predictions for end of 2014, page-21

Hey Twin, I feel for those heavily invested in PBT, but the real tragedy is that we still don't have an effective treatment for people suffering with Alzheimer's.

Specifically in PBT's case Alzheimer's was always going to be a tough nut to crack, encouraging data in animals is one thing but the amazing complexity and subtlety of human brain function means recovery was always going to be difficult even if the treatment was effective. Elderly people don't have the brain plasticity for rapid recovery even if the disease process is arrested. For the same reasons I don't think it's time to give up hope on PBT2, it may just take longer to have an effect or might be more effective in arresting progression/prevention than in reversing dementia - the science though incompletely proven for PBT2 is compelling.

Drug development upstarts can be more profitable than ever for investors, the mega pharma companies like Merck and Glaxo are moving away from in house drug development and becoming more active in acquiring successful small players who have already shouldered the risk and reduced the expensive false leads for established players.

BUT, I avoid them for a couple of reasons - too hard to tell which ones will make it, too long a gestation period to results (sucking up capital the whole way), but most importantly health systems are nearing the point of rejecting these ultra expensive new therapies wholesale (or at least at the marketed prices). Pharma has adopted a model of "the maximum the market will bear" rather than covering costs and reasonable profit. Just about every new drug that appears (and they're coming faster than ever) is costing into five figures (or more) per patient per year, often for marginal gains. There isn't enough money in even the US to keep paying for them. The US already spends 12%+ GDP on healthcare, and its business competivity is being eroded by the burden, it can't continue along the same path. Health systems across the rest of the world are more centralised and more able to reject newcomers (or their quoted prices), and equally at breaking point in terms of costs.

And before people start with the whole "Pharma companies have to pay for all the failed drugs with each successful one" it doesn't stack up, partly for the new(ish) business model of only acquiring established/likely to succeed drug pipelines from stock market or venture capital funded small players, but mainly because they're already hugely profitable and now spending more on marketing than drug research.

ADO is very, very different. They have none of the Phase 0/1/2/3 trial costs and hurdles, don't need to pin all their hopes on one 'blockbuster', and don't need to force new tests into the market for new costs by making existing profitable tests more profitable. We're not going to stop requesting CRP or Troponin I anytime soon. (not to mention all the drug development companies that will want to optimise their processes with Mix&Go!).