Alzheimer’s is an irreversible degeneration of neurons in the brain and is one of the most prominently observed brain disorders among people today. The condition starts with disruptions in cognition and behavior which causes impairment in the memory and sparks dementia, which is the most noticeable symptom. It accounts for over 65% cases of dementia across the world and affects approximately 40 million people worldwide. Initially Alzheimer’s disease signs are observed in the entorhinal cortex, then proceed to hippocampus and further spread through the brain causing cerebral cortex to shrink which results in death of neurons in the brain. By 2020, the number of people aged around 65-70 and older with AD is estimated to reach around 7.5-8 million in the United States. By 2050, there would be close to 16 million people living with Alzheimer’s. At present AD is one of the most leading cause of death in the United States and number of AD cases are seen higher in women than in men, nearly two third of the population in the United States suffering from AD are women. The global economic impact of Alzheimer’s disease is estimated to be pegged at US$ 640 billion per year and the annual costs of treating and caring patients exceeds US$ 200 billion in United States alone. Due to the lack of strong visible symptoms in the initial stages, Alzheimer’s is unfortunately diagnosed when more than 50% of nerve cells have been damaged.
There is currently no cure to the condition and existing drugs provide only symptomatic relief. Big pharma giants like J&J, Pfizer and Eli Lilly are spending millions of dollars in R&D with clear focus towards the amyloid plaques hypothesis with high hopes that their research molecules would block amyloid plaques formation in the brain. Major markets for AD are US, Japan, Germany, Spain, France, Italy and UK and current ongoing estimates value the markets at around US$ 9.5 billion and expected to reach around US$ 16.0 billion in the year 2020. Future market growth is expected to be driven by the first disease-modifying drugs. Aricept (donepezil hydrochloride) from Pfizer/Eisai’s was the world best-selling drug till 2010, which lost patent protection in November 2010 and at present, Namenda (memantine hydrochloride) from Forest Laboratories, Exelon (rivastigmine) from Novartis and Ebixa (memantine) from Lundbeck Ltd. are the top selling brands worldwide. About 70% of people on Namenda XR are also on Aricept.
In December 2014, the FDA approved a combination pill for moderate to severe Alzheimer’s called Namzaric that combines memantine hydrochloride extended-release (Namenda) and donepezil hydrochloride (Aricept). Biotechnology may also hold the cure to this condition and Boston based company Biogen’s experimental anti-body that targets beta-amyloid showed sincere promise in reducing plaques and reducing symptoms. Several other companies such as Signum are focusing on treating the disease rather than symptomatic relief. Analysts predict the value of the drug to be around US$ 6.5 billion by the time it may be approved, which is still quite far considering the 166 patient trials done currently. The largest targets are for neuromodular signaling, however several companies across the world are also focusing on microtubular structural targets, APP metabolism and immune response modulators. Top companies associated with molecules in this area are Eli Lilly, Roche, Genentech, Baxter International, Janssen Pharmaceuticals, Pfizer, Abbott Laboratories, Lundbeck, Merck & Co, and Bristol-Myers Squibb.
In terms of geography, the market is currently being analyzed for six regions namely, North America, Europe, Asia-Pacific, Latin America, Middle-East and Africa. North America leads the market with a share of approximately 40%, however the reimbursement situation has not improved for people to utilize the available treatments. Cost of disease treatment along with assisted care expenses is in most cases extremely expensive to treat and has severe burden on families. In coming years however, the picture is expected to change with the knowledge of approximately 20 potential target molecules that show significant potential.
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