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Parallel Discovery of Alzheimer’s Therapeutics

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Science Translational Medicine  18 Jun 2014:
Vol. 6, Issue 241, pp. 241cm5
DOI: 10.1126/scitranslmed.3008228

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  • Why the government risking $1 upfront to save $39 won’t solve Alzheimer’s
    • Yuri Khodjamirian, Student - Mphil in Bioscience Enterprise, University of Cambridge

    Alzheimer’s dementia (AD) is an epidemic. 50m people live with AD globally [1]. $290bn is spent in the US on Alzheimer’s care [2], a number that could reach, in real terms, $1.35trn by 2050 [3]. Developing a disease modifying treatment has had a 100% failure rate.

    There is a desperate need for solutions, and not just scientific ones. One innovative idea proposed by Lo et al (2014) [4] (henceforth LO) is the formation of a “mega fund” to develop drugs “simultaneously”.

    In this letter I will argue there are several important shortcomings with this approach. First, I will briefly outline the arguments of the original paper and summarise my critiques. Second, I will dig deeper into each critique. Finally, I will tie this all together and conclude.
    LO key points are summarised as follows:
    (1) “Although a greater upfront investment is required, the probability of at least one success should be higher with “multiple shots on goal”, increasing the efficiency of this undertaking.” [4]
    (2) Simultaneous development will decrease timelines.
    (3) The mega fund can tap debt markets which are deeper.
    (4) Using estimates of profitability, probabilities of success and co-variance, they calculate the returns of a 64 project AD portfolio (costing $38.4bn) and find it insufficient for viability in the private sector.
    (5) Replacing the “prize” with savings by Medicare and Medicaid they find attractive returns suggesting a government-based solu...

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    Competing Interests: None declared.

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