Alzheimer’s was considered commercially unviable due to repeated clinical failures, but the recent approvals of lecanemab and donanemab have since established proof that disease-modifying treatment is possible123. This regulatory validation has shifted risk perception, triggering renewed collaborations and acquisitions, licensing and investments into pipelines for Alzheimer’s.
Alzheimer’s disease is the most common cause of dementia, characterised by the accumulation of amyloid‑beta plaques and tau proteins in the brain, leading to progressive cognitive decline4. Historically, drug development in this area has been extremely high‑risk, with over 99% of clinical programmes failing to achieve approval between 2000 and 20203. This is due to misdiagnosed participants, poor predictive animal models, drugs failing to reach the brain, small or poorly defined patient cohorts, and trial durations often being too short with the slow disease progression. Available treatments, such as donepezil (Aricept), primarily manage symptoms but without slowing down disease progression3.
In recent years, however, investment in Alzheimer’s therapeutics has grown significantly. Acquisition and licensing deals in the sector rose from approximately US $2 billion in 2022 to nearly $17 billion by 2025, reflecting renewed interest from pharmaceutical companies and investors5.
Major transactions include AbbVie’s $1.4 billion acquisition of Aliada Therapeutics, Johnson & Johnson’s $14.6 billion purchase of Intra‑Cellular Therapies, and the $1.7 billion licensing agreement between SciNeuro and Novartis for next‑generation antibody therapies67. Sanofi has also partnered with South Korean biotech ADEL in a $1.04 billion deal targeting tau proteins8.
Regulatory approvals have played a central role in shifting risk perception. The US FDA approved lecanemab (Eisai/Biogen) in 2023 and donanemab (Eli Lilly) in 2024 for early Alzheimer’s disease, providing evidence that disease‑modifying therapies can slow cognitive decline by targeting amyloid plaques12. These trials succeeded where previous Alzheimer’s drugs failed by targeting Alzheimer’s in the early stages, correctly selecting patients using biomarkers to ensure they all had amyloid-positive disease, and using antibodies precisely aimed at aggregated amyloid plaques (rather than all forms of amyloid protein)3, combined with careful dosing910.
In addition, new approaches are emerging. Start-ups such as Korsana Biosciences have secured US $175 million to develop next‑generation antibodies capable of improved delivery across the blood–brain barrier, while Roche is advancing trontinemab and other candidates targeting tau proteins1112. These developments indicate a new generation of potential treatment beyond traditional amyloid-centric therapies.
For biotech and pharma sectors, these trends carry many lessons. Firstly, areas that were previously deemed as unviable commercially may quickly become investible once credible clinical evidence exists513. Companies should monitor emerging scientific evidence closely and be willing to reassess areas that were previously considered risky, as what seems unviable today can become a valuable opportunity once clinical proof exists.
Secondly, large pharmaceutical companies are driving innovation by acquiring or partnering with smaller biotech firms, signalling which areas of research that would now be considered commercially promising and in line with current market trends678.
Finally, as the industry moves toward more advanced therapies and the global population ages, opportunities are emerging beyond treatments that focus on treating amyloid plaques, opening opportunities for innovation even in antibodies, tau-targeted drugs, and improved delivery methods to treat Alzheimer’s78.
Market analyses project steady growth in the global Alzheimer’s therapeutics market, with estimates ranging from USD 15 billion to USD 28 billion over the next decade, driven by ageing populations, regulatory approvals, and the emergence of disease-modifying therapies1415. Companies should see Alzheimer’s therapeutics as a growing opportunity, but entering successfully requires strategic investment and potential collaborations. At the same time, broader trends linked to aging populations suggest other age-related growing markets are also worth exploring for start-ups and investors.