LUNDBECKMAGAZINE

Drugs of the future

Meet ouremployees

Growth through partnership

Lundbeckmilestones

p6 p10 p24 p39

2006

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39-4132-3520-23

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Malcolm

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Read also

Growth through partnership 24Clear guidelines 28The Lundbeck Foundation 30Treatment of depression under scrutiny 36Masterclass in psychiatry 42

Around the worldFrom being a Danish company with strong roots in Europe, Lundbeck is today a company with global operations.

ALZHEIMER’SDISEASE STOLE

Lundbeck Magazine

H. Lundbeck A/S Corporate Reporting Design: Bysted A/S Photo: Nicky Bonne, GettyImages p25-26, Scanpix p41, Cambridge Newspapers Ltd. p32 Illustration: Nis Nielsen Print: Quickly Tryk A/S Run: 8,000

Lundbeck milestonesLundbeck milestones are markers along a journey from 1915 to the present, during which the wholesaler became a research-based company. Today, more than 90 years later, Lundbeck is known as one of the world’s leading CNS specialists.

CONTENTS

Meet our employeesLundbeck’s long-term success depends on its ability to attract and keep the best people.

Drugs of the futureThe motivating force in Lundbeck research and development activi-ties is to ensure new and innovative medicine which can improve quality of life for patients suffering from mental and neurological disorders.

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We are a research-based company. We engage in research to find new drugs for treatment of CNS disorders, includ-ing depression, schizophrenia, Alzheimer’s disease and

Parkinson’s disease.

These are serious disorders. They affect not only patients, but also their families and friends. Besides the stress of having a CNS disorder, patients are often exposed to prejudice because, in many sections of society, there is still far too little understanding of how adversely a CNS disorder affects an individual’s life.

We have taken upon ourselves the task of improving quality of life for persons with a psychriatric or neurological disorder, and we are working intensely to find and develop new and improved drugs.

Our research units are located at our headquarters in Denmark and in New Jersey in the United States.

We also manufacture and market our drugs, and currently have subsi-diaries in more than 50 countries around the world. Our staff members everywhere are capable and committed. At the same time, we are conscious of the significant value partnerships can create. We believe that we can make a significant difference, and we are happy to do so in cooperation with others.

I hope you will enjoy reading about some of our staff, as well as lear-ning more about our company and activities.

Yours sincerely

Claus BræstrupPresident & CEO H. Lundbeck A/S

Lundbeck Magazine

Welcome to Lundbeck

This magazine is an introduction to our company and who we are. Lundbeck is an international pharma-ceutical company with strong roots in Europe, and now also with its own subsidiaries in more than 50 countries around the world.

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Dedicated to innovation

DRUGS OF THE FUTURE

Research has been the foundation of Lundbeck activities for more than 50 years. The motivating force in Lundbeck research and develop-ment activities is to ensure new and innovative medicine which can improve quality of life for patients suffering from mental and neurological disorders.

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At present, there is a major unmet need for treatment of stroke and its serious, long-term disabling consequences. Most cases of stroke are caused by cerebral thrombosis. There is currently only one treatment for dissolving blood clots in the brain. If this treatment is to have any effect, the patient must be treated within a maximum of three hours after the stroke takes place. This means that some 98 per cent of stroke patients cannot be treated in time.

Expectations are that desmoteplase can be given up to nine hours after a stroke has taken place, which will enable a considerably higher number of patients to be treated.

The art of the possibleSchizophrenia is a major area of disorder which has been known and described for more than 100 years.

Lundbeck has done research in the development of drugs for treat-ment of schizophrenia for more than 50 years. The first generation of substances for schizophrenia was invented in the 1950s and 1960s. During this period, Lundbeck developed the drugs Truxal®, Sordinol® and Fluanxol®.

The second generation was developed in the 1980s and 1990s, during which time Lundbeck developed Serdolect®. Lundbeck is currently developing new drugs for schizophrenia.

Schizophrenia is a very complex disorder, and there is no certain knowledge of its causes. It is known that genes exist which can increase the risk of schizophrenia developing later in life. It also appears that certain environmental influences during the embryonic stage and early childhood can increase the risk. But there is still a long way to having exhaustive knowledge of how the disorder arises.

Schizophrenia is characterized by various symptoms and entails changes in the patient’s mode of thought and perception. Schizophrenia is a pain-ful condition which often causes patients to lose control of their lives.

Despite the fact that the disorder is well described and that numerous drugs are available for treating it, there is still a long way to optimum treatment. One of the significant challenges of the disorder is its range of symptoms. The idea that one drug cannot cover all the areas of the brain which are under attack is gradually being accepted, and future drugs will, to a greater extent, be targeted to treat individual symp-toms and be part of treatment in combination with other drugs •

Lundbeck’s mission is to improve quality of life for people suffering from psychiatric or neurological disorders.

These disorders are often described collectively as malfunctions of the central nervous system (CNS).

CNS disorders can be divided into two main areas: psychiatric and neurological malfunctions. Psychi-atric malfunctions include disorders such as depression, anxiety and schizophrenia. Neurological mal-functions include disorders such as Parkinson’s disease and Alzheimer’s disease.

Psychiatric disorders like depression and schizophrenia are caused by disturbances or chemical imbalances in the brain. Medicine is available which can relieve the symptoms, but there is no actual cure as the causes of the conditions are not known.

Neurological disorders such as Alzheimer’s disease and Parkinson’s disease are caused by pathological conditions in the brain which break down and destroy the cells of the brain with serious consequences for the patients.

Lundbeck Magazine

L undbeck has been developing drugs for treatment of schizo-phrenia and depression since the beginning of the 1950s when it first became possible to offer medical treatment to

patients with mental disorders. During the last 10 years, Lundbeck research has also addressed neurological disorders.

