As U.S. life expectancy has fallen below that of most other developed countries, high-net-worth investors have targeted longevity and anti-aging solutions in the aftermath of the COVID-19 pandemic. About one-third of family offices have portfolios overweighted on health care investments, according to a 2023 study from Goldman Sachs.
The Food and Drug Administration does not classify aging as a disease but, rather, a natural process. This challenges physicians seeking FDA approval on trials to slow or reverse the aging process, as they don’t have defined criteria to measure whether their anti-aging drugs or therapies are working. So they instead need their drugs and trials to target a specific disease recognized by the FDA.
“It doesn’t mean folks won’t do trials, but what you’re going to be measuring is still a key question,” Dr. Daniel Kraft, a Stanford- and Harvard-trained physician-scientist and managing partner at Continuum Health Ventures, told Crain Currency. “It does make clinical trials more challenging if you’re going to do one. We know there are diseases associated with aging — cancer, heart disease, Alzheimer's, dementia, etc.”
Jason Stelmaszyk, a senior adviser at GenTrust, said the lack of FDA approval has exposed the anti-aging industry to pseudoscience. “The problem with the longevity space is you just see a lot of people pitching ridiculous diets and exercise routines, things that are very clearly not rooted in science,” he said.
INVESTMENT OPPORTUNITIES
Stelmaszyk fits his anti-aging investment strategy into two categories: longevity and quality of life. The longevity side consists mostly of companies innovating to solve cancer, heart disease or neurological disorders such as Parkinson's and Alzheimer's. Quality-of-life investments are geared toward companies working to keep people active — usually through enhancements in mobility, vision and hearing.
Investment opportunities mentioned by Stelmaszyk include the vision therapy company Unity Biotechnology and the mRNA vaccine technology company HelixNano.
On the cancer front, innovators include Cancer Check Labs, a blood test screening company founded by Sumit Rai of the Dallas-based Rai single-family office. CourMed, a private health concierge used by family offices and other high-net-worth individuals, counts Cancer Check Labs among its at-home services.
“What his company can do is identify cancer in very early stages, almost at stage zero,” said CourMed CEO Derrick Miles. “It's done through a blood draw. We utilize a concierge service to come to your own home and take the blood; then it undergoes analysis, and over 200 types of early cancer can be detected, [with] a 90% chance of survival.”
CourMed members are charged $995 per test, which Miles said is lower than the standard Cancer Check Labs test priced around $1,295.
It's common for family offices to fund causes that are personal to them, with one example being Rai's founding Cancer Check Labs after he lost his sister to the disease. Many blockbuster drugs and therapies are developed for decades before reaching breakthrough success — an investment timeline that family offices can afford.
“Family offices are patient capital. It’s been 14 years in the making of finally getting this technology out to the masses,” Miles said of Cancer Check Labs. “Family offices have worked out all the issues around legal, accounting and insurance. They’ve solved the lion's share of issues; now they’re looking for a competitive advantage,” he added, explaining why family offices sign up for CourMed’s at-home health care service.
Prime examples of patience paying off in health investment are GLP-1 weight loss drugs like Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro. Given the growing problem of obesity and its ties to heart disease, Stelmaszyk considers these weight loss drugs as investments in longevity.
“The real paradigm-shifting drugs and therapies out there are absolutely 10-, 20-year plays,” he said. “The first GLP-1s were starting to be issued in the early 2000s, back in 2002, 2003. This technology has been around, but it took another 20 years for it to really take off.”
While current GLP-1s are mostly injected, companies are racing to produce these weight loss drugs in pill form. Pfizer was making a twice-daily weight loss pill but stopped development in December after trial patients experienced high rates of side effects. Pfizer does plan to release data this year of a once-daily version of the pill still in development.
“I think whoever comes up with the pill form, tablet form, that’s the next big company,” Stelmaszyk said of weight loss drugs. “I don’t know who is going to do it first because everyone is working on it, but that is huge. Because there’s a lot of people who don’t want to inject themselves but absolutely would take a pill.”
At 89 years old, venture capital pioneer Alan Patricof recently launched an investment fund focused on longevity. Retro Fitness founder Eric Casaburi, himself a chair of Tiger 21’s ultra-high-net-worth peer group in Orlando, Florida, has launched Serotonin Anti-Aging Centers in cities across Florida, Tennessee, Massachusetts, New Jersey, Virginia, Missouri and North Carolina.
Continuum Health Ventures, backed by investor Howard Morgan among other family office limited partnerships, funds health tech and health-span-focused companies and typically invests between $500,000 and $1.5 million.
“We’re not going after a particular disease. We feel like the world’s a little bit overindexed on sick care," said Ricky Mehra, Continuum Health Ventures' managing partner. “I’m an advocate for whole-body MRIs, multicancer screening. The more we could look inside, the earlier we could detect, the better the outcome.
"We’re letting too many people get sick, and then we’re spending a lot of time and money figuring out how to solve for them.”
Continuum’s portfolio companies include the obesity management software platform Enara and the biotech company Immunis, which is working on drugs to reverse sarcopenia and other muscle atrophy diseases associated with aging.
“[Muscle atrophy] starts to hit human beings somewhere in their 30s in some sort of noticeable amount," Mehra said. "But really we start to see that muscle degradation problem happen in our 50, 60s and 70s. This might get worse if the GLPs continue to prove that some of the weight loss associated with Ozempic and Wegovy is also associated with muscle degradation.”
LONGEVITY AND AI
Much of Continuum’s investments leverage artificial intelligence, including the humanoid robot company Sanctuary AI, the infectious disease database Biotia and the health care data collaboration startup BeeKeeper AI.
“I think AI will have a huge role in drug discovery, in expediting how fast we get from an idea, disease to a solution,” Mehra said. “I feel strongly that we’re going to start to see this concept of a ‘doc and poc’ — a doctor in your pocket — where we can have pushes and nudges with a medical AI agent that sits in our earbuds — or our smart glasses, phones or watches — that’s constantly monitoring and looking for challenges that are impacting us in a negative way.”
Kraft, Mehra’s founding partner at Continuum Health Ventures, said he sees a future where AI — whether through a phone, smart ring or other wearable device — will analyze a user’s voice to detect depression, anxiety, neurological issues or even high blood sugar.
“If you can stay healthy and active for the next 10, 20 years, a lot of these emerging true technologies that are going to extend health and reverse aging might start to come online,” Kraft said, “whether it’s xenotransplantation of organs to vaccines for Alzheimer's or cancer.”