this way," said O'Connor, answering his own question with unexpected corporate brutality - the brutality of the ethicist rather than the moralist."
"Lanciano's solution to the problem is best illustrated by an example.
Let's say a wealthy individual is diagnosed with a mid-gut neuroendocrine tumour. He gives £2 million to the Dating Agency, which then hands it across to a biotech company that has a promising new but underfunded drug for this type of cancer. The £2 million is used to produce 100 doses of the potential medication. As soon as the drug is manufactured to the correct standard for human testing, the biotech company gives ten of the doses back to the Dating Agency and uses the remainder to run its trials, conduct further tests, etc. One of these ten donated doses is guaranteed to be given to the donor, which leaves nine doses for the Dating Agency to distribute to poorer patients. In total, therefore, the donor is now paying for all the people on the trial to have the drug, plus a further nine people who can't join the trial for whatever reason but are suitable for a compassionate usage exemption.
The next part is the critical one, and is composed of several elements:
1. The donor's consultant now sets up what in the USA is called a 'Physician IND' (a 'physician-initated investigational new drug' to give it its full name). In effect, this gives the consultant regulatory approval to run a bespoke trial for the donor using the company's drug. The advantage of this, from the company's point of view, is that it removes their liability if the wealthy individual dies. In the phraseology of medical litigation, a Physician IND "transfers ownership of the data" from the company to the physician. It takes about three to six weeks to arrange.
2. The nine other, poorer patients who can now be treated must also get their consultant's approval to use the new drug. In each case, their consultant must set up a bespoke IND. There is no legal requirement for these extra doses - it is entirely a matter of PR. As a Guardian journalist I spoke to recently said, "If you didn't have them, I could write the editorial against your modified proposal this instant. One rich person getting a medical exemption for a new drug, but no one else can afford it? It looks rotten. These extra nine doses keep the thing looking honourable."
3. All of the people being treated with the new drug under this scheme agree to supply their data (i.e. the details of their illness, what happens to them while taking the drug, etc.) to the Dating Agency."
""This is an industry-wide problem. Of course, the scheme shouldn't be limited to one donor or one supplier. Let's say five wealthy people with mid-gut neuroendocrine cancer put their money into the Dating Agency, and in return they each get access to trial drugs. The money in the Dating Agency is then handed out to, say, four or five different companies all wanting to run trials into different new treatments for this disease. You want to promote as much new research as possible. Pounds go to the companies and doses come the other way, to the patients. Let's say the companies agree to hand over 5 per cent of the doses, so if they make 1,000 doses the Dating Agency gets 50 - they'll be for a range of different potential new treatments. The most appropriate one can now be selected for each patient. Five donors only need to consume five doses, so you have 45 doses left over for other people."
Meanwhile, these drug companies will be getting the usual calls from all over the world asking for access to drugs for compassionate usage, just as Lanciano's company had Nancy Pelosi and the father of the four-year-old on the phone. But now the companies can reply, "Oh yes, perhaps something can be done. Contact the Dating Agency, because they have 45 doses to distribute. If your case is suitable, they will give you one and all you have to do is set up a Physician IND with your doctor." That doctor will then assume legal responsibility and ensure that a sick child isn't given 100,000 times the recommended adult dose."
"Lanciano is a corporate man, and a drug entrepreneur and plutocrat himself. He is involved in several venture capital programmes. But he also knows what it means to have cancer. His wife died of it. His sister, mother and father-in-law too. "I have a certain type of cancer myself," he revealed, almost as an aside, during another of his illustrations about how his version of the Dating Agency would work, "and I know where I am, and I'm letting the industry develop and just kind of waiting to see what happens to my disease. But if all of a sudden I realise I've only got 18 months, maybe I'll take some of my millions and plop it down in the Dating Agency and say, 'I'm going to do that and that', and get the drug real fast. If the mechanisms are in place it can happen pretty quick."
"And there are no such mechanisms in place at the moment?"
"No. Nothing. Nothing even close. What would be really brilliant is to have this agency also include an outreach capacity. There are so many millionaires and billionaires in the world. You're going to have a wealthy Saudi king, you're going to have an Indian maharajah and Silicon Valley billionaires and millionaires - all of them wanting to have access to this. They have brothers and mothers and sisters and, you know, they don't want them to die," he said. And then he repeated it, with genuine compassion and perhaps some fear: "They don't want them to die.""
