Are Longevity Assurance Therapies only for the Wealthy?

The Life Extension Advocacy Foundation is in the process of reworking their online presence and adding a lot more content. One of the new items is this discussion of the likely trajectory of cost for near future therapies that slow aging or produce rejuvenation, such as the panoply of SENS therapies presently under development. There is a tendency for people to assume, without giving it much thought, that rejuvenation therapies will always be enormously expensive and thus restricted to the wealthy, but this is basically nonsense. Once proven and packaged as a product, the projected types of therapy will be mass manufactured infusions and injections, the same for everyone. They will be administered by bored clinicians, needing little in the way of time from expensive medical staff, and only undertaken once every few years or so. If you look at comparable technologies today, even given the way in which a dysfunctional and highly regulated medical industry piles on unnecessary costs, this class of medicine is not expensive once it gets to the point of widespread availability and standardized manufacture in bulk. Further, consider that this is the case is when the number of patients, while large, is only a tiny fraction of the overall population. When the target market is instead everyone over the age of 40, enormous economies of scale will come into play.

The concern that rejuvenation biotechnologies might cause social disparity and further widen the gap between rich and poor is one of the most commonly raised ones, probably second only to concerns of overpopulation. Like many others, this concern may appear valid at first, but it does not survive careful analysis. The underlying assumption of the argument we are discussing is that rejuvenation therapies would be so very expensive that only rich people would be able to afford them, thus fracturing the world into the ever-young, ever-healthy rich ones, and the poor, sick, old ones with no access to these technologies. It is very likely that rejuvenation therapies will be quite expensive initially due to a number of factors. However, even if we can initially assume a high cost for rejuvenation biotechnologies, we need to keep in mind that new technologies generally start off as very expensive and eventually become affordable and widespread.

For instance, it took only 15 years for full genome sequencing cost to drop from $100 million to $300, making personalised medicine a reality globally. In the field of medicine, there are several other examples of this same trend of falling cost and prices. The drug metformin, used for the treatment of type 2 diabetes (and probably the first drug to slow down aging in healthy people, which is currently the subject of the TAME clinical trial), was initially expensive but eventually its price plummeted to a few dollars. Its price fell from $1.24 per tablet in 2002 to 31 cents in 2013. Similarly, improvements in technology have drastically reduced the costs of research diagnostics, and the advent of remote technology has allowed a cost reduction for both patients and hospitals as specialists can be contacted at a distance. As an example, this means hospitals do not need to have radiologists in location all the time, but can instead remotely send them patient data for analysis and thus only pay for each individual service; this, in turn, implies potentially cheaper services for the patients as well.

Technology typically becomes much cheaper as time goes by; there is no reason to believe the same would not be true of rejuvenation technologies, especially when one takes into account an extremely strong economic motivator: The market for rejuvenation biotechnologies would be the largest in history. Every single person in the world has aging and is thus a potential customer. It is of course very likely that those with wealth and therefore greater means will obtain cutting edge technology first (as we have seen repeatedly historically) before everyone else. However, one should consider that those early adopters are playing "guinea pig" and in effect are paving the way for the masses and helping developers offset the costs incurred during the development process due to paying premium prices for early access to these technologies.

If, for the sake of the argument, we assumed that rejuvenation biotechnologies could somehow be an exception to the trend of falling prices in technology, we would need to decide whether people ending up paying for their own rejuvenation therapies is more a realistic scenario than governments subsidizing the treatments, partly or wholly. The majority of countries in the world have universal healthcare systems that take care of their citizens or residents health needs either for free or for a nominal fee. These costs are offset by taxes which ensure the health service is able to provide this level of care to all. Presently, health expenditures for the elderly constitute a considerable burden on a country's economy. Although the elderly have already contributed wealth to society when they were younger, they often stop doing so when they retire. The desired result of rejuvenation therapies leads to a much better scenario. If rejuvenation therapies are reapplied with proper timing, no individual would ever reach a state of age-related decay and poor health that could make him or her unfit for work. Consequently, the costs of treating age-related diseases using current medicine could be reduced with the arrival of more robust therapies offered by rejuvenation biotechnology. Such rejuvenation therapies aim to prevent a plethora of diseases before they manifest, potentially saving money. However, even if the costs are the same and we are simply trading one set of medicines for another, the benefit to health, quality of life and productivity makes it more than worth it regardless.

