Delayed aging to bring $7.1 trillion by 2060

The economic benefits of living longer and healthier lives are expected to significantly outweigh the costs over the next 50 years.

In early February, 2016, scientists boosted the lifespan of genetically engineered mice by more than 20 percent. Their landmark paper, which targeted senescent cells involved in stress and aging, is one of many new approaches that shows delayed aging is now a realistic goal – with phenomenal health and economic returns.  

Health economist Dana Goldman from the University of dana goldmanSouthern California has assessed the costs and health returns on delayed aging therapies. We speak with him about how the benefits of aging outweigh the costs tenfold, and what needs to be done to ensure these economic returns.

ResearchGate: What are the economic benefits of delayed aging?

Dana Goldman: We need to think about benefits more broadly than just traditional measures like Gross Domestic Product (GDP). Now that people are living longer, we need to make decisions about a whole host of treatments for diseases like cancer and Alzheimer’s that are much more prevalent post-retirement. Thus, economists have developed ways to think about – and measure – the benefits of a healthy, productive life using the concept of a quality-adjusted life year. Thus, the ‘economic’ benefits come from better functioning, improved cognition, and a life free of comorbidities as much as possible. The key benefit of delayed aging is not just to extend life, but to also reduce the amount of time we spend with disability and disease – all of which can be measured and valued.

RG: How do the projected benefits compare with the costs?

DG: Once we do a good job valuing the health gains—both in terms of life expectancy and quality of life-- it is clear that the benefits likely outweigh the costs by a factor of ten or more. This does not mean that delayed aging will pay for itself in reduced health care spending – quite the contrary. However, it is a very different question to ask if the medical spending is less or more than to ask if the benefits outweigh the costs. That is because the benefits include all the value we place on healthier, longer life.  For example, we find that if the promise of delayed aging is fully realized – based on the best animal models – we could increase life expectancy by an additional 2.2 years, most of which would be spent in good health. The economic value would be about $7.1 trillion over fifty years—with little additional government costs if we index Medicare and Social Security to the life expectancy increases.

RG: Research has shown that delayed aging simultaneously lowers the risk of all fatal and disabling diseases. What changes to healthcare systems and related costs do you foresee?

DG: This makes delayed aging a lot like other important interventions we know about, like reduced smoking, more physical activity, or a better diet. All of those ‘treatments’ have benefits for a constellation of illnesses. The big change we need is to make sure the health care system is rewarded for keeping people free of disease, rather than getting paid only when people get sick.

RG: Do you think delayed aging will be open to everyone? If not, what may the societal effects be?

DG: That is a fundamental question. If I developed a drug right now that mimicked the effects of exercise, it would be enormously valuable to society—and probably pretty expensive too. Health insurers might argue that this drug is really a lifestyle intervention, and hence not covered by the insurance policy. Medicare, for example, might not put it on the Part D formulary. This means that only the affluent may have access to such a pill, at least initially. In a world where we already have a large gap in life expectancy, as a recent National Academy of Science make clear, this means we would be putting even more strain on our social safety net. The right answer, of course, is to figure out how to reward insurers and providers for preventing disease. This will tilt the playing field in a better direction and ensure that all people have access.

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RG: What new markets, products and services will delayed aging give rise to (or has already given rise to)?

DG: As I said earlier, there is a real issue about whether such products and services will be covered by health insurers. Most of these will be drugs. You will see an effort by insurers to proscribe treatment generally, and look for clinical niches where the products will work – e.g., as a treatment for Type 2 diabetes. Manufacturers will do the same with their clinical trial testing by trying to identify specific populations where the drugs might show the most benefit. Ironically, the greatest benefit may arise when healthy people are treated, but in the current climate such treatments will face very difficult regulatory hurdles.

RG: What about delayed retirement? What changes do you foresee in the workforce?

DG: Most people retire in their early to mid-60s. Much of this is likely motivated by the presence of social programs like Medicare and Social Security that kick in at those ages. In a world where people are living longer, these programs become very costly to administer and would put enormous stain on government finances. The right answer is to allow these programs to gradually adapt to longer and healthier lifespans by increasing the eligibility age (gradually). We have to be very careful to do so in way that does not only favor the rich, especially if they are the only ones living longer. This means simultaneously strengthening the safety-net for those who are unable to work due to disability. Social Security is a valuable tool to alleviate poverty in older age, and we need to make sure to keep it that way. That being said, there is enough money to do all of this if we are smart about adapting our social institutions.

RG: How might a more age-diverse workforce affect productivity and engagement?

DG: Many people hold prejudices – or at least preconceived notions – about the ability of older works to engage in society and be productive members. You see this not only in manufacturing but also software and the creative arts.  In fact, there is some fairly good evidence that the most productive teams are those that are intergenerational, and the nature of the workplace can probably be modified to accommodate older workers. For example, just designing the workplace to allow partial retirement should be quite helpful. This does not require government intervention either; what is needed are better studies of productivity throughout the life cycle and how workplace modification can impact that profile.

Featured image courtesy of Wellcome Images; Video by GeoBeats News