That's an interesting point, but I wonder how big of a problem it is? The way drug R&D dollars are currently allocated, it actually seems like we are steepening the histogram of death
These days it is actually easier and more financially viable to develop drugs for rare diseases than highly prevalent diseases. 58% of new FDA approved drugs in 2018 were for orphan disease [0]. This is consistent with other measures like % of pharma M&A, % of venture deals across indications, etc. This suggests that it's more profitable to develop drugs for rare disease -- otherwise we'd see more funding for more prevalent disease
Since we focus more on rare disease, we won't be making as much headway on "big killers". And since developing drugs for rare disease is more profitable, it seems the drug development model may actually work better in a world with more rare diseases.
Looking at some CDC numbers [1], in 1980 85% of total deaths were caused by a top 10 cause of death. In 2015, 74% of all deaths were caused by a top 10 cause of death. Cancer and heart disease are still up at the top, and cancer deaths have increased 43% since 1980 (with US population growth of 42%). We will make more progress on cancer, but the "big killers" will remain so for a while, esp as little is spent on cardiovascular disease R&D or mental health (which shows up in the top 10 as suicide, which in 90% of cases is mental-illness related, and "unintentional injuries" which include a lot of drug overdoses). Rare disease in aggregate would probably make the top 10 causes of death. It would be interesting to see how rare-disease related mortality has changed in the last decades
These days it is actually easier and more financially viable to develop drugs for rare diseases than highly prevalent diseases. 58% of new FDA approved drugs in 2018 were for orphan disease [0]. This is consistent with other measures like % of pharma M&A, % of venture deals across indications, etc. This suggests that it's more profitable to develop drugs for rare disease -- otherwise we'd see more funding for more prevalent disease
Since we focus more on rare disease, we won't be making as much headway on "big killers". And since developing drugs for rare disease is more profitable, it seems the drug development model may actually work better in a world with more rare diseases.
Looking at some CDC numbers [1], in 1980 85% of total deaths were caused by a top 10 cause of death. In 2015, 74% of all deaths were caused by a top 10 cause of death. Cancer and heart disease are still up at the top, and cancer deaths have increased 43% since 1980 (with US population growth of 42%). We will make more progress on cancer, but the "big killers" will remain so for a while, esp as little is spent on cardiovascular disease R&D or mental health (which shows up in the top 10 as suicide, which in 90% of cases is mental-illness related, and "unintentional injuries" which include a lot of drug overdoses). Rare disease in aggregate would probably make the top 10 causes of death. It would be interesting to see how rare-disease related mortality has changed in the last decades
[0] http://www.hbmpartners.com/media/docs/industry-reports/Analy...
[1] https://www.cdc.gov/nchs/data/hus/hus16.pdf#019