BOSTON— In 2004, Avi Kremer was on top of the world. His resume detailed the trajectory of a rising star: captain in the Israeli Defense Forces; graduate of Technion—the Israeli Institute of Technology; project manager at Elbit Systems, the largest private defense company in Israel; and a newly admitted member of the Harvard Business School MBA Class of 2007.
"I felt like a diamond- in-the-rough that only needed the MBA polish to fulfill its destiny. I was ready to conquer the business world," he said. "I wanted to make a difference, mark my name in the history pages, and I thought that all I would have to do would be to choose among the array of companies that would offer me the opportunity to become their CEO."
And then, in his own words, he fell "into the deepest, darkest hole one can imagine." He was diagnosed with ALS, or Lou Gehrig's disease. When Kremer asked his doctor what he could do, the doctor replied simply, "Prepare a will." At 29 years old, he was given a mere two to five years to live.
But Kremer would not go down without a fight. With the support of his fellow HBS classmates, he set out to find a way to cure ALS, saving his life and the lives of thousands of others. After closely examining the options that lay before them, he and his friends decided to launch a radical approach that was unproven in the biomedical field—incentive prizes. With little time and few resources, the prize model offered the best chance to quickly move the field of ALS research and drug development forward, since incentive prizes seek to focus attention and resources on very specific outcomes.
In 2006, Kremer cofounded Prize4Life, a nonprofit organization dedicated to pursuing that goal. That year, he and his colleagues, including Harvard Business School classmate Nate Boaz, organized a conference with some of the leading minds from the ALS research community and the biotechnology industry to determine what obstacles existed that prevented the bridging of the gap between ALS research and products that would benefit patients.
Two key challenges were identified. The first was the need for an effective biomarker, a tool to reliably track the progression of the disease in order to make clinical trials cheaper, faster, and more appealing to investment from industry. The second was the need to fill the drug development pipeline with promising therapeutic candidates to increase the chances that one or more could be brought to the market. "Our prize model is all about providing results-based incentives to researchers, regardless of background or training, to provide the most critical discoveries in ALS research," said Boaz, now a management consultant.
Thus were born the $1 million ALS Biomarker Prize for the identification of a tool that could substantially cut the cost of clinical trials (recently awarded to Dr. Seward Rutkove, chief of the Division of Neuromuscular Disease at Boston's Beth Israel Deaconess Medical Center and Associate Professor of Medicine at Harvard Medical School) and the $1 million Avi Kremer ALS Treatment Prize for developing a treatment that could reliably extend the lives of predictive mouse models of ALS by 25 percent, a key preclinical step in drug development.
These prizes focus attention on research obstacles that, once overcome, could open the door to extensive interest and investment from drug companies and have the greatest impact for ALS patients. The model also appeals to new donors, particularly those who are interested in supporting outcomes-based philanthropy and who have historically been less likely to support traditional research grant mechanisms, bringing new money into the ALS research arena and increasing the resources available. Finally, because the prizes can be awarded to anyone who meets the criteria, new minds from a variety of disciplines are drawn into the fight against ALS.
In 2006, as his disease rapidly progressed, Kremer's speech was slurred and he struggled to walk across the stage to accept his diploma from Harvard Business School. Today, he is confined to a wheelchair and cannot speak. He communicates by using a device on his forehead to control a computer mouse, typing his thoughts one letter at a time. But Kremer's courage and resiliency are unquestioned. He continues to serve as CEO of Prize4Life, which has grown into an organization that has raised more than $6 million to support research and employs six full-time employees.
Prize4Life's reach has also expanded. While prizes remain the core of the results-oriented model, Prize4Life is also conscious of the need to create a vibrant and supportive arena in which participating teams can effectively compete. After the launch of the Avi Kremer ALS Treatment Prize, prospective competitors expressed concern over the cost and availability of mouse models to use in their preclinical studies. In response, Prize4Life partnered with the Jackson Laboratory (JAX) in Bar Harbor, Maine, the world's leading provider of mouse models for research, to build a mouse colony to provide quality-controlled mice free of charge to labs aiming to compete for the prize. Prize4Life also worked with both the ALS Therapy Development Institute and JAX to create a manual to ensure that studies using the mice were properly designed.
In 2009, Prize4Life and the Alzheimer Research Forum announced the launch of a new ALS-focused internet portal known as the ALS Forum, providing researchers around the world with a one-stop access point for cutting-edge research news and unique Web-based resources.
The mission of Harvard Business School is to educate leaders who make a difference in the world. No one is a better example of the fulfillment of that mission than Avi Kremer.