Lou Gehrig's group dangles million-dollar bait for biomarker search

Can the lure of a prize produce a winner?

Prize4Life: Avichai Kremer and two friends hope their scheme will speed up research.

When Avichai Kremer discovered in October 2004 that he had Lou Gehrig's disease and would live perhaps another three years, he considered his options: move to an island, commit suicide or try to find a cure. A driven Harvard Business School student, Kremer chose the last option.

He and two colleagues spent more than 1,000 hours asking scientists and industry executives what would most help research on the fatal disorder. Nearly all said the same thing—that they need a better way to track disease progression. This November, Kremer announced that Prize4Life, a new philanthropic organization, would award $1 million to anyone who can come up with such a biomarker.

“You define the outcome you want and open it to every researcher in the globe. Avichai Kremer, Prize4Life”

“The beauty of this contest is that you define the outcome you want and open it to every researcher in the globe,” says Kremer.

Lou Gehrig's disease, or amyotrophic lateral sclerosis (ALS), is a neurodegenerative illness that attacks motor neurons and leads to paralysis and death, usually within five years after diagnosis. Two years after his diagnosis, Kremer, a former platoon commander for the Israeli artillery corps, can barely walk or enunciate his words.

About 120,000 people worldwide are diagnosed with the disease every year. Clinical trials for ALS treatments are costly and inefficient. A good biomarker could change that. Kremer came up with his idea after reading about the X Prize, a $10 million reward for anyone who could build a reusable human spacecraft.

The first phase of his prize will be $15,000 each for five teams for a theoretical proposal. The remaining $925,000 will go to the first team that shows that their biomarker can halve the costs of ALS drug trials. Sure, the scheme sounds interesting, but can it produce a winner?

In the case of the X Prize, corporations and wealthy individuals vied for publicity by sponsoring competitors, spending more than ten times the amount of the award (Nature 431, 620; 2004). In October, another $10 million prize challenged scientists to build a device that can sequence the human genome faster and for less (Nature 443, 733; 2006).

But this model may not work in medicine. Unlike the glamorous attention that accompanies a space flight contest, experts note, sponsors for medical research may be difficult to find.

“It's a terrible idea,” says Jeffrey Rothstein, a researcher at Johns Hopkins University. Scientists must have money before—not after—they do the research, he says. “How do you achieve the goal without funding upfront?”

Other groups have considered similar schemes, but eventually tabled them. “We've talked about it in the Huntington's arena,” says Allan Tobin, an advisor to the philanthropic group High-Q. “The question is, 'Is a prize a big enough motivation for people to do research on spec?' The answer we've come to is 'No'.”

Kremer says he hopes Prize4Life will at least generate publicity for ALS research. Even if they don't find a winner, adds Nate Boaz, Prize4Life's co-founder, the $1 million could still be used to fund other ALS research.

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Waltz, E. Lou Gehrig's group dangles million-dollar bait for biomarker search. Nat Med 12, 1334 (2006). https://doi.org/10.1038/nm1206-1334a

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