Lundbeck aims to launch a new drug every fourth year and currently has research and development projects in progress in depression, schizophrenia, sleep disorders, stroke, Parkinson’s disease, Alzheimer’s disease and epilepsy. The projects which are at the most advanced stages involve treatment of depression, schizophrenia, sleep disorders and stroke.

“We know that expectations to a substance will be different in future than they are to the drugs which are currently available. This is why Lundbeck is experimenting with finding substances which are different. We are operating in territory at the edge of current knowledge, but that is where we can make new conquests,” says Anders Gersel Peder-sen, Senior Vice President, Drug Development.

The secrets of disordersDespite many years of intensive research, drugs for mental and neuro-logical disorders offer primarily treatment of symptoms.

“One of the significant challenges of developing drugs for treatment of mental and neurological disorders is the fact that no one is certain why these disorders arise. Our scientists are in the process of obtaining a better understanding of biological causes of these disorders, and this will prepare the way for new and improved drugs in the coming years,” says Peter Høngaard Andersen, Vice President, Research.

Faster onset of actionLundbeck has for a number of years been among the leading compa-nies in treatment of depression. Today, it is possible to enable most patients suffering from depression to lead normal lives by relieving their symptoms.

Depression is the most common disorder of the central nervous sy-stem. The disorder varies in strength from mild depression to a prolon-ged, disabling and life-threatening condition. Depression strikes all age groups and WHO estimates that approximately 120 million persons worldwide suffer from depression requiring treatment.

While the biological cause of depression is still unknown, it has been established that a reduced level of the signal substance serotonin plays a significant role. However, even though the antidepressants currently in use increase the serotonin level at once, they do not become effica-cious until some weeks later.

The aim for future antidepressants is to ensure even faster onset of ac-tion. In addition to this, there is a group of patients who do not benefit from treatment with current antidepressants. Developing a drug which would benefit this group would therefore be a significant contribution to treatment of depression.

At present, Lundbeck has several drug candidates for treatment of depression in clinical development.

Improved sleep architecture In 2008, Lundbeck expects to be able to offer a new drug for treatment of sleep disorders. The substance is known as gaboxadol, and Lundbeck is currently carrying out the final and decisive clinical trials which involve several thousand patients.

Lundbeck has not previously developed drugs for treatment of sleep disorders, and gaboxadol is thus the first drug candidate of its kind in the Lundbeck development portfolio.

Sleep disturbances are very common and include a wide range of sleep disorders. Some patients have difficulty falling asleep, others wake up during the night.

Gaboxadol has an entirely unique mechanism of action which distinguishes it from other soporifics. It is expected that gaboxadol can normalize the sleep patterns of patients with sleep disorders without causing well-known side effects such as a sensation of fatigue on waking the next morning. Moreover, gaboxadol has shown no signs of being addictive, which is a serious side effect of the soporifics that are currently available.

Help in timeStroke is the third most common cause of death in the industrialized world, exceeded only by heart diseases and cancer. Lundbeck has begun collaborating with the German biopharmaceutical company PAION on developing an entirely new and innovative substance known as desmo-teplase for treatment of this serious disease.

Tine Stensbøl, Head of Department Molecular Pharmacology H. Lundbeck A/S, Denmark Hej

Hello

“Basically, I am driven by my urge to make a drug that matters; a drug that makes a difference for people suffering from a detrimental disease. Hunting down a drug that makes a difference; finding the drug that makes the difference – that’s what my job is all about. Cross-divisional teams of highly dedicated peers, bosses and employees that share the enthusiasm for neuroscience and drug discovery has a huge impact on my satisfaction as an employee at Lundbeck.”

Lundbeck’s long-term success depends on its ability to attract and keep the best people.

Lundbeck wants to give staff members the best possibilities for achieving good results, professional and personal development, and the opportunity of being part of a global network of talented

colleagues around the world.

Lundbeck has staff members with core competencies in the entire value chain, ranging from ideas through development to production, sales and marketing. This is why Lundbeck emphasizes career and development opportunities which cater for the interests of all types of employees. There is a classical route for management advancement, but there is also an advancement route for specialists who are interested in profes-sional development rather than a traditional managerial post.

At Lundbeck, we understand the value of having a wide variety of staff members •

Lundbeck currently has more than 5,000 employees. Approxi-mately one-third of them work at the headquarters in Denmark, while the remaining two-thirds are employed by Lundbeck subsidiaries around the world.

5,000+

Sofia Lemos, Medical Director Lundbeck Portugal OláJanakiraman Seshachalam, Product Manager

Lundbeck India

“I have a very special regard for Lundbeck because I joined the company back in January 2002 when it was just starting in Portugal. As we were only a few staff members then, we soon became like a small family.I am proud and confident to be part of a company that challenges me every day. Lundbeck gives me the opportunity to continue expanding my activity into new therapeutic areas while, at the same time, reinforcing my expertise in the fascinating area of CNS.”

“As a Lundbeck person, I am respected and welcomed by psychiatrists. The most important binding force with Lundbeck is the fact that we help restore humanity. Diversity can enrich performance and provide a wealth of fresh ideas, so Lundbeck should have talented people from around the world working at headquarters.”

João Carlos Rocha, Regional Vice President Lundbeck Latin America OláHej“I have worked in the pharmaceutical industry for 18 years, and the work environment at Lundbeck is like no other I have previously encountered. From the start, I knew that my experience here would be unique. The primary factors that drive me to enjoy working at Lundbeck are the people, the overall sense of teamwork and the constant challenges.”

