My naive linear model is that ~$400 billion research funding currently spent per year buys about 1 year increased lifespan per decade, so it would take about $4 trillion per year spent on research to stop aging, or a one-time investment of $80 trillion. For 99% confidence I’ll add a safety factor of 4, yielding a one-time payment of $320 trillion, or $16 trillion per year. In other words, this back-of-the-envelope guess suggests the entire economic output of the United States would be just sufficient to discover and maintain an aging cure.
I don’t think that all of the increased lifespan is due to healthcare spending. Various enviromental regulation likely increased lifespan.
Our current paradigm of drug development unfortunately get’s exponentially more expensive via Eroom’s law. I doubt that simply spending more money in the same way produces linear progress.
I think the problem of the mythical man month also exists in research. You can’t simply throw in more money.
Given researchers money can often make them spend money on fancy equipment instead of thinking hard about what to do.
As far as hopes for the future of biology goes, I hope that Theranos will introduce something like Moore’s law into blood testing prices. If it succeeds with that mission it’s not simply because there a lot of money thrown into blood testing but because Theranos focus on producing cheap blood testing while currently the companies in the market have no incentives to test cheaply.
YCombinators turn to fund biotech companies also fills me with hope. Bikanta Nanodiamond technology that allows very high resultion imaging of anything that you can hit with an antibody fills me with hope. The promise 100X more precise cancer imaging but if their technology really works and the can do it cheap, it has application beyond just cancer because being able to image anything at high resolution will allow us to learn to tag a lot of different things with antibodies. You could tag drugs with the nanodiamonds to see where in the body the drug travels.
The fact that nanodiamonds are a solution also suggests that simply moving all research dollars to biology would be bad because nanodiamonds needed a lot of physics research to become viable.
Better signal processing algorithms and AI might also further increase the precision of their imaging.
Another great biotech company founded by YCombinator is uBiome. Thanks to relatively cheap DNA sequencing they track bacteria population on skin/mouth/gut/nose and penis/vagina. At present sequencing prices their technology isn’t mass market compatible but if sequencing prices continue to drop at rates of Moore’s law or faster than Moore’s law we will have a new area of medicine. In 20 years we might all consciously repopulate our bacteria populations.
As far as hopes for the future of biology goes, I hope that Theranos will introduce something like Moore’s law into blood testing prices.
Isn’t Theranos currently going down in flames?
because Theranos focus on producing cheap blood testing while currently the companies in the market have no incentives to test cheaply.
Why wouldn’t they have such incentive? It seems that Theranos could offer prices much lower than the market price because Theranos tests were much less accurate than standard medical tests, perhaps to the point of outright fraud.
There a lot of money currently invested in attacking Theraros. That’s no indication that the company has a problem but that it threatens established interests.
because Theranos tests were much less accurate than standard medical tests, perhaps to the point of outright fraud.
A company for that’s true wouldn’t lobby for the FDA to regulate their tests.
Nothing that happened indicates that Theranos believes that they aren’t confident that the FDA will approve their test.
Why wouldn’t they have such incentive?
Prices are fixed by the Medicare reinbursement rate and other insurance companies paying that rate. Lab companies in the existing market can’t win by offering lower prices than their competitors. That changes through the direct to consumer sales that Theranos is doing. At the point where the governments believes tests can be done more cheaply they reduce reinbrusements rates. As a result the labs don’t focus on developing technogy to get cheaper testing and the basic way testing is done is the same at it was four decades. They have incentives to develop better tests and tests for new things but they don’t have real incentives to reduce the prices.
Theranos is completely right in their lobbying agenda of pushing for direct to consumer sales to produce a functioning marketplace and push for patients rights to see the exact results of their medical tests while asking the FDA to regulate them.
There a lot of money currently invested in attacking Theraros. That’s no indication that the company has a problem but that it threatens established interests.
Sounds like a conspiracy theory.
A company for that’s true wouldn’t lobby for the FDA to regulate their tests. Nothing that happened indicates that Theranos believes that they aren’t confident that the FDA will approve their test.
