where PY is the number of “patient years,” P is the number of patients and Y is the number of years for which patients live after diagnosis. Calculating with the conservative prevalence estimate of 1 in 500, there may be approximately 600,000 ASD patients in the USA alone. These persons may live for an average of 76 years. Using the conservative age of 3 years for the time of diagnosis, PY may be calculated as follows.
PY=600,000×73=43,800,000, i.e., almost 44 million patient years.
To put this number into perspective, let us consider Alzheimer's disease, a disorder that is considered to represent the largest market by big pharmaceutical research companies. Calculating with P=9 million (say 15% of people above 65 years of age will have Alzheimer's disease in the Unites States) and Y=6 (Alzheimer's disease patients live, on average, for 6 years after first diagnosis), PY=54 million for Alzheimer's disease. The actual numbers may slightly vary. The number of Alzheimer's disease patients is actually smaller than 9 million but the disease may be diagnosed earlier and patients may live longer than for 6 years after diagnosis. On the other hand, the number of ASD patients can easily be twice or even three times higher than the presently estimated 600 thousand. Thus, it is clear ASD represents an unmet medical need that is comparable in order of magnitude to the largest neurological disease market, that of Alzheimer's disease. Thus, ASD should be of major interest to pharmaceutical research companies even when the 17-year patent expiration rule is considered.
[Update: Now listen to Pfizer’s (Geodon, Neurontin, Xanax, Zoloft, Chantix; through Wyeth merger, Effexor, Ativan, Pristiq, Prevnar) Robert Ring, newly partnered with Autism Speaks. echoing the title of the study ( HERE ) . Of the partnership, Ring says, “This a real opportunity to really make a difference for a huge unmet need using expertise we’ve acquired over a number of years. In fact we’re working right now to build a pre-competitive consortium amongst our competitors, including Lilly (original manufacturer of thimerosal; maker of Zyprexa, Prozac, Cymbalta, Symbyax, Stattera), Roche (Valium, Klonopin, Tamiflu), Novartis (Ritalin, Tofranil, Trileptal; vaccines: Fluverin, Menveo), Janssen (Johnson & Johnson: Risperdal, Haldol), and trying to agree that this is an important population to be developing medicines for…”]
The study abstract was sent to me by Ben Hansen, a Michigan mental health activist and satirical blogger (Bonkers Institute HERE )Hansen was covered by the New York Times when his Freedom of Information Act inquiry of Michigan Medicaid turned up evidence that an Eli Lilly account executive may have influenced drug prescribing within the program, which had generated a 100% rise in child drug prescriptions in just 10 months.
HPY= goose egg
As far as autism’s impact on the psychopharm market, considering the following:
That doesn’t mean pharma won’t occasionally follow the cues of autism recovery research, but in the hands of many drugs companies, anything can become a weapon: following the discovery that glutamate feedback may be disrupted in schizophrenia and autism (interesting that both mercury and the antiseizure drug Depakote—a rare, known cause of autism—induce glutamate feedback disruption), drug companies rushed to find chemicals with sedating properties which could be shown to do something to glutamate—so that the drug could be called a “targeted treatment”—though it would not necessarily do anything therapeutic to the “target”. No matter though—whatever the drug did do could be spun as clinically beneficial, as has been done for antidepressants and other classes of psychotrope (easy to pull off because, for one example of lab spin, the testing methods used in killed-animal drug studies cannot distinguish between DNA synthesis in the brain which occurs as a part of supposedly beneficial neurogenesis—cell division and proliferation— and DNA synthesis which occurs as a part of cell death, but the FDA looks the other way). Once researchers found a likely candidate—in this case, variations of a “metabotropic glutamate agonist antipsychotic” ( HERE )— companies lined up for FDA approval . A small hitch in the approval process has been that glutamate agonists appear to have an even higher level of lethal neuroleptic malignant syndrome than either first or second generation antipsychotics ( HERE ). Nothing a little spin and a lot of cash can’t fix.
Fortunately, an activist and database programmer named Steven Helgeson figured out how to untangle the FDA Adverse Events Reporting System. He created a searchable site for the purpose of consumer education ( HERE ).
Adriana Gamondes is an Age of Autism contributor and one of our Facebook administrators. She lives in Massachusetts with her husband and recovering twins.