New life in old age

Joseph Jimenez ZURICH – Many of us have seen our aging parents or grandparents lose their independence. In 2012, more than 2.4 million Americans over the age of 65 were treated in emergency rooms for injuries from falls alone. With populations worldwide aging fast, the scale of such challenges is growing exponentially, affecting not only health-care systems, but also economies, government policies, and, of course, families. The United Nations estimates that, by the middle of this century, the number of people older than 60 will double, with people over the age of 65 outnumbering – for the first time in history – children under the age of five. The explanation for this demographic trend is straightforward: global fertility rates have plummeted, from five children per woman, on average, in 1950-1955, to 2.5 children per woman in 2010-2015. Of course, aging citizens should not be viewed simply as an economic burden. In fact, they can play a positive role as active consumers – a potential that many industries have already recognized and begun to tap. According to Bank of America Merrill Lynch, people over 50 are responsible for almost 60% of consumer spending in the United States. But that does not ameliorate the seemingly intractable underlying challenge: a shrinking pool of taxpayers to support a growing number of retirees. This imbalance has already driven some governments to raise their retirement ages and change their pension policies to delay or reduce benefits and keep people in the workforce. To keep people working longer, it is crucial to keep them healthy. That is why the health-care industry must play a significant role in efforts to address the challenges of population aging. Old age must be viewed not simply as an inevitable stage of life, but as an opportunity for health-care companies and systems to help people thrive. To this end, health-care companies should shift the focus of their research-and-development efforts toward conditions that are prevalent among older patients, including chronic diseases like diabetes, heart disease, glaucoma, rheumatoid arthritis, and cancer. Such efforts are also vital to find ways to stem more effectively the deterioration of people’s productivity and independence, by preserving their physical strength, mental acuity, and senses like hearing and vision. This is important not only for older patients themselves, but also for their families and caregivers. One particularly promising area is regenerative medicine, which has many potential applications – including for preventing or reversing hearing loss. As it stands, one-third of people aged 65-70 (and half of those over 75) experience significant hearing loss, often caused by damage to or loss of inner-ear hair cells, which sense and transform sound waves into signals that register in the brain. To address this issue, my company, Novartis, is testing a compound called CGF166, which targets certain healthy cells in the inner ear in order to “turn on” a specific gene that stimulates hair-cell development. We have already entered the clinical-trial phase of our research, during which we will assess the tolerability and efficacy of CGF166 in treating patients with severe hearing loss. But such treatments will mean little if they are not affordable or accessible to ordinary people. And the current trajectory, with the burden of rising health-care costs increasingly being shifted onto patients themselves, is not encouraging. To reverse this trend, the health-care industry must work with all stakeholders to support the financial sustainability of health-care systems, so that they can better handle the growing demand for care. Success will require innovative strategies for improving patient outcomes in a financially sustainable way. For example, the health-care industry could work with governments to offer health-enhancing services – such as remote patient monitoring, health apps, and patient-engagement tools – in addition to medications. Ensuring the availability of trained health workers or counselors to answer patients’ questions about their treatment or related issues like insurance could also help. For their part, payers – both governments and private insurers – should create a mechanism for rewarding health-care companies based on the real-world benefits of their products and services. Beyond the annual payment per patient, the health-care company could receive a bonus or penalty, depending on the outcomes achieved. Addressing the needs of aging populations is the biggest challenge facing health-care companies and payers. A successful model will lower health-care costs, increase life expectancy, and improve elderly people’s quality of life. And, by providing a more comprehensive understanding of the aging process, it could also guide us toward treatments and cures for other diseases – including those affecting the young. Ensuring that every person lives as healthy a life as possible, for as long as possible, is in everyone’s interest. That is why it makes sense now to focus on the most senior among us. Jimenez is CEO of Novartis. Copyright: Project Syndicate.

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New life in old age