deep dive: the silvers series vi - deborah weinswig · • nutraceuticals: health supplements and...

1DEBORAHWEINSWIG,MANAGINGDIRECTOR,FUNGGLOBALRETAIL&[email protected]:917.655.6790HK:852.6119.1779CN:86.186.1420.3016Copyright©2016TheFungGroup.Allrightsreserved.

NOVEMBER24,2016

DEEP DIVE: The Silvers

Series VI: The Methuselah Complex and an Industry Thriving

on the Promise of Longevity

D E B O R A H W E I N S W I G M a n a g i n g D i r e c t o r ,

F u n g G l o b a l R e t a i l & T e c h n o l o g y d e b o r a h w e i n s w i g @ f u n g 1 9 3 7 . c o m

U S : 6 4 6 . 8 3 9 . 7 0 1 7 H K : 8 5 2 . 6 1 1 9 . 1 7 7 9

C N : 8 6 . 1 8 6 . 1 4 2 0 . 3 0 1 6

1) In this, the sixth in our Silvers Series of reports onconsumers aged 65 and older, we look at threesectors that encompass various antiaging and life-extension treatments and therapies. The first isbeauty, including antiaging cosmeceuticals.Worldwide, consumers spent $24.3 billion onantiagingfacialskincarein2015,whichwasequivalentto 29% of total global facial care product sales lastyear.

2)The nutraceuticals sector includes nutritionalsupplements and functional foods that promotehealth, and consumers worldwide spent some $166billionontheseproductsin2014.

3)Thethirdsectorisregenerativemedicine,abranchofmedicine dedicated to restoring degenerated cells,tissues and organs. The sector received some $2.5billioninfundingin2015intheUSalone.

Developers of antiaging technologies face a number ofsignificant challenges in terms of regulatory approval,ethical implications,mass-market affordabilityandefficacyinprolonginghealthylife.


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TABLEOFCONTENTSEXECUTIVESUMMARY....................................................................................................................................3

INTRODUCTION...............................................................................................................................................5

THEMANIFESTATIONSOFAGING....................................................................................................................6

1.BEAUTY:ANTIAGINGFACIALSKINCARE,COSMECEUTICALSANDAESTHETICSERVICES................................8COSMECEUTICALSANDOTHERANTIAGINGPRODUCTS......................................................................................8ANTIAGINGPRODUCTSMAKEUPNEARLYATHIRDOFFACIALSKINCARESALES.................................................9ANTIAGINGFACIALCAREBEGINSEARLY............................................................................................................11COMPANIESTOWATCHINTHISSPACE..............................................................................................................12AESTHETICMEDICALANDSURGICALTREATMENTS...........................................................................................13FORMSOFAESTHETICTREATMENTSFORANTIAGING.......................................................................................14COMPANIESTOWATCHINTHISSPACE..............................................................................................................15

2.NUTRACEUTICALS…………………………………....................................................................................................16SENIORS’HEALTHANDTHENEEDFORNUTRACEUTICALS.................................................................................17GLOBAL SENIOR POPULATION AND GOVERNMENT REGULATION TO BE KEY DRIVERS OFGROWTH.............................................................................................................................................................19COMPANIESTOWATCHINTHISSPACE..............................................................................................................21

3.REGENERATIVEMEDICINE………………...................…......................................................................................22FILLING THE WIDENING GAP BETWEEN THOSE ON ORGAN TRANSPLANT WAITLISTS ANDDONORS…………………………………………………………………………………………………..…………………………………………………23

STEMCELLTHERAPY....................................................................................................................................24GENETHERAPY............................................................................................................................................25TISSUEENGINEERING..................................................................................................................................27

COMPANIESTOWATCHINTHISSPACE..............................................................................................................27

OTHERTRENDSANDPROPOSEDAPPROACHESTOEXTENDLIFE.....................................................................28

KEYTAKEAWAYS:TECHNOLOGIESMAYADVANCE,BUTCHALLENGESABOUND.............................................30

APPENDIX......................................................................................................................................................31


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EXECUTIVESUMMARYInthis,thesixthreportinourSilversSeries,weexaminethreesectorsthatencompassvarioustreatmentsandtherapiesthataresaidtoslowtheagingprocess and promote life extension: cosmeceuticals (cosmetics that areclaimed to have medicinal properties), nutraceuticals (products derivedfrom foods that are claimed to have added health benefits) andregenerative medicine (a branch of medicine that deals with healingdamagedtissuesororgans).

Research firm FutureMarket Insights forecasts that the globalmarket forantiagingproductsandserviceswill reach$151.8billion in2016,andthengrow at a CAGR of 8.0% to 2020, reaching $206.5 billion. Worldwide,consumersspent$24.3billiononantiagingfacialskincarein2015,accordingto Euromonitor International. This was equivalent to 29% of total globalfacialcareproductsaleslastyear.

Globalconsumersspentsome$5.5trilliononaestheticmedicalandsurgicalproceduresin2014.IMCAS(InternationalMasterCourseonAgingScience),aninternationalorganizationfocusedonexcellenceinteachinginthefieldsof plastic surgery and dermatology, expects that figure to grow at anaverage annual rate of 7.2% to 2018,when itwill reach $8.3 trillion. Thenumber of nonsurgical procedures performed in the US grew by 22.3%between2014and2015,andthenumberofsurgicalproceduresperformedgrew by 7.1% year over year, according to the latest data from TheAmericanSocietyforAestheticPlasticSurgery.

Consumers worldwide spent $166 billion on nutritional supplements andfunctional foods in2014,accordingtoTransparencyMarketResearch,andthefirmexpectsthemarkettogrowataCAGRof7.7%,to$279billion,by2021.

In 2015 in the US, regenerative medicine, stem cell and gene therapyresearch received some$2.5billionbywayof grants, contracts andotherfundingmechanisms,accordingtotheNationalInstitutesofHealth.Oneoftheproblemsregenerativemedicinehopestoaddressisthegrowingorganshortagecrisis.

Theglobalmarketforantiagingproductsandserviceswillreach$151.8billionin2016,andthengrowataCAGRof8.0%to2020,reaching$206.5billion.

Source:Shutterstock


NOVEMBER24,2016

THESILVERSSERIES

Theeraof the silvergenerationhasarrived. Silvers,orpeopleaged65and above, are driving a hugely disproportionate share of consumer-spending growth inmany key regions globally. In somemarkets, theyaredrivingnearlyallsuchgrowth.Thistrendwillcontinue forthenext20 years, and it is being fueled by two related forces. The first isdemographics, as the silver population is growing considerably fasterthan other age groups are. The second is economics, as silvers hold adisproportionateshareofwealthglobally.

DEMOGRAPHICS

The population of silvers aged 65 and over will grow from 8% of theworld’s population in 2015 to 13% in 2035, and will account for overone-third of total population growth through 2035, according to theUnitedNations’PopulationDivision. The sizeandgrowth rate of silverpopulations—and of the subgroups within them—vary considerablyacrosskeyregions.By2035,Japan,SouthKorea,WesternEurope,NorthAmericaandChinawillseesilversaccountforthehighestshareoftheirtotalpopulations,with seniors comprisingmore than20%of the total.India, Southeast Asia and South America still have young populations,and the growth of the silver demographic relative to the rest of thepopulationintheseareaswillbelower.

AFFLUENCE

Olderhouseholdstendtobewealthier,whenmeasuredbytotalassets—which is understandable and inevitable, given that most peopleaccumulate assets over their lifetime.What is more interesting is thedisproportionate growth in the wealth of senior households seen insomecountries.Thistippingofthewealthbalancefromyoungtooldhasbeen fueled by changes such as the degradation of job security andopportunities,andtheerosionofcompensationandbenefitsforyoungerworkers. The impact of the economic downturn, whether throughgovernment austerityor private-sector cutbacks, appears only to haveamplifiedthisdisparity.

