By Howard Fillit, MD
Executive Director and Chief Science Officer, the ADDF
The current and projected costs of dementia care are enormous, costing the US as much as heart disease or cancer today, and creating a potentially crippling financial burden on our society in the future, as the number of people diagnosed with dementia is expected to more than double in the next 30 years.
The most common cause of dementia is Alzheimer’s disease. There are currently no drugs available to prevent or even slow Alzheimer’s, and it’s unlikely that any one drug will be the solution. The only way to change this is to invest in drug discovery and development.
Equally important, health economics plays a significant role in drug development. In today’s world, the risk of bringing a drug to market is exponentially increased by whether the therapy is deemed to have “value” to patients and is cost-effective. Although a drug or diagnostic may bring significant clinical benefit to patients, payers such as Medicare may not view these as valuable if they are not demonstrated to be cost-effective.
For example, the FDA approved Amyvid™ last year, the first diagnostic test for Alzheimer’s disease, and a major breakthrough in the field. Amyvid, which the ADDF helped develop, is a valuable because it enables doctors to accurately diagnose and then manage and treat patients, especially those with mild cognitive impairment in whom diagnostic uncertainty with regard to prognosis is often very high.. However, despite regulatory approval, the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) recommended that the Centers for Medicare & Medicaid Services (CMS) not provide payment for the test, although this remains under review with the agency.
There is much to be done to reduce the impact of Alzheimer’s disease on people lives and on our society. It is critical that we pursue and develop drugs and diagnostics that are safe, effective, and clinically meaningful as determined by payers, providers such as physicians, patients and their caregivers.
The ADDF is working tirelessly to do just that. Together, we can conquer this disease.