Aduhelm (anucanumab) for Alzheimer’s

Alzheimer’s is the most common type of dementia, impacting close to 6 million Americans, with a large percentage being female. Roughly 80% of patients with dementia have Alzheimer’s, usually affecting those 65+ age bracket. Alzheimer’s is the sixth-leading cause of death in the United States. It is estimated that Alzheimer’s and other dementias will cost the nation $355 billion for this year alone.

Stages of Alzheimer’s

Early-stage Alzheimer’s (mild): in this stage of Alzheimer’s, a person can still do daily activities on their own. For example, driving, going to work, and take part in everyday social activities. During this stage, a person can start to have some memory loss and trouble planning or organizing daily tasks.

Middle stage Alzheimer’s (moderate): this is usually the longest lasting stage and can last for many years. At this stage, symptoms are more noticeable and require a higher level of care. Symptoms are different for each person. They can include forgetting important life events, forgetting addresses or telephone numbers, confusion over what day it is, becoming lost, and having problems with bladder control.

Late-stage Alzheimer’s (severe): in this stage of the disease, a person may require around-the-clock assistance. People with Alzheimer’s at this stage may experience changes in physical abilities such as walking, sitting, and eventually swallowing. Individuals also experience a gradual loss of speech and considerable weight loss.

Treatment for Alzheimer’s

There are several treatments available for Alzheimer’s disease. These treatments work only to help with symptoms associated with Alzheimer’s disease. The newest addition to Alzheimer’s treatment, Aduhelm® (anacanumab), is used to slow the progression of Alzheimer’s in early stages. In Alzheimer’s, clusters collect between nerve cells in the brain and cause communication issues between these cells.

Aduhelm® (anacanumab) works by slowing the formation of those clusters. This medication is given intravenously for over 45 minutes to 1 hour. Each treatment is given every four weeks. As with most medications, there are some potential side effects. One major side effect is brain swelling associated with higher doses of the drug. For this reason, this drug requires multiple MRIs throughout treatment. Some other common side effects are headache, dizziness, nausea, confusion, and vision changes.  

Cost

Just like all new medications, they all come with a high price tag. Aduhelm® (anacanumab) is no different with its estimated cost at $56K for a one-year treatment. This cost does not include 3 MRIs that are required in the first year. At this time, it remains unclear if and when insurance plans will cover some of the cost. Some plans have already said the cost is too high.

Debate

There is also debate if the medication is effective. The FDA approved Aduhelm, even after its advisory board voted for it not to be approved. Because of scrutiny and high cost, many insurance companies have reported they would not cover the medication.

References:

1. Alzheimer's Stages - Early, Middle, Late Dementia Symptoms | alz.org
2. Alzheimer’s Disease Symptoms, Causes, Diagnosis and Treatments (healthcentral.com)
3. Caregiving for Person with Alzheimer's Disease or a related Dementia | Alzheimer's Disease and Healthy Aging | CDC
4. FDA’s Decision to Approve New Treatment for Alzheimer’s Disease | FDA
5. aduhelm-pi.pdf (biogencdn.com)
6. Medicare to Review Coverage for New Alzheimer’s Drug Aduhelm - WSJ
7. ‘This is unprecedented’: Several private insurers won’t cover Biogen’s Alzheimer’s drug (msn.com)