Very interesting project, Jim.
Hi Jim Antonio, very nice subject if,
very touchy subject and makes my quite riled-up in anger to some point (wars were started because of that (just think of the French Revolution were peasant people revolted against Rich elite and changed the 'before-rich-runned' entire country).
Money - a resource - at the center of conflict, because it's a race and Competition, life is just that - one big Competition to Have Those $$Resources to Survive. David Suzuki said money and mercantilism/savage capitalism is the downfall of humanity (putting a price tag on everything and a tax on anything - including the air your breathe or the number of thoughts you think per day! it's coming they'll tax each one of your cells - just 'for being'. Yeah that sounds super alarmist hysterical but seriously it seems we're going that way) My 3 cents.
''But then, added O'Connor, there's the adjusted problem: what happens if the drug works for some of the people on the trial, but not for the donor? He still finds a £10 million bill on his doormat, only this time he's come home knowing he's about to die. "I suppose that's just the risk of doing business in this way," said O'Connor, answering his own question with unexpected corporate brutality - the brutality of the ethicist rather than the moralist." ''
Yes, he still finds a 10 million dollar bill and comes home knowing he's going to die.
Or, put another way, he's going to die - Anyway. The problem with many rich wealthy people is they don't realize
that money can't bring you back from death (and it's too late when they realize that..''Oh..they died...too bad..still I kept my millions''). Once you're dead, you're dead. What do you want to be ?
A Rich Living Hero - with a couple less millions in your greedy ridiculous bank account ? Or,
A Dead Living Non-Hero - with a couple more millions in your now futile no-name-anymore ridiculous bank account filled with something called 'money' or should we put that as 'financial resources' in the 'real life' - not that it's important in the 'after life' since you'Re now dead ?
Financial resources won't save you of anything (SENS may save your life, even then it's a big wager (you've got cash - go SPEND it now while you're alive - yeah like at the casino, life's a gamble, gamble away your cash instead of being a scrooge scared of losing your pennies ''But I'm too scared to go bankrupt and 'become a poor', so I hold on to my cash and don't give any to no one. I thus rather die rich'') - but
you've got money that is really coming out of your ears - you don't know what to do with all this money -
oh right you want to keep it like some Uncle Scrooge Peny Pincher assw*pe dbag cheap mooch - and Die Rich(er), Right ?
Because Dying Rich(er) (then the next Richer(-less) Sucker) is Better than Living Longer - A litte Poorer and Having Saved The Life of Many Poor People
who can't afford that special therapy that you only you can because of your big bang account. Learn the word Compassion, it's in the Bible and in the dictionnary but not in the Rich's Dictionnary. I know some rich will jump in and say : ' I have compassion, I give, I donate my money to causes...I give some...'. What you give is generally very small and you DO NOT need all of your fortune to live a good life - but you hold on to it like scrooge.
Sometime,s I think being rich with millions should be BANNED because this creates such a huge gap between rich and poor people (poor people being hundres of thousands times less rich than Rich people - it's pure unfairness at a certain point -there needs to be a Maximum 'Cap' if you will (in french we say 'plafond salarial' 'salary ceiling' (salary limit) is what rich people should be bound by).
It's true you don't owe anything to anyone, you don't have to 'Save The World or Anyone's Else's 'poor' Life' with your 'hard-earned millions' - It's YOUR money, and you can keep Your Cash for Yourself, Egoism/Selfishness and all...and you will Die with It,
Alone. Like a Rich Greedy Fatcat D*mb 'I am The King$' Ftard... greed is one of the 7 sins in the bible, Learn to Understand
why it is so. It's true that life is all about survival and resources gives us survival, Rich people have access to EVERYTHING because they have
the resources, the financial resources. I know they will say 'I have exactly the same chance or less as any other poor people - they just need to get off they asses and MAKE MONEY like - I - did - I'm Rich and I Earned It'
I won't put you down on that point, many rich people are rich by FAMILY HERITANCE/HEIRS not having worked for it at all, they are born in Rich Families and pampered since birth.
