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Investment Opportunities

Longevity and Anti-Aging Investment Opportunities

Healthspan, Life Extension and Longevity Company Investment Opportunities 

October 2020

 

Question: “What’s the easiest way to make a small fortune?” 

Answer: “Start with a large one!”                                                                              

 

[Necessary disclaimer]:  Keep Health is not an investment advisor and the content of this website is not to be used for making or refraining from investment decisions. The information provided is for general information purposes only. It may not be suitable for your situation. Although Keep Health has made every effort to ensure accuracy of the information, Keep Health makes no representation about accuracy and completeness. Keep Health does not assume and hereby disclaims any liability to any party for any loss or commercial damages, including, but not limited to special, incidental, consequential, or other damages or disruption caused by errors or omissions which result from accident, negligence or any other cause. [End disclaimer]

 

How much does wealth matter for increasing healthspan? 

How much does wealth matter to enjoy living those extra healthy years? 

Does it make sense to invest in anti-aging, healthspan, life extension and longevity companies?

 

Keep Health does not recommend investing in this sector unless you are an expert or getting trusted expert advice. There has been a tremendous amount of money made and lost investing in life sciences and healthcare companies. We do not want you to be on the “lost” side, especially because of anything you read here. There are plenty of people who claim to be experts in healthspan investing and want you to pay them for their expertise. There are few with verifiable track records of success.

 

Below, we provide a list of some interesting emerging companies in the healthspan space. We attempt to highlight their strengths and weaknesses. They may or may not be successful and even if they are successful it is important to understand their fundamentals to determine whether they are valued appropriately. Emerging healthcare startups are speculative investments and are more likely to be overvalued than undervalued. It is risky to try to take advantage of over-valuations with short selling or buying put options because emerging companies may be bought by large companies for premium valuations.

 

Warren Buffett once said that as an investor, it is wise to be “Fearful when others are greedy and greedy when others are fearful.”  Market timing for investments is important and following sources like CNN’s Fear and Greed Index and Investor’s Business Daily’s Market Trends can provide a sense for when the market is overbought or oversold.  Market conditions and company valuations as of October 2020 are historically very high. For those wondering whether the stock market typically goes down post-Presidential elections, there is no clear trend in either direction. However, post-election year stock markets generally do not fare as well as election year stock markets.

Keep Health’s investment opportunities cover notable healthspan, life extension and longevity-focused Exchange-Traded Funds (ETFs), venture capital funds and a few individual public companies. Here they are:

Healthspan, Life Extension and Longevity ETF Investing Opportunities

There are three interesting ETFs focused on profiting from increasing number of elderly people in the world. To get a sense for the size of the rapidly growing market these companies are pursuing, see the 2019 Organization for Economic Cooperation and Development report:  Fiscal Challenges and Inclusive Growth in Ageing Societies

  1. The Long-Term Care ETF (OLD) — Pessimistic View of Aging
    • Tracks a market-cap-weighted index of global companies focused on long-term care services and products required by an aging population.
    • OLD is 90+% invested in specialized Real Estate Investment Trusts (REITs) and healthcare facilities of which 75% are in the United States.
    • OLD has a reasonable expense ratio of 0.35% and a three year average return of ~8%, through 2019 results.
    • In 2020, OLD is down because of the negative impact of COVID-19 on long-term care services and the elderly population. As COVID-19 treatments and vaccines continue to show more promise, it has been gradually recovering since March, 2020.
  2. Global X Longevity Thematic ETF (LNGR) — Optimistic View of Aging
    • Tracks an index of mostly large-cap equities from companies involved in lifespan extension and improved quality of life efforts for senior citizens.
    • Includes companies from developed countries who derive the majority of their revenue or whose stated business objective falls under the “longevity” label. 29% of companies are outside the United States.
    • LNGR has an expense ratio of 0.50% and a three year average return of ~9% through 2019 results.
    • In 2020, LNGR dropped sharply because of the negative impact of COVID-19, but recovered quickly and is up ~12%.
  3. Goldman Sachs Motif Human Evolution ETF (GDNA)
    • Tracks a market-cap weighted index of global equities related to the development of medical treatments for overall human health.
    • Centered around companies with exposure to “the development of new knowledge, medicines, and technologies for the medical treatment of the human condition, from birth to end-of-life care”. The fund’s index is constructed from five sub-themes: Precision Medicine, Genomics, Life Extension, Robotic Surgery, and Digital Health. To select its constituent securities, the index provider uses automated semantic search algorithms to go through many datasets and documents to generate company correlations to key terms related to GDNA’s theme.
    • GDNA launched in March 2019. As of October, 2020, it has generated about a 30% return, significantly beating its benchmark of the Thomson Reuters Global Healthcare index.