Link: http://www.lifeextensionadvocacyfoundation.org/education/only-the-rich/

Comments

I think early longevity therapies will involve transferring something (organs, stemcells, plasma, platelets, etc) from young third world people to older first world people. So economies of scale and cost reduction via technology would not apply, at least until man made duplicates could be grown or made.

Posted by: JohnD at December 19th, 2016 8:31 AM

"The concern that rejuvenation biotechnologies might cause social disparity and further widen the gap between rich and poor is one of the most commonly raised ones"

Further widen?? It's not widening, it's narrowing!!

https://youtu.be/FACK2knC08E?t=2780

Posted by: Antonio at December 19th, 2016 8:37 AM

@Antonio the general perpection among the public is the gap between rich and poor is widening, this is why we have said this in our article. Rejuvenation Biotechnology should hopefully reduce inequality in the long term but the rich will almost certainly get first access as they usually do.

Posted by: Steve Hill at December 19th, 2016 9:10 AM

Aren't you perpetuating the misperception with that sentence?

Anyway, the article is very comprehensive and well written.

Posted by: Antonio at December 19th, 2016 9:56 AM

Thanks. We have done a few others there too and we have some waiting in the wings which we will be launching in coming months. We plan to roll out more and more content including videos and articles to create an educational hub as well as our platform for fundraising (lifespan.io) and our research arm which will be announced in 2017.

Posted by: Steve Hill at December 19th, 2016 10:59 AM

Also Steve, since you're here, do you still plan to make educational infographics ? I remember we discussed those not so long ago.

Because I'd like to direct some people towards the SENS donation page but there's no "quick read, easy to grasp, mass public compliant" material over the SRF's website. That's why infographics would be so precious.

Let me reiterate my offer to make a modest donation to help make those infographics. Translation in many languages could later be crowdsourced.

Posted by: Spede at December 19th, 2016 11:13 AM

Hi Spede,

Yes we have already started on those we just did a clinical trials one which appears on the LEAF website and we are planning an advocacy section to include all these for people to use. These will be LEAF branded rather than SENS but are still aimed at education. We are applying for some educational grants in 2017 as we plan educational content, talks and events in the new year.

We will be running some "mini" patreon style fundraisers on lifespan.io for LEAF, a few hundred to pay for infographic production, a few 1000 to pay guest writers and other small things to build community. All our assets are of course free to use too.

I wonder if this fits your vision also?

Posted by: Steve Hill at December 19th, 2016 12:01 PM

@Spede: Those graphs are only for France. The video refers to world data. Also, the chage is bigger worldwide than inside France. This can also be seen in other sources. For expample, this is a very comprehensive report from the UN: http://hdr.undp.org/fr/2013-report

Posted by: Antonio at December 19th, 2016 12:28 PM

Once therapies reach the general public the prices will come down. However, in the 10 years I have been filming scientists on the subject, I have come to understand the 5-15 year lag time between the lab and the clinic. The well connected and wealthy can have that 10 year head start. They can begin to buy time now. In terms of cost, receiving these therapies in the early stages is quite expensive.
And, that head start may make all the difference. By the time the general public has access, the elite group will be onto the next reversal therapy the general public doesn't have access to yet. And so on. I'm not sure how this will play out. I remember "the internet will democratize everything " or words to that effect. We shall see.

Posted by: Robert Kane Pappas at December 19th, 2016 1:01 PM

@ Steve : glad to hear about these developments, I will definitely contribute once those fundraisers are up !

I'm thinking that if I am to tell people about the SRF or direct them towards its website, giving them LEAF materials might confuse them.

To mitigate that, would you envisage putting the "organisations we work with" band (currently found on the LEAF website) at the bottom of your materials ? I think this would be a simple and fair practice.

@ Antonio : Gracias for the resource. I found the 2015 version of this ONU report. It focuses on the developing countries and argues that poverty has fallen, however is clearly states : "Human development has been uneven among regions, across countries and within countries." It further claims : "While outsourcing in general seems beneficial to developing country regions, it has consequences for workers in developed countries."

That's in line with national findings, such as the one I linked above.

And it has important implications in terms of advocacy : you cannot decently tell people that the planet is getting better... when all they see around them is the worsening of their own world. Especially since, I surmise, most donators to the longevity cause are from developed countries where economic progress has more been of a regression for many years.