“I have worked at Lundbeck since 1992. Lundbeck has always given me ample opportunity and challenges to grow professionally and personally. There is not one specific thing Lundbeck needs to do, but a number of things starting with the Lundbeck ambition of daring to be different.

What do we really want to be and to create? Lundbeck must have the ambition not to do the same, but to be better – to dare to be different. We need to create the space and willingness to invest in innovative ways to attract the best people.”

Peter Holm Tygesen, Vice President Pharmaceutical Production, H. Lundbeck A/S, Denmark

Dirk Haasner, Head of Regulatory and Medical Affairs Lundbeck Inc. USA HelloTina Ying Zhang, Office Administrator

Lundbeck China

“I like working at Lundbeck for a number of reasons. From a scientist’s viewpoint, the CNS is a fascinating organ system and Lundbeck has dedication and a history of excellence in this therapeutic area. From a business viewpoint, working at Lundbeck USA allows me to cover the areas of Medical Science, Regulatory Affairs, and Marketing, while helping to build a fully operational US subsidiary from a handful of colleagues to several hundred over the next few years.”

“The Lundbeck star impressed me at first sight. It reminds me of a story about starfish. An old man was picking up stranded starfish and throwing them back into the sea. A passer-by asked, ‘Why are you spending so much energy doing something that is only a waste of time? There are thousands of beaches and millions of starfish. How can you make any difference?’

Looking at the small starfish in his hand before tossing it back to the safety of the sea, the old man replied, ‘It makes a difference to this one.’ Helping others makes our work valuable, and it makes my job fun. Lundbeck’s values give me the same feeling, and I am very excited to be part of Lundbeck on its new journey in China.”

Wayne Morton, Sales Representative Lundbeck South Africa HiPhilip Jenkins, Section Head

Lundbeck Pharmaceuticals, England Hello“I have been employed at Lundbeck for the last six years and have loved every minute. What I like most is that I am part of a family and not just another big-company statistic. Lundbeck is specialized and focused on the CNS field, which makes us as employees specialized and – due to the superb training – experts in our respective positions. Lundbeck is extremely ethical and has outstanding relationships with its customers.”

“I like working for Lundbeck mainly because of the people I work with. I have been with the company for several years now and different people have come and gone. Many have been good friends and competent colleagues. However, the working culture at Lundbeck has remained the same - friendly, honest and reliable. The pharmaceutical industry also provides a variety of areas to work with; no two days are ever the same!”

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Lundbeck introduced the drug Cipramil® in 1989. This drug for treatment of depression was a notable success everywhere – not just for treatment of depression, but also a sales success which

paved the way for Lundbeck to expand its corporate as well as its research activities. Among other things, the success of Cipramil made it possible to build new and ultramodern research and manufacturing facilities at Lundbeck headquarters and at the factories in Denmark and England.

In 1989, Lundbeck opened a subsidiary in South Africa, and then crossed the Atlantic for the first time in 1995 by establishing a company in Canada. Developments have since been very rapid indeed. During the ensuing years, Lundbeck looked eastward by establishing companies in the former Eastern bloc countries. Later, companies were also founded in the Middle East and Asia. Today, Lundbeck is represented on six conti-nents. The task is now to complete this global expansion by establishing independent Lundbeck companies in the United States and Japan.

AROUND THE WORLD

From being a Danish company with strong roots in Europe,

Lundbeck is today a company with global operations.

22-23Lundbeck Magazine

New productsThanks to the success of Cipramil, it has been possible for Lundbeck to establish sales companies around the world and to strengthen its research and development activities at the same time. During recent years, several products have been added to the product portfolio. In addition to the commercial potential of opening in new markets, increasing numbers of people are gaining access to treatment for disorders which were previously treated only inadequately – or perhaps not at all.

Help is availableThe World Health Organization (WHO) estimates that 120 million persons around the world suffer from depression requiring treatment. This has major humanitarian and economic consequences.

Schizophrenia and psychoses are disabling conditions which make life very difficult for the large group of patients – often young people – who are struck by these serious disorders.

While more and more people are living longer, rising numbers are also being struck by dementia diseases such as Alzheimer’s. Parkinson’s disease will likewise affect the lives of more people as the percentage of aged persons rises in national populations.

As specialists in CNS disorders and diseases, it is important for Lundbeck to offer the best possible treatment for these patients, and during recent years we have increased the number of drugs on offer from one to four.

Our drugsCipralex®/Lexapro® represents the newest generation of antidepres-sants and offers patients a number of benefits in treatment of depression and anxiety. Cipralex/Lexapro has a unique mechanism of action which results in faster onset of action, high efficacy and good tolerability.

Ebixa® is the only drug with regulatory approval for treatment of moderate to moderately severe and severe Alzheimer’s disease. Ebixa has a positive effect on the disease symptoms and prolongs the period during which patients can perform daily functions such as personal care, eating and communicating. With Ebixa’s indication, it is possible to treat 80 per cent of patients. They are also able to obtain Ebixa as initial and on-going treatment, which is a major benefit for this patient group.

Azilect® is a new drug for treatment of Parkinson’s disease. Azilect is efficacious for the symptoms in the early as well as advanced stages of the disease. Moreover, Azilect is extremely easy to use, due to the simple dosage of one milligram in one tablet, once a day.

Serdolect® is an antipsychotic drug for treatment of schizophrenia. Serdolect is efficacious and has fewer side effects such as sedative effect, weight gain and involuntary movements which are especially typical of products that are somewhat older than Serdolect. Moreover, many patients say that Serdolect does not affect their clarity of thought •

ProductionSalesResearch

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Developing new drugs has become more difficult and resource-intensive than ever before. At the same time, however, the time available for capitalizing on investments has grown shorter. In

the pharmaceutical industry, networks and partnerships are increasingly being used to deal with these challenges.

