In the past few years, patients and families have watched as several large drug-makers have trimmed or closed their labs investigating new treatments for brain disorders. Meanwhile the need for preventives and treatments for schizophrenia, depression, bipolar illness, and other ailments remains—and the need for help for people developing Alzheimer’s and other dementias grows exponentially.
Taking a promising treatment from basic-science labs to everyday use for patients has always been risky. Drugs take a long time to develop and test; those that alter the brain and nervous system take longer than most and can cost more. The repeated, expensive, last-stage failures of drugs targeting Alzheimer’s have added to the chilling effect. What could help re-balance the scales, and entice manufacturers back into the pipeline?
That was the topic of a two-day workshop held at the Institute of Medicine in Washington, DC, this week. The main question, said co-organizer Dennis Choi, was “Can feasible incentives be put into place that would bring drug makers back into central nervous system research?” More than six dozen researchers, policymakers, patent lawyers, industry representatives, foundations, and advocates for patients chewed on ideas new and old.
Some of the chewiest ideas came from a perspective paper published in Neuron in November 2014, “Medicines for the Mind: Policy-Based “Pull” Incentives for Creating Breakthrough CNS Drugs.” Pull incentives are changes in policy and process, not additional funding. While “push” incentives like NIH grants and the BRAIN Initiative lower risk by directly supporting research and development (less cost to business), pull incentives increase market returns (more earnings), said Choi, of the State University of New York at Stony Brook and a member of the Dana Alliance for Brain Initiatives.
The total global cost of non-communicable diseases, in terms of early death as well as loss of productive worktime due to chronic conditions like depression, is predicted to total $47 trillion over the next two decades, according to a study released by the World Economic Forum; of that total, mental health issues contribute 35%. “It is important to find incentives to find better medicines across the board,” said Steven Hyman of the Broad Institute and also a Dana Alliance member. “Otherwise, society is not going to be able to pay these medical costs.”
Slides from the presentations will be posted on the IOM website within a month; a report will be available in six months.