Pfizer Inc. / Medivation, Inc.

Alzheimer's Disease (mild-to-moderate)

Disease Overview

Alzheimer's disease is a progressive neurodegenerative disorder accounting for 60–70% of dementia cases. It typically begins after age 65 with short-term memory loss and progresses to severe cognitive and functional decline. No therapy halts or reverses the disease; symptomatic treatment options at the time of the 2008 Pfizer–Medivation deal were limited to acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine) and the NMDA antagonist memantine.

Competitive Landscape

When Pfizer paid Medivation $225M upfront plus up to $500M in milestones in September 2008 for global co-development and co-promotion of dimebon (latrepirdine), the Alzheimer's symptomatic-treatment market was dominated by Aricept (donepezil, Pfizer/Eisai), Exelon (rivastigmine, Novartis), Razadyne (galantamine, J&J) and Namenda (memantine, Forest). Aricept alone was generating >$3B annually and faced 2010 patent expiry, so Pfizer urgently needed a follow-on CNS asset. Dimebon's Phase 2 Russian data, published in The Lancet in 2008, reportedly showed cognition improvement on all five primary endpoints — described by analysts as 'better than anyone has ever seen in Alzheimer's'. Howard Liang of Leerink Swann flagged that Medivation structured the Pfizer pact to retain unusual rights, signaling its own confidence in the Russian data. The CONNECTION Phase 3 trial failed in March 2010, the HORIZON Huntington's Phase 3 failed in April 2011, and the CONCERT add-on-to-donepezil Phase 3 failed in 2012, after which Pfizer wrote off the entire program — making this a landmark case study in CNS deal risk and cross-border data validation.