Novartis bets on ageing as next frontier in drug development

The hunt for drugs for diseases that appear or worsen as we get older has become more urgent, and potentially lucrative, for pharmaceutical companies, as the developed world faces an unprecedented demographic shift. Helen James, SWI swissinfo

Series Longevity, Episode 4:

Swiss pharma giant Novartis is re-entering the booming field of ageing research. It wants to develop a blockbuster drug in one of the most rapidly growing, and potentially lucrative, markets: keeping older adults healthy.

Last December, Novartis announced an unusual partnership with a relatively unknown California-based biotech firm. The deal, which could cost the Swiss pharma giant as much as $550 million (CHF453.5 million), didn’t involve access to a new drug candidate or a specific technology. Instead, the prize Novartis had its eyes on was BioAge Labs’ vast trove of data – a crucial asset in an increasing number of industries, including pharmaceuticals, and so valuable it’s often dubbed the new oilExternal link.

BioAge claims to have one of the world’s largest and most comprehensive data sets on human longevity available for drug discovery. It obtained it by securing exclusive rights from biobanks to genomic profiles, medical histories, and other health data on thousands of people followed up to 50 years. Using AI and other advanced tools, the company aims to pinpoint the determinants of a healthy lifespan, facilitating the discovery and development of new therapies.

Why we wrote this

People have been searching for the secrets to longevity for centuries. Huge advances in the science of ageing and technology such as AI in the last decade have given scientists reason to believe we are on the cusp of a major breakthrough. This has fuelled a new longevity movement with clinics and companies popping up in many parts of the world such as Saudi Arabia, the US and Switzerland, offering sophisticated tests, novel therapies, and a world of promises.

Switzerland has been a key player in the pursuit of eternal youth dating back centuries when people came from across the globe to experience the healing powers of its thermal baths. Swiss wellness clinics, scientists, investors and pharmaceutical companies have all advanced the longevity field. But how much is the latest longevity trend just hype and good marketing? Can we really extend our lifespan and why do we want to?

This article is part of a series investigating the growing longevity trend and Switzerland’s role in it. You can find all the articles and videos in the series at the bottom of this article.

That makes it a perfect fit for Novartis, which missed out on the obesity drug boom. The Basel-based firm doesn’t have its own version of the blockbusters Wegovy or Ozempic in the pipeline and has been searching for new growth drivers. In 2023 it set up a research group called Diseases of Ageing and Regenerative MedicineExternal link (DARe) to build on its expertise in musculoskeletal diseases and understand what causes age-related diseases at the molecular level.

“Our goal is to understand the biological drivers of ageing to develop novel treatments for diseases related to ageing,” Michaela Kneissel, who joined Novartis in 1996 and is now the global head of DARe, told SWI swissinfo.ch. “The hope is this opens the door to not only treat one illness but tackle entire classes of diseases.”

The hunt for drugs for diseases that appear or worsen as we get older has become more urgent, and potentially lucrative, for pharmaceutical companies, as the developed world faces an unprecedented demographic shift. The United Nations estimates that by 2050, the number of people aged 60 and over will double from 1 billion in 2020 to 2.1 billion, making up around 20% of the world’s population, while those aged 80 and over is expected to tripleExternal link to nearly 430 million.

The older we get, the greater our risk of developing illnesses such as coronary heart disease, dementia, and cancer. To meet these needs, the market for geriatric medicinesExternal link is expected to surge from $153 billion in 2023 to $222.5 billion by 2030 according to Ireland-based Research and Markets analytics firm.

Brazil, China, Saudi Arabia, and Japan are among countries investing heavily to improve the health of their ageing populations and prevent chronic diseases. In 2024, Brazil established its first national-level policy on dementia care. The world’s seventh-largest country in terms of population is forecastExternal link to see the number of dementia sufferers triple by 2050 from an estimated 1.8 million in 2019 to 5.6 million.

While pharma companies like Novartis have invested billions in drugs to treat age-related diseases and alleviate their symptoms, in the past they’ve spent very little investigating the biology of ageing – the biological processes and mechanisms that explain why cells, tissues, and organs gradually lose function, leading to age-related decline and disease.

But with huge advances in science and technology, and tech billionaires like Jeff Bezos and Sam Altman pouring billions into start-ups working on therapies to extend lifespan, Novartis and other pharma heavyweights are jumping into the race.

“We have reached the age of the quantification of biology,” said Kneissel. “There is an enormous amount of data coming in on human biology. We now have the ability to address spaces that we couldn’t before and use human data rather than relying a lot on data from animals.”

Artificial intelligence can measure and analyse millions of health records, genomic profiles, and lab results to find patterns that can predict disease. This has all made research on ageing much easier, faster, and cheaper.

“We can now get our genome sequenced for a few hundred bucks,” said Vittorio Sebastiano, a reproductive biologist at Stanford University and founder of Turn Biotechnologies, a preclinical-stage start-up focused on developing therapies to reverse age-related cellular decline. “In the past we weren’t able to access this much information so cheaply. And we also have much better ways to manage it.”

Lessons from the past

Novartis has dabbled in ageing research before. In 2014, it conducted clinical trialsExternal link of its cancer drug everolimus for possible anti-ageing properties after research showed a closely related drug, rapamycin, extended the lifespan of several animal species. Both drugs target mTOR, a protein that regulates many cellular processes affected by age.

Media reports at the time heraldedExternal link the everolimus trials as a sign that big pharma was on the cusp of a breakthrough in the quest for the fountain of youth and hopes grew that this would usher in a new era of drug development for ageing, which had long struggled to attract Big Pharma.

