Changewave Research: Alzheimer S and Parkinson S Disease Survey

ChangeWave Research: Alzheimer’s and Parkinson’s Disease Survey

ChangeWave Research Report:

Alzheimer’s and Parkinson’s Disease Survey

Overview

During the week of October 27 – November 2, 2004, we conducted a survey of Alliance healthcare members to examine the issues and technologies for addressing both Alzheimer’s and Parkinson’s disease. A total of 85 healthcare industry members participated, including 27 doctors who treat patients with Alzheimer’s disease and 22 who treat patients with Parkinson’s disease. Here’s what we found:

(A) Alzheimer’s Disease

· Alzheimer’s on the Rise. The vast majority of doctors who treat patients with Alzheimer’s disease (78%) reported seeing an increase in the number of Alzheimer’s patients over the past year. None of the doctors surveyed reported seeing a decrease.

· Earlier Detection. Fifty-two percent (52%) of doctors who treat Alzheimer's say new patients are coming in "Earlier" than the historical norm, while 37% say they are coming in "As They Have in the Past.”

· Most Effective Drugs Currently. Doctors found Aricept (59%) to be the most effective drug in the treatment of Alzheimer’s, followed by Namenda (44%) and Reminyl (30%).

· Market Share Gainers – Next 12-24 Months. Namenda (41%) is rated by doctors as the drug positioned to gain the most market share over the next 12-24 months. Reminyl (30%) came in second, followed by Aricept (22%).

· Most Promising Research and/or Drug Development Trend. We asked respondents about the most promising trends in Alzheimer's research and drug development today. MJW5673 writes, "We are gaining a more complete understanding of the complete series of events that contributes to the disease. This gives more targets for treatment that, even if they do not cure, can slow progression... A combination of approaches to treating the disease is likely to be better than one..."

(B) Parkinson’s Disease

· Increase in Parkinson’s Patients. Thirty-seven percent (37%) of doctors who treat patients with Parkinson’s have seen either a significant or moderate increase in the number of Parkinson’s patients over the past year, while 64% say they have seen no change in the number of patients.

· Earlier Detection. Twenty-three percent (23%) of doctors who treat Parkinson's say new patients are coming in at an "Earlier" stage of the disease than has typically been the norm. Only 5% say patients are coming in "Later," while 68% say patients are coming in "As They Have in the Past."

· Most Promising Treatment Areas - Next Two Years. Neuroprotective Agents (27%) is seen by doctors as the most promising treatment area in the next two years, followed by Brain Implants (18%) and Neural Tissue Transplants (14%).

· Most Effective Drugs Currently Prescribed. One-in-two doctors (50%) found Sinemet (Carbidopa) as the most effective drug currently being prescribed for the treatment of Parkinson’s. Another 23% found Comtan (Entacapone) to be most effective.

· Market Share Gainers – Next 12-24 Months. Sinemet (Carbidopa) (18%) tops the list of drugs for Parkinson’s that doctors believe will gain the most market share over the next 12-24 months. Comtan (Entacapone) (9%) and Requip (Ropinirole Hydrochloride) (9%) came in tied for second.

· Most Promising Research and/or Drug Development Trends. Regarding the most promising trends in research and drug development for Parkinson's today, STE3218 writes, "Parkinson's seems to have more environmental factors (viral or toxin) that affect progression. Research in these areas seems to be progressing." DJA1158 writes, "There are not any truly ground breaking advances just a series of incremental advances. No one really stands out."
Interestingly, 18% of respondents cite Stem Cell research as the most promising research in Parkinson's today.

Bottom Line: According to the survey findings, doctors who treat Alzheimer’s overwhelmingly report that the number of Alzheimer’s patients has risen over the past year (78%), and that they are coming in at earlier stages of the disease (52%). Aricept, Namenda and Reminyl were found to be the most effective drug treatments currently on the market, and are considered likely to gain the most market share over the next two years.

The findings also show better than one-in-three doctors (37%) treating Parkinson’s have seen an increase in the number of patients over the past year, and 23% report patients are coming in at earlier stages of the disease. Respondents see Sinemet (Caridopa) as the most effective drug treatment currently being prescribed, and believe it is most likely to gain market share over the next two years.

The ChangeWave Alliance is a group of 4,900 highly qualified business, technology, and medical professionals in leading companies of select industries—credentialed professionals who spend their everyday lives working on the frontline of technological change. ChangeWave surveys its Alliance members on a range of business and investment research and intelligence topics, collects feedback from them electronically, and converts the information into proprietary quantitative and qualitative reports.

