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Magic Pills Are Coming

I'll take the Red pill!

Magic Pills Are Coming

Wearable ultrasound machines and other inventions could reduce medical costs.

By Andy Kessler, WSJ

Nov. 26, 2023

At healthcare conferences, someone always asks, “What if there was a magic pill?” One that could cure major diseases. What would the healthcare industry look like? Some emergency rooms and hospitals but less doctors and spending? Inevitably, the discussion ends with, “But, of course, there is no magic pill.” So we spend, spend, spend on healthcare, from $1.4 trillion in 2000 in the U.S. to more than $4.3 trillion—18% of the economy—in 2021.

Could there be magic cures? History shows plenty of wonder drugs and treatments. Aspirin reduces inflammation. Penicillin and other antibiotics fight infections. Insulin treats diabetes. Stents unblock arteries. These treat but don’t cure diseases. Plus, two-thirds of American adults are overweight or obese, which puts them at greater risk for many chronic diseases such as heart disease and stroke. According to the National Institutes of Health, “86% of health care costs are attributable to chronic disease.”

By now you’ve heard about glucagon-like peptides (GLP-1). Drugs that mimic these hormones, like Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro, seem to treat diabetes by lowering blood-sugar levels. They also promote weight loss and lower the risk of heart disease. What can’t GLP-1s do?

A friend of mine with diabetes started taking Mounjaro and now, because of shortages, takes Ozempic. He lost 70 pounds, got his A1C levels back to normal and told me, “I’m simply not hungry anymore. It’s not even like I’m full. I used to throw back a whole pizza and a gallon of milk. Now a slice and a bottle of water is more than enough. The food I used to crave has no interest for me.” Amazing. Goldman Sachs Research expects this to be a $100 billion market by 2030. It could save multiples of that in healthcare costs.

Patients take these drugs via injectable pens. Pills are coming—dare I say magic pills?

Here’s another magic cure: Israeli company Insightec, backed by Koch Industries, has made a helmet with 1,020 acoustic sources that when placed on a shaved head can focus ultrasound signals to specific spots in the brain. For patients with tremors,

including some with Parkinson’s disease, the system uses magnetic resonance, similar to an MRI, to guide “focused ultrasound” to a specific spot in the brain, which it heats to 113 degrees Fahrenheit. This creates a lesion, which miraculously eliminates tremors with a less than 1% chance of side effects.

Insightec CEO Dr. Maurice R. Ferré tells me the company’s “incisionless brain surgery” is in 200 medical centers. Its devices have been used to perform 20,000 procedures that cost $18,000 to $20,000, replacing $60,000 electrode-implanting brain surgery. He adds that the company has 35 ongoing trials investigating focused ultrasound for things like depression, obsessive-compulsive disorder, Alzheimer’s, and even neurodegenerative diseases like ALS.

One trial caught my eye. The Rockefeller Neuroscience Institute at West Virginia University has been running trials on curing opioid and substance abuse. After putting the ultrasound helmet on a patient, researchers apply triggers for drug use, via images on virtual-reality glasses and scents, to look for areas where the brain “lights up.” Instead of heat, the focused ultrasound uses neuromodulation to excite the appropriate tissue.

Yes, it sounds right out of “A Clockwork Orange”—but it works! I heard of one patient, a longtime opioid user, who said he hasn’t had a craving for drugs in years. A study published in September in Frontiers in Psychology says the procedure “acutely reduced substance craving,” even 90 days later. Sounds similar to GLP-1s and food cravings. So far, 12 people have had the procedure and Dr. Ferré says “there has been no relapse or recurrence of cravings.” A brave new world indeed.

There are other promising technologies. Crispr gene therapy can fix gene mutations for Duchenne muscular dystrophy and coming soon are one-off treatments for sickle-cell anemia. Even cancer treatment is changing rapidly. I paid $950 for the Galleri blood test from Grail, a subsidiary of Illumina. Using AI, it looks for patterns in your blood that can identify over 50 different cancers, even at a very early stage. My tests came back negative. Whew.

And if it found cancer? The same mRNA that quickly turned out Covid vaccines from BioNTech and Moderna is being used to fight cancer, including hard-to-detect pancreatic cancer. Wouldn’t that be a magic pill? Find cancer with a blood sample and take the appropriate mRNA pill before cancer requires expensive hospital care.

For other ailments? Medical chatbots are already here. Type symptoms into an AI large language model and out pops a diagnosis. Google claims its Med-PaLM 2 scores 86.5% accuracy on United States Medical License Exam-style questions. I doubt chatbots will ever be 100% accurate, but they will help augment doctors. And, according to JAMA Internal Medicine, patients think chatbots are more empathetic than doctors 80% of the time anyway.

Technology is changing medicine. Maybe there is a magic pill after all.

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