The Caring Corner®
A cure for Alzheimer’s?
Wow! The Alzheimer’s care community got more good news with the announcement that another drug, Donanemab, can slow cognitive decline by 35%. This is the 2nd Alzheimer’s medicine promising to significantly slow down the impacts of the disease, and the best results reported so far. But what are the risks? Can you get the drug? And what does this mean for you and your loved one with Alzheimer’s?
Eli Lilly, the drug’s manufacturer, reports that Donanemab slowed cognitive decline in people with early stage Alzheimer’s disease based on a measure of daily activities such as driving and talking about current events. It is not yet available to the public, however. Lilly said it plans to file for approval from the FDA in a few weeks.
How does Donanemab work?
Donanemab is a monoclonal antibody that targets the amyloid-beta plaques that form in the brains of people with Alzheimer’s. By the way, if you have ever wondered why many drugs end in MAB, it stands for Monoclonal antibody. Donanemab triggers an immune response that clears these proteins from the brain. Experts believe that by removing these plaques, Donanemab slows down the progression of Alzheimer’s.
- The medicine is given by infusion once a month.
- Donanemab clears amyloid so effectively, the manufacturer says, that a majority of patients in the trial – 52% – were able to stop taking the medicine by one year, and 72% were able to do so by a year and a half.
The manufacturer emphasizes, however, that the drug slows the progression of Alzheimers, but it does not cure the disease. Regardless, a significant slowing means you have more time to enjoy life as well as more time to organize eventual care matters and end-of-life planning issues.
What are the risks?
One of the main risks with Donanemab is brain swelling and bleeding. In rare cases, it has led to the deaths of trial participants. That side effect is similar for a competing drug, Lecanemab, produced by a different drug company but which also targets the removal of beta-amyloid plaques.
How much will it cost?
Eli LIlly has not set pricing yet, but experts believe the pricing will be the range of $25,000 to $30,000 per year. That the price range for similar drugs from other companies that target Alzheimer’s. At that price, there are few people who can pay for it independently, so the great hope is that Medicare and private insurance companies will reimburse you for it.
Are these drugs worth it?
It seems like a harsh question. If you are the one with Alzheimers, or if it’s your loved one, you want well-being at any cost. However, at some point, economic realities set in. A recent study in Jama Neurology concluded that “at current expected prices” Donanemab would not be “cost-effective for early AD in the US.” These decisions are way above my pay grade, but I think the takeaway here is that, after decades of searching for a cure for Alzheimer’s we are indeed on the verge of seeing a light at the end of the tunnel. It may still take years, however, for these drugs to be widely available and affordable.
It’s worth noting, however, that researchers have discovered other drugs, available now, which also may have a positive impact on the reduction of beta amyloid. See a video here about a common insomnia medicine that may have similar properties.
What are your thoughts?
Should these drugs be made available at any cost? If your loved one has Alzheimer’s, no cost is too great.
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