Saturday, June 19, 2010

Penny Wise and Pound Foolish: As Alzheimer's Increases, Government Funding to Combat Alzheimer's Decreases

The June 17th issue of The Economist features an important article on the penny-wise-pound-foolish nature of America's health expenditures on Alzheimer's Disease (AD.)

As the magazine notes, AD costs the US some $170 billion a year.   And the number of Americans suffering from AD is projected to triple by 2050.

Yet the NIH is cutting back on anti-AD research, thus condeming us all to a terrible public-health and fiscal fate.  As the magazine explains:

Yet Alzheimer’s research, on which the NIH spent $643m in 2006, is to receive only $480m in 2011. It has not been singled out for these cuts. They are part of a general belt-tightening at the agency. But in this as in everything, you get what you pay for. And that might, in the future, be an awful lot of witless, wandering elderly.


It might not be so bad that the government is cutting back if the private sector were making up the difference.  But there's plenty of evidence that Pharma companies have hit a wall.   As The Economist notes, Pfizer just abandoned its effort on the anti-AD drug Dimebon, after having spent $725 million.

Making drugs is hard--harder, even than plugging oil spills.   So absent suitable incentivizing and/or prodding, it’s possible that the drug companies will work on something else.

So clearly, leadership is needed.  But from where is it going to come?  The White House? The Congress?  The private sector?  Philanthropy?   And it's not just money that's needed,
 of course: To cure AD, we will need to reform the FDA, clear away the trial lawyers, and probably revisit intellectual property rules.   


And by the way, there's political advantage to be had here.   The elderly vote in disproportionate numbers; if one politician, or one party, emerges as a clear champion of effective AD research--that is, genuine victory, as opposed to just propping up the status quo--it's a safe bet that that politician/party will reap a substantial political reward at the polls.   

The alternative to effective leadership is a continuation of the current system, which is to say, fiscal disaster: A big chunk of our population comes down with AD, and we pay the bills for their futile care over the course of decades    That's a grey dawn, indeed.  



It would be a lot cheaper, as well as more humane, if we could figure out a cure for AD, focusing on it as we did with polio and AIDS.    And who knows--if we could figure out a cure, here in the US, we would have a new precious export.