Now, for those rich people who earned it through hard work and 'Made It BIG$$$' OK. I will give it to them
still they are Making Money - Disproportionately - I don't care if you invented a Space Shuttle or You
Reversed Death - You won't be a Billionaire or Triollionaire or Quadriollionaire or... - EVER. That is Wrong,
you invented something incredible you worked hard and you will paid, have no worries but you will not live
like some Dictator King$$$ on your High Perch praying on poor populace and reaping the cash from the deathly starving ones.
Because Money is Power Right ? Money is Greed ? Money is Time ? Time is Money ? Time is Life ? Time is Death ? Money acn buy you Time ? Money Could buy your Eternal Life (SENS LEV) ?
What haev you got to lose - but only your life ? Your Money ?...no, that's gonna be gone - when you're gone. Dead gone.
''One of these ten donated doses is guaranteed to be given to the donor, which leaves nine doses for the Dating Agency to distribute to poorer patients. In total, therefore, the donor is now paying for all the people on the trial to have the drug, plus a further nine people who can't join the trial for whatever reason but are suitable for a compassionate usage exemption.''
At least the Rich who partake in this know on their greedy selfish conscience (for the greedier ones) that at least they helped other people - with THEIR MONEY.
They SAVE A LIFE...is that not enough WORTH IT ?... ''But I have to pay for my condos, my helicopters, my castles, my many cars or boats... it's not paying itself you know... oh and I saved someone's life with a couple of my bucks...a small detail''
''But he also knows what it means to have cancer. His wife died of it. His sister, mother and father-in-law too. "I have a certain type of cancer myself," he revealed, almost as an aside, during another of his illustrations about how his version of the Dating Agency would work, "and I know where I am, and I'm letting the industry develop and just kind of waiting to see what happens to my disease. But if all of a sudden I realise I've only got 18 months, maybe I'll take some of my millions and plop it down in the Dating Agency and say, 'I'm going to do that and that', and get the drug real fast. If the mechanisms are in place it can happen pretty quick."
"And there are no such mechanisms in place at the moment?"
"No. Nothing. Nothing even close. What would be really brilliant is to have this agency also include an outreach capacity. There are so many millionaires and billionaires in the world. You're going to have a wealthy Saudi king, you're going to have an Indian maharajah and Silicon Valley billionaires and millionaires - all of them wanting to have access to this. They have brothers and mothers and sisters and, you know, they don't want them to die," he said. And then he repeated it, with genuine compassion and perhaps some fear: "They don't want them to die."" ''
Oh...it dawns on them...that 'someone Could die in their family'...and then 'Someone Does die'... when you read something like this you think, are they THICK and DUMB or what ?
Or JUst f...BLIND(ED) by they f...million dollars...again, Pure Greed - Avarice at the utmost degree...
They think ''I might be able to save my family members who are cancer-stricken...so I'll put so millions for them; I must calculate my ROI perfectly to make sure I do not lose a penny of my rich fortune because after all, I am rich and will keep being it if I manage my resources''.
They come up with that 'Realization' like some epiphany - all by themselves. I heard some people say 'Rich people are totally 'different' and 'think differently'' now I believe that so much.
No, you are Not Rich, you are empty, void and soulless, The only True richness you get is from your (dying) family members; that richness you can treasure it for a little while as they die on you by your stupidity and stuborness.
You will die alone and contribute to more poverty, Rich...-less.
''And then he repeated it, with *genuine compassion* and perhaps some fear: "They don't want them to die."" ''
genuine compassion, seriously?..we'll pass...fear is what they need, the fear that comes from Realization Dawning on them that they are not Eternal and waking-up their 2brain cells.
''But I don'T want to die or my family members to die...but I don't want to lose my big money either...'' You can't have everything in life - Take Life - Over Money. Take Life - Over Stupidity. Take Life - Over Greed. Take Life - Over Selfishness/Ego. Take Life/Soul/A Conscience - Over sin. etc...
Thank you so very much Reason for this great profile of our work! As stated above, our current roster of treatments appears specifically tailored to serve patients with terminal conditions - most especially lung cancer, although we maintain a network of clinics offering treatments in other terminal conditions. Our transition towards providing senolytics and other treatments for life extension and longevity proceeds at a rapid pace, and we look forward to sharing more in early 2017.