You could fill a small book with all the medical problems that overtook my mother in the last year of her life. Some of her illnesses, like cancer, became increasingly grave, while others were robbing her of something as important as life itself.  She couldn’t remember things and got easily mixed up. Soon a lot of routine chores became too hard to manage. Sometimes she confused me with my father, who had died nearly two decades earlier. The person I knew was fading away right in front of me and the drug we tried didn’t seem to do a bit of good.  This is not an unusual story. In fact, I’m telling it now because it’s become so common; so many of us have seen a person we know or love afflicted that way. Most also know that modern medicine offers little in the way of help.  So an effective treatment for Alzheimer’s has become a kind of holy grail of biotechnology, a goal that has proved difficult to achieve but would surely could change millions of lives and be worth untold fortunes.  “It’s one of the biggest health challenges in the world for the next couple of decades,” said Rajiv Kaul, the portfolio manager of Fidelity Select Biotechnology Portfolio, who invests more than $13 billion in life sciences companies.  The experimental drug showed “extremely positive” results in slowing the mental decline of a small number of patients with the disease.  Consider the recent news from Biogen Inc., the Cambridge company that last week showed real promise for slowing the progression of Alzheimer’s. To be sure, Biogen tested the drug among just a small group of patients with early or mild cases of the disease. But the showing was strong enough that the company said it planned to jump ahead to advanced clinical trials, a process that could take several years.  So what is news like that worth? Many billions of dollars.  By one simple measure, the stock of Biogen has boomed by more than 50 percent since December, when it first released a summary of those early test results. In less than four months, Biogen’s total market value has increased by some $38 billion.  Stock prices don’t go up or down in a vacuum. The biotech business has been riding high lately; a broad biotech industry stock index, for example, was up 23 percent over the same period. Biogen, already the most valuable company in Massachusetts, operates a big drug business with products treating other diseases such as multiple sclerosis.  But $38 billion is a lot of money. It’s more than the total value of other big companies, such as Vertex Pharmaceuticals Inc., Boston Scientific Inc., and State Street Corp. Clearly, the stock market is ready to put huge sums of money into companies with promising treatments for Alzheimer’s patients.  Biogen, which tested its drug on fewer than 200 people, has a long way to go to prove the therapy can help a big patient population. Other Alzheimer’s drug candidates looked good in the early stages of development, only to disappoint later.  Failure has been the expensive norm for drug companies attacking the disease: By one account, more than 100 different efforts to develop a treatment for the disease have failed since 1998.  For all the pressing needs of patients and families dealing with Alzheimer’s today, drug companies and investors look to the future and see something much bigger. Simple demographics tell you that America’s Alzheimer’s population, perhaps 5 million people, will multiply in the years ahead. Some estimates suggest as many as 30 million.  Beyond personal suffering, growth like that has important economic implications. It will cost a fortune to take care of all those people, so drugs that at least slow the progression of the disease will be very valuable.  “It’s not only the devastating nature of the disease but, frankly, there’s an intrinsic threat to a society that isn’t well equipped to deal with an aging population with a cognitive disability,” said Jonathan Gertler, managing partner and chief executive of Back Bay Life Science Associates, a Boston consulting company.  It’s important to note that no one is talking about drugs to cure or stop Alzheimer’s in its tracks. Even Biogen’s drug, the therapy embraced so enthusiastically on Wall Street, is only hoped to slow the progression of the disease.  Sadly, there is no shortage of terrible diseases and some of them afflict large numbers of patients around the world. All compete for the attention of scientists and investors.  One of them — cancer — was once spoken about as a single all-encompassing disease. Years of progress in labs and hospitals changed that. Now there are many different types of cancer, and each needs its own specific treatment. Patients think of themselves dealing with this particular kind of cancer, or that one, benefiting from much better science to help them.  In the future, I would bet that the world’s Alzheimer’s patients will be treated the same way. Better medicine will help identify their problems and treat each one of them with much greater precision. Like many cancer treatments, management of a disease will be the main goal.  And that would be real progress.
Drug companies taking aim at Alzheimer’s disease face big obstacles but see huge demand for therapies that would help milllions of patients.