As a small pharmaceutical specialist, Lundbeck has for a number of years entered into partnerships which can counterbalance its limited size and financial resources. Partnerships also provide access to com-petencies, knowledge and resources which are important to ensuring success in both research and commercialization of drugs.

Formula for successPartnerships have enabled Lundbeck to have an R&D portfolio on a par with much larger companies in the industry. Sharing costs and risks with partners has made it possible to increase the number of research projects, and thus the probability of success. Moreover, partners’ com-petencies contribute to Lundbeck being able to avoid delays and thus reduce development times, besides ensuring better and more extensive market penetration when launching a product.

Today, Lundbeck has a reputation of having a solid foundation and being a reliable partner in CNS.

Growth through partnerships Success on the pharmaceutical markets of the future will be created in networks.

PAION AG, GERMANY

One of the newest partners is the German biopharmaceutical company PAION. Lundbeck entered into an agreement with PAION in the summer of 2005 on the development and marketing of desmoteplase, a medication for treatment of stroke (blood clot in the brain).

PAION was founded in 2000 in Aachen, Germany, and has 60 employees.

PAION aims to become a leader in development of drugs for treatment of blood clots and other related diseases where there is a large and un-met need for treatment. Since it was founded, PAION has been working on development of desmoteplase.

Stroke is the third-highest cause of death in the industrialized world, and many thousands of people are disabled every year due to stroke which, in most cases, is caused by blood clots in the brain.

Desmoteplase is a biotechnological development of an enzyme found in the saliva of the vampire bat, and is a very promising substance to which both PAION and Lundbeck have great expectations •

Desmodus rotundusFound in Mexico, the vampire bat desmodus rotundus lives from sucking the blood of animals such as cattle. Mexican scientists observed that the bat can keep the blood flowing when it bites an ani-mal, and subsequently discovered that the saliva of the bat contains an enzyme which dissolves coagu-lated blood. This enzyme has since been synthesized and has proved to be not only very strong, but also to have a lasting effect.

Desmoteplase has shown potential for treatment of patients up to nine hours after a stroke has taken place.

FOREST LABORATORIES, INC., USA

In 1995, Lundbeck entered into an important strategic alliance with the American company Forest Laboratories, Inc.

Platform for the US The alliance with Forest Laboratories became Lundbeck’s ticket to the American market. The first Lundbeck product that Forest marketed in 1998 was the antidepressant Cipramil® which was sold in the United States as Celexa®. Forest marketed Celexa with great success, and the launch of its successor Lexapro® (escitalopram) in 2002 was one of the fastest and most successful introductions of a new drug which has ever taken place in the United States.

Collaboration with Forest Labs has since evolved to include partner-ships with other pharmaceutical companies. Thus, Forest Labs and Lundbeck work jointly with the German pharmaceutical company Merz + Co. on developing and marketing memantine, the substance which is currently marketed as Ebixa®/Namenda® for treatment of Alzheimer’s disease. Forest and Lundbeck are also cooperating with PAION AG on development of a new substance known as desmoteplase for treatment of stroke.

MERCK & CO., USA

Lundbeck and Merck & Co. Inc. began a strategic partnership in 2004 to develop and market the innovative Lundbeck soporific substance gaboxadol. The partnership with Merck & Co. is a natural strategic alliance in which Lundbeck, as a CNS specialist, contributes know-ledge and expertise, and Merck contributes professional versatility and strength on the American market.

The partnership is making it possible for Lundbeck to build up its own sales organization in the United States which is the largest pharmaceu-ticals market in the world. Gaining a foothold in the American market is a challenge for all pharmaceutical companies. The partnership with Merck & Co. gives Lundbeck a considerable boost in competence as well as knowledge of the American market, while also minimizing Lundbeck’s risk in establishing its own American sales organization.

Merck & Co. has more than a century of history as a research company, and was the American laboratory which supplied the first dosage of penicillin in 1942. Today, the company has more than 50,000 employ-ees and is involved in research, development and marketing of drugs in all major fields of medicine.

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Lundbeck has worked for many years to ensure high environmental, health and safety standards at its production facilities in Denmark, England and Italy. Europe has traditionally been Lundbeck’s home

market, also when selecting suppliers. Like so many other things in globalization however, it has now also become natural for Lundbeck to work with suppliers in countries which have other views of environ-mental, health and safety issues. Naturally, the challenge is to ensure that Lundbeck suppliers also focus on environment, health and safety, as well as their HR.

“Lundbeck’s mission is to help sick people become well – and with that aim we cannot operate our business in a manner that would harm either people or the environment. We must ensure that everything is as it should be from start to finish”, says Claus Bræstrup, CEO.

Lundbeck has therefore compiled a system to ensure that suppliers comply with Lundbeck requirements for entering into supply contracts. The system is based on the recognized principles of the UN Declara-tion of Human Rights and the conventions of the International Labour Organization.

Lundbeck will be initiating a dialogue with all of our suppliers to clarify which requirements must be fulfilled. This will take place as a natural development in cooperation with our suppliers. For large suppliers, our requirements will be stipulated in the contracts which are signed by both parties.

In cases of large orders – which have inherently greater risks due to products being manufactured in countries where national legislation on environment, health and safety is inadequate and/or where person-nel are not protected in accordance with ILO conventions and the UN Declaration of Human Rights – Lundbeck will visit companies and review the conditions on site in accordance with a detailed checklist.

Dialogue paves the wayNot all companies in the global market have the same high environ-mental, health and safety standards as those in most European companies. By choosing suppliers who are willing to discuss the issues and are prepared to work actively to improve the environment, health and safety, Lundbeck can contribute to influencing developments in a positive direction.