Venture Capital Firms Focused on Healthspan, Life Extension and Longevity Investment Opportunities

  • Deep Knowledge Ventures (DKV) including subsidiaries Longevity.Capital and Longevity FinTech 
    • Founded in 2014 as a data-driven investment fund focused on the synergetic convergence of DeepTech, frontier technologies and renowned for the use of sophisticated analytical systems for investment target identification and due-diligence.
    • Major investment sectors include AI, Precision Medicine, Longevity, Blockchain and InvestTech. Major short-term interests include AI and DeepTech, with a long term strategic focus on Longevity and Precision Health.
    • One of their board members is a computer algorithm called VITAL which they use to analyze huge amounts of data
    • DKLS investments include:
  • Juvenescence Ltd (UK)
    • Co-founded by British billionaire Jim Mellon.
    • Led by Dr. Greg Bailey. See his April, 2020 interview with Longevity.Tech. Sees opportunity within growth of longevity market to $600B by 2025.
    • Seeking to raise $150MM C-Round in Q4, 2020, then progress to an IPO in 1H 2021. Have previously raised $165MM.
    • Partnered with Buck Institute and Insilico AI to advance the understanding of a new molecular pathway potentially implicated in aging and age-related diseases and to discover and develop molecules to target this pathway.
    • Investments include:
      • AgeX Therapeutics (NASDAQ: AGE). 53.7% ownership. Details on AgeX below in publicly traded company section of this article.
      • BYOMass to develop therapeutics to modulate the central control of metabolism associated with aging and age-related chronic illnesses
      • BHB Therapeutics focuses on approaches to induce a state of ketosis, which may have protective effects against age-related disease. Have formulated an inexpensive direct-to-consumer ketone ester beverage product that is geroprotective, neuroprotective and cardioprotective, providing 8+ years of healthspan benefit. Mammals such as mice live 25% longer.
      • Fox Bio a 50/50 joint venture between Juvenescence and Antoxerene, a subsidiary of growing discovery/pre-clinical CRO Ichor Therapeutics. The company is focused on developing small molecule senolytics targeting a major survival pathway relied on by senescent cells.
      • Generait Pharmaceuticals (formerly Juvenescence AI), a 2017 joint venture with Insilico.  Generait Pharmaceuticals gets first dibs on any five compounds per year that Insilico’s AI drug discovery platform develops. Juvenescence AI was formed to investigate the therapeutic properties of specific compounds. Mellon is particularly optimistic that this venture can develop a “senolytic” drug that helps the body clear out cells that have stopped dividing and can damage other cells.
      • Insilico Medicine artificial intelligence for drug discovery, biomarker development and aging research.
      • Juvenomics — a joint venture with G3 Therapeutics for developing validated nutraceuticals and pharmaceuticals to combat aging and aging-related diseases such as those of the musculoskeletal system. Juvenomics is built on the unique combination of G3 Therapeutics ‘ proprietary, multi-omic biological dataset, consisting of trillions of proprietary data points collected in the GLOBAL Clinical Study (NCT01738838) of over 7,500 patients, and the unique machine learning platforms assembled by Juvenescence.
      • LyGenesis focused on organ regeneration. Lead program is for liver regeneration. In 2H, 2020, plans to begin a Phase 2a clinical trial for patients with end stage liver disease, which will inject hepatocytes (liver cells) into the patient’s lymph nodes that drain into the liver and the bile duct. Also, attempting to undertake thymus replacement using the lymph nodes by 2023-25.
      • Napa Therapeutics  —  Founded by The Buck Institute, Insilico Medicine, and Juvenescence to develop drugs to impede age-related disease. Focused on NAD-type solutions.
      • NetraPharma is a 50/50 partnership between Juvenescence and NetraMark Corp, and is a clinical-development focused machine learning company. NetraPharma plans to help companies with failed clinical trials identify overlooked subpopulations of responding patients.
      • Souvien Therapeutics is founded on the pioneering research of Professor Li-Huei Tsai, the director of The Picower Institute for Learning and Memory at MIT, and Associate Professor Stephen Haggarty, the director of the Chemical Neurobiology Laboratory at Harvard Medical School/Massachusetts General Hospital, on the epigenetic regulation of cellular aging in neurodegeneration.
    • JuvYou Division is launching web and app-based personalized healthcare recommendations in Q4 2020 / 1 H 2021 based on inputs such as blood sugar and VO2 Max.
    • Juvenescence Life Division is launching products based on licensing and technology from investment companies and internal research. These include:
      • Metabolic Switch, the brand name of a new powdered beverage drink which is combining licensing and technology from:
        • BHB Therapeutics
        • Evgen‘s cruciferous vegetable extract Sulforaphane which removes toxic metabolites and markers of inflammation.
      • A product to increase autophagy. It expects to improve cognition, boost immunity and help bones, cardiac health, skin and hair.
    • Juvenescence RX Division is entering two to four drugs into human clinical trials clinic in 2021 for obesity, cachexia, immunometabolism and fibrosis, as well as combinations of those products.
  • Longevity Vision Fund
    • Founded by Sergey Young.
    • Raised $100MM and is dedicated to making longevity affordable and accessible to all.
    • Invested in Juvenescence in Oct, 2019 as well as Insilico Medicine and Lygenesis.
    • Invested in Life Biosciences, focused on becoming the leader in epigenetic reprogramming, chaperone-mediated autophagy and mitochondrial uncoupling.
  • Longevity Investor Network
  • Longevity VC (USA)

