Help for Alzheimer’s disease?

Help for Alzheimer’s disease?

The first drug to slow down the effects of Alzheimer’s disease hit the market in January, but treatment using the drug for most has not happened yet. The two biggest factors behind its slow market release are the poor insurance coverage and the long setup time needed by the health care systems.

The drug

The U.S. Food and Drug Administration (FDA) approved Leqembi from the Japanese drug manufacturer, Eisai, in early January. This drug is used for patients with mild or early onset cases of dementia related to Alzheimer’s.

Regulators used the FDA’s accelerated pathway, which allows drugs to launch before they are confirmed to benefit patients, like the steps we had seen taken when the COVID-19 vaccines came to market.

Studies show that the new drug moderately slowed the fatal disease, but it’s unsure yet how that translates into greater independence for the users who need to get the drug by IV every two weeks. The company has shipped the drug to U.S. specialty drug distribution centers. From there it can be delivered overnight to hospitals or medical centers where infusions are given.

Early Alzheimer’s typically hits people ages 65 and older, causing cognitive impairment and other issues. Leqembi has shown promise in slowing the disease’s progression in that population, but it carries risks of brain swelling and bleeding.

Cost and coverage

The treatment for this drug will cost about $26,500 for a year. Patients who can afford that out-of-pocket will be able to start treatment if they are deemed a candidate. With only a few options, outside of private pay, many patients who might be a candidate for this drug are currently on Medicare and the federal program does not currently cover it.

Diagnosing Alzheimer’s disease

The company, which developed the drug with Biogen, estimates 100,000 people are expected to receive an early Alzheimer’s diagnosis and become eligible for Leqembi by 2026 though the number of undiagnosed people is almost certainly higher. The fact remains that it could take several months to even a year for doctors to properly diagnose a patient and then figure out what would be the best course of treatment.

The first thing that the doctor must do is determine whether a patient has mild dementia or not. Then, the doctor has to decide what caused this condition. If it is found to be related to Alzheimer’s disease, the doctors must then determine whether or not the patient’s brain has amyloidal proteins present. This new drug aims to slow the progression of Alzheimer’s by removing that protein.

After all that, some doctors may still hesitate to prescribe the new drug, Leqembi, because they do not yet know how the drug will help the patient or if it will have a positive effect on their day-to-day life. It was launched before the benefits could be confirmed and because of the risk of brain swelling and bleeding, this makes doctors reluctant to prescribe it to their patients until more data can be collected.