Unless they believe that they could cheat or bribe the FDA.
Prices are fixed by the Medicare reinbursement rate and other insurance companies paying that rate. Lab companies in the existing market can’t win by offering lower prices than their competitors.
If a lab company could run the test for a lower cost and charge the same price as its competitors, it would make a larger profit.
That changes through the direct to consumer sales that Theranos is doing.
I don’t see the rationale for this business model. If Theranos had a technology that allowed them to provide the same tests that other lab companies do, with the same quality, and at a lower cost, then Theranos would have an incentive to sell to health care providers. Even if the price is set by the buyer, lower costs would allow Theranos to make a profit.
Directly selling to patients tests that they probably don’t need and they have no expertise to interpret, skipping the licensed health care system, reeks of quack medicine and is a major warning sign that their product is not good enough for medical purposes.
At the point where the governments believes tests can be done more cheaply they reduce reinbrusements rates. As a result the labs don’t focus on developing technogy to get cheaper testing and the basic way testing is done is the same at it was four decades.
That would require massive collusion between nominal competitors at a worldwide level. Seems unlikely.
If you consider a companies who might go bankrupt because a cheaper competitor undercuts them in price hiring a PR team to fight against their competitor a conspiracy theory, than call it a conspiracy theory.
I don’t see the rationale for this business model.
At current prices you can only sell blood tests that screen for cancer for people who have symptoms that indicate they might have cancers. If you radically reduce the costs of the blood tests you can also start to sell the tests to people who might have risk of cancer because of DNA but who show no symptoms.
As a result the Theranos is optimized for providing tests as cheaply as possible. Of course that conflicts with the business model of the established players.
Directly selling to patients tests that they probably don’t need and they have no expertise to interpret
Studies consistently show that most doctors don’t have real experience to interpret tests either. They get Bayes rule wrong and Bayes rule is the key to interpreting testing results.
Software that can actually calculate the right probabilities has a good chance of doing a better job. Over time it can throw in a bunch of machine learning algorithms and interpret DNA to make better judgments than doctors can.
Currently a lot of people take Vitamin supplements without actually having data about their Vitamin levels. Cheap over the counter tests would change that state of affairs. Less people who have too much iron in their blood would take iron supplements as self medication.
If we move from a model where the average person on the street doesn’t buy a multivitamin in the health store but buys a bunch of tests and takes vitamins if there a deficiency that would be a radical improvement over the status quo and you don’t need to involve doctors for that.
I don’t think that the model of health where it’s about having 10 minute conversations with doctors that tell you what you should do with the limited knowledge they gained in the 10 minutes is an effective model. For myself daily measurement of my lung function gave me information that a session at the doctors office didn’t because the doctor only measured my lung function on a single day. For healthy living it’s important to not externalize the concern for one’s own body.
That doesn’t mean that it can’t be valuable to talk to doctors but it doesn’t have to be the only action. Plurality of approaches is valuable.
Apart from that science profits a lot from a lot of people have a lot of blood values tested and the results uploaded to the Electronic Health Records. Having more testing because tests are cheaper is very valuable for that.
That would require massive collusion between nominal competitors at a worldwide level.
That’s a bit like like saying the taxi industry engaged in massive collusion because it didn’t invent Uber-like software itself. An entrenched industry seldom disrupts itself.
The lab companies decided to compete only based on quality instead of competing based on price. That’s their business. For clinical purposes a tiny loss of test accuracy is well worth an improvement in the price (both money and blood) by one to two orders of magnitude.
In DNA sequencing shotgun sequencing was strongly opposed because it results in lower quality data. At the same time it gave multiple orders of magnitude cheaper DNA sequencing.
If the DNA sequencing industry would have operated like the blood testing industry it wouldn’t have radically faster than Moore’s laws price improvements. If we want immortality than we need to copy the lessons we learned from DNA sequencing to other areas in biology.
Unless they believe that they could cheat or bribe the FDA.
