Quality vs. quantity - the changing role of pharma in our lives

Ishaan Chaudhury
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“Would you rather live a short yet glorious life or settle for a long, lacklustre existence?” This was the question posed to a class full of ten-year-olds when our history teacher explained the story of the two destinies presented to the mythological hero Achilles. Our teacher was astonished that this dilemma could trigger such deep, philosophical angst amongst children whose main priorities typically revolved around trading football stickers and playing computer games. While that time at school is a distant memory, I still find the theme of quality of life versus quantity of life a source of perpetual fascination.

A recent report about the progress of life expectancy in the UK grinding to a halt this year is indicative of the challenges that lie ahead for the pharmaceutical industry and healthcare technology. While there’s certainly room for improvement to match the leading countries (the UK is currently hovering around twentieth in the world), it’s inevitable that we reach a plateau where mankind can’t push the biological boundaries any further. Ongoing advances in the treatment of infectious diseases, chronic conditions and cancer have consistently boosted human longevity for decades. Many blockbuster drugs, particularly in oncology, have based their marketing narratives on the promise of prolonging survival.

What therefore happens when the drugs of tomorrow offer improvements that are negligible and don’t offer substantial cost benefit returns to healthcare systems? It may not be completely inconceivable that we’re on the cusp of one last ‘golden generation’ for the pharma industry as we know it, where the next series of drug launches maximise our potential for reaching everyone’s optimal life expectancy. And to what extent will that change the current narrative? It could be feasible that a game-changing cancer therapy in a decade or two from now positions itself as the last thrust towards a longer lifespan.

‘Quality of life’ is a term that’s used extensively to justify prescribing decisions

‘Quality of life’ is a term that’s used extensively to justify prescribing decisions and can be the key differentiator for many of the brands we have helped to cultivate. As the gains in life expectancy over the next ten to fifteen years become more incremental, it’s likely that features such as method of administration and tolerability form the backbone of positioning for future products.

However, the mere concept of death and a theoretical life expectancy is being challenged in some quarters with various movements exploring mankind’s ability to attain ‘immortality’. Mark O’Connell’s recent book To Be A Machine superbly explores the principles behind ‘transhumanism’ – a movement that seeks to use technology to enhance the human body to a state where it can exist, ultimately forever, free from the restrictions imposed by ageing and disease. To be fair, medicine has always tried to rectify the frailties of the human condition – from an antibiotic to treat an infection to a pacemaker to alleviate cardiac insufficiency – but transhumanism goes even further.

O’Connell’s exchanges with various members of this growing movement introduce us to organisations and startups exploring the possibilities that are akin to those seen in episodes of Black Mirror. These include the uploading of digital versions of ourselves for future implantation into android-like bodies, the insertion of implants to augment our brain capacity and the coding of all our behavioural traits to expand the use of artificial intelligence to help us navigate every step of our lives. Of course, a number of these developments appear outlandish in the current context, but when we reach a point that we’ve exhausted all pharmaceutical and medical improvements, human nature typically steers us to the next frontier.

Pharma companies still have a pivotal role in ensuring that people live as well as possible if not for as long as possible. This will certainly serve our immediate needs … before we seriously consider transitioning ourselves into digital avatars for eternity.