Small-Cap Publicly Traded Companies Focused on Healthspan, Life Extension and Longevity Opportunities

Although there are many large publicly traded companies focused on healthspan, life extension, longevity and anti-aging, Keep Health is only covering a few notable high risk, high reward small-cap companies at this time.

  • AgeX Therapeutics (NASDAQ: AGE)
    • Key points from 2019 Year End Letter to Shareholders
      • Focusing on two platforms:
        • Immunotolerance UniverCyte™ platform for the generation of universal cells
        • Pluripotent stem cell-based PureStem® platform for the derivation and manufacturing of allogeneic, off-the-shelf cells
      • Partial cellular reprogramming to reverse the age of cells is set to open up a whole new field of pioneering therapeutics. We aspire to lead in this revolution using our partial cellular reprogramming technology “iTR™”.
      • Acquisition of ‘universal’ cell generation patents was timely and strategic. There is growing interest by large biotechnology and pharmaceutical companies.
      • Plan to execute on external licensing and collaboration cell therapy deals with third parties.
    • Leader in high purity induced pluripotent stem cells (IPS)  to restore organ function or grow replacement organs.
      • IPS can be re-differentiated into human tissue types. Non-pure IPS have minority of cells in undifferentiated stage or differentiated in the wrong direction. 
      • Can repair organs by eliminating cells in a damaged state and then restore using AgeX IPS in-situ (in the body).
      • 400+ patents and patent applications worldwide for pluripotency therapeutics.
    • Market valuation: ~68MM. Has fluctuated between ~25MM to ~$200MM within the last 52 weeks. Extensive patent portfolio is key to its valuation.
    • IPO’d in November 2018. Stock peaked at $5.95/share before falling to $0.67. Juvenescence has 53.7% ownership, acquired at ~$2/share and in return for investments to cover cash burn rate.
    • ~-5MM in tangible assets minus current liabilities. ~3MM quarterly burn rate. Insignificant current revenue streams.
    • Need to raise substantial cash soon and create high value partnerships for non-core applications of pluripotency such as Cytiva II adult cardiac cells for drug testing.
    • In January, 2020 signed deal with UC-Irvine to develop cellular therapies to treat neurological disorders and diseases for which there are no cures such as Huntington’s disease. Targeting a launch of clinical trial in 2H, 2021. As of April, 2020, Dr. Bailey was hopeful that they would land more licenses near-term. Recently, Jim Mellon noted they have completed 7 cell licensing agreements so far this year.
    • Near-term commercialization activities are focused on bailment of UniverCyte master cell banks.
    • Long-term, have four therapies in preclinical trials. However, work on most of these has been deferred because of Q2, 2020 layoffs. This may lead to outsourcing and potential development of AgeX’s iTR technology at AgeX’s subsidiary Reverse Bioengineering, Inc. subject to successful financing of the subsidiary.
      • AGEX-BAT1 to correct metabolic imbalances in aging including to reverse age-related changes in metabolism, especially those who suffer from obesity and Type 2 diabetes.
      • AGEX-VASC1 to restore vascular support in ischemic tissues respectively. Initial focus is on the development of young vascular cells to rebuild circulation in the context of age-related ischemic disease. Vascular progenitor therapy would deliver a youthful endothelium to rejuvenate and protect the cardiovascular system.
      • AGEX-iTR1547 is a drug-based formulation in preclinical development through Reverse Bioengineering subsidiary intended to restore regenerative potential in a wide array of aged tissues afflicted with degenerative disease using the company’s proprietary Induced Tissue Regeneration ( iTR) technology. Some animals in nature can regenerate damaged tissues after trauma; for instance an amputated leg of a Mexican salamander completely regenerates. 
