November 22, 2015
Gene Therapies to have 6 and 7 figure price tags
Early gene therapies will come with serious sticker shock. Half a million dollars for one, 4 to 6 million dollars for another. On the bright side, after a 15+ year delay due to safety concerns it looks like they are really coming this time.
My advice: save a lot of money for your old age to be able to buy expensive optional therapies. Wondering whether you should go to a high work, high pay, big city, bright lights career trajectory? Yup. It might just save your life.
Medical costs for treating cancer were really low in the 1950s because most of the time all the doctor could do is tell you that you are going to check out of the Life Hotel sooner than you had planned. The totally untreatable disease is cheap to treat because it comes with no expensive therapy to pay for. Saves money. Kills you. We are starting to enter a completely different era where some therapies have incredibly high efficacy but also incredibly high price.
Growing old means having lots of body parts start to fail. You might find yourself at age 70 wanting 3 different high priced therapies for 3 different conditions. Might have a failing heart or liver or thyroids. Perhaps a bad need or bad discs in your spine. Maybe wet age-related macular degeneration in your eyes. Or maybe tinnitus due to messed up cilia in yor ears. If you max out your retirement savings every year and index in low fee index funds and choose jobs to put yourself on a higher earnings growth path then you might save enough money to get your failing parts fixed when you get older.
Randall Parker, 2015 November 22 02:09 PM
The price will not come down much, because a large part of it is the professional fees of the physicians and technicians performing the therapy plus the liability insurance they and the clinics must carry. Gene therapy will always be a minor part of total medical practice.
Many of these are cures and not therapies. There is a difficult question on how much to charge for them because they cannot do the actuarial math as easily.
Suppose the US government created a "prize" based on the present value of the next X years worth of, for example, Alzheimer's Medicare costs with the cure becoming immediately generic for US citizens. That is a billion dollar pay day, completely neutral in cost, and is a quantifiable goal for the developers. The increase in productivity and happiness is just a bonus.
But, Bob, that's exactly why the price will come down. Just not in the US. Because most of the cost won't be actual *costs*.
The fees are not elastic. First, because of the risk of damaging mutations and cancers, these will be very high risk therapies and will require highly skilled physicians, who in turn will have to carry high cost liability insurance. A good example is in vitro fertilization. Depending on the age of the woman, the cost ranges from $10,000 to $100,000 dollars. That is for a procedure that was first performed by Dr. Robert Edwards in 1978, almost forty years ago. And in vitro fertilization only offers risks to the embryo, not the actual patient. Again, the cost of the equipment and procedure itself falls with time, but not the fees.
It is also possible that gene therapy in humans will be very tightly regulated or even banned in many jurisdictions because of the risk to the patient.
On the bright side, after a 15+ year delay due to safety concerns it looks like they are really coming this time.
If that was the reason for the delay, why is that reason no longer a cause for a delay.
Color me skeptical, since this will probably be just as far away in 2030.
Any such therapy's cost will drop precipitously after a few years, due to technology improvements and competition from other countries. There are plenty of highly skilled (but cheap) physicians elsewhere, with much more lax laws and liability.
What makes gene therapy a nice target for price reductions (aside from it being a new technology and thus ripe for improvements): it's not a major time investment; there's no heroic 12-hour surgery with a dozen physicians.
Good and the rich will pay out the nose to be the guinea pigs as well.
The cost of the physicians who administer the gene therapy is a really small fraction of the total cost. Gene therapy is going to be a really expensive drug. Drugs do not fall in price once they've been in the market for a few years. Only competing drugs will drive down their costs.
Yes, I'm aware of just how hand-to-mouth most people are in how they earn and spend. I'm saying there is going to be a much bigger survival advantage in the future from not living that way. Study more valuable topics, develop valuable skills, work hard, live cheap, and save. It'll pay off in your old age.