What makes them special? Large pharma companies tend to lose billions of dollars in valuation when a promising drug fails FDA trials—clearly, they are unable to “cheat or bribe” the FDA.
But going back to Theranos, I believe the problem they ran into is local variance: when you analyse tiny amounts of blood, two samples from the same blood draw end up with very different measurements for some quantities of interest. You just need a larger sample and that is a big problem for Theranos.
But going back to Theranos, I believe the problem they ran into is local variance: when you analyse tiny amounts of blood, two samples from the same blood draw end up with very different measurements for some quantities of interest. You just need a larger sample and that is a big problem for Theranos.
I think that’s an issue but Theranos tests don’t need to match existing tests in accuracy to be useful in a clinical setting.
Both blood to be drawn from veins and money are limited resources. If Theranos can mange over time to test two orders of magnitude cheaper on both resources then you circumvent the problem of local variance by testing multiple times.
Testing multiple times has the advantage that you can circumvent temporal variance as well which current testing procedures don’t do well.
Multiple tests also give you data about the local variance and the size of the local variance is plausibly a clinically relevant number.
What makes them special? Large pharma companies tend to lose billions of dollars in valuation when a promising drug fails FDA trials—clearly, they are unable to “cheat or bribe” the FDA.
What is your point? If Theranos is a scam, then it wouldn’t be the first scam operated by overconfident people, or just people with very little risk aversion.
How could Bernie Madoff run a massive Ponzi scheme right under the SEC’s nose without expecting to get caught? Well, he did it anyway, and in fact he managed to get away with it for perhaps decades, and if it wasn’t for the 2007 financial crisis, I’d bet he would be still running it.
But going back to Theranos, I believe the problem they ran into is local variance: when you analyse tiny amounts of blood, two samples from the same blood draw end up with very different measurements for some quantities of interest. You just need a larger sample and that is a big problem for Theranos.
Maybe. I don’t know anything about blood testing, so I can’t evaluate their claims at object level. What I know is that their business consists in a product based on an alleged technological breakthrough that they were never been able to conclusively demonstrate. And they are trying to sell to non-experts who aren’t able to evaluate the quality of the product that they buy.
How could Bernie Madoff run a massive Ponzi scheme right under the SEC’s nose without expecting to get caught?
He didn’t invite the SEC to audit him. Theranos did invite the FDA. The FDA audited them and found issues where they think Theranos has to improve and Theranos plans to improve on them. That the system working as it should.
It’s not a problem for Theranos business model that they will have to add a few extra processes to raise quality. The system is working as it should.
What I know is that their business consists in a product based on an alleged technological breakthrough that they were never been able to conclusively demonstrate.
That’s because you are uninformed because you believe media that tries to trash Theranos.
To date Theranos got two FDA approvals.
And they are trying to sell to non-experts who aren’t able to evaluate the quality of the product that they buy.
While they do plan to sell to non-experts they want the FDA to be the judge over whether they can sell the product and that also means the FDA will regulate what Theranos can write on the label of the tests.
My naive linear model is that ~$400 billion research funding currently spent per year buys about 1 year increased lifespan per decade, so it would take about $4 trillion per year spent on research to stop aging, or a one-time investment of $80 trillion. For 99% confidence I’ll add a safety factor of 4, yielding a one-time payment of $320 trillion, or $16 trillion per year. In other words, this back-of-the-envelope guess suggests the entire economic output of the United States would be just sufficient to discover and maintain an aging cure.
I don’t think that all of the increased lifespan is due to healthcare spending. Various enviromental regulation likely increased lifespan. Our current paradigm of drug development unfortunately get’s exponentially more expensive via Eroom’s law. I doubt that simply spending more money in the same way produces linear progress.
I think the problem of the mythical man month also exists in research. You can’t simply throw in more money. Given researchers money can often make them spend money on fancy equipment instead of thinking hard about what to do.
