There is no magic bullet for Alzheimer’s disease and finding a cure will require substantial investments in science. The question is, what kind of science? I believe the investment should be in drug discovery and development.
There has already been enormous progress in the field. When I started the first Alzheimer’s clinic at The Rockefeller University 35 years ago, researchers would not have believed that diagnosing Alzheimer’s in a living brain was possible without an invasive biopsy. But in 2012, the FDA approved Amyvid™, the first diagnostic test for Alzheimer's disease. The Alzheimer’s Drug Discovery Foundation (ADDF) provided the seed funding for this test, which is now playing a critical role in improving clinical trials for Alzheimer’s.
Philanthropies like the ADDF are well-positioned to address current gaps in research funding. Our role is to take risks and fund diverse, novel approaches in the early stages, so there are more potential drugs available for testing in human clinical trials. Since 1998, the ADDF has funded 500 such early-stage research projects in 18 countries. And every idea is another chance at a cure.
Drug discovery and development is risky and expensive. It takes more than 12 years and $1.2 billion to create a single drug and funding gaps exist at every stage, from basic research through preclinical drug discovery and human clinical trials. A single phase 3 clinical trial in Alzheimer’s disease costs $300–400 million. Today, there are more than 100 ongoing clinical trials testing numerous drugs in patients with Alzheimer’s disease, and most of the funding for these has come from the pharmaceutical industry. This is a dramatic advance, but we aren’t there yet.
In 1976, when my mentor Robert Butler was appointed as the first director of the National Institute on Aging, the National Institutes of Health devoted billions of dollars toward cancer and heart disease research, but only $625,000 for Alzheimer’s disease. Today, the government spends nearly $600 million on drug research for Alzheimer’s disease. And yet, Alzheimer’s funding still lags far behind other major diseases. More has to be done.
Finding a cure requires substantial investment of time and money in drug research at every stage, and we all have an important role to play. The public can donate to philanthropies that support critical early-stage clinical research and preclinical drug development. The pharmaceutical industry can continue its investment in human clinical trials. And the government can allocate more of its resources to Alzheimer’s research. We all share a common vision of a healthy old age, and we must marshal all our resources to achieve it. And I am certain that one day soon, we will have drugs that are safe and effective to prevent, treat, and cure Alzheimer’s disease.
Howard Fillit, MD is the Founding Executive Director and Chief Science Officer at the ADDF