CHICAGO - With the first of the baby boomers set to turn 65 in only a few years, the question facing the life sciences industry is whether the need for effective treatment for chronic and degenerative diseases justifies the anticipated increase in health care costs, and panelists at a bioethics session during BIO 2006 argued both sides of the issue.
Gathering in a meeting room in the McCormick Place convention center on the first day of the conference, panelists debated the research imperative, the notion today's society is obligated to support efforts to discover and develop new technologies.
Dan Perry, executive director for the Alliance for Aging Research, said yes, particularly since previous innovations have helped people live longer lives, adding 30 years to the average 47-year lifespan people in the U.S. could expect in 1900. That increase will contribute to the growth of diseases linked to the aging process, yet the number of drugs approved by the FDA has declined, and "we're having trouble translating basic science into therapies," he said.
For people older than 65, about two-thirds suffer from two or more chronic diseases, so "clearly we need to focus on technology," Perry added, to avoid what he called "a silver tsunami of aging people" in need of chronic medical care.
Using Alzheimer's as an example, Perry said the number of people diagnosed with the disease has doubled since 1986 to 4.5 million people and is expected to "double again in the next 20 years."
Today's drugs primarily treat the symptoms rather than the cause of Alzheimer's, and the only "way to cope will be if we get lucky in a lab" and figure out a drug that will prevent, postpone or reduce the effects of Alzheimer's disease.
"If we could just delay the onset by five to seven years, we could reduce by half the number of people who encounter it in their lifetimes," Perry said, which ultimately would help reduce the health care costs for those who would no longer require chronic disease care or management.
The problem arises when research and development of drugs to treat diseases such as Alzheimer's takes place at the expense of health care consumers, who can no longer afford health insurance due to rising costs.
"We need to rethink our priorities," said Dan Callahan, director of international programs at The Hastings Center in New York, who said that medical advances made in the past have had an ironic impact on the present.
"The healthier we're getting, the more we spend on health care," he said.
While biomedical research is a "moral good," it is not a "moral obligation," he said, suggesting that the bill approved by voters in California last year to allocate $3 billion over 10 years for stem cell research might have been used, instead, to address the state's adult illiteracy problem.
The value of research does not "trump" other values, such as creating jobs, educating children and funding national defense, Callahan said, allowing for only two exceptions when research and drug development should be regarded with top importance: epidemic or pandemic diseases or diseases that cause premature death.
Research beyond those indications will cause health care costs for the average person to "run wildly away," he said.
Total health care costs in the U.S. have increased over the years to make up more than 17 percent of the country's gross national product, a figure some have protested, but Ron Bailey, science correspondent for Reason, said is appropriate for a society in a $13 trillion economy.
"As we get richer, we want to spend more of our disposable income on things like increasing quality" of life, Bailey said.
And so far, some of that money has yielded a promising start, he said, referring to technology that has been shown to be effective in silencing a gene to reduce atherosclerosis, or in creating investigative cancer vaccines like Austin, Texas-based Introgen Therapeutics Inc., which is working on Advexin, a drug that combines the p53 tumor suppressor gene with a non-replicating, non-integrating adenoviral gene delivery system.
"So indeed, we may have pills [to cure these diseases], and they might cost less than the chemotherapy cocktails we have now," he said.
While previous innovation has helped delay mortality, further work is to improve morbidity, which affects a person's quality of life, Bailey said, though he did not discount one day preventing mortality.
"Who knows?" he said. "Reversing the aging process might be possible at some distant point in the future."