There’s plenty to welcome in the Government’s newly launched Life Sciences Vision. Proposals on improving the use of public data, making it easier for innovative start-ups to win public contracts and equipping potential life science entrepreneurs with management training would all be positive steps forward.
But what really excites me is the Vision’s emphasis on ageing, with the overarching ambition to “advance the medical science and understanding of ageing, in order to begin to advance viable products towards the clinic”.
Both the incidence and severity of disease are strongly associated with age. You are much more likely to suffer from dementia, heart disease or cancer at 75 than at 20. There’s no better example than Covid-19. You have a 1 in 5 chance of dying if you catch it aged 80 or over, but a 1 in 1000 chance if you’re in your 30s. Understanding the mechanisms behind ageing has the potential to unlock new treatments and significantly increase the number of healthy years we can expect to enjoy.
The good news is there are already a number of promising solutions in the works. There are clinical trials taking place for some 50 different interventions, many of which have managed to extend the lifespans of lab animals. And recent advancements in CRISPR technology mean some think we might be able to stop the ageing process altogether.
So what can the Government do to accelerate progress?
A key problem is speed. If you were testing a new treatment for an infectious disease like coronavirus, you could run a trial relatively quickly. It only took a few months for the NHS Recovery trial to discover Dexamethasone, a cheap steroid, could cut coronavirus deaths by a third. Ageing, by contrast, is a slow process. To test a treatment that slows the ageing process would require an expensive longitudinal study that tracks participants over a decade – and in some cases, their entire lives.
To speed this up we need to identify the biomarkers for ageing. It might not be possible to swiftly prove that a treatment is slowing the ageing process, but we might be able to look at the underlying hallmarks of ageing. The recent controversial approval of AduHelm, an Alzheimer’s treatment, was based on its ability to clear amyloid plaques, which many (but not all) researchers think cause the disease. A similar approach to drug approval may work here, though there is a risk we end up looking at the wrong biomarkers and investing a lot of resources in dealing with a benign side effect of ageing, while doing nothing about the other harmful issues it entails.
Identifying biomarkers will require more research funding. The best estimates suggest UK funding for ageing research is in the low tens of millions. Small change when you consider the massive economic impact (not to mention personal cost) of age-related illnesses on the UK.
Working out exactly what research is already underway is another issue. As author and scientist Andrew Steele notes: “There are…no centralised data on investment in biomedical research into ageing. This makes it difficult to establish the extent of work being performed in different areas, or the total amount invested.”
Collaboration is also key. As it stands, researchers working on ageing-related fields maybe unaware of the wider research agenda. In a recent essay collection from The Entrepreneurs Network, Henry Fingerhut and Benedict Macon-Cooney advocate the creation of a new Atlas Institute designed to map out entire fields of study and enable better collaboration across disciplines. Initiatives such as UK SPINE are promising but could and should receive more funding.
Encouraging private sector start-ups to focus on longevity is another crucial task. One way of greasing the wheels here would be for the NHS to pre-commit to buying anti-ageing treatments when they work. NICE already uses Quality Adjusted Life Years (QALYs) to determine which drugs the health service prescribes. This framework should be used to guarantee a price for treatments which will increase the quality and length of NHS patients’ lives. Doing so would give investors and longevity entrepreneurs more security to invest in treatments, knowing there will be a guaranteed buyer if they work.
That approach would also put Britain at the front of the queue for new anti-ageing treatments. The US is a much larger market, and most drugs companies prioritise getting FDA approval and selling to American companies. But if the NHS commits to buying anti-ageing treatments before American insurance companies do, that shifts the balance in favour of selling these drugs in Britain and setting up these companies here too. That in turn feeds into the Government’s broader life sciences agenda.
It is very tempting to focus on sci-fi scenarios where people live to 1,000 and debate what it means for humanity. The real stakes here – understanding diseases and extending healthy life – are more prosaic, but no less exciting. With the right investment and strategy, we can develop treatments for diseases which will burden all of us as we get older. Then there’s the potential knock-on effects: if we invest in anti-ageing research and accidentally discover a cure to diabetes or liver cancer, it will have been money very well spent indeed.
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