Dementia is too big a problem to walk away from – for Pfizer or any of us

Comment published 11 January 2018, The Guardian

Author: Professor Bart De Strooper, UK DRI Director

If you were to go out on the street today and run a straw poll on big pharma, I doubt that it would come back very positive. More often than not, these companies are seen by the public as corporate behemoths committed only to the bottom line, and not particularly patient-focused. This week’s news that Pfizer is pulling out of neuroscience research will likely bolster that impression. It’s a tragedy for the millions suffering from Alzheimer’s and Parkinson’s and the many more who are at risk of developing one of these devastating diseases.

But it doesn’t have to be this way. Pharmaceutical companies are absolutely crucial in our war against Alzheimer’s and other dementias, and their input, financial muscle and insight hold the key to better treatments and prevention. Dementia, a general term that describes forgetfulness and a decreasing ability to think about and manage everyday mental functions, is one of the toughest medical and economic challenges facing not just the UK but the global population.

Around 850,000 people in the UK have dementia. In the absence of effective treatments or ways to prevent the disorder, that number will more than double over the next 30 years. The World Health Organisation predicts 82 million patients worldwide by 2030. Alzheimer’s accounts for 60-70% cases of dementia. But there are many other diseases that result in dementia.

Over the last 10 or 20 years big pharma, biotech, government, universities, charities and others have devoted increasingly significant resources to the problem – money, time and effort. Despite this, there is currently no cure for any of the neurodegenerative conditions that give rise to dementia. The brain is the most complex organ and we’re still trying hard to understand it.

Given that track record you might be forgiven for thinking that Pfizer is justified in pulling out. Perhaps even smart to do so. But you’d be wrong. Society simply cannot afford to throw in the towel. The economic burden of dementia is truly frightening. The Alzheimer’s Society estimates that the annual cost to the UK economy is £26bn. In the US it’s closer to $200bn. And according to Alzheimer’s Disease International, the global cost is an eye-watering $818bn; that’s 1% of global GDP.

But it’s not all about economic risk. If you have had the misfortune of watching a close friend, parent or partner with Alzheimer’s or another dementia-causing disease, you know how utterly devastating and emotionally draining it is to witness the gradual loss of everything that makes us human. Dementia inflicts blow after blow, day after day, on millions of people. So what on earth is Pfizerthinking?

Yes, they have already invested billions in this set of diseases. And yes, to date they don’t have a blockbuster drug to show for it. And no, they have not yet been able to help a single patient. It’s demoralising. I know, I’ve devoted my career to beating the disease. But thanks to Pfizer’s work and that of many others, we have learned a lot about this disease and year on year we are better placed to finally beat it. It will take many more years and much more funding. But we will get there.

Thanks to £250m of funding from the Medical Research Council, Alzheimer’s Society and Alzheimer’s Research UK, the UK Dementia Research Institute (UK DRI) is rising to the challenge of dementia. We still have a lot to learn about the fundamental molecular underpinnings of these diseases and are therefore assembling a dream team of university investigators who will work together to better understand the root causes of dementia and then design treatment and prevention strategies to beat it. But we can’t do it alone.

Pharmaceutical companies are absolutely essential to this effort. They are a critical part of the process that will eventually lead to the right drugs. That’s not to say that pharma should just do more of the same and repeat the failed experiments of yesterday. It’s time to step back from the costly phase three clinical trials and to look afresh at the basic biology of these diseases. But above all we need big pharma to stay the course; come on this journey with us to improve the lives of so many.

Pharmaceutical companies must look at the long-term potential. It is essential that all of us make long-term commitments to dementia research if we are to conquer it. My message to Pfizer is simple. Dementia represents too big a problem for you or any of us to walk away from. Stick with us. For sure we need your expertise, technical knowhow and resources. We also need to know that like us, you’re in this for the long run and won’t quit until the job is done. Millions of patients are looking to us for help. Are you with us?