In 2005 Lundbeck screened a number of suppliers of intermediate products for manufacturing drugs in India and China. In effectuating the screening process, Lundbeck has dispatched environmental, health and safety consultants who have assessed the various suppliers on the basis of international standards.

“For some companies in countries such as India and China, our requirements can initially seem difficult to fulfil, but we insist that these things must be in order. By doing this, however, we also give these companies – and not least their employees – the opportunity for long-term positive development”, says Lars Bang, Executive Vice President, Supply Operations, Engineering & IT •

Lundbeck assesses its potential suppliers in the following areas:➔ environmental impact

and management➔ environmental

improvement and reporting➔ work environment and safety➔ wages and benefits➔ work hours and contracts➔ child and forced labour➔ freedom of association➔ discrimination➔ disciplinary measures

Lundbeck expects to enter into its first large contracts with Chinese and Indian suppliers in 2006.

Lundbeck Magazine

Clear guidelinesLundbeck has always endeavoured to maintain high standards in environmental, health, safety and HR matters throughout the company. Today, these standards are being extended to external suppliers which must be prepared to protect their employees and the environment if they wish to work with Lundbeck.

30_31Lundbeck Årsmagasin 05

The Lundbeck Foundation was establis-hed in 1954. The foundation owns the majority of the shares in H. Lundbeck A/S, and a significant amount of the return on the foundation’s capital of more than DKK 10 billion goes to research in Denmark. Since 1999, the foundation has donated DKK 706 million to scientists and their projects in Denmark.

The Lundbeck Foundation currently owns 70 per cent of the share capital in Lundbeck. The primary aim is to consolidate and expand the activities of the Lundbeck group and to make donations to research in health and natural science in Denmark.

The Lundbeck Foundation is the largest private donor to scientists and research projects in Denmark

The Lundbeck Foundation was established in 1954 by Mrs. Grete Lundbeck, the widow of Lundbeck’s founder Hans Lundbeck. The purpose of the foundation is to consolidate and expand the

activities of the Lundbeck group, and to contribute financial support to high-quality scientific research.

As the result of H. Lundbeck A/S being listed on the stock exchange in 1999 and the continued success of its activities, the Lundbeck Founda-tion can now make more funds available for research than ever before. There has thus been a marked rise in donations made by the founda-tion during the last five years.

The Lundbeck Foundation has doubled its donations to Danish scientists and research centres in 2005, thereby enhancing its role as a significant figure in research in Denmark. In 2005, the Lundbeck Foundation donated approximately DKK 225 million to primarily scientific purposes in health and natural science.

“The money is donated with no stipulations concerning rights or confidentiality as regards results. Scientists must primarily demonstrate research of the highest international calibre,” says the Chairman of the Lundbeck Foundation, Arne V. Jensen.

In addition to the approximately 100 contributions to scientists and their projects, the foundation grants a number of research awards, including the Lundbeck Foundation Nordic Scientist Award, and finances a number of Lundbeck Foundation professorships.

As something new, the Lundbeck Foundation has also begun financing a number of research centres. The decision led to the foundation being able to announce its largest individual donation to date totalling DKK 120 million for brain research in Denmark.

During the next five years, three research institutes will benefit from the DKK 120 million. Among other things, the three centres are engaged in research involving the survival of nerve cells in the brain, molecular image formation in the brain, and research in blood circulation in the brain.

“The Lundbeck Foundation’s many initiatives and extensive possibilities for encouraging interest in natural science, as well as for carrying out research projects on a par with research outside Denmark’s borders, can be seen as support for Danish society as a whole.”

Mr. Arne V. Jensen, Chairman of the Lundbeck Foundation.

“We support brain research because brain diseases comprise 35 per cent of the total disease load. Despite this fact, brain diseases do not receive as much attentions as, for instance, heart diseases. As a conse-quence, there is both a need for more focus on brain diseases and for financial support for research of a high international standard,” explains the Vice Chairman of the Lundbeck Foundation, Dr. Nils Axelsen, Con-sultant Psychiatrist and DMSc.

As is the case with all other Lundbeck Foundation donations, the money is given with no stipulations concerning rights, as the foundation empha-sizes free exchange of research results. Moreover, research which receives funds has no direct connection with research being done at Lundbeck •

The Lundbeck Foundation

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Malcolm In this interview, Barbara Pointon describes how her life changed from being the one partner in a passionate, harmonious and giving marriage, to being a carer for the person she loves so deeply.

Lundbeck Magazine

Alzheimer’s disease stole

“ When all the outward things have gone, when no one needs to make an impression, then we are down to the basics of two people who love each other.” Barbara Pointon

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Some members of the family and friends began distancing themselves.

Barbara and Malcolm were no longer invited to social gatherings because

Malcolm ate with his fingers, spilled food and drooled. A cousin who had

always been particularly close to Malcolm no longer came to their home.

He wanted to remember Malcolm as he once had been.

Nursing home The day finally came when Barbara had to put Malcolm in a nursing home

some 26 miles away.

“That was the worst decision I have had to make. I wept and wept. But he

was now incontinent, required vigilance around the clock, and could no

longer wash, dress or feed himself nor articulate his needs. The carer now

had to do all these things for him, Barbara explains.”

Malcolm stayed in the nursing home for two years. During that time, Barbara

regained some of her energy, but spent time visiting him almost every day.

Home againIn 2000, Malcolm lost his ability to walk. In March, Barbara decided he

should return home, as his doctors did not expect him to live much longer.

What she did not expect was improvement.

“The first thing he said when he came into the living room was ‘home’.