Source:Shutterstock


NOVEMBER24,2016

INTRODUCTIONMethuselah lived to be 969 years old, according to the Old Testament.Today, many are trying to follow in his footsteps. The MethuselahFoundation,aninstitutededicatedtoresearchonagingandlifeextension,activelyencouragesandpromotescutting-edgeagingresearch,fundingthesearchforsolutionsfortheglobalorganshortageandplacing3Dbioprintersinresearchlabs.

AchievingMethuselah’s longevityisstillnotfeasible,ofcourse,butwearealreadymakingstridesonthelongevityfront:globallifeexpectancyatbirthshotupfrom52yearsin1960to72yearsin2014.Somecountries,suchasJapan,theUSandtheUKhaveseenanexplosioninthelevelsoftheirseniorpopulation,due to this surge in lifeexpectancy levels. Someof the recentdevelopmentsthatweexamine inthisreportmaynotdirectlyprolong lifebut they do show promise in terms of reversing or arresting agingsymptoms.

This is the sixth report in our Silvers Series, which has already looked athealthcare technology, homecare and assisted living, technology formobility-constrained seniors, the reconfiguration of retail to meet theneeds of older people, and leisure services for seniors. In this report, weexamine various treatments and therapies that are said to help slow theaging process and extend life, including health supplements, dietarypractices, gene and cell therapies, and other developments in beauty,medicineandtechnology.

Thisreportexaminesthreesectorsindetail:

• Beauty: antiaging facial skincare or cosmeceuticals and aestheticservicessuchassurgeryandinjections.

• Nutraceuticals: health supplements and functional foods thatpromotehealth,growthorrejuvenation.

• Regenerativemedicine:an interdisciplinarybranchofmedicinethatworkstorestorethefunctionandformofdegeneratedcells,tissuesand organs by way of stem cell therapy, gene therapy and tissueengineering.

ThisisthesixthreportinourSilversSeries.

Source:Shutterstock


NOVEMBER24,2016

An innovation in any field becomes a game changer when it solves aproblemandisamoreefficientandeconomicalsolutionthananythatcamepreviously.Beforewe lookat thevariousadvances in theantiagingspace,letus takeacloserat theproblemtheyattempt to solve—senescence,orthegradualdeclineinfunctionalityassociatedwithaging.

THEMANIFESTATIONSOFAGINGSenescencemaybemanifestedinsinglecellsorinanorganismasawhole.Thehumanbodyismadeofinnumerablecells,eachwithspecificfunctions,and these cells constantly grow and multiply. Senescence involves thegradual loss in cells’ ability to divide and grow and, so, their ability tomaintainregularbodilyfunctions.

Someexpertsdefine theprocessofagingas theaccumulationofphysical,psychological and social change. Physical aging encompasses illnesses,weaknessandfrailtyexperiencedasonegrowsolder.

Psychologicalagingreferstohowoldapersonfeelsandbehaves.Manyofus perceive ourselves in our minds to be a different age than we arechronologically.Somepeoplefeelolderthantheyactuallyareand,so,feelcompelled to behave in a certain way, to “act their age” and alter theiractivities, tastesandpreferenceseven though there isno realneed todoso. Other peoplemay feel younger than they actually are—theymay notthinkof themselvesas seniorseven though they lookphysicallyolderandarepastacertainage.

Socialagingiswhenaperson’sstatusinsocietychangesasaconsequenceoftheirage,resultingintheirexclusionfromsocialgroups,eventsandjobs.Peoplemaynotnecessarilyperceive themselvesas silversoras “old,”butemployers, social factions and governments may group them togethersimplybecausetheyareoveracertainage.

Psychologicalageishowoldapersonfeelsandbehaves;somepeoplemayperceivethemselvestobeolderthantheyactuallyare.

Senescenceisthegradualdeclineinfunctionalityassociatedwithaging.

Source:Shutterstock


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Figure1.TheManifestationsofAging

Source:FungGlobalRetail&Technology

Ofthesethreemainmanifestationsofaging,senescence,orphysicalaging,has been the most widely researched and debated by scientists anddoctors.Itisalsothemostobviousmanifestationofaging:physicalchangesareclearlyvisibleasoneagesandtheyalterone’sappearanceconsiderably.

Theindicationofagepurportedbythesephysicalchangescanconsiderablyaffectone’ssocialandpsychologicalstate,andsopromptapersontotakeactiontoaddressthechangeinhisorherappearance.Thego-toremediesfor addressing or slowing the physical changes that accompany the agingprocesstendtofallinoneofthreemaincategories:cosmeticandantiagingbeautytreatments,dietaryregimens,andsupplements.

Butmanyconditionsaremore than just skin-deepandcanseverelyaffectregular bodily functions, causing much pain and weakness. (For moredetails, see“TheEffectsofAging,byBodySystem” in theAppendixat theendofthisreport.)Thesolutionsforaddressingsuchconditionsrangefrommedicationtoperiodictherapytointensemedicaltreatment.

Thepromiseofescapefromdeclininghealthandthepossibilityofextendingone’s life have led to a burgeoning market for pills, practices andprocedures.Theseincludeseveralnewtrendsintreatments,particularlyinthefieldsofgenomicsandregenerativemedicine,thatarestillinanascentor investigative stagebut that couldhold life-savingpotential. In thenextsection,welookathowmuchthismarketisworth,brokenoutbysegment:beauty,nutraceuticalsandregenerativemedicine.

TheManifestaWonsof

Aging

PhysicalAging:Experiencingillnesses,

weaknessandfrailtyasonegrowsolder

SocialAging:Whenaperson’sstatusinsocietychangesasaresultoftheir

age

PsychologicalAging:Feelingandbehavingasifolderthanone

actuallyis

Manyconditionsofagingcanseverelyaffectregularbodilyfunctions,causingmuchpainandweakness.


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1. BEAUTY:ANTIAGINGFACIALSKINCARE,COSMECEUTICALSANDAESTHETICSERVICES

Beautysectionsatdepartmentstoresanddrugstoresarepackedwith“lift-and-tightenthis”and“cell-generationthat”products,andstaffedbystoreassistants dutifully upselling companion “night repair” serums, “anti-gravity” skincare and “age-defying” lotions. But such cosmeceuticalsgenerallytendtohaveatemporaryeffectandmanyarenotveryeffectiveforpartsofthebodythatneedmoreintensivetreatment.

Cosmetic surgeries, Botox injections and lifts—which we refer to as“aesthetic treatments”—help provide longer-lasting effects. As one of themoreeasilyaccessiblesolutionstoreverseormaskthevisiblesignsofaging,antiaging products and services comprise a lucrative segment of personalcareandareonasteadygrowthtrajectory.

Research firm FutureMarket Insights forecasts that the globalmarket forantiagingproductsandserviceswill reach$151.8billion in2016,andthengrowataCAGRof8.0%to2020,whenitwillreachsome$206.5billion.

Figure2.EstimatedGlobalMarketSizeofAntiagingProductsandServices(USDBil.)

Source:FutureMarketInsights/FungGlobalRetail&Technology

Below,wetakealookatthecategoriesofantiagingproductsandservicesinmoredetail.

CosmeceuticalsandOtherAntiagingProducts

“Cosmeceuticals” is a termused to describe cosmetics that possess drug-like ormedicinal properties. The US Food and Drug Administration (FDA)does not recognize the term, but it defines “cosmetics” generally asproducts intended to make people more attractive and “drugs” and“medicaldevices”asproducts intended toaffect thestructureor function

$151.8$163.9

$177.1$191.2

$206.5

2016 2017 2018 2019 2020

In2016,theglobalmarketforantiagingproductsandservicesisexpectedtoreach$151.8billion.


NOVEMBER24,2016

of a part of the body, such as the skin. The FDA has different approvalproceduresforproductssoldundereachcategory.

Nevertheless,most antiaging skincareproducts are likely to fall under thebannerofcosmeceuticals,astheycontainingredientsthataltertheskininsomewayoranother.

AntiagingProductsMakeUpNearlyaThirdofFacialSkincareSales

Worldwide, consumers spent $24.3 billion on antiaging facial skincare in2015,accordingtoEuromonitorInternational.Thiswasequivalentto29%oftotal global facial care product sales last year,making antiaging productsthesecond-most-valuablesegmentwithinskincare,afterfacialmoisturizers.

