Decades of scientific investment have paid off just in the last month, with researchers announcing promising breakthroughs against cancers and other deadly afflictions.

Why it matters: They're all the product of a rigorous innovation system that delivers — though some have one important limitation: All they can do is buy someone a few more years.

The big picture: We're still in the era of medicine where most miraculous new drugs don't cure the disease as much as allow sick people to live longer.

• In economic terms, that ongoing medical care is expensive, and long-term diseases usually limit the number of years people are productive while increasing their lifetime medical costs.

Driving the news: Recent weeks have featured a series of positive developments.

• The biggest surround Revolution Medicines' experimental pancreatic cancer treatment, which late-stage clinical trial results found doubled patients' life expectancy compared with standard chemotherapy.
• Though that translates to a median overall survival of 13.2 months compared with 6.7 months, pancreatic cancer has infamously eluded researchers' attempts to target it. And the mutation the drug targets is found in other cancers.
• Also, Eli Lilly's latest experimental anti-obesity drug appears to reduce body weight at levels approaching bariatric surgery in clinical trials.

Between the lines: Most of the recent progress is the culmination of decades of work and investment.

• "What we're seeing today is really 50 years of putting the pieces together," said Zeke Emanuel, an oncologist and a professor at the University of Pennsylvania's Department of Medical Ethics and Health Policy. "It is this accumulation story instead of this eureka story."
• "This is not because we're smarter now. It's because we were smarter back then and made a very significant investment in this country in biopharmaceutical research," former FDA commissioner David Kessler told me.
• The excitement over these new therapies stands in contrast to researchers' and the drug industry's fears about the state of U.S. science funding and the competence of the FDA under the Trump administration.

Yes, but: The most cutting-edge curative drugs brought to market in recent years — particularly gene therapies — have price tags in the millions, and some haven't had an easy path to commercialization.

• And the new wave of anti-obesity drugs, which have the potential to stave off cardiovascular disease in the long term, are expensive and must be taken indefinitely to retain their benefits.
• It all means the most affordable option is prevention of disease — a goal the health care system has had for years, but America is still very bad at.

What we're watching: New advances are also fueling hopes for a transformational era of medicine, where diseases are detected earlier and cured altogether.

• Another experimental drug acquired by Eli Lilly earlier this year that targets multiple myeloma by editing cells inside the body showed a 100% response rate in early-phase clinical trial results.
• A small, early-stage study found that an experimental gene-editing therapy could potentially permanently lower cholesterol levels after just one infusion, opening the door to a one-and-done heart disease prevention.
• And late-phase trial results for a hepatitis B treatment found it was "a functional cure" for 20% of patients who received it.

The bottom line: Modern medicine has transformed once-deadly conditions into chronic ones, and further progress would be even more meaningful to the patients who suffer from them and their loved ones.

• But the next frontier of medicine is to cure more diseases — or prevent them altogether.
• "What does it say about the kinds of processes we have to pursue?" Emanuel asked. "One is, you've got to have a long-term perspective on investing in science. Number two is, you want a longer health span? You've got to invest in prevention, and we don't do that at all."

Helping sick patients live longer doesn't have to be prohibitively expensive, Kessler told me.

Between the lines: It's well-known that the U.S. is bad at prevention, which contributes to the country's relatively low lifespan compared with peer nations. It's also well-known that a lot of prevention comes down to access to primary care and individual lifestyles.

• But Kessler made the case that we now have both the scientific knowledge and the drugs needed to treat our way toward less later-stage disease.
• In other words, there's a huge role for medications that we already have, some of which are really cheap.

What they're saying: If we can "get our act together" and return people to good cardiometabolic health, "we can return five, six years of healthy lifespan to people," Kessler told me, arguing that poor cardiometabolic health is the root of many of the diseases that ultimately kill people.

• "Heart failure, cirrhosis, kidney failure — we have a health system that deals with this end organ stuff. This is all a result of these earlier conditions, this continuum," he added.

Specifically, he calls for controlling three measures: visceral fat, blood lipids and hypertension.

• That can be done through the use of cheap generic drugs and GLP-1s — which are currently expensive but at some point will go generic in the U.S.
• "We finally have tools that can drive these cardiovascular endpoints to dramatically change people's lives, and we just have to make it available," he said. "The drugs get us part of the way ... but now we need a health care system that drives this."

The intrigue: Kessler said he's discussed the need to better incentivize doctors to manage cardiometabolic health with senior Trump administration officials.

My thought bubble: Prevention via lifestyle adaptations is the cheapest option when it comes to helping people live healthier, longer lives, but early-stage intervention with cheap drugs is second-best.