title: Medicines for the mind: policy-based "pull" incentives for creating breakthrough CNS drugs.
abstract: Several large pharmaceutical companies have selectively downsized their neuroscience research divisions, reflecting a growing view that developing drugs to treat brain diseases is more difficult and often more time-consuming and expensive than developing drugs for other therapeutic areas, and thus represents a weak area for investment. These withdrawals reduce global neuroscience translational capabilities and pose a serious challenge to society's interests in ameliorating the impact of nervous system diseases. While the path forward ultimately lies in improving understandings of disease mechanisms, many promising therapeutic approaches have already been identified, and rebalancing the underlying risk/reward calculus could help keep companies engaged in making CNS drugs. One way to do this that would not require upfront funding is to change the policies that regulate market returns for the most-needed breakthrough drugs. The broader neuroscience community including clinicians and patients should convene to develop and advocate for such policy changes.
authors.affiliation: Department of Neurology and Neurosciences Institute, SUNY Stony Brook, Stony Brook, NY 11794, USA; Brain Science Institute, Korea Institute for Science and Technology, Seoul 136-791, Korea. Electronic address: dennis.choi@stonybrookmedicine.edu.
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Choi
authors.affiliation: Eli Lilly and Company, Indianapolis, IN 46285, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Armitage
authors.affiliation: National Institute of Mental Health, NIH, Bethesda, MD 20892, USA.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Brady
authors.affiliation: National Multiple Sclerosis Society, 1100 New York Avenue NW, Washington, DC 20005, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Coetzee
authors.affiliation: School of Law, Harvard University, Cambridge, MA 02138, USA.
authors.forename: William
authors.initials: W
authors.lastname: Fisher
authors.affiliation: Broad Institute, MIT and Harvard University, 75 Ames Street, Cambridge, MA 02142, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Hyman
authors.affiliation: Verity BioConsulting, 4711 Hope Valley Road, Durham, NC 27707, USA.
authors.forename: Atul
authors.initials: A
authors.lastname: Pande
authors.affiliation: Voyager Therapeutics, 75 Sidney Street, Cambridge, MA 02139, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Paul
authors.affiliation: National Institute of Mental Health, NIH, Bethesda, MD 20892, USA.
authors.forename: William
authors.initials: W
authors.lastname: Potter
authors.affiliation: Sloan School of Management, MIT, 50 Memorial Drive, Cambridge, MA 02142, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Roin
authors.affiliation: The Michael J. Fox Foundation for Parkinson's Research, P.O. Box 4777, New York, NY 10163, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Sherer
mesh_terms: D000818:Animals; D002491:Central Nervous System Agents / Q000627:therapeutic use*; D006291:Health Policy / Q000191:economics / Q000639:trends; D006301:Health Services Needs and Demand; D006801:Humans; D009042:Motivation; D009422:Nervous System Diseases / Q000188:drug therapy*
chemical_list: D002491:Central Nervous System Agents