Figure3.GlobalSalesofFacialSkincareProducts,byCategory,2015(%)

Source:EuromonitorInternational/FungGlobalRetail&Technology

FacialMoisturizers

35%

AnlagingProducts29%

FacialCleansers16%

Toners8%

FaceMasks6%

AcneTreatments3%

LipCare3%

Consumersspent$24.3billiononantiagingfacialskincarein2015.

Source:Shutterstock


NOVEMBER24,2016

EuromonitorestimatesthatsalesofantiagingproductswillgrowataCAGRof4.1%from2015to2020,whentheywilltotal$29.7billion.

Figure4.GlobalAntiagingFacialSkincareProductSales(USDBil.)

Source:EuromonitorInternational/FungGlobalRetail&Technology

By geography, the Asia-Pacific region accounts for the highest share ofantiagingfacialskincaresales,withChinaitsmostvaluablenationalmarket.The region far outranks the next two biggest regionalmarkets,which areWesternEuropeandNorthAmerica,respectively.

Yet China’s market value is driven by the scale of its population, not byhigher per-capita spending. The table below shows the market size forantiaging products on a per-capita basis for five major economies, usingdataforthe65-and-overpopulationonly.Bythismeasure,Chinacontinuestounderindexonantiagingproduct sales,which indicates that substantialopportunityexistsinthatcountry:

• Among silvers, China’s per-capita spend on antiaging facial careproductswas$42in2015,lowerthantheaverageof$57forthefiveeconomiesweanalyzed.

• Theper-capita spendof the senior population in eachof theotherfourcountriesoverindexedChina’sfigurebymorethan$30.

$24.3$25.3

$26.3$27.4

$28.5 $29.7

0

5

10

15

20

25

30

2015 2016E 2017E 2018E 2019E 2020E

Australasia

LalnAmerica

MiddleEastandAfrica

EasternEurope

NorthAmerica

WesternEurope

Asia-Pacific

Chinacontinuestounderindexonantiagingproductsales.


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Figure5.ComparisonofSalesSharetoSeniorPopulationShare,2015

Country

SalesofAntiagingFacialCareProducts

(USDBil.) 65+Population

Per-CapitaSpendonAntiagingFacialCareProducts(USD)*

China 5.48 130,968,055 42

US 3.61 47,525,209 76

Germany 1.43 17,292,683 83

France 1.06 12,774,105 83

UK 0.90 11,568,791 77

Five-CountryAverage 12.48 220,128,842 57

Basedon65-and-overpopulationonly.Source:EuromonitorInternational/WorldBank/FungGlobalRetail&TechnologySilversarenottheonlygroupbuyingantiagingproducts,however.Youngerconsumersarealsolikelytobuythemasapreemptivemeasuretodelaythesignsofaging.

AntiagingFacialCareBeginsEarly

There is evidence that consumers’ use of antiaging facial skincare beginsearly.AglobalsurveyconductedbyDatamonitorin2011foundthat68%ofconsumersaged25–34and67%ofconsumersaged35–49wereconcernedabouttheappearanceofwrinklesandfinelines,indicatingthattheyhavea“fearof growingold.” Some61%of consumers ages50–64expressed thesame concern,whileonly about47%of consumers aged65 andoverdid.The implication is that the biggest opportunities lie in selling antiagingproductstothosewhoarenotyetseeingthemostsevereeffectsofaging.

Figure6.Global:ConsumersConcernedAboutWrinklesandAppearanceofFineLines,byAge,2011(%)

Source:Datamonitor/FungGlobalRetail&Technology

55%60%

68% 67%61%

47%

61%

18–21 22–24 25–34 35–49 50–64 65+ Average

Some45%ofglobalbeautyconsumerslookforantiagingbenefitswhenshoppingforbeautyproducts.


NOVEMBER24,2016

AnotherDatamonitorsurvey,conducted in2013, foundthat45%ofglobalbeauty consumers look for antiaging benefits when shopping for beautyproducts.

Figure7.Global:EssentialProductBenefitsConsumersLookforWhenShoppingforSkincareProducts,2013

Source:Datamonitor

Inthefollowingsection,welookatsomeofthetreatmentsthatproduceamoredramaticandlonger-lastingantiagingeffect.

CompaniestoWatchinthisSpace

According to Euromonitor, some51.6%of the globalmarket for antiagingfacial skincare products is controlled by the top-ten beauty and personal-carecompanies.L’Oréalcontrolsthehighestshareof15.7%,andthisisovertwiceasmuchas that controlledby its closest rival,Procter&Gamble,at7.6%.

Figure8.GlobalMarketShareforAntiagingFacialSkincareProducts

Source:EuromonitorInternational

37%

43%

45%

51%

54%

62%

SkinLightening/Brightening

ReducloninAcneandAssociatedScars

AnlagingBenefits

SuitabilityforSensilve/HypoallergenicSkinTypes

Natural/OrganicIngredients

SunProteclonBenefits(e.g.,UVFilters)

15.7

7.6

6.2

4.5

3.93.1

3.02.92.52.2

48.4

L'Oréal

Procter&Gamble

EstéeLauder

Shiseido

Beiersdorf

Unilever

AmorePacific

MaryKay

Avon

LGHousehold&HealthCare


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Away from themarket-leading giants, promising companies in this sectorinclude:

Ever Skincare:EverSkincare isadirect-sellingbeautycompany thatoffersantiagingskincareproducts.TheuniquesellingpropositionofitsproductsisabioactiveingredientcalledLSR10,whichisacompoundofmagnoliabark,an antioxidant and a probiotic,which Ever says helps reduce the signs ofaging.

Ever says its products show results within 30 days, and the company’ssellers even promote them through social media with before-and-afterphotosofcustomersthathaveseensuccesswiththeproducts.AccordingtoaMay2015Fortunemagazinearticle,Everachievedmorethan$1millioninsales and grew to have over 1,000 specialist sellers within its two-monthtrialphasewhenitlaunchedin2015.EverSkincareispartoftheStellaandDotfamilyofsocial-sellingcompanies.

Rodan & Fields: Dermatologists Katie Rodan and Kathy Fields launchedpremiumskincarebrandRodan&Fieldsin2002.Theyarealsothecreatorsof the famous Proactiv range of skincare products, the most popular ofwhichisthethree-stepanti-acnekitwhichsoldextensivelyintheUS.AstheProactiv treatment proved successful for addressing acne, the founderslaunchedtheRodan&Fieldsbrandtoaddressagingskin.Inapressrelease,the company reported net revenue of $626.9million and 90% year-over-yeargrowth,in2015.

AestheticMedicalandSurgicalTreatments

Unlike the products discussed so far, surgeries, injections and otherprocedures designed to restore youthful vitality to wrinkled, sagging skinneedtobeadministeredasaservicebyaqualifiedprofessional.

Worldwide, consumers spent some $5.5 trillion on aestheticmedical andsurgical procedures in 2014, according to IMCAS, an internationalorganization focused on excellence in teaching in the fields of plasticsurgeryanddermatology.Theorganizationexpects thisvaluetoriseatanaverageannualrateof7.2%andreach$8.3trillionin2018.

IMCASnotesthattheUSwillretainthemajoritymarketshareofabout49%until2018,butitexpectsAsiatowitnessthefastestaverageannualgrowth,ofapproximately12.6%.TheorganizationexpectsthegrowthrateintheEUtobeloweruntil2018,at3.1%,duetosocioeconomiccrisesintheregion.

Worldwide,consumersspentsome$5.5trilliononaestheticmedicalandsurgicalproceduresin2014.

Source:Everskin


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Figure9.EstimatedGlobalAestheticMedicalandSurgicalMarketValue(USDTril.)