He had not uttered a recognizable word for two years! And even though

his Alzheimer’s has continued to progress, he is content. Here we are now

– and he has broken all the doctors’ prognoses. He is more anxious now

and needs a lot of reassurance, especially when he hallucinates. The hardest

thing of all is that he can’t tell us when or where something hurts.”

Barbara believes that Malcolm can sense touches and respond to music,

friendly faces and cuddles. She has an excellent team of carers that she has

put together and trained herself. Peace and quiet reign. It is very important

that people with dementia have a sense of calm and security in their sur-

roundings.

“But the worst thing is that I, at some point, must make decisions that

concern life and death. When Malcolm becomes weary of suffering, my

greatest act of love will be to let him go with dignity and not prolong his

life with artificial interventions. That is an enormous responsibility when

I do not know for sure his innermost wishes, yet I believe that is what he

would want and I hope I will be able to sense it when that day comes.”

Light in the darkness“Even though all doors had apparently closed to me, others amazingly opened.

There was a TV documentary about us – and that meant that I was invited

to speak at conferences and was included in the Government’s consultations

on caring for Alzheimer’s patients. I now use the skills I acquired as a music

lecturer and drama director to advocate our cause. I give many talks to spread

knowledge and understanding of the illness as a positive way of channelling

my own intense anger at Alzheimer’s taking Malcolm away from me.” •

In 2004, Barbara Pointon received a 25th Anniversary Alzheimer’s Society Award which was given to six volunteers who had made a difference by spreading knowledge and understanding of dementia.

Alzheimer’s diseaseThere are more than five million per-sons around the world with Alzhe-imer’s disease. Alzheimer’s disease gradually destroys the brain with major consequences for patients as well as their families and friends who are forced to watch powerlessly as the person they have known and loved turns into a helpless individual who is unable to communicate or care for him or herself.

In Barbara and Malcolm Pointon’s charming house in Thriplow (near Cambridge) in England, there are demijohns of home-made wine bubbling in the kitchen, rows of home-made preserves, and

the afternoon sun is shining on the old apple trees in the beautiful well-kept garden.

Inside, the house is bright and inviting. In the living room, however, the

family’s large oval dining table stands squeezed in behind the sofas and the

grand piano. The dining room is no longer used for meals; it has been turned

into a sickroom for Malcolm Pointon, Barbara’s husband, who has been ill

with Alzheimer’s disease since 1991.

Malcolm Pointon was 51 years of age when he was diagnosed with Alz-

heimer’s disease. Barbara was 52.

Malcolm was a dynamic music lecturer and pianist; he painted, liked working

with electronics, spoke several foreign languages and made wine. He enjoyed

living. Together, Barbara and Malcolm had a rich and rewarding life.

During the time before Malcolm was diagnosed, there were things he was

suddenly unable to do, such as differentiate between right and left.

“It weighed him down and he went into depression. His doctor treated the

depression but did not consider the reasons behind it. If he had, he would

have seen the signs of early dementia, Barbara says.“

During the same period, Malcolm lost his sense of money and family

finances. He either paid the bills twice or did not pay them at all.

“I didn’t suspect Alzheimer’s disease, because I didn’t know anything about it.

One day he lost his way on the road home from Cambridge.

We had lived here for 25 years, but he took more than three hours getting

home. Malcolm was beside himself. Pale with fright, he threw his keys on the

table and never drove again. That’s when we went to the doctor.”

The GP referred Malcolm to a neurologist, but it had taken two years to get

that far. Until then, the focus had been on the depression rather than on

the changes in Malcolm’s life. Barbara believes that early diagnosis is vital

and that GPs should have better training in dementia, especially now with

rising numbers of elderly people.

Early retirementOn Christmas Eve in 1991, the doctors told Barbara they suspected

Alzheimer’s while Malcolm sat in the waiting room. They did not want

Malcolm to know about it until they were certain.

The actual diagnosis came in June of 1992, and Malcolm decided to take

early retirement. Six months later, Barbara realized it was becoming hazard-

ous for him to be left alone – for example, he placed an empty saucepan

on a hot hob and forgot it – and in the summer of 1993 she decided to

retire to be able to spend the good time Malcolm had left with him.

“At that point, he was still able to speak, though there were many things

he could no longer do. I concentrated on the things he could still do,

Barbara recalls.”

From wife to carerBetween 1991 and 1994, life was reasonably good for Barbara and Malcolm,

but in 1994 it began to get difficult. Malcolm began misinterpreting his

surroundings. One afternoon when Barbara and a friend were working in the

garden, he perceived their use of an ordinary compost shredder as some form

of devil worship. In his anger and bewilderment, he struck Barbara – some-

thing he had never done before.

Malcolm was at that time on his way into the intermediate stage of Alz-

heimer’s disease when patients, among other things, begin hiding things in

the strangest places.

“We sought the help of a behavioural psychologist. He explained that people

with dementia feel that they have lost so much of themselves that they must

hide important things in case they too get lost. However, they have no sense

of appropriate hiding places so the handbag ends up in the washing machine,

the chequebook in the ventilator shaft, and the car keys in the freezer. But the

carer becomes very agitated and irritated when things disappear.”

For the first time during our conversation, Barbara uses the word “carer” about

herself. It had now become necessary to keep Malcolm under constant surveil-

lance to avoid the most extraordinary situations.

“The next thing that happens as the disease progresses is that they hallucinate.

They also begin regressing in time and resume former behaviour patterns. The

carer should never argue, but somehow go along with this, no matter how

bizarre it seems. It is so easy to see only the physical shell of the person who

no longer exists. One must enter into the world of the person with dementia

because they can no longer inhabit our real world.”

