In the beginning of this year, Pfizer, the third largest pharmaceutical company in the world, announced that it would end its neuroscience discovery programme, effectively ending all research into finding new treatments for dementia. This has come as a shock to many, as dementia is quickly turning into a global health issue, and finding preventative and curative treatments is crucial. Pharmaceutical companies such as Pfizer have immense financial resources, and their input and insights into disease are key in finding these treatments.
Luckily, there are many companies who have pledged to continue their research into dementia and other neurodegenerative conditions, and there are currently 100 ongoing clinical trials. The G7 nations have committed to finding a disease-modifying treatment by 2025, and Alzheimer’s society has committed 50 million pounds to fund new research at the UK Dementia Research institute (UK DRI) alongside Alzheimer’s research UK and the medical research council. We can continue to hope.
From a economic point of view, Pfizer’s decision makes sense (for Pfizer). There has been no new drug for dementia in the last 15 years. 99% of drug trials on Alzheimer’s disease have been unsuccessful. 15 years of failed trial means a lot of money has been invested, but no money has been made. The below diagram outlines how lengthy and how expensive drug discovery is, starting from when a potential drug is identified to when it actually comes to the market:
Only about 1 in 50-100 discovery projects ends up putting a drug on the market, taking 12 years on average. In practice, only one drug in three that goes on the market brings enough revenue to cover its developmental costs. So if we look at these numbers, then we can perhaps understand why Pfizer chose to end its research on neurological conditions.
However, although Pfizer’s decision may have made sense for them from an economic perspective, it does not make sense for us as a society. Giving up is not something that we can afford to do. The economic burden of dementia is enormous. Currently, it is costing the UK 26 billion pounds, and the US 200 billion dollars each year. Globally the costs of dementia are a mind-numbing 818 billion dollars, as estimated by the Alzheimer’s society. And all these numbers are expected to rise significantly in the next 20 years. What these numbers cannot show is how devastating dementia is to those affected by it. To have to suffer the gradual loss of everything that defines us as humans or watch someone you love go through this process is unimaginable to anyone who has not experienced it.
So, we should perhaps see Pfizer’s decision to withdraw from neuroscientific research as a wake-up call. The brain has proven to be the body’s most complex organ, and we have not come close to truly unraveling its workings. The problem we are facing is that we do not fully understand how memory and thinking work in a healthy brain, which makes it difficult to find out what goes wrong in people with dementia. Maybe there is need for us to step away from expensive Phase III clinical trials, and focus more on our basic understanding of the brain. We need to understand the genetic, and environmental factors that affect disease trajectory, so that we can use precision medicine to bring the right treatment to the right person at the right time. Let us focus on the fact that one third of dementia may be preventable, and educate people on risk factors that can reduce their chances of getting dementia. And as we continue to deepen our understanding of the diseases that cause dementia, we will come closer to a treatment that can truly make a difference.