Source:IMCAS/FungGlobalRetail&Technology

FormsofAestheticTreatmentsforAntiaging

Injections, skin rejuvenation treatments andother nonsurgical proceduresgainedpopularityoversurgery in2015,according to theAmericanSocietyfor Aesthetic Plastic Surgery. According to the latest data from theorganization, the number of nonsurgical procedures performed in the USgrew by 22.3% between 2014 and 2015, whereas the number of surgicalproceduresperformedgrewbyonly7.1%.Inabsoluteterms,thenumberofnonsurgicalproceduresperformedin2015intheUS(10.9million)eclipsedthe number of surgical procedures performed (1.9million) by more thanfivetimes.

We lookedat someof themorecommonantiaging treatmentsand foundtwo key distinguishing features that make nonsurgical treatments thepreferredchoiceoversurgicaltreatments:

• Downtime: Recovery times for nonsurgical treatments are shorter.Since many nonsurgical treatments can be more discreetlyadministered and not necessitate that the recipient take time offfromworkordisruptadailyscheduleinordertorecover,nonsurgicalproceduresseemtobeamoreconvenientoption.

• Cost:Nonsurgicaltreatmentscostmuchless.Whilemostnonsurgicaltreatmentscosta fewhundreddollars,surgical treatments typicallycostatleastafewthousand.

Despite their high cost, painful procedures and longer recovery times,surgicaltreatmentstendtobemoreeffectivethannonsurgicaltreatments.So, many people prefer surgical treatments due to the “permanence” oftheireffectsrelativetononsurgicaltreatments.(Figure15intheAppendix,“Common Antiaging Aesthetic Treatments,” details the contents,

$5.5

$6.3

$7.3

$8.3

$2.7$3.1

$3.6$4.1

$1.2 $1.4$1.4 $1.5

$0.9 $1.1$1.4

$1.8

2012 2014E 2016E 2018E

Worldwide US EU Asia-Pacific

ThenumberofnonsurgicalaestheticproceduresperformedintheUSgrewby22.3%between2014and2015.

TheUSwillretainthemajorityshareofabout49%until2018,butAsiaisexpectedtowitnessthefastestaverageannualgrowth,ofapproximately12.6%,intheaestheticmedicalandsurgicalproceduresmarket.


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procedures and costs involved in some of themost common treatments.Thelistisnotexhaustive,asthereareseveraltreatmentsavailablethataremore specific with regard to the body part treated and the intensity oftreatment.)


Services in this sector tend to be provided by doctors—cosmetologists,dermatologists, specialized surgeons—and other such qualifiedprofessionals. Considering the medical aspect of aesthetic surgeries,providers of these servicesmay be part of a hospital or other healthcareinstitutions, or a clinic/facility set up to specifically provide aesthetictreatments.

While the universe of providers is large and fragmented with numerouslargeandsmallplayers,theleadingsellersoftheproductsusedinaesthetictreatmentsaremoreclearlydefined.Wediscusssomeoftheleadersbelow.

Allergan: Allergan is a global pharmaceutical company whose productportfolio consists of ophthalmic pharmaceuticals, neuroscience therapiesand treatments, and several other products to address breast and facialaesthetics. The company’s FY2015 revenue was $15.1 billion, of which10.0%wasfromthesalesofitsaestheticsanddermatologyproductsintheUSandtherestwasfromotherproductsitsellswithinandoutsidetheUS.Its most famous antiaging treatment is the botulinum toxin injectionmarketedunderitsbrandBotox.

Valeant:Valeant is a globalpharmaceutical company thatmanufacturesadiverse range of products spanning dermatology, neurology, women’shealth, ophthalmology and several others. In FY2015, Valeant’s revenueswere$10.4billion.

Galderma: Galderma develops dermatological and aesthetic products; itwasboughtfor$3.6billionbyNestléin2014.Itcreatessolutionscontainingbotulinum toxin, hyaluronic acid and other compounds to address skinconditionsincludingthosethatareagingrelated.

The aforementioned three companies, along with privately held MerzAestheticsandJohnson&Johnson-ownedMentorWorldwide,commandedapproximately74%oftheglobalaestheticsmarketsharein2015,accordingtolifesciencesmarketresearchfirmDeciBioConsulting.

Otherbusinesses thatare formingasa resultof thegapbetweenservice-providers and customers are marketplace apps and social-media sitesrelatedtoaestheticsurgery.China-basedYuemeiandSoYoungare twoof

Providersoftheseservicesmaybepartofahospitalorotherhealthcareinstitutions,oraclinic/facilitysetuptospecificallyprovideaesthetictreatments.

Source:Galderma


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the better-known cosmetic surgery marketplaces that are being used byconsumers seeking cosmetic surgery. The latter raised over $50million infinancing earlier in 2016 and has evoked interest from WeChat’s parentTencent.

RealSelfisasocialmediawebsitethatoffersfirst-handreviewsofaesthetictreatmentsundergoneby itsusers, theclinicswhere the treatmentswereperformedandtheservice-providersintheUS.Thewebsite’susersprovidereviews of their experience, along with before-and-after pictures, andseveral surgeons have vouched that they have seen considerable successfromreviewsonthesiteratherthanadvertising.

Cosmeceuticals and aesthetic treatments address the exterior signs ofaging, which are in part the result of lifestyle, nutritional choices andenvironmental effects on one’s health that manifest through the skin. Inmanycases,visiblesignsofagingcanbeaddressedtosomeextentthrougheatinghealthyfoodortakingessentialnutritionalsupplements.Inthenextsection,weexploresomeofthesewaystoaddressaging.

2. NUTRACEUTICALSWhereas cosmeceuticalsare cosmeticswithapharmaceutical component,nutraceuticals are products that contain both a nutritional andpharmaceuticalcomponent.

• Our definition of nutraceuticals includes both health supplementsthat come in the form of pills, syrups and powders and functionalfoods (those fortified with a beneficial ingredient) that promotehealth,growthorrejuvenation.

• We define nutricosmetics as supplements that are specificallydesigned for beauty and cosmetic purposes. So, nutritionalsupplementssuchasironcapsulesandcalciumtablets,whichbenefitthewholebody,arenotincludedinourdefinitionofnutricosmetics,but keratin-rich supplements that help promote healthy hair, skinandnailsareincluded.

Consumersworldwidespent$166billiononnutraceuticalsin2014.

Source:Shutterstock


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Consumers worldwide spent $166 billion on nutraceuticals in 2014,accordingtoTransparencyMarketResearch,anditsresearchersexpectthemarket to grow at a CAGR of 7.7%, to $279 billion, by 2021. The firmestimates that consumers spent $3.7 billion on the nutricosmeticssubcategoryglobally in2014,and it forecasts that that figurewill grow to$7.9billionby2021,representingaCAGRof11.6%.

Figure10.Global:NutraceuticalsandNutricosmeticsMarketSizes,2014and2021E(USDBil.)

Source:TransparencyMarketResearch/FungGlobalRetail&Technology

Seniors’HealthandtheNeedforNutraceuticals

Some age-related deterioration in health may be affected by lifestylechoicesanddietaryhabits.Asdietarypatternsandnutritionalrequirementschange with age, some silvers may not regularly consume the requisiteproportionofnutrients.

Official nutrition surveys support the view that older consumers may beunderconsuming.Manyseniors intheUS,forexample,areconsuming lessthantheestimatedaveragerequirement(EAR)ofsomenutrients,accordingto the 2015 Dietary Guidelines for Americans report published by theDepartment of Health and Human Services. The report surveyed olderadults(definedasthoseaged71andolder)andfoundthat:

• Some 71% of men and 81% of women fell short of the EAR forcalcium from food and beverages.When their calcium intake fromfood, beverages and supplementswas considered, the percentagesfellto55%formenand49%forwomen.

• About93%ofmenandmorethan97%ofwomenhadintakesbelowthe EAR for vitamin D from food and beverages. The resultsimproved to 52% for both men and women when the source ofintakeincludedsupplementsalongwithfoodandbeverages,similartothefindingsforcalcium.

$161.9

$271.0

$3.7

$7.9

2014 2021E

CAGRforNutraceuWcalsMarket:7.7%CAGRforNutricosmeWcsMarket:11.6%

ResidualNutraceulcalsSegment Nutricosmelcs

Officialnutritionsurveyssupporttheviewthatolderconsumersmaybeunderconsuming.Adeficiencyofnutrientscanleadtodevelopingseveralhealthconditions.