Barbara describes this period of the disease as being an enormous strain on

the carer. The person who is ill often becomes aggressive due to frustration,

especially in connection with personal care and hygiene. Malcolm often struck

Barbara during this period – something that was entirely remote from his previ-

ous behaviour – and he also began throwing furniture about. He was prescribed

sedatives, but they only worked for a few hours, after which he became worse.

2-336-37

TREATMENT OF DEPRESSION UNDER SCRUTINY

Lundbeck is financing a study which is to clarify why only some patients with depression are diagnosed correctly by their GP. Known as InDep, the study is being led by the British doctor Alan G. Wade.

InDep is being carried out by means of a questionnaire which is distri-buted to the first ten patients who are given an initial prescription for antidepressants during a specified period of time. The doctor fills in one questionnaire with the patient independently filling out a second que-stionnaire with corresponding questions. Subsequent questionnaires are completed after eight weeks. The responses are sent to the Biostati-stics Department at the University of Glasgow which is in charge of collecting the data.

What is the aim of InDep?

“We know from clinical studies that antidepressants are efficacious in treatment of depression. However, we also know that many people with depression do not receive the correct treatment. There is conside-rable difference in the results we can obtain in clinical studies and the

Alan G. Wade is a doctor and direc-tor of the private research institute CPS Research in Glasgow. The insti-tute specializes in performing clini-cal studies for the pharmaceutical industry, and Dr. Wade works mainly in the field of psychopharmacology with studies of depression, panic, anxiety, and social phobia. He has a particular interest in data capture direct from patients in real-life situations.

WHO estimates that approximately 120 million persons worldwide have depression requiring treatment. Lundbeck is a world leader in treat-ment of depression.

Lundbeck Magazine

2-3

90Lundbeck milestones are markers along a journey from 1915 to the present, during which the wholesaler became a research-based company. Today, more than 90 years later, Lundbeck is known as one of the world’s leading CNS specialists.

“Guidelines suggest that depression is an illness which requires long-term treatment, but many patients stop taking medication after only a few weeks. InDep can perhaps help us find an explanation for this and also point towards potential solutions.” Does it mean anything that

Lundbeck is financing the study?

“We are attempting to get to the bottom of a very real problem and the study is not specifically aimed at any particular Lundbeck product. Naturally, increased use of antidepressants would benefit their manu-facturers, but patients and society will gain the most if we succeed in becoming better at treating and managing depression. While we need more clinical studies to help us refine future guidelines, the biggest problem at present is implementing the guidelines which currently exist. We doctors are well aware of what we should do, but not always of how to do it. We hope that InDep can help point that out and provide a platform for educating both doctors and patients.” GPs and their patients are participating in InDep in a number of countries. The first results are coming in from Sweden and Turkey and are expected to be made public towards the end of 2006. Portugal is also participating, and countries such as Greece and Great Britain are expected to follow •

results patients obtain from the management they receive when they consult a doctor. We believe, therefore, that the explanation must lie in the interaction between doctor and patient, but we do not know what the explanation is.”

“InDep is studying this interaction by questioning both parties. The study is the first ever in which the GP and the patient respond individually to the same questions at the same time. Among other things, we ask what the patient believes he or she has told the doctor, and what the doctor actually understands the patient as saying. We would also like to know why the patient has consulted the doctor.”

“Many patients with depression leave their doctor without being treated for their disorder. But why do doctors prescribe antidepressants for one patient and not for another? What is the trigger to giving the prescrip-tion for an antidepressant? Does the patient say ‘I am depressed,’ or does he or she say ‘I have a headache problem’? And does the doctor inform the patient if he or she prescribes an antidepressant? Or does the doctor merely say ‘here is something for your headache’? We would like to have the answers to these questions.”

“Perhaps we can help people with depression become better at telling their doctor how being depressed feels and, at the same time, train doctors to recognize the symptoms.”

“Perhaps we can help people with depression become better at telling

their doctor how being depressed feels and, at the same time, train doctors to

recognize the symptoms.”

Depression is a disorder which has been known and referred to by philosophers and physicians throughout the ages. Indeed, there are descriptions of depressed indi-viduals in numerous mythological, religious and literary texts in the Hellenic, Arabic, Indian and Western cultures. The disorder is also described in medical literature from Greece, across India to Southeast Asia. Melancholy and depression were described by the Greek physi-cian Hippocrates (460-377 BC) in the 4th century BC.

Scientific research in depression began gaining momentum in the 19th and 20th centuries.

40-41

Truxal®

90

2005 Azilect® (rasagiline) is launched for treatment of Parkinson’s disease.

2005 The EMEA Committee for Medicinal Products for Human Use (CHMP) revokes suspension of Serdolect®, whereby Lundbeck regains the right to market the drug.

2005 Lundbeck enters into an agreement with the German biopharmaceutical company on development of the substance desmoteplase for treatment of stroke (blood clot in the brain).

1987 Erik Sprunk Jansen becomes President & CEO.

1980a Lundbeck defines CNS as its overall strategy.

1989 Cipramil® is launched in Denmark.

2002 Lundbeck acquires the American research company Synaptic, establishing an American research unit as a bridgehead in the United States.

2003 Claus Bræstrup succeeds Erik Sprunk Jansen as President & CEO.

2004 Lundbeck and the American company Merck & Co. establish a strategic partnership with a view to marketing the soporific gaboxadol.

1972 The Cipramil molecule is synthesized.

1975 Microbiological research ceases.

1975-80 The trading company and cosmetics department are phased out.

1970s

1980s

1996 Serdolect® is launched.

1997 Lundbeck gets new logo. Designed by Wolff Olins, the star becomes part of the original Lundbeck logo that was designed by the Hungarian-French artist Victor Vasarely in the 1930s.