But a couple of years later Novartis offloaded the research to a small firm, ResTORbio, keeping a small stake as it initiated a major corporate restructuring to focus on new, innovative medicine. As the US Food and Drug Administration (FDA) didn’t accept ageing as a treatable condition and everolimus’s patents were about to expire, it would have been difficult to make serious money from the drug.

There’s good reason why Novartis is getting back into the field now that it is armed with fresh perspective, new tools and better data. For one, many age-related diseases have been difficult to crack through traditional drug discovery.

Decades of research into Alzheimer’s, for example, have yielded few treatment options. Researchers still don’t know what causes the disease, and recent drugs have shown only modest improvements in slowing memory loss.

The same is true for osteoarthritis – a degenerative joint condition that affects around 600 million people, most of whom are aged 55 and over. In April, Novartis dropped two drug candidatesExternal link for osteoarthritis that were in phase II clinical trials because they didn’t provide sufficient pain relief. 

These experiences set the stage for a sharper focus on the root causes of disease. “There’s more interest from big pharma in the biology of ageing as a source of novel targets (a specific molecule targeted by a drug for the first time), because for diseases like Alzheimer’s it’s clear that to treat them you have to look earlier in the course of disease, before symptoms even start,” said Kristen Fortney, the CEO and founder of BioAge.

Novartis hasn’t provided details of the specific disease targets it is pursuing through DARe but has said that “exercise biology” is a key priority, because exercise is “an absolute proven intervention in quite a lot of diseases of ageing,” said Kneissel. This could for example reveal ways to preserve muscle mass during weight loss, and regenerate knee cartilage for osteoarthritis.

At some point, “as the ageing field evolves, there is an opportunity to reach very early patient populations, or even maybe in the future, prevention. That would be the long-term trajectory,” said Kneissel.

Medical breakthroughs like cell and gene therapies that treat diseases at their root cause are raising hopes that one day drugmakers might be able to directly manipulate genes and cellular pathways involved in the ageing process. Some scientists are confidentExternal link that we will be able to turn back the clock on ageing cells to restore functions characteristic of younger cells.

The success of obesity-fighting drugs like Ozempic, a GLP-1 agonist, have added to the enthusiasm for ageing biology and raised the prospect that one drug can tackle the root causes of many illnesses. GLP-1, a gut hormone that regulates blood sugar, appears to lose function as we get older.

“If you look across the 8 billion people on this planet, there are a lot of people who already are ageing much more successfully than most of us,” said Fortney. “If we can better understand ageing, we can discover the real drivers of disease and develop drugs that can even target multiple age-related diseases.”

Improving incentives

These breakthroughs are coinciding with increasing concern about the economic, financial, and social costs of caring for an ageing population which is fueling an increase in research funding for the field.

The National Institutes of Health, the US’s leading medical research agency, doubled the amount of money it provided for ageing research from $3.1 billion in 2016 to $6.3 billion in 2023. The Trump administration has elevatedExternal link chronic diseases to the top of its Make America Healthy Again strategy to address the country’s health problems.

The growing financial burden of age-related diseases, not only on governments but also on individuals, means regulators and health authorities need to rethink how pharma companies are rewarded to incentivise them to develop new therapies to treat or prevent such illnesses, according to Johan Auwerx, an expert in cellular metabolism at the Swiss Federal Institute of Technology Lausanne (EPFL).

In 2022, people over 60 accounted for more than half (52%) of the total costs of healthcare in Switzerland but made up only a quarter of the population according to a reportExternal link by consulting firm Deloitte.

Ageing is currently not classified as a disease by regulatory authorities which means drugs that target ageing per se don’t receive approval and are unlikely to be reimbursed. Instead, companies have focused on specific, diagnosable conditions related to ageing – such as Alzheimer’s, osteoporosis, or sarcopenia – to get regulatory approval. This presents a challenge for the development of therapies aimed at slowing or reversing the biological processes of ageing, rather than treating a single disease.

“Health systems and insurers won’t be able to cope with the increase in spending from an ageing population,” said Auwerx, a founder of several start-ups focused on age-related diseases. “They need to create a model so that the people who do serious work to bring down these costs can get their money back. Then you will see the drug industry get involved.”

Getting across the finish line

Kneissel is clear that DARe’s focus is on making medicine. This is different than “longevity approaches where people are setting out to just live longer,” she told SWI. “It’s just an indirect consequence in our case.”

Even if Novartis hasn’t set its sights on longevity, any successful drug based on the biology of ageing would be a game-changer for a field that has struggled to bring good science from the lab to the market.

Calico, a subsidiary of Google’s parent Alphabet, was set up in 2013 with around $3.5 billion in investment, to develop interventions that extend human lifespan. After more than 10 years of research, the company has produced a lot of academic papers but no approved drugs. In January, the company announced the failureExternal link of clinical trials for fosigotifator, a drug developed in collaboration with US pharma group AbbVie, to treat amyotrophic lateral sclerosis (ALS).

In early May, Unity Biotechnology, a San Francisco-based company focused on ageing and eye diseases, laid off its entire workforce after the result of a clinical trial showedExternal link its treatment didn’t perform any better than another therapy on the market. BioAge also faced a setback in January, unrelated to its partnership with Novartis, when it decided to stop developing a drug for obesity after safety concernsExternal link in trials.

“People are really realising that prevention is valuable to the healthcare system. That has always been the ageing pitch,” said Fortney. “What we need now is for some drugs to make it across the finish line.”

Edited by Nerys Avery/vm/hs/ds

Series Longevity

• Episode 1: 1. Longevity clinics: modern-day snake oil or the key to healthy ageing?
• Episode 2: 2. The Basel researcher whose work triggered a longevity revolution
• Episode 3: 3. How Switzerland became a longevity hot spot
• Episode 4: 4. Novartis bets on ageing as next frontier in drug development