Some71%ofmenand81%ofwomenfellshortoftheEARforcalciumfromfoodandbeverages.Whentheircalciumintakefromfood,beveragesandsupplementswasconsidered,thepercentagesfellto55%formenand49%forwomen


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• Only4%ofmenand13%ofwomensurveyedmetorexceededtherequiredintakeoffiber.

• Forpotassiumintakefromfoodandbeverages,lessthan3%ofmenand women had intakes that met the recommended amount, andthis did not improve even when intake from supplements wasconsidered.

• Proteinwastheonlynutrientforwhichmostseniors’intakesmettherecommendedamount.

A deficiency of these nutrients can lead to tiredness, difficulties inperforming everyday tasks and, in some cases, to developing seriousconditions. For example, a deficiency of calcium increases the risk ofosteoporosis—aconditionthatdepletesbonedensity.Thoughthesefiguresrefer to the state of seniors’ health only in the US, we believe similarpatternsmaybeseeninothercountriesduetochangesinpeople’seatinghabitsandlifestylesastheyage.

Below,weprovidemoredetailsonhealthconditionsthatcanaffectseniorsandthenutrientsnecessarytoremedythem.

Figure11.Nutrients,NaturalandNutraceuticalSources,andRelatedBodySystemsandHealthConditions

NutrientExamplesofNaturalSourcesofNutrient

ExamplesofNutraceuticalSourcesofNutrient SystemTargeted HealthBenefit

Calcium Dairy;sardines;anddark,leafygreens

Fortifiedorangejuice,soymilkandcereal

Musculoskeletalandcardiovascular

Reducesriskofosteoporosisandcancer

VitaminD Salmon,tunaandmackerel

Fortifiedorangejuice,dairyandcereal

Musculoskeletal Helpscalciumabsorption,immunefunctionandcancerprevention

Fiber Beans,wholegrainsandnuts

High-fibercereals,foodsupplementpillsandpowderswithaddedfiber

Digestiveandimmune

Helpsbodyabsorbvitalnutrientsandregulatedigestion

Potassium Fruit,vegetablesandfish

Potassiumisnaturallyfoundinadequateorhighamountsinregularfoodssuchasfruitsandvegetables;compoundsofpotassiumareaddedtovariousfoodproductstopreservethem

Renal,nervousandcardiovascular

Helpsrelievehypertensionandhighbloodpressure

Protein Meat,fish,poultryanddairy

Highproteinmealpowdersandwheyproteinpowders

Musculoskeletal Helpsstrengthenbonesandmuscles

Phospholipids Eggyolks,wheatgerm,soyandmilk

Soyapowderwithaddedphospholipids,omega-3supplementsand“brainnutrient”supplements

Brainandnervous Helpspromotebrainandcognitivefunctions


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NutrientExamplesofNaturalSourcesofNutrient

ExamplesofNutraceuticalSourcesofNutrient SystemTargeted HealthBenefit

Carotenoids Dark,leafygreens Supplementswithlutein,zeaxanthinandlycopene

Exocrine,brainandnervous

Reducesriskofcancer,age-relatedmaculardegenerationandskindamage

Antioxidants Fruits;dark,leafygreens;andnuts

Krilloil,acaiberryandspirulina

Brain,nervous,andcardiovascular

Reducesriskofcancer,heartdiseaseandneurodegenerativedisease

Source:NationalInstitutesofHealth/FungGlobalRetail&Technology

GlobalSeniorPopulationandGovernmentRegulationtoBeKeyDriversofGrowth

Theglobalpopulationofseniorsandgovernmentregulationswillbothdrivegrowthofthenutraceuticalsmarket.

RisingGlobalSeniorPopulationMeansRisingHealthcareConcernsandCosts

Thegrowing silverpopulation isnaturallyboostingdemand forhealthcareproducts and services. Some 36% of Americans aged 65 and over, orapproximately 15.5 million people, reported experiencing some kind ofdisability in 2014, according to theAmericanConsumer Survey conductedbytheCensusBureau.

In theUK,more thanone-quarterof seniorshave reportedchronichealthproblems related to their muscles, bones, heart or circulation. The UK’slatestGeneralHouseholdSurvey, from2007,foundthatmorethan27%ofpeople aged 65–74 and 30% of those aged 75 and over had experiencedlong-term conditions that affect the musculoskeletal and cardiovascularsystems.

Prescriptionmedicines andmedical procedures are themainstays for thetreatment of such conditions. But for health conditions that are not asserious or for which no treatment procedures are available, supplementsare an option. In some cases, supplements may even bemore attractivethanprescriptionmedicinesarebecausetheymaybe lessexpensive,havefewer sideeffectsorbemoreeasily accessible through supermarkets anddrugstores.

There is evidence that seniors are already using supplements to addressvarious health needs. A 2013 survey conducted by the Council forResponsibleNutritionand Ipsos found that75%ofUSadults aged55andover tookdietarysupplements.At least40%of thosesurveyed in thisagegroup stated that overall health and wellness benefits, heart health andhealthyagingwerethetopreasonsfortakingsupplements.

Some36%ofAmericansaged65andover,orapproximately15.5millionpeople,reportedexperiencingsomekindofdisability.


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Figure12.USConsumersAged55+:ReasonsforTakingDietarySupplements,2013

Source:CouncilforResponsibleNutrition/Ipsos/FungGlobalRetail&Technology

Given seniors’ growing awareness of healthy aging, the rising costs ofhealthcare and lower incomes in the later stages of life, we expect olderconsumerstodrivegrowthofthenutraceuticalsmarket.

GovernmentRegulations:FewerRulesMeanFasterGrowth

Theregulationofnutraceuticalproductsvariesamongcountries.IntheUS,the FDA recognizes nutraceuticals and functional foods as part of the

23%

24%

25%

28%

36%

39%

40%

42%

57%

Energy

HelpReducetheRiskofIllness

ImmuneHealth

JointHealth

BoneHealth

ToFillNutrientGapsinmyDiet

HealthyAging

HeartHealth

OverallHealth/WellnessBenefits

Givenseniors’growingawarenessofhealthyagingandtherisingcostsofhealthcare,weexpectolderconsumerstodrivegrowthofthenutraceuticalsmarket.

Source:Shutterstock


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broader foodscategory rather thanaspharmaceuticals, so theseproductsneedtocomplywithrulesthatapplytofoodproducts.

In Japan, thegovernmenthasbeenapioneer innutraceuticals. In1991, itinstitutedapolicyallowingfoodmanufacturerstoassertthattheirproductis a “food for specific health use” if it or one of its ingredients is on anapprovedlist.Manufacturersofsuchproductsmaystatethattheirproductpromotes good health, but they cannot state that it reduces the risk ofdiseases.

Regulations in theEUandChina involveamorestringent setofapprovalsandinspections,andthelistofclaimsaproduct’spackagingcancarrytendstobemorerestrictive.

AccordingtomarketresearchcompanyFrost&Sullivan, theUSandJapanare the two largest national markets for nutraceuticals. It is probably nocoincidence that these two countries also have a considerably higherproportionofsilversintheirpopulationsthandoothercountries,aswellaslessrestrictiveregulatoryenvironments.

Figure13.ShareofNutraceuticalsMarket,byRegion,2011

Source:Frost&Sullivan


Identifying a singlemarket leader in this space is complex, asmany largebiotechnology, pharma and food-manufacturing companies offer healthsupplements and functional foods with ingredients to address theconditions of aging. Some of such companies that are key players in thesectorare:

Nestlé Health Science: Global food and drink manufacturer Nestlé has aHealth Science division that focuses on producing nutrient-rich food andsupplements for sale through retail, pharmacy and healthcare providerchannels. Nestlé Health Science capitalizes on biomedical researchgeneratedby itsSwitzerland-basedresearcharmNestlé InstituteofHealthSciences.