As far as hopes for the future of biology goes, I hope that Theranos will introduce something like Moore’s law into blood testing prices. If it succeeds with that mission it’s not simply because there a lot of money thrown into blood testing but because Theranos focus on producing cheap blood testing while currently the companies in the market have no incentives to test cheaply.
YCombinators turn to fund biotech companies also fills me with hope. Bikanta Nanodiamond technology that allows very high resultion imaging of anything that you can hit with an antibody fills me with hope. The promise 100X more precise cancer imaging but if their technology really works and the can do it cheap, it has application beyond just cancer because being able to image anything at high resolution will allow us to learn to tag a lot of different things with antibodies. You could tag drugs with the nanodiamonds to see where in the body the drug travels.
The fact that nanodiamonds are a solution also suggests that simply moving all research dollars to biology would be bad because nanodiamonds needed a lot of physics research to become viable. Better signal processing algorithms and AI might also further increase the precision of their imaging.
Another great biotech company founded by YCombinator is uBiome. Thanks to relatively cheap DNA sequencing they track bacteria population on skin/mouth/gut/nose and penis/vagina. At present sequencing prices their technology isn’t mass market compatible but if sequencing prices continue to drop at rates of Moore’s law or faster than Moore’s law we will have a new area of medicine. In 20 years we might all consciously repopulate our bacteria populations.
Isn’t Theranos currently going down in flames?
Why wouldn’t they have such incentive? It seems that Theranos could offer prices much lower than the market price because Theranos tests were much less accurate than standard medical tests, perhaps to the point of outright fraud.
There a lot of money currently invested in attacking Theraros. That’s no indication that the company has a problem but that it threatens established interests.
A company for that’s true wouldn’t lobby for the FDA to regulate their tests. Nothing that happened indicates that Theranos believes that they aren’t confident that the FDA will approve their test.
Prices are fixed by the Medicare reinbursement rate and other insurance companies paying that rate. Lab companies in the existing market can’t win by offering lower prices than their competitors. That changes through the direct to consumer sales that Theranos is doing.
At the point where the governments believes tests can be done more cheaply they reduce reinbrusements rates. As a result the labs don’t focus on developing technogy to get cheaper testing and the basic way testing is done is the same at it was four decades. They have incentives to develop better tests and tests for new things but they don’t have real incentives to reduce the prices.
Theranos is completely right in their lobbying agenda of pushing for direct to consumer sales to produce a functioning marketplace and push for patients rights to see the exact results of their medical tests while asking the FDA to regulate them.
Sounds like a conspiracy theory.
Unless they believe that they could cheat or bribe the FDA.
If a lab company could run the test for a lower cost and charge the same price as its competitors, it would make a larger profit.
I don’t see the rationale for this business model. If Theranos had a technology that allowed them to provide the same tests that other lab companies do, with the same quality, and at a lower cost, then Theranos would have an incentive to sell to health care providers. Even if the price is set by the buyer, lower costs would allow Theranos to make a profit.
Directly selling to patients tests that they probably don’t need and they have no expertise to interpret, skipping the licensed health care system, reeks of quack medicine and is a major warning sign that their product is not good enough for medical purposes.
That would require massive collusion between nominal competitors at a worldwide level. Seems unlikely.
If you consider a companies who might go bankrupt because a cheaper competitor undercuts them in price hiring a PR team to fight against their competitor a conspiracy theory, than call it a conspiracy theory.
At current prices you can only sell blood tests that screen for cancer for people who have symptoms that indicate they might have cancers. If you radically reduce the costs of the blood tests you can also start to sell the tests to people who might have risk of cancer because of DNA but who show no symptoms.
As a result the Theranos is optimized for providing tests as cheaply as possible. Of course that conflicts with the business model of the established players.
Studies consistently show that most doctors don’t have real experience to interpret tests either. They get Bayes rule wrong and Bayes rule is the key to interpreting testing results. Software that can actually calculate the right probabilities has a good chance of doing a better job. Over time it can throw in a bunch of machine learning algorithms and interpret DNA to make better judgments than doctors can.