1998 Cipramil® is approved in the United States under the name Celexa®, and launched on the American market. 1998 Claus Bræstrup becomes Executive Vice President of Research.

1998 Lundbeck voluntarily withdraws Serdolect® in all countries, due to a suspicion that it could cause serious heart problems for a very small group of persons with schizophrenia.

1999 Lundbeck is listed on the Copenhagen Stock Exchange.

1990s

2000-05

Lundbeck Magazine

14 August. Hans Lundbeck founds a trading company in Copenhagen which deals in everything from machinery, biscuits, confectionery, artificial sweeteners, aluminium foil, photography paper, cameras and cinema equipment, to Hoover (vacuum cleaner) rentals.

1940 Lundbeck introduces Lucosil® for treatment of urinary infections.

1943 Hans Lundbeck dies. Poul Viggo Petersen is employed. He initiates drug research activities, creating Lundbeck’s psychopharma-ceutical niche.

1915

1924 Eduard Goldschmidt joins the trading company and brings in suppositories for haemorrhoids, painkillers, etc. Colognes and creams are added to the company portfolio.

1920s

1937 Lundbeck introduces its first original drug Epicutan® for treatment of wounds.

1939 Lundbeck moves to Ottiliavej in Valby.

1930s

1954 The Lundbeck Foundation is established with Grete Lundbeck as chairman.

1957 Lundbeck succeeds in synthesizing Truxal®.

1959 Truxal® is marketed, followed by Cisordinol® and Fluanxol® which have been refined as sustained-release drugs.

1950s

1940s

1961 Lundbeck purchases the former creamery in Lumsås to acquire more production capacity. Production of active substances is soon in progress.

1967 The Lundbeck Foundation purchases the shares owned by the Goldschmidt family, making it the sole owner of Lundbeck.

1960s

2-3

Doctors from all around the world attend Lundbeck Institute seminars to compare notes with leading specialists.

How would you define depression? What is normal ageing? Can you estimate how many young people under the age of 24 will commit suicide today? André Joubert, chairman of

the meeting, bombards the assembly with questions as they attempt to respond at the same pace. Again and again, the individual participants enter suggestions and guesses on their voting pads which transmit the answers to a big screen.

While the voting pad procedure is familiar from the TV quiz “Who Wants

to be a Millionaire?”, there are more serious issues on the agenda this

morning in Skodsborg, north of Copenhagen. Approximately 30 psychia-

trists from six countries are assembled in the conference room, and the

exercise is part of a seminar at the Lundbeck Institute where the subject

is mood disorders. The object is first to open a discussion of how the par-

ticipants each diagnose and treat patients with depression and, secondly,

how they ensure that this treatment – in the long term – builds on

scientific documentation rather than custom and suppositions.

Masterclass in psychiatry

42-43Lundbeck Magazine

Since the Institute opened in 1997, more than 2400 doctors and other health-science professionals from some 40 countries have attended seminars in King Frederik VII’s and Countess Danner’s old villa on the shores of the sound separating Denmark and Sweden. Most of the participants have been invited by Lundbeck subsidiaries. The 15 or 16 annual seminars are in high demand, and several of the subsidiaries have waiting lists of people who would like the opportunity of having discussions with colleagues and meeting international experts.

Extremely good reputationThis blend of debate among colleagues and of lectures and presenta-tions by world-famous experts sets Lundbeck Institute seminars apart from other conferences organized by the pharmaceutical industry. The seminars at Skodsborg place the professional level and regard for patients far above commercial interests. No distinction is made bet-ween products from Lundbeck and other companies, and the courses are therefore recognized officially as supplementary training for medi-

cal professionals. This is also the reason why top names from the world of psychiatry and neurology visit the Institute year after year to share their knowledge and experience with others.

Professor Brian Leonard from Ireland is a pharmacologist with a long international research career. He is familiar with the work of the Insti-tute from his many visits as a lecturer and in his capacity as a member of the Institute advisory board of international experts.

According to Brian Leonard, “The Lundbeck Institute and the Lundbeck Foundation are unique – I wish there were more organizations like them. Far too many of the scientific forums organized by the industry are motivated by commercial interests. To my knowledge, Lundbeck is the only international pharmaceutical company that sponsors quality educational and research programmes without having an eye to com-mercial interests, and this gives the Institute an excellent reputation.” •

Camilla Jebsen, Psychiatrist, Norway.It has been a fantastic multidimen-sional experience. There have been good discussions and we have been able to exchange viewpoints and clinical experience with colleagues. This is a real strength. I have got a great deal out of the conference that I can use in my clinical work.

Bruce Chenoweth, Psychiatrist, Australia.It has been an outstanding seminar – totally different from any others I have attended. I have rarely found a conference so professionally absorb-ing. Some of my patients are retarded in their psychological development, and many suffer from depression. The seminar opened my eyes to new ways of viewing their problems, and I am very grateful for that.

The Lundbeck International Neuro-science Foundation (LINF) and the Lundbeck Institute were founded in 1997. The aim of the Institute is to raise awareness of psychiatric and neurological disorders and their treatment through educational activities, expansion of professional networks, and patient forums on the Internet. LINF has an advisory faculty consisting of more than 90 of the world’s leading experts in psychiatry and neurology. Members of the faculty act as advisers, lecture at seminars held by the Institute, and assist in compilation of educa-tional materials.

The specialist in psychiatry and pioneer in neurology

H. Lundbeck A/S

Ottiliavej 9

DK-2500 Copenhagen Valby

Corporate Reporting

Tel +45 36 30 13 11

Fax +45 36 30 19 40

information@lundbeck.com

www.lundbeck.com

CVR-no 56759913