US,36%

Japan,22%

Europe,25%

RestoftheWorld,17%

Regenerativemedicine,stemcellandgenetherapyresearchreceivedsome$2.5billionbywayofgrants,contractsandotherfundingmechanismsin2015intheUS.


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Elysium Health: Amore recent player is New York-based startup ElysiumHealthwhichsellsanantiagingpillformulatedatanMITlab.Theover-the-counter pill, called Basis, claims to “repair key metabolic processes,including DNA repair, cellular toxicity, energy production and proteinfolding.” Its advisory board boasts over 30 scientists, five of whom areNobelPrizewinners.

Google-backed Calico: California Life Company, which was shortened toCalico,was createdandbackedbyGoogle in2013. Themain focusof thecompanyistoaddress“thechallengeofagingandassociateddiseases”andbringmedicalproductstothemarketthatwill improve longevity.Since itslaunch,Calicohaspartneredwithseveralbiopharmafirmstoresearchanddeveloptherapiesandsolutions.Afewexamplesare:

• A partnership with global biopharma company AbbVie, to developandcommercializenewtherapiestotreatage-relateddiseases.

• A partnership with collaborative research institute QB3 to conductresearch into the biology of aging and to identify potentialtherapeuticsforage-relateddiseases.

• ApartnershipwithconsumergeneticsfirmAncestryDNAtoconductresearchintothegeneticsofhumanlifespan.

• A partnership with nonprofit biomedical research institute TheJacksonLaboratory,toconductresearchonthebasicbiologyofagingthroughtheapplicationofresultsfromstudyingmousegenetics.

3.

Source:Shutterstock


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4. REGENERATIVEMEDICINEMoregroundbreakingthanskincareproducts,plasticsurgeryornutritionalsupplements is regenerative medicine, a branch of medicine focused onsolvingtheproblemsposedbydegenerativeillnessesandconditions,whichareusually responsible for thedeterioration in the functionof tissuesandorgans. Failing tissues and organs can eventually lead to disability, andreducedfunctionisaresultofthenaturalagingprocess.

Aubrey deGrey, a leading bio gerontologist, believes that the diseases ofaging can be treated, reversed or prevented throughmedical technology,which can ultimately enable human beings to live forever. De grey co-foundedtwononprofitorganizations—theMethuselahFoundationandtheStrategies for Engineered Negligible Senescence (SENS) ResearchFoundation—focused on spreading awareness, raising funds andencouraging research to prevent aging. Both organizations have severalresearch projects under way that investigate emerging medicaltechnologies, including regenerativemedicine, as potential cures for age-relateddiseases.

Regenerativemedicineisaninterdisciplinaryfield,soformulatingasingular,comprehensivedefinitionofitischallenging.But,generally,thetechnologydevelopedunderthisbranchofmedicineaimstorestorethefunctionandform of degenerated cells, tissues and organs to their former or originalstate.

Stemcell therapy,genetherapyandtissueengineeringareallbranchesofregenerativemedicine and, according to theNational InstitutesofHealth,regenerativemedicine,stemcellandgenetherapyresearchreceivedsome$2.5 billion byway of grants, contracts and other fundingmechanisms in2015intheUS.

Beforeweexplore themarket segments inmoredetail, let us first take alookattheneedfortheapplicationsofregenerativemedicine.

FillingtheWideningGapBetweenThoseonOrganTransplantWaitlistsandDonors

Thetransplantableorganshortageisarealandgrowingcrisis.Attheendof2015,thereweresome15,068livinganddeceasedorgandonorsintheUS,butthenumberofpeopleinneedofanorgantransplantwasmuchhigher,

Attheendof2015,thereweresome15,068organdonorsintheUS,butthenumberofpeoplewhoneededanorgantransplantwasfarhigher,at119,926.

Source:Shutterstock


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at119,926.Everyyear,thenumberofpatientsonorgantransplantwaitlistscontinuestogrow,butthenumberofdonorsisstillinsufficienttomeetthedemand.

Figure14.US:OrganDonorsandPatientsonOrganTransplantWaitlists,byAgeGroup(2015)

Organsincludelungs,kidneys,liver,heart,pancreasandintestine.Source:OrganProcurementandTransplantationNetwork

Even if there were just as many donors as there were people on thetransplantwaitlists, thenumberswould still prove challenging, as there isalwaysahighrisk thatapatient’sbodywill rejectadonatedorganduetothebody’snatural immuneanddefensesystems.This isoneof issuesthatregenerative medicine hopes to solve through advances in stem celltherapy,genetherapyandtissueengineering.

StemCellTherapy

Everyorganismismadeoftrillionsofcells—whicharethebasicunitorthesmallestleveloflivingbeings.Scientistsestimatethatthereareatleast200differenttypesofcellsinthehumanbody,eachwithauniquestructureandcharacteristicsthatimpartspecialfeaturesandfunctionstothepartofthebodyinwhichthecellisfound.

Stemcellsareatypeofcellfoundinvariouspartsofanadulthuman’sbody(inadults,thesearecalledtissuestemcells)and inanembryo(embryonicstem cells). Scientists recently discovered that specialized cells can bereprogrammed to act like embryonic stem cells, which can then be givenunique characteristics again. These are termed induced pluripotent stemcells (iPSCs).Twokeycharacteristics thatdistinguishstemcells fromothercellsare:

9414,440 4,727 4,131

8221,926

10,207

27,894

53,368

26,535

<17 18–34 35–49 50–64 65+

AllDonorTypes Waitlist

Arecentbreakthroughinstemcellresearchwasthediscoverythatspecializedcellscanbereprogrammedtoactlike“blank”cells,whichcanthenbegivenuniquecharacteristicsagain.


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• Theyare“blank”cells,sotheycangrowtotakeoncharacteristicsofother cell types as required by the body and work as an internalrepairsystem.

• Underexperimentalandphysiologicalconditions,theycanbeinducedtobecomecellsspecifictoanorgan,outsidethehumanbody.

Howcanstemcellsprolonglife?

Asapersonages, thebody’s repositoryof stemcells is depleted, and thebody’sabilitytohealfrominjuriesandfightinfectionsdeteriorates,asdoesthe immune system in general. By creating or reprogramming cells tobehaveinacertainway,scientistsanddoctorsareabletotreatconditionsinamoretargetedmanner.

Stemcell therapyhasbeenused for the last20 years in the treatmentofmore than 75 diseases, including numerous types of cancers, anemias,inherited metabolic disorders and deficiencies of the immune system,accordingtoCryo-CellInternational,acordbloodbank.

GeneTherapy

Everypersonhasasetofgenesthataremostlysimilarbutthatvaryslightlyfromperson toperson.While genes impart features such ashair andeyecolor, and abilities such as being able to roll one’s tongue, they alsodeterminesomeconditionsandillnessesthatapersonmightexperience.

Howcangenetherapyprolonglife?

Genetherapyaimstotreatdiseasesandillnessescausedbygeneticdefects,usingthreekeyapproachesthatarestillbeingresearched:

• Replacingadisease-causinggenewithahealthygene.

• Deactivatingordisablingadefectivegene.

• Introducinganewgeneintothebodythatcanhelpfightadisease.

The actual application of these approaches is more complex, as genesthemselves are intricately structured. Telomeres, a component ofchromosomes, keep shortening over time as people age, and reduce the

Genetherapyaimstotreatdiseasesandillnessescausedbyageneticdefect.

Source:Shutterstock


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generation of new cells, leading to senescence. Pioneering molecularbiologist and gerontologist, Dr. Bill Andrews, and his team atbiopharmaceutical company Geron Corporation, have been credited withthe discovery of human telomerase—a protein present in complex cell-structuresthatisresponsibleforpreventingtelomeresfromshortening.

Dr.AndrewslaterfoundedSierraSciences,abiotechnologyfirmfocusedonfinding a cure for aging through the control of telomere length. In 2011,SierraSciencespartneredwithhealthsupplementssellerIsagenixtolaunchProduct B, an antiaging nutraceutical marketed for its “telomerase-supporting properties.” But many pharma critics dismiss Product B as ahealthsupplementwithwellnesspropertiesthatdonotnecessarilyinclude“life-extension” or antiaging, as the studies published about itseffectivenessdonotexplicitlystatenorprovethelengtheningoftelomeres.