      • Renelon™ is a first-generation iTR product designed to promote scarless tissue repair which the Company plans to initially develop as a topically-administered device for commercial development through a 510(k) application.
  • Amarin (NASDAQ:AMRN)
    • Provide Vascepa (icosapent ethyl), the active ingredient in fish oil. They have no other products.
    • Clinically proven to reduce triglycerides and cardiovascular risks such as heart attacks and strokes.
    • Amarin’s Reduce-IT trial showed it substantially cut major adverse CV events by 25% over about 4.9 years in statin takers with blood fat levels of 150 mg/dL or higher.
    • Market Cap of $2B down from $7.5B as of Jan 1, 2020.
    • $500MM+ in tangible assets – liabilities.
    • 2019 revenue of ~$430MM.
    • 1H 2020: $290MM in revenue despite COVID-19. $16MM loss. Approaching profitability.
    • Believe they have regulatory exclusivity in major global markets through 2028-2033.
      • However, in March, 2020, lost patent protection in the United States where analysts expected a $3-4B market opportunity. Their appeal of the decision failed in September 2020. They will face competition from generics, although because of manufacturing complexity, it will take a major investment to compete. Will that happen? Teva, Hikma Pharmaceuticals and Dr. Reddy’s are among potential market entrants.
      • Expecting EU approval by 1H, 2021 and plan to launch for what analysts estimate is a $650MM annual revenue market opportunity.
      • Planning launches into Asia, Canada and the Middle East as well.
    • Alternative proprietary competitive solutions such as Epanova have been discontinued.
    • Vascepa contains only purified EPA, whereas Epanova included both EPA and DHA. As FiercePharma writes, “Evidence suggests that DHA may raise the level of bad LDL cholesterol, which is itself a risk factor for heart disease and stroke. So, it’s possible that DHA’s presence has compromised Epanova’s CV disease reduction ability.” This impurity is rather ironic given EPAnova’s name.
  • Chromadex (NASDAQ: CDXC)
    • Leader in product sales and IP for anti-aging dietary supplement  Nicotinamide Riboside (NR).
    • NR is proven to promote proper mitochondrial function and thus enhance the immune system. Evidence on NRs’ health benefits has validated safety and efficiency across animal and human studies for treatment of cardiovascular, neurodegenerative, and metabolic disorders.
    • Market cap of ~$300MM.
    • As of Q2, 2020, $60MM runrate from Tru-Niagen brand NR sales. > 100% YoY sales growth. Tru-Niagen is available directly from Chromadex and on Amazon.
    • ~28MM annual loss in 2019. Need to get to ~80MM in annual sales for break-even. On pace for that in 
    • Less than $20MM liquid assets less total liabilities.
    • Although raised another $7MM from international investors in Q4, 2019, may need to raise cash again before they achieve profitability.
    • Won lawsuit against competitor Elysium Health. October 2019 legal discovery found egregious behavior by Elysium related to the theft of trade secrets and confidential information including text messages revealing unethical conduct and a stated intention to “destroy” ChromaDex.  Another good article on the history of the lawsuits is here.
    • 31 registered clinical studies in progress on NR focused on various health benefits.
    • Partnerships with Nestlé and Watsons, the largest healthcare chain store in Asia. Nestlé revenue will come onboard in 2H 2020. Pursuing markets in Hong Kong, Macau, China and Turkey. Recently approved in the European Union (EU), Australia, Canada and New Zealand. In the EU, received market exclusivity through February, 2025.
    • Competition comes from many new market entrants including Juvenescence’s Napa Therapeutics and David Sinclair’s MetroBiotech.
    • Emerging biosimilar supplements such as Nicotinamide Mononucleotide (NMN) have not proven effective.
  • CohBar (NASDAQ: CWBR)
