There may be a long way to go before a new treatment for Alzheimer’s comes on the market.
Just three months after drug company Eli Lilly ended the clinical trial of its Alzheimer’s drug solanezumab, Merck has stopped the trial of its Alzheimer’s drug verubecestat because an independent study found the drug had no chance of working.
It’s been a decade since a new drug was placed on pharmacy shelves to help treat the symptoms of Alzheimer’s disease, and there were high hopes for both the Eli Lilly and Merck drugs.
“The more recent failures have certainly been disappointing, both from the patient advocacy point of view, but also from the perspective of the entire research field,” Bruce Lamb, PhD, Roberts Family Chair in Alzheimer’s Disease Research, and executive director of the Stark Neuroscience Research Institute at Indiana University, told Healthline.
“However, on the flip side, we now understand a great deal more about the disease processes than we did just a few years ago, and there is general consensus that we must redouble our efforts and work to speed these efforts as much as is possible,” he said.
A growing, expensive problem
More than 5 million people in the United States live with Alzheimer’s, a type of dementia that causes problems with memory, thinking, and behavior.
Alzheimer’s is the most common form of dementia, accounting for 60 to 80 percent of cases.
Of the 5.4 million Americans with Alzheimer’s it is estimated 5.2 million are 65 years of age or older.
Every 66 seconds, someone in the United States develops Alzheimer’s, and this number is expected to increase significantly in the coming decades.
“We know the numbers are going to triple by the middle of the century if we don’t find a way to stop, slow, or cure the disease,” James Hendrix, PhD, director of Global Science Initiatives at the Alzheimer’s Association, told Healthline.
Research from the Alzheimer’s Association shows that by 2050, the number of people 65 years of age or older with Alzheimer’s disease is projected to hit almost 14 million.
Unless a medical breakthrough is discovered that can prevent or cure the disease, this will have a devastating effect on those living with the disease and the people who care for them. And it will likely have significant economic ramifications.
In 2016, care for those with Alzheimer’s and other dementias cost the United States $236 billion.
“If we don’t find a way to stop or slow the disease by the middle of the century, one third of the Medicare budget as it currently exists would go to one disease. … Alzheimer’s disease,” Hendrix said.
And with 47 million people worldwide affected by dementia, the economic impact will be felt on a global scale.
“This disease has the potential to actually bankrupt whole health systems in some countries. It’s not just an issue of compassion for families and people who are dealing with Alzheimer’s and dementia, it’s also an urgent issue in terms of economics. … This is a very expensive disease,” he said.
The Alzheimer’s Association calculates that a successful treatment introduced in 2025 that could delay the onset of Alzheimer’s by just five years could reduce the number of people with the disease by 5.7 million by the middle of the century. This would save more than $220 billion within the first five years.
Tackling the unknown
The potential market for a new Alzheimer’s therapy would be considerable.
However, some experts worry that pharmaceutical companies will stop pursuing trials for Alzheimer’s drugs if their efforts continue to fail.
“There is certainly a risk that some of the other big players in development of Alzheimer’s therapies may not continue to develop their drug pipelines if the risk is too high,” Lamb said.
“On the flip side, there is an extremely large market for Alzheimer’s therapies, so even a relatively modest success would be transformative and potentially quite lucrative,” he said.
Despite decades of research, experts say there is still so much that is unknown about Alzheimer’s that producing effective therapies remains challenging.
“Our understanding of this very complex disease is still rudimentary at best,” Lamb said. “We still understand very little about all of the changes occurring within the brain over the 20 to 30 years’ disease course. This makes it very difficult to both identify potential targets and also know when to target these therapies over the disease course.”
Hendrix says although the recent failures in clinical trials are disappointing, there are still other options to pursue.
“With every trial we learn something. … And there’s a vast amount of information and data that comes out. We need a better understanding of the disease and that will lead to better care,” he said.
Lamb argues that more funding for Alzheimer’s research is crucial given the prevalence of Alzheimer’s disease.
“Funding for Alzheimer’s research by the federal government is not appropriately scaled given the problem,” Lamb said.
He says it is estimated the federal government spends more than $200 billion a year on care for Alzheimer’s patients yet only spends $950 million on Alzheimer’s research.
“The numbers don’t lie. We need better therapies for the millions who are dealing with the disease and the millions more who will get the disease in the coming decades,” Hendrix said.