Yes, but i’m concerned it won’t be relevant for any funder or foundation, or did you talk to any that wants to see this?
We did not have payers secured in advance with VDP-17, which was not an issue, so it seems odd to raise this now as an issue, especially when we are already pushing forward with engaging with large payers such as NHS, CMS, VA, Clalit, Pharmac in NZ, Medicare in Australia, and Health Canada. For institutional philanthropy, will have in mind Gates Foundation, Wellcome Trust, Lifearc and Partners in Health. We have contacts with all of these payers and over the next 2 months, as we get more feedback and interest from specific payers (e.g. Pharmac in NZ or a specific philanthropy) the feasibility study will be tailored towards them. So we cast the net wider then focus, as with any typical “sales-cycle” with large institutions. If we go too narrow, the risk is that we miss out.
As mentioned above, most large institutions like to see feasibility studies - this is a “de-risking” exercise for them, particularly as nobody gets fired for doing the same thing they did last year. We are trying something new and it will be a lot harder to do this self-funded (as we have been over the last 12 months).
I’d be more excited if we bring together the efforts on Brad stanfields project, and the open longevity prize to do a feasibility study and working out the concrete retroactive longevity prize / pay for success, instead of spending this on a feasibility study that wont move the needle meaningfully for anyone (especially if it comes from cfc itself)
You are conflating different projects. Longevity Prize is not the same as an IVPE RCT study and PFS contracts. It’s the web3 version whereas to “move the needle” you need to actually get payers on board. Also, payers do not currently recognise ageing as a disease. To be honest, as we have discussed in many conversations, the web3 aspect is quite simple, just get a multisig and put money into it with some criteria to pay it out. The potential for massive impact is that if a large institutional philanthropy or government payer sees the advantage of the IVPE / PFS model, and the web3 aspect is kept under the hood.
And also would keep this focused on longevity, and not ketamine etc. which isnt our focus as a DAO
Not sure if you read the comment above, but Longevity Science Foundation made a funding call announcement regarding the overlap between healthy lifespan and psychedelics, and the fact ketamine has been shown to promote neurogenesis. I am not sure what you mean by “focussed on longevity”. Is mental health not important to longevity? What indications are acceptable?
We cannot expect to engage with payers yet on the basis of life-extension. In the interim, ketamine is a very compelling use case for creating a business model for open source medicine because it has similar efficacy to esketamine at 1/400th of the cost.
I’m just concerned with CFCs ability to execute meaningfully on all of the proposed steps, with specific success and outcomes for VitaDAO as a broad community
I’d rather use this money in a focused way for maximum likelihoods of successs… imo lots of feasibility studies etc published here wont move the needle on anything
Regarding execution of the feasibility study, CFC will be using contractors (e.g. pharmacoeconomists) that management consulting firms would be using. CFC have already been engaging with payers at a very high level (e.g. exchanging correspondence over the last year, working with partners such as Ketamine Task Force and just had a call with VA, and several calls with CMS, NHS, Pharmac, senior representatives in NZ and UK government). I am not sure why you think CFC cannot find contractors and cannot engage with payers to get feedback. Are you basing this on any prior evidence? As you know, we have been pushing extremely hard to get the Generic Drug Repurposing Longevity Prize published on the Longevityprize.com website since early last year when we received the VDP-17 grant. We provided you with website copy and also got tentative support from mFoundation. I am more concerned by the fact you have not been spending much time reviewing what we have sent and also understanding the broader context.
→ what does success look like here? getting a funder for a PFS retro prize??
As noted above, the Longevity Prize and this IVPE / PFS project are different. It is more like an advance market commitment with a payer - web2 aspect and engaging with large payers. I agree the people funding the web3 Longevity Prize probably won’t care about feasibility studies but almost every large institution in “meatspace” does when you are proposing something new.
- Conducting literature review and clinical study for longevity-related intervention that can be used in an IVPE RCT (optimal dosing regime for ketamine for TRD or impact of ketogenic diet on glioblastoma).’
Conducting literature review and clinical study for longevity-related intervention that can be used in an IVPE RCT
who would conduct this with deep longevity expertise? and how can we make sure it leads to a concrete longevity prize
As mentioned, initial focus is not to engage with payers on “ageing” as an indication. Improving mental health and cancer outcomes are longevity-related, and eventually we can look at things like metformin and rapamycin, but ‘longevity’ is broader than that.
- Conducting pharmacoeconomic analysis of cost impact and financial model for IVPE RCT.*
→ who is the payor, and have you confirmed with them that they want this or that it would meaningfully move their commitment to such a PFS contract??
Have already mentioned this above as well - we will engage with NHS, CMS, VA, Clalit, Pharmac in NZ, Medicare in Australia, and Health Canada. For institutional philanthropy, will have in mind Gates Foundation, Wellcome Trust, Lifearc and Partners in Health. We have contacts with all of these payers and over the next 2 months, as we get more feedback and interest from specific payers (e.g. Pharmac in NZ or a specific philanthropy) the feasibility study will be tailored towards them.
→ what would the CRO support with?
The CRO will agree to conduct the IVPE RCT. If the IVPE RCT is multisite, we can aggregate the RCT data and the goal would be eventually for this to support FDA-approval.
- → agree that this is probably what success looks like, would just inclujde them from the get go to understand what they want to see etc., otherwise i’m fairly certain it wont succeed if they are only consulted at the very end
We will go wide, then once we get feedback on IVPE + PFS model from enough payers, focus on the ones that we think are most interested.
- → lets forgot ketamine vs esketamine in this context here, and focus fully on longevity interventions
As noted above, to engage with payers we need to speak their language. At the moment, payers do not recognise ageing as an indication. However, in a few years, once we have some drugs approved, they will be interested, and we will ideally already have infra set up to fund a generic longevity drug from cost savings, either under an PFS contract or IVPE RCT.