Dr. Andrews is also on the advisory board of BioViva, a Seattle-basedbiotech company which recently tested a gene therapy that claims tolengthen telomeres and thus reduce the risk of contracting age-relatedconditions and diseases. Elizabeth Parrish, its CEO, was the first to trialBioViva’s gene-therapy treatment to lengthen the telomeres in herchromosomes, in September 2015. In March 2016, independent labsverifiedthatthetelomeresinDr.Parrish’swhitebloodcellshadlengthenedby9%,whichBioVivasaysistheequivalentto20yearsofherlife.

ManyscientistsdismissBioViva’sclaim,as itdoesnot followthenormsofproperscientificprocedurewhichnecessitatedetailedpre-clinicalresearchtoprogresstohumanstudies.BioVivaevenhadtoconducttheexperimentonDr. Parrish in Colombia, and not theUSwhere it is based, in order tocircumventregulation.Moreover,theclaimisbasedonatrialconductedona single subject who may not be representative of the intended patientpopulation.Assuch,gainingapprovaltousethetherapyinregularpracticemaystillbealongwayoff.

Source:Shutterstock


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TissueEngineering

Cellsformtissues,whichformorgans,whicheventuallyformvariousbodilysystems.Tissueengineering involves implantinghumancells into scaffoldsmade of biological or synthesized material, in a controlled environment.Some damaged tissues and organs can be repairedwith the use of theseengineered tissues. Currently, engineered tissues are being applied inorthopedicsurgery,abdominalsurgeryandgastrointestinalsurgery.

Howcantissueengineeringprolonglife?

Tissue engineering technology has been used to create synthetic bonegrafts to build the bones of the skull and face and scientists continue toresearch how to create tissues and organs in the lab. Researchers havealready managed to grow tiny livers, kidneys, intestines and hearts, andimplant them into mice. If such technology can be replicated for thetreatmentofhumans,theremaybeachanceofprolonginglifebyreplacingdamagedorworn-outorgans.


There are many companies making waves in the revolutionary field ofregenerative medicine. We discussed BioViva in the earlier part of thissection,andbelowwe lookatsomeof theotherorganizationsthatareattheforefrontofthissector:

HumanLongevityInc.(HLI):RenownedbiotechnologistandgeneticistCraigVenter,whowasoneofthefirsttosequencethehumangenome,foundedHLI to create the world’s largest database of sequenced genes. The firmcombines advanced genetic information with developments in stem celltherapies“toenhanceandimprovethehealthylifespan.”InApril2016,thecompany raised$220million in SeriesB funding; in theprevious round in2014,itraised$80million.

Source:Shutterstock


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Samumed: Biotech company Samumed develops therapeutics to treatdegenerativediseases through tissue-level regenerationandWntpathwaymodulation—a mechanism in the body that involves the transmission ofmolecularsignalsthatcaneventuallyshapeormanipulateacell’slifecycle.AccordingtoaForbesarticlepublished inMay2016,Samumedhadraised$220millioninitsinitialroundoffunding,andwashalfwaythroughraisingafurther$100millionatthetime.Oneof itsproductsaimstoregrowhairfor those affectedbybalding, turn greyhair to its original color andeventreatwrinkledskin.Anotherproductaimstoregeneratecartilageinarthriticknees,andathirddrugaimstorepairdegenerateddiscsinthespine.

Alkahest: Alkahest aims to solve age-related diseases through tissue-regeneration therapies derived fromblood and its components. In clinicalstudies,theStanfordscientistswhocreatedthecompanyfoundthatbloodfromayounganimalinfusedintothebodyofanoldanimalhelpsincreasetissue regeneration. Nanalyze, a website that writes about disruptivecompanies, reported in February 2016, that Alkahest has raised over $50million in funding so far to further its research and be able to test itsfindingsinhumantrials.

Osiris: Osiris is an advanced regenerative medicine company and thedeveloper of the first approved stem cell drug remestemcel-L. Its cellulartherapy is used for the repairofwounds, soft tissue injuries and cartilageinjuriesfromsportsandorthopedicconditions,ortotreatinjuriessufferedby those who have other health conditions such as diabetes that usuallyimpede regular healing. The company was delisted from the NASDAQ inSeptember 2016 following an ongoing investigation into its accountingpractices and has not disclosed its financials for 2015. In 2014, thecompany’srevenueswereabout$60billion.

Source:Osiris


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OTHERTRENDSANDPROPOSEDAPPROACHESTOEXTENDLIFECosmetics and nutritional supplements are merely temporary fixes forhalting or slowing the effects of aging, and even the approaches inregenerativemedicinearemainlyremedial,notpreventive,solutions.Thereare,however,otherapproachesthatclaimto“cure”aging.

One of these is calorie restriction (sometimes called caloric restriction orenergy restriction), a dietary regimen that requires reduced calorie intakewithout eliminating essential nutrients. Calorie restriction withoutmalnutrition has been shown to delay the biological aging process duringexperiments on lab animals and to prolong youthful health. The effect ofthisregimenonhumanhealthisstillunknown,andresearchisongoing.

Another approach is the 2045 Initiative, developed by a nonprofitorganizationwiththesamename.StartedbyentrepreneurDmitryItskovin2011,themaingoaloftheinitiativeistocreatetechnologiesthatwillallowthe transferofan individual’spersonality toa sophisticated,nonbiologicalcarrierand,thus,extendlife.Inotherwords,theinitiativeaimstocreateacyborg.Thegoalistodosoby2045,withthehelpofateamspecializinginneuralinterfaces,robotics,artificialorgansandsystems.

Athirdapproach,whichwemostoftenseeinsciencefictionmovies,isthecryonic preservation of the human body (storing the body at lowtemperatures) with the intention of resuscitating it through advancedtechnology.Nomammalhasbeenbroughtbacktolifethroughthismethodexceptforfrozenhumanembryos.

With the possible exception of calorie restriction,which is likely to proveunappealingformanypeople,theseapproachescontinuetolookmorelikesciencefictionthanlikerealisticprospectsforextendinghumanlife.

Calorierestrictionwithoutmalnutritionhasbeenshowntodelaythebiologicalagingprocessduringexperimentsonlabanimals,buttheregimen’seffectonhumanhealthisstillunknown.

Source:Shutterstock


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KEYTAKEAWAYS:TECHNOLOGIESMAYADVANCE,BUTCHALLENGESABOUNDOne of the biggest challenges that organizations in the food,pharmaceutical, cosmetics and health industries face ismeeting stringentregulations and standards in order to make their products suitable forhumanuse.Thebenchmarkstoapprovetheuseandcommercializationofcosmeceuticalsandnutraceuticalsareseeminglystraightforward,butthereare ethical implications for many other potential solutions to age-relateddeterioration.

Research in the fields of embryonic stem cells, gene therapy and genemodification, cryonic preservation of the human body and otherrevolutionarymethodsfor“curing”aginghasalreadyspurredmuchethicaldebate.Evenifnew-agetechnologiesforaddressingagingsomehowevadeethical controversy and receive regulatory approval, they will still facechallengesintermsofmass-marketadoption.

Currently, many drugs and treatments are unaffordable for mostconsumers. These high-tech, expensive solutions may become theprerogative of the wealthy and/or powerful, which could have negativeeffectsonsocietyasawhole.

Life-extension strategieswill also need to consider “the Tithonus Error”—namedafteraprincefromGreekmythologywhowasgrantedimmortality,butnoteternalyouth,bythegodZeus.Tithonusgrewincreasinglyinfirmashelivedonandon.The“error”referstotheideathatlife-extensioneffortswill lead to people spending an increased number of years in a fragile,dependent state rather than in a healthy state. Many think that lifeextensionshouldnotsimplymeanprolongingthetimethatoneisalive,butprolongingthetimethatoneisabletoleadahealthy,youthfullife.

