In 2011, Alzheimer’s disease (AD) affected more than 7
million people in the seven major pharmaceutical markets under study, and this
patient population is poised to expand rapidly. No available therapies can
prevent, stop, or even modify the progression of AD; they can only address the
symptoms of the disease over the short term. The growing patient population,
coupled with the high unmet need for treatments that have a long-term effect on
the underlying cause of the disease, represents large untapped commercial
opportunity. Although several therapies are in late-stage trials for mild to
moderate AD, they have yet to meet the efficacy and/or safety requirements that
surveyed neurologists expect of a therapy that they would consider a major
improvement over currently available agents. Thus, considerable opportunity
exists for therapies that can modify the underlying course of AD and/or are
more effective than current symptomatic therapies while offering a safety and
tolerability profile on par with that of current agents.
Attributes included in our conjoint analysis-based assessment of target product profiles for mild to moderate AD:
- Effect on cognition.
- Effect on functional decline.
- Effect on brain beta-amyloid (Aβ) load.
- Effect on cerebrospinal fluid (CSF) biomarkers.
- Rate of gastrointestinal (GI) side effects.
- Delivery burden.
Attributes included in assessment of U.S. payers’ receptivity to new therapies for mild to moderate AD:
- Effect on cognitive decline—symptomatic therapies.
- Effect on cognitive decline—disease-modifying therapies.
- Rate of serious adverse events.
- Delivery burden.
Physicians surveyed: 60 U.S. and 36 European neurologists.
Payers surveyed: 20 U.S. MCO PDs.
Comprehensive List of Therapies Included in Our Research and Modeling:
- Donepezil (Eisai/Pfizer’s Aricept, other brands, generics)
- Galantamine extended-release (ER; Shire Pharmaceuticals/Janssen/Takeda’s Reminyl/Reminyl LP/Razadyne/Razadyne ER, generics)
- Rivastigmine patch (Novartis’s Exelon Patch, Ono Pharmaceutical/Novartis Pharma KK’s Rivastach Patch)
- Memantine (Merz Pharmaceuticals/Grünenthal’s Axura; Lundbeck’s Ebixa, generics; Forest Laboratories’ Namenda/Namenda XR; Daiichi Sankyo’s Memary)
- Solanezumab (Eli Lilly)
- IVIG (Baxter’s Gammagard/Kiovig)
- MK-8931 (Merck)
- EVP-6124 (EnVivo Pharmaceuticals/Mitsubishi Tanabe Pharma)
- Lu-AE58054 (Lundbeck)