    • Founded in 2007, CohBar discovered hundreds of genes in the mitochondrial genome that encode peptides (small proteins), and identified the first mitochondrial derived peptide (MDP) associated with age related diseases in human centenarians and their offspring. Studies in animal models demonstrated metabolic regulation and protection, cytoprotection and anti-inflammatory affects across multiple age-related diseases.
    • Peptides encoded in the mitochondrial genome are messengers regulating multiple organs and systems in the body. CohBar discovered 100 peptides and >1,000 analogs. 12 issued patents, 65+ CohBar patent filings.
    • CohBar’s peptide therapeutics target chronic and age-related diseases with underlying mitochondrial dysfunction, such as NASH, obesity, cancer, fibrotic diseases, acute respiratory distress syndrome (ARDS), type 2 diabetes, and cardiovascular and neurodegenerative diseases. US healthcare spending for these diseases tops $500 billion annually.
    • Market Cap: $57MM
    • $26MM in cash after August 2020 $15MM dilutive fund raise. Quarterly burn rate of $2.5MM.
    • Lead compound, CB4211, is in Phase 1b clinical trial of 20 people for an advanced form of Non-Alcoholic Fatty Liver Disease and impact on weight loss. Data expected in Q1, 2021.
    • Four other preclinical targets with results from three in Q4, 2020. CohBar plans to advance one to clinical trials. This will require more funding.
    • For more, see the Q2, 2020 corporate presentation.
  • Unity Biotechnology (NASDAQ: UBX)
    • Initial leader in senolytics, the selective removal of senescent (old, poorly functioning) cells from the body to halt, slow or reverse age-associated disease and restore tissue to a more functionally healthy state.
    • Senescent cells secrete large quantities of harmful proteins, which cause inflammation, tissue degradation and the production of unwanted growth factors.
    • Unity’s injectable therapies disrupt proteins that senescent cells need for survival.
    • Pipeline of targeted therapies:
      • Osteoarthritis in the knee
        • Phase 1 complete.  Achieved some reduction in pain and improved functionality.
        • Failed Phase 2 in August 2020. Discontinued.
      • Age-related eye disease targets include macular degeneration, diabetic macular edema and proliferative diabetic retinopathy (Preclinical). There are many more-advanced competitors in this space.
      • Liver, kidney and neurodegenerative diseases (Preclinical). They seek to remove abnormal Tau from the brain to slow or prevent Alzheimer’s. There are many more-advanced competitors in this space.
    • Market valuation is ~210MM down from !340MM at the beginning of 2020.
    • Tangible assets – liabilities of ~112MM as of June 30, 2020.
    • Quarterly burn rate of $24MM, mostly from research and development. This will be reduced with the discontinuation of Osteoarthritis. Forecasting sufficient cash to fund operations through mid-2022. Will need to raise additional capital to bring therapies through clinical trials and potential FDA approval.
    • Co-founded by Judy Campisi, a member of the faculty at the Buck Institute for Aging Research, Jan van Deursen of the Mayo Clinic College of Medicine and Dr. Daohong Zhou. In 2008, Campisi showed that senescent cells produce damaging proteins, the same year that van Deursen showed that mice engineered to produce large amounts of senescent cells aged rapidly. In 2015,  Zhou showed at the University of Arkansas for Medical Sciences that a single drug-like molecule could eliminate senescent cells.
    • Investments from Jeff Bezos and Amazon provided beneficial early publicity.
    • For more, see webcast and company presentation as of September 2020.

 

Thanks for reading this article. As your reward for continuing to focus on your health and wealth, treat yourself to 50 billion-dollar bills.

 

[Disclosure]: Keep Health wrote this article and it expresses our own opinions. We are not receiving compensation for it. We have no business relationship with any company whose stock is mentioned in this article. We have no positions in the ETFs or venture capital funds mentioned. We may at times take either long or short positions in the individual public stocks mentioned.

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