Alzheimers disease (AD) is the third leading cause of death in recent times and with an unprecedented patient potential, this disease area attracts awareness from a broad base of stake holders. With the grey population being the single most influencial factor in driving the economic growth within this sector, Visiongain believes the real market of the AD industry still remains untapped.

Over the past decade the AD market has been flagged by a quartet of approved pharmacological agents; acetyl cholinesterase inhibitors (AchEIs), N-methyl D-aspartate (NMDA) receptor antagonists and other non-AD specific therapeutics for management of comorbidities. The AchEIs comprise products from some of the leading larger pharmaceutical companies;
Esia/Pfizer's Aricept (Donepizel)
Novartis Exelon (Rivagstigmine) and Shire/J&J's Razadyne (galantamiune) previously Reminyl and
recent entrant a non-AchEI
NMDA receptor antagonist Mementine, marketed in the US by Forest
as Nemanda and in EU as Ebixa by Lundbeck Mementine

However, all the listed drugs only elicited modest clinical benefits in treating the various stages of the AD. In addition, the UK National Institute of Clinical Excellence (NICE) decision not to place the drugs on the NHS for reimbursement generated major controversy across the larger markets, only to affect the potential revenue growth on the major drugs particularly in the UK, one of the significant markets.
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Chapter 1. Executive Summary

Chapter 2. An Introduction to Alzheimer's Disease
2.1 Introduction
2.2 Symptoms and Differential Diagnosis
2.3 The Risk Factors for AD
2.4 Type of Protein as a Cause for AD?
2.4.1 Neuronal and Synaptic Loss of AD
2.4.2 Chromosomal Mutations of AD
2.4.3 Inflammation of AD
2.4.4 Using brain scans to detect Alzheimer's
2.5 The Demographics for AD
2.6 Financial Burden of AD

Chapter 3. Pharmacotherapy for Alzheimer's Disease
3.1 Current AD Pharmaceutical Drug Therapies
3.2 Acetylcholinesterase Drugs - How do you Treat Mild to Moderate
AD?
3.2.1 Pfizer/Eisai Aricept (Donepezil hyrdochloride) - The leading
drug choice for AD
3.2.1 Aricept clinical data
3.2.1.1 Pre-clinical data
3.2.1.2 Aricept clinical data outcomes
3.2.1.3 Eisai and Pfizer Aricept post marketing research for AD
3.2.1.4 Eisai severe Alzheimer's disease trials
3.3 Novartis Excelon (Rivastigamine) - Popular Drug Therapy for AD
3.3.1 Excelon mild-to-moderately severe Alzheimer's disease clinical
data
3.3.2 J&J/ Shire Razadyne (Galantamine) is a Mild-to-moderate
Treatment for AD
3.3.3 J&J/ Shire Reminyl (Galantamine) clinical studies
3.3.4 Forest and Lundbeck (Namenda/Ebixa) The Drug Treatments for
Moderate to Severe AD
3.3.4.1 Lundbeck Ebixa (Namenda) severe Alzheimer's disease
clinical data
3.3.4.2 Lundbeck Ebixa (Namenda) mild-to-moderate Alzheimer's
disease clinical data
3.3.5 Comparative efficacy of Clinical Approved AD drugs
3.3.6 Cognex (Tacrine)
3.3.7 Non steroidal anti-inflammatory drugs (NSAIDs)
3.4 Comorbid Conditions
3.5 Depression associated with Alzheimer's disease and its
management

Chapter 4. UK Alzheimer's Disease treatment guidelines
4.1 UK-National Institute for Clinical Excellence guidelines
4.2 NICE 2001 AD guideline
4.2.1 NICE reversal to 2001 AD guidance
4.2.2 Stakeholders' reaction to NICE 2001 AD guidelines reversal
4.2.3 NICE 2006 AD Guidance Review- Aricept, Razadyne, Exelon and
Memantine
4.2.4 Judicial Review of NICE guideline 2007

Chapter 5. Global AD market
5.1 Overview of Global AD market and Geographical analysis
5.2 US Alzheimer's disease market
5.3 US AD Market Drivers and Restraints
5.3.1 Market Drivers
5.3.2 Market Restraints
5.4 Japan Alzheimer's disease Market
5.5 Japan Market Drivers and Restraints
5.5.1 Market Drivers
5.5.2 Market Restraints
5.6 France Alzheimer's disease Market
5.7 France AD Market Drivers and Restraints
5.7.1 Market Drivers
5.7.2 Market Restraints
5.8 Germany Alzheimer's disease Market
5.9 Germany AD Market Drivers and Restraints
5.9.1 Market Drivers
5.9.2 Market Restraints
5.10 UK Alzheimer's disease Market
5.11 UK AD Market Drivers and Restraints
5.11.1 Market Drivers
5.11.2 Market Restraints
5.12 Italy's Alzheimer's disease Market
5.13 Italy AD Market Drivers and Restraints
5.13.1 Market Drivers
5.13.2 Market Restraints
5.14 Spain's Alzheimer's disease Market
5.15 Spain AD Market Drivers and Restraints
5.15.1 Market Drivers
5.15.2 Market Restraints

