Untangling the Web isn't Easy

CRISPR, the gene editing tool, allows for the editing of specific genes. The keyword is “specific”. To understand the point, think of breeding racehorses. While one gets to pick the “best” horses to breed, one has no control over which genes the child will inherit. That part’s still a roll of the genetic dice. But with CRISPR, one can target and edit specific genes. The level of control is unprecedented.

And scary. Will it lead to the assembly line production of humans “superior” on whatever parameter we choose? Can we anticipate long term consequences of any such changes? Or would it be too late by the time we discover side-effects? Only time will tell how we decide to self-regulate ourselves with such powers. And how successfully those rules are enforced.

The one area where it might seem that the benefits would outweigh the risks is when it comes to fixing genetic diseases. But that raises an existential question for pharma and biotech companies, what Goldman Sachs asks in its paper titled “The Genome Revolution”: “Is curing patients a sustainable business model?”. As you’d have guessed, the answer seems to be No:

While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow (aka recurring revenue).”

So will that be the reason why such genetic treatments will never see the light of day? Because the very companies that can bring it about would be signing their death warrant by doing so?

Or can some company from a non-medical field release such cures because their core business isn’t medicine? A la how Apple and Google killed Windows, the money churner for Microsoft, by making their own OS free (iOS and Android)?  They could do that simply because the OS wasn’t what made them money (You can see how much Windows’ revenues have fallen when you see Microsoft’s latest reorg: Windows isn’t even a standalone business unit anymore!).

Of course, the key difference was that the OS was never a regulated business, so anyone could write one (theoretically and practically). Whereas the medical industry is regulated. And needs to be so. So will any genetic cures never see the light of day because getting regulatory clearances involve clinical studies costing billions, and so nobody could afford that much just for charity?

Or will this trigger a change to some parts of medical regulations which will then have unintended consequences? Ah, what a tangled web we try to unweave…