PharmTech: The PhRMA Research & Hope Awards go beyond solely scientific awards to include honorees for patient advocacy and volunteer work. Why do you think this broader scope is important?
Parker (Merck): The awards honor people who have gone to tremendous lengths to improve the lives of patients suffering from various diseases, with the focus of the 2012 awards being Alzheimer's disease. It's important to recognize not just medical advances and research but also the people who are working to alleviate suffering through caring directly for patients. These people are very often family members and loved ones. It's through collaborative efforts among many stakeholders that we can best hope to achieve the goal that we all have–to help stop the suffering caused by Alzheimer's disease.
PharmTech: Along these lines, in your experience, what major two or three challenges do researchers face in finding a drug to prevent and/or treat Alzheimer's?Parker (Merck): All neurological diseases are complicated and AD is no different in that regard. We are still working to increase our overall understanding of AD and to identify approaches through which we can help to modify its course and/or provide symptom relief.
That said, there are many challenges that we've faced and continue to face in our research. Many of the latest setbacks that we've seen in the recent studies that have not met their primary endpoints can be attributed to at least two factors. First, the treatments being tested had significant side effects that limited the doses that could be administered, which may have also limited their effectiveness. Second, these studies have reinforced a collective opinion in the field that we may need to start treatment years before patients begin to show symptoms. However, that means being able to identify people who are at risk for developing AD in the first place, and that research is still ongoing.
PharmTech: Because Alzheimer's is so complicated and because of certain R&D/clinical study setbacks in recent months, some reports have stated that people are giving up hope, as well as research funds, toward curing Alzheimer's. What might be your argument or response to these reports?
Parker (Merck): AD is one of the most challenging and devastating diseases of our time, causing untold physical, emotional and financial suffering to patients and their caregivers. We are trying to find new therapies that can help to prevent or slow its onset and that may help to alleviate the disease symptoms. We cannot let ourselves lose sight of the fact that this disease has tremendous human and economic costs.
Yes, there have been many setbacks, but with each setback we can learn new information, draw new conclusions and move the field forward. From this perspective, we don't consider them "failures," per se, but rather, stepping stones.
We know that finding new therapies to help Alzheimer's patients will not be easy, but AD research remains a top priority for Merck. We will continue to make strides and believe that we are already on our way.
PharmTech: A report from PhRMA and the Alzheimer's Foundation talks about delaying the onset of Alzheimer's Disease, and specifically how even just a 5-year delay in onset can save millions of healthcare and medical dollars. What's your perspective on delaying the onset versus preventing the disease altogether? What are the benefits of disease modification in Alzheimer's patients?
Parker (Merck): There are currently no treatments on the market that can slow the progression of AD and few treatments to control some of the symptoms. Of course, preventing the disease altogether is the ultimate goal, but delaying the onset has not only tremendous financial benefits, but significant personal benefits for those dealing with the disease every day. Currently, patients and their families are grateful for even the very modest improvement in symptoms that current treatments afford. Until a cure or prevention is found, delaying the onset of this disease for as long as possible would be a "win" for all concerned.