Helping You Profit From A Rapidly Changing World ™

www.ChangeWave.com

Table of Contents

Summary of Key Findings 4

The Findings 5

(A) Alzheimer’s Disease 5

(B) Parkinson’s Disease 10

ChangeWave Research Methodology 15

About ChangeWave Research 16

I. Summary of Key Findings

Introduction

The findings focus on the two disease areas as follows:

(A) Alzheimer’s Disease

(B) Parkinson’s Disease

II. The Findings

(A) Alzheimer’s Disease

Doctors Who Treat Patients with Alzheimer’s Disease (n=27)

All Other Respondents Working With/Knowledgeable about Alzheimer’s Disease (n=45)

(1) Question Asked: Alzheimer's is a disease associated with aging populations. In your practice, have you seen an increase in the number of Alzheimer's patients, a decrease, or has the number of Alzheimer's patients remained the same over the past year?

Doctors
Significant Increase in Alzheimer's Patients / 4%
Moderate Increase in Alzheimer's Patients / 74%
Decrease in Alzheimer's Patients / 0%
No Change in the Number of Alzheimer's Patients / 22%
Do Not Work in a Practice / 0%
Don't Know / 0%

Alzheimer’s on the Rise. The vast majority of doctors who treat patients with Alzheimer’s disease (78%) reported seeing an increase in the number of Alzheimer’s patients over the past year. None of the doctors surveyed reported seeing a decrease.

(2) Question Asked: Over the past year, has your typical new Alzheimer's patient been coming in earlier, later or at the same stage of the disease as has typically been the historical norm?

Doctors
Patients are Coming in Earlier / 52%
Patients are Coming in Later / 4%
Patients are Coming in as They Have in the Past / 37%
Do Not Work in a Practice / 4%
Don't Know/No Answer / 4%

Earlier Detection. Fifty-two percent (52%) of doctors who treat Alzheimer's say new patients are coming in "Earlier" than the historical norm, while 37% say they are coming in "As They Have in the Past.”

(3) Question Asked: What do you believe is the most promising trend in research and/or drug development for Alzheimer's today? (n=49)

Preventive Measures and Identification of Causes / 22%
Drug Development / 18%
Stem Cell Research / 16%
None / 10%
Other / 18%

Sample of Alliance Member Responses:

(a) Preventive Measures and Identification of Causes (22%)

· BIO9114 writes, "Baby boomers have cared for parents and relatives and are aware of their propensity to develop AD. They are taking more anti-oxidants and other vitamins and will seek earlier diagnosis and treatment than the last generation. There have also been some early but promising drugs developed which may inhibit the formation of amyloid fibrils."

· LAH6124 writes, "Prevention is the best cure here and hence research focusing on immunization is very promising."

· MTL7799 writes, "Research directed both at preventing memory loss and identifying risk factors for the disease."

· COB6520 writes, "Prevention. Alzheimer's has been linked to Polio and other contaminated vaccinations, aluminum toxicity and stealth pathogens. These are areas that would pay off if research dollars were directed more at prevention."

· STE3218 writes, "Looking for underlying causes … Medications really only keep mild symptoms at bay for short periods of time and dramatic improvements are lacking."

· 2464180 writes, "Identification of memory genes."

· FSC4718 writes, "Studies of causative factors."

· MJW5673 writes, "We are gaining a more complete understanding of the complete series of events that contributes to the disease. This gives more targets for treatment that, even if they do not cure, can slow progression. And slowing progression is functionally equivalent to cure. A combination of approaches to treating the disease is likely to be better than one, particularly since the process is likely to vary somewhat in different individuals. This means that the "space" for products will be larger. Also, several neurodegenerative diseases (Alzheimer's, Parkinson's ALS, Huntington's, etc.) seem to have general similarities in regard to mechanism of disease (i.e., they are all probably aberrant protein folding diseases). Thus, knowledge of and treatments for one disease will contribute to understanding of and treatments for other diseases."

· FLO8176 writes, "Better animal models (well, better than nothing I suppose). A validated animal model with a human disease relevant (clinical) endpoint remains to be found. Some of the treatments aimed at slowing down the progression appear promising but are difficult to progress."

· KLL5671 writes, "The discovery of an increase of Beta Amyloid in patients with Alzheimer's and that it involves the nerve processes called the tangles."

(b) Drug Development (18%)

· DJA1158 writes, "The vaccine which is still early stage and several years away from proven efficacy and safety."

· BUC1834 writes, "Statins, neuroprotective agents."

