The principle public funder of research is the US NIH, investing more in health research than any other public enterprise in the world with an annual budget of approximately $34 billion U.S. dollars. The federal budget devoted to NIH has had support from both Republican and Democratic parties. There is a mismatch between the cost of disease to society and the amount of research devoted to it. AD, for example, costs the US society more than $216 billion annually, and it has an NIH budget of $1.8 billion; for every $1 spent on AD, less than 1% of that amount is devoted to research [15], [16]. AD has a greater impact on the US economy than cancer or cardiovascular disease [15]; it has a smaller NIH research budget than either of these disorders (cancer – $6.0 billion, cardiovascular disease - $2.2 billion; www.nih.gov).
Success in AD drug development will produce a very high return on investment. This possibility attracts venture capital investment to AD research, but the high rate of failure has kept this funding stream small [67]. Venture capital investment in Central Nervous System disease declined 40% in the 2009–2013 period compared with the 2004–2008 period [68].
Axon anyone?
Candidate therapies may pass from smaller to larger biotech companies as biotechs seek to strengthen their pipelines, progress toward vertically integrated Central Nervous System companies, or attract investors interested in a broader portfolio. This can be a healthy process allowing drugs to progress in testing before major pharmaceutical companies invest; however, the process also may lead to abuse by passing flawed agents from company to company and attracting capital from enthusiastic but under-informed investors.