Magic Pills Are Coming
Nov 29, 2023
Wearable ultrasound machines and other
inventions could reduce medical costs.
At healthcare conferences, someone always asks, “What if there was a magic
pill?” One that could cure major diseases. What would the healthcare industry
look like? Some emergency rooms and hospitals but less doctors and spending?
Inevitably, the discussion ends with, “But, of course, there is no magic pill.”
So we spend, spend, spend on healthcare, from $1.4 trillion in 2000 in the U.S.
to more than $4.3 trillion—18% of the economy—in 2021.
Could there be magic cures? History shows
plenty of wonder drugs and treatments. Aspirin reduces inflammation. Penicillin
and other antibiotics fight infections. Insulin treats diabetes. Stents unblock
arteries. These treat but don’t cure diseases. Plus, two-thirds of American
adults are overweight or obese, which puts them at greater risk for many
chronic diseases such as heart disease and stroke. According to the National
Institutes of Health, “86% of health care costs are attributable to chronic
disease.”
By now you’ve heard about glucagon-like peptides (GLP-1). Drugs
that mimic these hormones, like
Novo
Nordisk’s Ozempic and Wegovy and Eli
Lilly’s Mounjaro, seem to treat diabetes by lowering blood-sugar
levels. They also promote weight loss and lower the risk of heart disease. What
can’t GLP-1s do?
A friend of mine with diabetes started taking Mounjaro and now, because of
shortages, takes Ozempic. He lost 70 pounds, got his A1C levels back to normal
and told me, “I’m simply not hungry anymore. It’s not even like I’m full. I
used to throw back a whole pizza and a gallon of milk. Now a slice and a bottle
of water is more than enough. The food I used to crave has no interest for me.”
Amazing. Goldman Sachs Research expects this to be a $100 billion market by
2030. It could save multiples of that in healthcare costs. Patients take these
drugs via injectable pens. Pills are coming—dare I say magic pills?
Here’s another magic cure: Israeli company Insightec, backed by
Koch Industries, has made a helmet with 1,020 acoustic sources that when placed
on a shaved head can focus ultrasound signals to specific spots in the brain.
For patients with tremors, including some with Parkinson’s disease, the system
uses magnetic resonance, similar to an MRI, to guide “focused ultrasound” to a
specific spot in the brain, which it heats to 113 degrees Fahrenheit. This
creates a lesion, which miraculously eliminates tremors with a less than 1%
chance of side effects.
Insightec CEO Dr. Maurice R. Ferré tells me the
company’s “incisionless brain surgery” is in 200 medical centers. Its devices
have been used to perform 20,000 procedures that cost $18,000 to $20,000,
replacing $60,000 electrode-implanting brain surgery. He adds that the company
has 35 ongoing trials investigating focused ultrasound for things like
depression, obsessive-compulsive disorder, Alzheimer’s, and even
neurodegenerative diseases like ALS.
One trial caught my eye. The Rockefeller Neuroscience Institute at
West Virginia University has been running trials on curing opioid and substance
abuse. After putting the ultrasound helmet on a patient, researchers apply
triggers for drug use, via images on virtual-reality glasses and scents, to
look for areas where the brain “lights up.” Instead of heat, the focused
ultrasound uses neuromodulation to excite the appropriate tissue.
Yes, it sounds right out of “A Clockwork Orange”—but it works! I
heard of one patient, a longtime opioid user, who said he hasn’t had a craving
for drugs in years. A study published in September in Frontiers in Psychology
says the procedure “acutely reduced substance craving,” even 90 days later.
Sounds similar to GLP-1s and food cravings. So far, 12 people have had the
procedure and Dr. Ferré says “there has been no relapse or recurrence of
cravings.” A brave new world indeed.
There are other promising technologies. Crispr gene therapy can
fix gene mutations for Duchenne muscular dystrophy and coming soon are one-off
treatments for sickle-cell anemia. Even cancer treatment is changing rapidly. I
paid $950 for the Galleri blood test from Grail, a subsidiary of Illumina.
Using AI, it looks for patterns in your blood that can identify over 50
different cancers, even at a very early stage. My tests came back negative.
Whew.
And if it found cancer? The same mRNA that quickly turned out
Covid vaccines from BioNTech and Moderna is being used to fight
cancer, including hard-to-detect pancreatic cancer. Wouldn’t that be a magic
pill? Find cancer with a blood sample and take the appropriate mRNA pill before
cancer requires expensive hospital care.
For other ailments? Medical chatbots are already here. Type
symptoms into an AI large language model and out pops a diagnosis. Google
claims its Med-PaLM 2 scores 86.5% accuracy on United States Medical License
Exam-style questions. I doubt chatbots will ever be 100% accurate, but they will
help augment doctors. And, according to JAMA Internal Medicine, patients think
chatbots are more empathetic than doctors 80% of the time anyway.
Technology is changing medicine. Maybe there is a magic pill after
all
Source: Wall Street Journal