Chapter 6. Key players in Alzheimer's Disease Pharmacotherapy
6.1 Eisai/Pfizer's Aricept
6.1.1 Eisai Aricept product expansion
6.1.2 Eisai R&D
6.2 Forest Laboratories Namenda /Lundbeck
Ebixa product expansion
6.3 Shire Razadyne product expansion
6.4 Novartis Exelon product expansion
6.4.1 Novartis Exelon TransdermalPatch for AD
6.4.2 Potential Success of Exelon Transdermal Patch
6.4.3 Novartis' Exelon and Forest Namenda combinatorial study
6.5 Will there be generic competition?
6.6 Market growth indications

Chapter 7. Alzheimer's disease R&D and pipeline
7.1 Unmet medical needs for Alzheimer's disease
7.2 Present clinical approaches to delivering AD therapies
7.2.1 Biomarkers a prospective diagnostic tool
7.3 Overview of pipeline products
7.3.1 Pipeline Drugs for AD
7.3.2 Neurochem's Alzhemed (anti-amyloid compound) illuminates strong
therapeutic potential
7.3.3 Forest's Neramexane potential follow-on product for Namenda
7.3.4. Other compounds presently in the pipeline
7.3.4.1 PBT-1 (Coloquinol)
7.3.4.2 Phenserine
7.3.4.3 Allon Therapeutics'AL-108 and AL-208 to inhibit neuronal
death
7.3.4.4 Martek's DHA reduces brain lesions in AD animal models
7.3.4.5 Phytopharm Cogane -an orally active neuroprotective
compound
7.3.4.6 Nicotine Replacement Therapy as a Potential Treatment
for AD
7.4 Emerging Therapies for Alzheimer's disease
7.4.1 Vitamin E (Antioxidants) for AD
7.4.2 Research has revealed that Vitamin E, Vitamin C and other
health foods possess oxidative properties.
7.4.3 OTC Ginko Biloba May Slow AD Symptoms
7.4.4 Oestrogen HRT May Protect Against AD

Chapter 8. Conclusions
8.1 Expansion of Global Population
8.2 Prevalence of Alzheimer's disease in the Major Markets
8.3 FDA Approved Alzheimer's disease Therapies and NICE's
Cost-Effective Analysis
8.4 Alzheimer's disease Drug Sales across Major Markets 2006
8.5 Barriers to Generic entrants
8.6 Alzheimer's disease Revenue ($m) Forecast
8.7 Leading Companies with Products in late-stage Alzheimer's
disease Pipeline
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Table 1.1: Prevalence of AD Accross The Seven Major Markets(2006)
Table 1.2: AD Revenue Forecast ($m) for Seven Major Markets,2007-2012,2017 & 2022
Table 1.3: SWOT Analysis on Alzheimer's disease market
Table 2.1: Prevalence of AD 2006-2050 In Three Geographical Regions
Table 3.1: Assessment Scale for Defining Magnitude of AD
Table 3.1: contn'd Assessment Scale for defining magnitude of AD
Table 3.2: Summary of AD drugs clinical data
Table 3.3: SSRIs Considered in Managing Depression in AD
Table 3.4: Atypical antipsychotic agents considered in managing depression in AD
Table 3.5: Typical antipsychotic agents considered in managing depression in AD
Table 3.6: Anxiolytic Drugs Benzodiazepines Considered
Table 3.7: Mood-Stabilizing (anti-agitation) Drugs Considered in
Managing Depression in AD
Table 5.1: The Global AD Market, 2004-2006
Table 5.2: Sales for AD Therapies in the US, 2003-2006
Table 5.3: US AD Sales Revenue Forecast ($m), 2007-2012, 2017-2022
Table 5.4: Japan AD Sales Revenue Forecast ($m), 2007-2012, 2017-2022
Table 5.5: Sales Revenues of AD Agents in France, 2003-2006
Table 5.6: France AD Sales Revenue Forecast ($m), 2007-2012, 2017 2022
Table 5.7: Sales Revenues for AD Therapies in Germany, 2003-2006
Table 5.8: Germany AD Sales Revenue Forecast ($m), 2007-2012, 2017-2022
Table 5.9: Sales Revenues for AD Therapies in the UK, 2003-2006
Table 5.10: UK AD sales revenue forecast ($m), 2007-2012,2017-2022
Table 5.11: Italy's Sales Revenues for AD Therapies, 2003-2006
Table 5.12: Italy AD Sales Revenue Forecast ($m), 2007-2012,2017 -2022
Table 5.13: Spain Sales Revenues for AD Therapies, 2003-2006
Table 5.14: Spain AD Sales Revenue Forecast ($m), 2007-2012, 2017-2022
Table 6.1: Summary of Aricepts Approved indications for AD
Table 6.2: Present Aricept Extra indications in Major Markets
Table 6.3: Patent Expiration on leading AD products in Major Markets
Table 7.1: Alzheimer's disease phase III Pipeline
Table 7.2: Alzheimer's disease phase II Pipeline
Table 7.3: Alzheimer's disease phase I Pipeline
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