Currently a lot of people take Vitamin supplements without actually having data about their Vitamin levels. Cheap over the counter tests would change that state of affairs. Less people who have too much iron in their blood would take iron supplements as self medication. If we move from a model where the average person on the street doesn’t buy a multivitamin in the health store but buys a bunch of tests and takes vitamins if there a deficiency that would be a radical improvement over the status quo and you don’t need to involve doctors for that.
I don’t think that the model of health where it’s about having 10 minute conversations with doctors that tell you what you should do with the limited knowledge they gained in the 10 minutes is an effective model. For myself daily measurement of my lung function gave me information that a session at the doctors office didn’t because the doctor only measured my lung function on a single day. For healthy living it’s important to not externalize the concern for one’s own body.
That doesn’t mean that it can’t be valuable to talk to doctors but it doesn’t have to be the only action. Plurality of approaches is valuable.
Apart from that science profits a lot from a lot of people have a lot of blood values tested and the results uploaded to the Electronic Health Records. Having more testing because tests are cheaper is very valuable for that.
That’s a bit like like saying the taxi industry engaged in massive collusion because it didn’t invent Uber-like software itself. An entrenched industry seldom disrupts itself.
The lab companies decided to compete only based on quality instead of competing based on price. That’s their business. For clinical purposes a tiny loss of test accuracy is well worth an improvement in the price (both money and blood) by one to two orders of magnitude.
In DNA sequencing shotgun sequencing was strongly opposed because it results in lower quality data. At the same time it gave multiple orders of magnitude cheaper DNA sequencing. If the DNA sequencing industry would have operated like the blood testing industry it wouldn’t have radically faster than Moore’s laws price improvements. If we want immortality than we need to copy the lessons we learned from DNA sequencing to other areas in biology.
What makes them special? Large pharma companies tend to lose billions of dollars in valuation when a promising drug fails FDA trials—clearly, they are unable to “cheat or bribe” the FDA.
But going back to Theranos, I believe the problem they ran into is local variance: when you analyse tiny amounts of blood, two samples from the same blood draw end up with very different measurements for some quantities of interest. You just need a larger sample and that is a big problem for Theranos.
I think that’s an issue but Theranos tests don’t need to match existing tests in accuracy to be useful in a clinical setting.
Both blood to be drawn from veins and money are limited resources. If Theranos can mange over time to test two orders of magnitude cheaper on both resources then you circumvent the problem of local variance by testing multiple times. Testing multiple times has the advantage that you can circumvent temporal variance as well which current testing procedures don’t do well. Multiple tests also give you data about the local variance and the size of the local variance is plausibly a clinically relevant number.
What is your point? If Theranos is a scam, then it wouldn’t be the first scam operated by overconfident people, or just people with very little risk aversion.
How could Bernie Madoff run a massive Ponzi scheme right under the SEC’s nose without expecting to get caught? Well, he did it anyway, and in fact he managed to get away with it for perhaps decades, and if it wasn’t for the 2007 financial crisis, I’d bet he would be still running it.
Maybe. I don’t know anything about blood testing, so I can’t evaluate their claims at object level. What I know is that their business consists in a product based on an alleged technological breakthrough that they were never been able to conclusively demonstrate. And they are trying to sell to non-experts who aren’t able to evaluate the quality of the product that they buy.
He didn’t invite the SEC to audit him. Theranos did invite the FDA. The FDA audited them and found issues where they think Theranos has to improve and Theranos plans to improve on them. That the system working as it should.
It’s not a problem for Theranos business model that they will have to add a few extra processes to raise quality. The system is working as it should.
That’s because you are uninformed because you believe media that tries to trash Theranos. To date Theranos got two FDA approvals.
While they do plan to sell to non-experts they want the FDA to be the judge over whether they can sell the product and that also means the FDA will regulate what Theranos can write on the label of the tests.
You said: “Unless they believe that they could cheat or bribe the FDA”. Do you actually have any reason to think this is a likely possibility?
So why did you decide to jump in and focus the discussion on Theranos?