· SR14084 writes, "Aricept is the most popular tx; however, many more 'naturally' inclined, have had good results using essential oils and nutritional supplements and exercise…"

· KES5963 writes, "Vaccines and inhibitors of amyloid deposition."

· 8486810 writes, "Exelon being a "bi-modal" approach that might indeed retard advancement. Aricept has been the "mainstay" treatment."

· DOC6228 writes, "Stem cell research."

· WSE7249 writes, "Stem cell."

· GHM8270 writes, "Stem cell research and genetic manipulation."

· JES5551 writes, "Disease can be thought of by analogy to faulty electrical circuits. If neurons die as a result then stem cells could be useful and possibly the only possible cure."

· MAM7387 writes, "Genetic and stem cell research."

(d) None (10%)

· BTB1963 writes, "None."

· HS06634 writes, "No change."

· KCO6695 writes, "Namenda holds short term promise for patients but nothing that I am aware of will stop this terrible disease in its tracks."

· WSH1329 writes, "No clear trend yet."

(e) Other (18%)

· SCM5876 writes, "Antibody treatments to remove the proteins that cause the disease."

· DRJ5952 writes, "Cognitive enhancers."

· MIN9289 writes, "Inhibition of plaque formation."

· JSA8571 writes, "To slow the rate of progression of impairment of cognitive function."

· PWG2815 writes, "Calcium EDTA chelation."

· GJI8677 writes, "New generation of therapies."

· GAN7111 writes, "Elan and Wyeth's antibody."

· CAN7667 writes, "Symptom easing."

· GOP2712 writes, "General awareness."

(4) Question Asked: There are a handful of drug treatments currently being prescribed for Alzheimer's. Which of the following drugs do you find are most effective in the treatment of Alzheimer's? (Check All That Apply)

Doctors
Aricept (donepezil hydrochloride) / 59%
Namenda (memantine hydrochloride) / 44%
Reminyl (galantamine hydrobromide) / 30%
Exelon (rivastigmine tartrate) / 15%
Cognex (tacrine) / 11%
Don't Know / 15%
Other / 19%

Most Effective Drugs Currently. Doctors found Aricept (59%) to be the most effective drug in the treatment of Alzheimer’s, followed by Namenda (44%) and Reminyl (30%).

(5) Question Asked: And which of the following drug treatments do you believe will gain the most market share over the next 12-24 months? (Check All That Apply)

Doctors
Namenda (memantine hydrochloride) / 41%
Reminyl (galantamine hydrobromide) / 30%
Aricept (donepezil hydrochloride) / 22%
Exelon (rivastigmine tartrate) / 11%
Cognex (tacrine) / 7%
Don't Know / 22%
Other / 7%

Market Share Gainers – Next 12-24 Months. Namenda (41%) is rated by doctors as the drug positioned to gain the most market share over the next 12-24 months. Reminyl (30%) came in second, followed by Aricept (22%).

(6) Question Asked: What about off-label drug treatments for Alzheimer's? Do you know of any off-label drug treatments for Alzheimer's that are gaining industry acceptance?

Sample of Alliance Member Responses:

· BUC1834 writes, "Folic acid/b vitamins (foltx/cerefolin), maybe statins."

· PWG2815 writes, "CaEDTA works but is not accepted by industry or main stream medicine because it is too difficult to make money."

· LST2748 writes, "Memantine for early disease."

· GJI8677 writes, "Modafinil."

· MJW5673 writes, "Merck has shown interest in a potential treatment for lymphoblastic leukemia that involves an inhibitor of gamma secretase (being developed at Harvard, not yet in clinical trials but may be close). The leukemia does not affect very many people, but inhibiting the secretase could be an off-label treatment for Alzheimer's. The secretase is believed to be involved in processing of beta-amyloid protein, an early step in the series of events believed to result in Alzheimer's."

· DJA1158 writes, "No. A better question is are AD drugs being used off label for other conditions associated with memory loss or even as ‘cosmetic neurology’ or for ‘performance enhancement.’ The answer unequivocally is yes with all drugs being used, probably Aricept the most."

· RAF5760 writes, "Huperzine; but doubt it is widely used."

(B) Parkinson's Disease

Doctors Who Treat Patients with Parkinson’s Disease (n=22)

All Other Respondents Working With/Knowledgeable About Parkinson’s Disease (n=52)

(7) Question Asked: In your practice, have you seen an increase in the number of Parkinson's patients, a decrease, or has the number of Parkinson's patients remained the same over the past year?