July 2023
Genetic medicine is still nascent, but the technology is constantly improving. Here, Newton healthcare analyst Matthew Jenkin explains why he believes genetic medicine is poised to potentially create functional cures for many diseases and shake up the pharmaceutical industry..
Highlights
- Global genetic medicines markets are projected to exceed US$70 billion by 20301
- Genetic medicine showing promise in potentially curing conditions ranging from hemophilia to high cholesterol
- Chronic conditions are the leading cause of the US$4.1 trillion in annual healthcare costs in America2
There have been numerous advances in medicine over the years, but genetic medicine stands to have a great impact – creating potentially functional cures for many chronic diseases. In Jenkin’s view: “the biggest disruptive change going on now is genetic medicine.” In fact, the global genetic medicines markets are expected to exceed US$70 billion by 2030.
If you look in your medicine cabinet today, you’ll notice the medicines are designed to treat symptoms of whatever ails you. If your condition is chronic, you’ll be getting prescriptions filled for the rest of your life. Genetic medicine could change that.
Some conditions are caused by genes missing proteins or proteins not working correctly. With genetic medicine, your own DNA and/or RNA could be modified with specific proteins so your genes function normally. 3
“Over the very long run if you can create functional “cures” in many diseases, not just genetic-based diseases, the drug industry will have to adapt,” notes Jenkin. “Today you are a repeat customer, in the future it might just be a one-time treatment and therefore they (pharmaceutical companies) can’t count on you as a repeat customer.”
Genetic medicine in action
One disease showing particular promise with genetic medicine is hemophilia, a genetic disease where people cannot clot their own blood. Currently, those with the condition must get weekly injections of a drug that replaces the factor VIII protein so patients can clot normally. With genetic medicine, those weekly injections could be a thing of the past.
“A gene therapy in this case essentially inserts a gene into the person’s cell that is responsible for making their own factor VIII (in the case of hemophilia) just like healthy people have, and then that cell will divide and divide and divide,” says Jenkin. “Once it divides, the factor VIII protein will rise to a critical level where the patient can form blood clots on their own, preventing bleeding episodes.”
It’s not just those with rare disorders who stand to benefit from genetic medicine. Conditions as mainstream as high cholesterol can one day be treated with such technology, Jenkins says. While current treatments of statins, oral pills and injectables work well for many patients, there is a portion of the population who never really get their cholesterol levels under control.
“Scientists have discovered one of the main culprits of high cholesterol is the PCSK9 gene. Some day with gene editing you may be able to turn off or silence that gene,” says Jenkin. “If you eliminate the PCSK9 gene then the patient won’t have high cholesterol anymore no matter what they do. Whether they eat cheeseburgers every day or they’re genetically disposed to not being able to lower their cholesterol.”
Jenkin expects adoption of genetic medicine will follow the traditional course seen with most new drug innovations. “There will be pioneers who will want to take it. People who are tired of weekly injections,” he says. “The second group will be the fast followers, those who noticed the pioneers did quite well and they’re still doing well. They’re technically/functionally cured and saving a lot of money.”
Sustainable healthcare systems
Hemophilia medications coupled with the costs associated with emergency room or hospital visits can be costly. While genetic solutions may be more expensive up front, in the long run it may ultimately end up being cost-effective, he notes.
“Once you’ve dosed with one drug assuming it’s a functional cure, if you go out six or seven years, you’ve already covered the cost of what you would have cost yourself the payer, the government or the hospital system in treatments,” says Jenkin. “If the medication is effective, it’s kind of a no-brainer because the math works and everybody benefits.”
In Jenkin’s view, one of the biggest problems with the healthcare system today is that it’s overrun with patients with chronic conditions, which is the leading cause of the US$4.1 trillion in annual health care costs in America. With genetic medicine potentially curing diseases, resources can be better utilized.
“Not only are there labor and economic waste benefits, but think of the physical waste,” says Jenkin. “Less syringes. Less dressings. You can think of a million things when you lower demand for services that healthcare capability could be used for lots of other things.”
1 Newton Investment Management. September 2022.
2 Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. The health and economic benefits of chronic disease interventions. May 2022.
3 National Library of Medicine. Medline Plus. How does gene therapy work? February 2022
All investments involve risk, including the possible loss of principal. Certain investments involve greater or unique risks that should be considered along with the objectives, fees, and expenses before investing.
Newton Investment Management North America, LLC (“NIMNA” or the “Firm”) is a registered investment adviser with the U.S. Securities and Exchange Commission (“SEC”) and subsidiary of The Bank of New York Mellon Corporation (“BNY Mellon”). The Firm was established in 2021, comprised of equity and multi-asset teams from an affiliate, Mellon Investments Corporation. The Firm is part of the group of affiliated companies that individually or collectively provide investment advisory services under the brand “Newton” or “Newton Investment Management” (“Newton”). Newton currently includes NIMNA, Newton Investment Management Ltd. (“NIM”) and Newton Investment Management Japan (“NIMJ”).
BNY Mellon Investment Management is one of the world’s leading investment management organizations, encompassing BNY Mellon’s affiliated investment management firms and global distribution companies. BNY Mellon is the corporate brand of The Bank of New York Mellon Corporation and may also be used as a generic term to reference the corporation as a whole or its various subsidiaries generally.
This material has been provided for informational purposes only and should not be construed as investment advice or a recommendation of any particular investment product, strategy, investment manager or account arrangement, and should not serve as a primary basis for investment decisions.
Prospective investors should consult a legal, tax or financial professional in order to determine whether any investment product, strategy or service is appropriate for their particular circumstances. Views expressed are those of the author stated and do not reflect views of other managers or the firm overall. Views are current as of the date of this publication and subject to change.
The information is based on current market conditions, which will fluctuate and may be superseded by subsequent market events or for other reasons. References to specific securities, asset classes and financial markets are for illustrative purposes only and are not intended to be and should not be interpreted as recommendations. Information contained herein has been obtained from sources believed to be reliable, but not guaranteed. No part of this material may be reproduced in any form, or referred to in any other publication, without express written permission.
Not FDIC-Insured | No Bank Guarantee | May Lose Value
© 2023 BNY Mellon Securities Corporation, distributor, 240 Greenwich Street, 9th Floor, New York, NY 10286
MARK-404694-2023-07-18