Posted by: Spede at December 19th, 2016 1:15 PM

Those quotes doesn't refute the huge decrease in inequality in the world. If you want to see it clearly, see the video again. In 50 years, from a world with two income peaks, we became a world with only one (and bigger) peak, in the middle of the previous two.

The data is everywhere. For example, in 2015, world life expectancy was 72 years, while Japan life expectancy was 84 years. You can't have that in a highly inequal world.

Posted by: Antonio at December 19th, 2016 4:08 PM

@Spede:

"And it has important implications in terms of advocacy : you cannot decently tell people that the planet is getting better... when all they see around them is the worsening of their own world."

Totally disagree. Above all, you must tell the truth. The world is not worsening, it's better than ever before. Even if you consider your very reduced local environment, it's so. Europe never had such a long period of peace. Life expectancy was never so large. Literacy was never so high. Etc.

If you even reduce it more: My mother told me about when she was a child and that sometimes they had only one chicken egg for all the family for the whole day, that they had no toilet, no shower nor even a tap, that she quit school at age 10 to work collecting olives or caring for rich people's children, that it was commonplace to eat cats and dogs, that she slept in the same bed with her parents and sister until she was 16, that they washed their clothes in the river, that her brother died at the age of one year and half from an infectious disease, etc. I never had lack of food in my entire life. I always had sanitation. I have a PhD. I could study in the other side of the world (Japan). None of my brothers have died. Etc.

Posted by: Antonio at December 19th, 2016 4:39 PM

I agree with you that the truth should be told ; or rather, the truthS.

Overall the world is doing better, but it is not doing so uniformly. To the point that, in some countries and for some social classes more than others, inequalities have actually and factually become worse - not better. So telling the people of said countries "Rejoice ! We're all better off !" is, in a way, insulting.

What Steve could do, in order to mitigate the contradictions of those two truths, is to re-write his sentence along the line of : "(...) might cause social disparity and, in certain settings, further widen the gap between rich and poor (...)".

It's a simple addition which takes into account the multiple realities currently occuring in the world.

P.-S. : I hope your mother is enjoying a well-deserved retirement.

Posted by: Spede at December 19th, 2016 6:34 PM

@Spede: Even in your link about only France, the Gini index has decreased from 1970 to 2015. Most of the decrease is from 1970 to 1990 and since then there have been mostly fluctuations rather than increase. There is a small increase trend, but the range of the fluctuations is much bigger than that trend and that range is also much smaller than the decrease in 1970-1990. So I would not say that the correct assessment of the situation in France is "further widening of inequalities".

Posted by: Antonio at December 20th, 2016 3:42 AM

The source of our misunderstanding is that you keep looking at the big picture whereas I don't want to ignore sub-trends.

Yes, the amplitude of the increase in inequality is overall less important than the increase in equality, but that is still a potent indication that the world's growth remains inconsistent and by no means guaranteed - it is precarious.

And people are getting accustomed to precarity, as the following article underlines : https://www.weforum.org/agenda/2016/11/precariat-global-class-rise-of-populism/

With that in mind, I don't think it is wise to tell people to be optimistic because they're only experiencing fluctuations and their country has made great strides in the grand scheme of things ; whilst right now there's a palpable growth in precarity (e.g. more temp jobs and "zero hours" contracts than ever), itself responsible for a widening of inequalities and growing social discord.

Posted by: Spede at December 20th, 2016 5:18 AM

@Spede

We will likely do a series of infographics in the LEAF brand showing the various damages of aging in 2017. It is likely we will take our lead from Hallmarks of Aging which we tend to subscribe to, this should be ok as it incorporates SENS in there anyway although we will include crosslinks too as they miss this out of Hallmarks making 10 damages in total. Hopefully this will help educate people.

Suggestions for other infographics welcome and we will include all these in our advocacy section in due course. We have a good artist who will do this for us.

Posted by: Steve Hill at December 20th, 2016 5:28 AM

Steve, in addition to those, I suggest making infographics from the materials you've already written at http://www.lifeextensionadvocacyfoundation.org/education/concerns/.

Each article could be turned into an infographic, where you cwuld compile the takeaway points and accompany them with visual explanations. And indicate the URL of the complete article tied to this particular infographic, for those who need to read more about the details of your argumentation.

Posted by: Spede at December 20th, 2016 7:35 AM

Good idea I like it.

Posted by: Steve Hill at December 20th, 2016 8:58 AM

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