Alzheimer's Cure by 2025: An Unnecessary Goal?

Contributed by: Dennis Fortier, President, Medical Care Corporation

The National Alzheimer's Prevention Act, signed into law one year ago, calls for a national strategy for defeating this terrible disease. A late-stage draft of the strategy sets a goal to develop a cure by the year 2025.  While many have suggested a timeline with more urgency, say by 2020, others have suggested that this timeline is too ambitious.

On the one hand, given our still poor understanding of the disease, coupled with a dismal track record of success for pipeline drugs over the past decade, it seems unlikely that a cure could be developed prior to 2025.  In fact, against the backrop of recent evidence, it may well take longer than that.

On the other hand, we could stop short of a cure and still have great success.  For example, many chronic diseases like diabetes and hypertension have no cure, but we have effective treatments, and we manage those diseases with high efficacy.  It is likely that new drugs, developed well before 2025, will give us greater treatment benefits for patients with Alzheimer's.

Perhaps of greater importance is the fact that we already have approved therapies that can significantly slow Alzheimer's disease progression.  However, since we commonly detect the disease too late and intervene only after massive brain damage has occurred, the perception among physicians is that treatment is unhelpful.  This nihilistic perception actually perpetuates the cycle of late intervention because, believing that there is no treatment, many MDs don't look for early signs Alzheimer's.

In this regard, a key element to an effective national Alzheimer's strategy would be to update physicians about the benefits of early detection and equip them with the tools and training to proactively monitor the cognitive health of their patients.  When a cure is developed, that will be great.  But in the meantime, we can find the disease early and treat it as effectively as possible with robust therapy (drugs, diet, physical exercise, control of diabetes and hypertension, intellectual stimulation, social engagement, and caregiver education).  Such a comprehensive approach has been shown to significantly delay disease progression in a meaningful percentage of early-stage patients.

Positive Press for Alzheimer's Drug

Contributed by: Dennis Fortier, President, Medical Care Corporation

A few days ago, I wrote about some "negative press" for the Alzheimer's drug Namenda, that I felt was misleading.  Basically, it was a series of stories emphasizing that, when used in a way that is not approved, the drug provides little benefit to the patient's health.  What should have been legitimate news about bad prescribing habits, became an illegitimate story about poor drug efficacy.

Now, the press is covering the same drug in a new light.  Based on news from Reuters today, Germany's health care watchdog agency has reversed an earlier stance and now advocates that Namenda has clear health benefits.  They consider the drug to be a cost effective approach to treating moderate and late stage Alzheimer's disease.

The new position from German authorities was based on ongoing review of a growing data set that demonstrates the drug's beneficial effects.  This is reminiscent of the recent news from the UK where authorities changed their stance on the cost benefits of a group of Alzheimer's drugs, including Namenda, and began to cover the cost of their use.

There is no doubt that better treatments, be they drugs or other interventions, are needed in the Alzheimer's field.  But the long debate about efficacy of the current drugs is being clarified through the ongoing collection of evidence that early intervention and proper treatment are beneficial.