Once thesechallengesareovercome, theMethuselahcomplex thatdrivesthehumanpursuitoflongevitymaybecomemoreachievablethanwehaddreamed.

Manythinkthatlifeextensionshouldnotsimplymeanprolongingthetimethatoneisalive,butprolongingthetimethatoneisabletoleadahealthy,youthfullife.

Source:Shutterstock


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APPENDIX

Figure15.TheEffectsofAging,byBodySystem

Source:Invista.com/Belmarrahealth.com/MSDmanuals.com/FungGlobalRetail&Technology

•  Funclon: Control immediate responses to slmuli and manage aclvilesbetweensystemsandsenses.

•  Effects of aging: Decline in regular brain/neural funclon leading to condilonssuchasdemenla,strokeandmildcognilve impairment;thepersonmayneedpsychiatricayenlon.

BrainandNervousSystem

•  Funclon:Circulalngoxygenandnutrientstovariouspartsofthebody.•  Effects of aging: Thickening and slffening of arteries or blockage of arteries,whichaffectsbloodpressureandcirculalonbetweentheheartandtherestofthebody.

CardiovascularSystem

•  Funclon:Breakdownfoodintosimplerstructuresthatcanbeeasilyabsorbedbythebodyandprovidefuelforenergy.

•  Effectsofaging:Declineintheabilitytoconsumeandmetabolizecomplex,hardorspicyfoods.

DigeslveSystem

•  Funclon:Responsibleforregulalnghormonesecrelon,circulalonandbiologicaclvity.

•  Effectsofaging:Hormonalchangesaffectvariousfunclonsofthebody;forexample,reducedsecrelonfromthethyroidglandreducesthemetabolicrateofthebody.

EndocrineSystem

•  Funclon:Asthemainorganinthissytem,theskinhelpsregulatebodytemperatureandremovewasteproductsfromthebody.

•  Effectsofaging:Growthofnewskinslowsdown,thehairlinebeginstorecedeandhealingfrominjuriesisslower.Astheskinbeginstothin,thereisareducloninbodytemperatureregulalon.

ExocrineSystem

•  Funclon:Responsibleforreturningcleansedlssuefluidtotheblood;helpsthebodydefenditselfagainstdisease.

•  Effectsofaging:Personbecomesmorevulnerabletoinfeclonsanddiseases.Lymphalc/ImmuneSystem

•  Funclon:Helpssupportthebody,controlmovementsandprotectorgans.•  Effectsofaging:Weaknessinbonesandwearandtearonmusclesleadtoinvoluntarytremorsandreducedstrengthinarmsandlegs,whichcanresultininjuriesfromfalls.

MusculoskeletalSystem

•  Funclon:Filteringbloodandremovingwasteandfluidsfromthebody.•  Effectsofaging:Age-relatedweakeningofkidneylssues,bladdermusclesanddeclineoffilteringunitscancauseurinarytractinfeclonsandinconlnenceissues.

RenalSystem

•  Funclon:Produclonofcellsnecessaryforprocrealon.•  Effectsofaging:Hormonalchangesleadtoreducedferllityandfunclonofthereproduclvesystem.

ReproduclveSystem

•  Funclon:Transportairtothelungs,supplythebodywithoxygenandexpelcarbondioxide.

•  Effectsofaging:Musclesaroundtherespiratorysystemlosetheirstrength,leadingtodifficullesinbreathing.Seniorsalsobecomemorepronetolunginfeclonssuchaspneumoniaandbronchils.

RespiratorySystem


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Figure16.CommonAntiagingAestheticTreatments

Type Name WhatItIs HowItWorksDowntime/HowLongResultsLast

AverageCostintheUS,2015

BotoxInjection Botoxisadilutedversionofthebotulinumtoxin.

Onceitisinjectedintotheskin,Botoxpreventsmusclesfromcontractingandwrinkling.

Nodowntimeforrecovery;resultsareusuallyvisibleintwotofourweeksandlastforaboutfourmonthsormore.

$317

HyaluronicAcidFillerInjection

Hyaluronicacidisanaturallyoccurringsubstance.

Thefillerisinjectedtogivevolumetosaggingskinandmakeitappearplumpandfirm.

Nodowntimeforrecovery;theresultsareusuallyvisiblewithinaweekandlastfromsixmonthstoayear,dependingontheareainjected.

$591

Microdermabrasion

Aprocedurethatbuffsawayalayeroftheskin’ssurface,torevealrejuvenated,youngerskin.

Aninstrumentisusedtospraytinygrainsathighspeed,whichexfoliatetheouterlayerofskinandrevealfresh,rejuvenatedskinbelowthesurface.

Nodowntime;thelengthoftimethattheresultslastdependsontheperson’sregularskincareregimen.

$129

Sclerotherapy Injectionoffluidcontainingasaltsolutiontotreatvaricoseveinsandspiderveins.

Thesolutionisinjectedintotheveinstodamageandscartheinsidelining,causingthemtoclose.Thescarseventuallyfadeaway.

Nodowntime;iftheveinsrespondtotreatment,theywillnotreappear,butfreshveinsmayappearatthesamerateasthosethatweretreated.

$338

PhotorejuvenationorIntensePulsedLight

Lightofvaryingwavelengthsisusedtotargetspecificareasoftheskinthatneedtreatment.

Intensepulsesoflightareappliedtotheskinfromahandhelddeviceoralamp.Thistriggerstheskin’snaturaldamage-controlmechanism,causingittoshedtheoldlayerandrevealnewskin.

Thereisnodowntime,unlesstherewassomebruisingduringtreatment.Treatmentslastforaboutayear,dependingontheperson’sskincareregimenandlifestyle.Annualmaintenancetreatmentshelpprolongresults.

$341

FullFieldAblativeResurfacing(LaserSkinResurfacing)

Laserbeamsareusedtoremoveskin,layerbylayer.

Agedskinisablatedorvaporizedwithlaserbeams.Oncetheouterlayerisremoved,theheatfromthelasersstimulatescollagenproduction,causingskintolooksmootherandtighteraftertheprocedure.

Downtimedependsontheareaandintensityoftreatmentandcanlastupto10days.Thelengthoftimetheresultslastvaries.Thetreatmentwillnotstopthesignsofaging,butmayhelpthepersonappearyounger.

$2,398


NOVEMBER24,2016

Source:AmericanSocietyforAestheticPlasticSurgery/Realself.com/Agein.com/FungGlobalRetail&Technology

Type Name WhatItIs HowItWorksDowntime/HowLongResultsLast

AverageCostintheUS,2015

Face-Lift Asurgeryperformed

onthefacetoremoveexcessfat,wrinklesanddeeplinesintheskin.

Incisionsaremadearoundthetemple,behindtheearand/orunderthechin.Musclesandtissuearerepositionedandtightened,theskinispulledupwards,andtheincisionsareclosed.

Theprocedurelastsacoupleofhoursandrecoverytakesabouttwoweeks.Theresultsareknowntolastforatleastfiveyears.

$7,286

Neck-Lift Asurgerytoaddressexcesswrinklingofskinaroundtheneckandlowerjaw.

Similartoaface-lift,butincisionsaremadeatthehairlinenearthesideburnsandbehindtheear.

Procedureandrecoverytimesarethesameasforaface-lift.Resultsmaylastforaboutfiveyears,dependingontheperson’slifestyle.

$4,729


NOVEMBER24,2016

DeborahWeinswig,CPAManagingDirectorFungGlobalRetail&TechnologyNewYork:917.655.6790HongKong:852.6119.1779China:86.186.1420.3016deborahweinswig@fung1937.comJohnMercerSeniorAnalyst

SwaroopraniMuralidharResearchAssistantHONGKONG:8thFloor,LiFungTower888CheungShaWanRoad,KowloonHongKongTel:85223004406LONDON:242-246MaryleboneRoadLondon,NW16JQUnitedKingdomTel:44(0)2076168988NEWYORK:1359Broadway,9thFloorNewYork,NY10018Tel:6468397017FungGlobalRetailTech.com

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