Curing Alzheimer’s is possible, but needs investment – prevention will be cheaper than coping!
Blain’s Morning Porridge 6th Sept 2024: Curing Alzheimer’s is possible, but needs investment – prevention will be cheaper than coping!
Alzheimers is becoming the most common cause of death. The costs it imposes, usually on families, but also on society are immense. Preventing it will require investment to research and therapies, but these makes sense in terms of the quantum (all of us!), and reducing the healthcare burden on society. There are investment solutions!
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Bill’s Pub to Club Swim:
Let me remind readers about Bill Blain’s Pub to Club Swim on September 14th. It’s a Charity Event in support of Wessex Heartbeat, the cardiac care charity. I will be swimming 2.5 miles down the River Hamble as a thank you to the Medical Staff who care for cardiac patients and their families. You don’t have to anything except click the link – here – and make a donation.
Without Heartbeat, well, you would not be reading the Morning Porridge.
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Apologies for slightly late Porridge this morning. I was training for the Charity Swim next week – there was a strong incoming tide running to swim against! It was well worth the extra effort, which is no doubt doing my cardio-vascular system some serious good. Yet it doesn’t seem to matter that no many times I walk the dog or go to the Gym…. every morning needs a little extra stretch..
When you get to my age, taking an interest in healthcare developments takes on an increasing immediacy. I’ve already had a personal adventure in Cardiac care – an operation for a heart problem left me with an infection that caused the massive heart attack the treatment had been designed to prevent. (My recovery was due to excellent care from the cardiac team at Southampton General – which is why I’m planning Bill’s Pub to Club 2.5 mile charity swim next weekend for Heartbeat. You can read about it here.)
When it comes to investment business, my current work in Health and MedTech is some of the most interesting stuff I’ve ever done.. learning about the process, the science, the regulatory environment, and what are the factors that enable a clever medical invention to become a game changing, successful innovation in treatments. Yes, its about investment returns, but also doing something good. It is absolutely fascinating, and frankly more beneficial than the 20 odd years I spent raising and innovating various Bank Capital plays.
The reality is we don’t get to choose what will ail us, or how we inevitably will meet our end. Top of my list of worries is Alzheimers – a fear reinforced every morning when I can’t remember where I left my phone, watch, pen, specs, keys, whatever. She-who-is-Mrs-Blains can get a bit exasperated.
Alzheimers is the most common form of dementia and now the most frequent cause of death across the West – meaning it’s a “huge addressable market” in Venture Capital speak. As populations age and live longer (ironically on the back of improving health care), more and more of us will suffer some form of age-related neuro or neurovascular disease. Today there are around 57 million diagnosed cases of dementia – but that will grow to over 150mm by 2050.
The numbers look bleak; there are numbers that suggest a 40% chance of some form of dementia over the age of 85 – much of it is missed because of co-morbities. Alzheimer’s is the largest neuro-disease by numbers, but other untreatable neurological conditions include Parkinson’s – which is number 2 on my threat board.
The good news is Dementia is now a Healthcare focus. New drugs are coming online. US and UK medical regulators have approved a number of drugs that can clear protein plaques from the brain. However, just a couple of weeks ago the UK’s National Institute for Health and Care Excellence (NICE) declined to approve one new treatment, Lecanemab, for early-stage Alzheimers as the benefits, a short-delay in symptoms if given early enough, were “just too small to justify the significant cost to the NHS”.
According to the FT, the treatment would likely cost £20k per annum for the drug, £19,000 to administer in terms of monitoring and ongoing scans and reviews, and a further £1000 per month to infuse the patient every fortnight! Call it £50k per annum for a short-term fix.
To be effective in breaking up beta-amyloid plaques in the brain, Lecanemab needs to be administered during the early stages of the disease, but diagnosis within the NHS is notoriously slow, and less than 2% of aging UK patients are recommended access to the PET brain scan or the Lumbar puncture that is required to diagnose Alzheimers in time for the treatment to be effective.
The UK’s struggling NHS simply isn’t set up for the kind of care and monitoring that the growing number of Dementia patients will require. Clinicians are calling for greater resources – in a cash strapped spending adverse NHS – to facilitate diagnostics and provide treatment. Given the history of the NHS and its current precarious financials, it feels unlikely to happen soon. When it does it will be haphazard and likely a postcode lottery.
On the other hand, the costs of caring for dementia are set to rocket as more of us survive other conditions, only to suffer from some neurological condition requiring greater care, and raising additional social costs. At some point, probably now, the cost of prevention and curing dementia is going be much cheaper than treating it – spending money to treat and stop it will be less than the cost of care, and the heartbreak for families it causes.
The burdens of dementia are largely borne directly by families – 50% of carers will be family members providing at least 5 hours of care daily, with women providing the bulk of that care. An estimate by the World Health Organisation reckoned the cost of dementia care is a $1.3 trillion social cost on the global economy.
In terms of the economics of Neurodegeneration Diseases, at the moment it is around a $45bln dollar sector – set to rise to $92 bln by 2032, a Compound Annual Growth Rate (CAGR) of 7%. The Alzheimer market size in 2020 was $2.8 bln in 2020 – but will hit $26 bln by 2030.
The issue is how to best direct funding into successful Alzheimer treatments and even find a cure. That will involve a holistic approach – ensuring diagnostics/imaging is brought up to speed, that new therapeutic treatments come on line, and biomarkers from the molecular and cellular mechanisms of aging are identified to enable swift and effective disease identification to target the clinical development of treatments.
Fortunately, it is happening. There may be cures and treatments on the horizon – a number of firms are working on vaccines that could halt or even stop Alzheimers developing. But to get there the sector needs investment – from early stage VC right up to treatments – but it will take time.
My chums at Kinled, one of the leading Healthcare/Medtech VC investors, are closely involved in financing new innovative Neuro treatments, working closely with co-investors and partners to identify early-stage projects in universities and research institutes. These are then incubated and developed through to exit or IPO.
Danube BioVentures is led by Patrick Aisher, Kinled’s CEO. They have just launched DanubeNeuro Fund II – focused on building a worldwide portfolio of new life-science ventures that can deliver innovative therapeutics, diagnostics, biomarkers, and imaging platforms across the field of neurodegeneration. If you’d like to learn more – give me a shout – and I’ll send you further info.
Out of time, and back to the day job (which includes raising funds for the Neuro Fund!) Have a great weekend
Bill Blain
Author of the Morning Porridge, founder of Wind Shift Capital