The New York Times announced we’re in a Golden Age of medicine, saying:
We may be on the cusp of an era of astonishing innovation — the limits of which aren’t even clear yet.
Hype springs eternal in medicine, but lately the horizon of new possibility seems almost blindingly bright. “I’ve been running my research lab for almost 30 years,” says Jennifer Doudna, a biochemist at the University of California, Berkeley. “And I can say that throughout that period of time, I’ve just never experienced what we’re seeing over just the last five years.”
Doudna shared a Nobel Prize for her contributions to medicine, so her opinion is not to be taken lightly.
A Nobel laureate, Doudna is known primarily for Crispr, the gene-editing Swiss Army knife that has been called “a word processor” for the human genome and that she herself describes as “a technology that literally enables the rewriting of the code of life.”
And when Doudna allows herself to imagine applications a decade or two down the line, the possibilities sound almost intoxicating: offering single-gene protection against high cholesterol and therefore coronary artery disease, for instance, or, in theory, inserting a kind of genetic prophylaxis against Alzheimer’s or dementia.
An immunologist had this to say:
“It’s stunning,” says the immunologist Barney Graham, the former deputy director of the Vaccine Research Center and a central figure in the development of mRNA vaccines, who has lately been writing about a “new era for vaccinology.” “You cannot imagine what you’re going to see over the next 30 years. The pace of advancement is in an exponential phase right now.”
U.S. funded research began sowing the seeds of rapid innovation decades ago. It’s not an overnight success:
[O]ften stretching back several decades through the time of the Human Genome Project, which was completed in 2003, and the near-concurrent near-doubling of the National Institutes of Health’s budget, which helped unleash what Donna Shalala, President Bill Clinton’s secretary for health and human services, last year called “a golden age of biomedical research.”
There have already been many successes. The AIDS epidemic peaked nearly 30 years ago. Death rates have plunged since and AIDS is now mostly a chronic disease rather than a death sentence. A more recent example, messenger RNA vaccines turned Covid-19 from a pandemic that killed nearly 7 million worldwide into a bad memory for most. There are numerous other examples from the New York Times:
A couple of decades later, it looks like a golden age for new treatments. New trials of breast-cancer drugs have led to survival rates hailed in The Times as “unheard-of,” and a new treatment for postoperative lung-cancer patients may cut mortality by more than half. Another new treatment, for rectal cancer, turned every single member of a small group of cases into cancer-free survivors.
Ozempic and Wegovy have already changed the landscape for obesity in America — a breakthrough that has been described and debated so much in terms of cosmetic benefits and medical moral hazard that it can be easy to forget that obesity is among the largest risk factors for preventable death in the United States.
The question I have is at what cost? GoodRx created a list of the 10 most expensive medications. The most expensive drug is a $2.1 million one-time gene therapy for spinal muscular atrophy. The other nine range from just over $1 million to nearly $700,000.
As societies become wealthier, they tend to spend a greater share of income on health. The societal value of medicines vary from drug to drug. Many are obviously high, extending life and curing debilitating diseases. Others may provide benefits so marginal that it’s hard to measure. It will be interesting to see all the new therapies that come out in the next few decades.