Aug 1, 2012

Less Than Half of Newly Diagnosed Alzheimer’s Disease Patients Begin Drug Therapy within a Year of Diagnosis

The sooner a patient suffering from Alzheimer's or a related dementia is diagnosis and started on treatment, the better the likely outcome.

By Bob DeMarco
Alzheimer's Reading Room


Newly Diagnosed Alzheimer’s Disease Patients Begin Drug Therapy Diagnosis
I'll start by saying it was many months after the initial diagnosis of probable Alzheimer's before I started Dotty on Aricept. This happened because the then current doctor refused to send Dotty to a memory specialist; and refused to do all the appropriate testing to rule in, or rule out, dementia.

At least 20 percent of the persons diagnosed with Alzheimer's or a related dementia or misdiagnosed. This is why it is necessary to make sure that the dementia like symptoms are not being caused by a sluggish thyroid, depression, and even something like brain lesions, NPH, or stroke. See Is it really Alzheimer's Disease or Something Else?.

This study also indicates that a greater number of patients are now receiving combination therapy. The combination of Namenda and an acetylcholinesterase inhibitor like Donepezil (brand name Aricept). Even though I am not a doctor, I always recommend that caregivers discuss the possibility of combination therapy with their doctor regardless of stage.

I am convinced that the combination therapy really helped Dotty.

I can't really say much about her memory because I don't know what would have happened without the drugs. I can say the combination of Aricept and Namenda did help improve Dotty's behavior, attitude, and outlook on life.

I also know that an increasing number of Alzheimer's patients are being put on the combination of the two drugs earlier in the desease. I know quite a few patients that at diagnosis are put on Donepezil, and then about 3 months later Namenda.

When the combination treatment works, it appears it works very well. We have quite a few readers that can back me up on this.

I still remember paying about $250 a month for Aricept, you can now buy the generic for about $9 a month. Wonderful.

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Less Than Half of Newly Diagnosed Alzheimer’s Disease Patients Begin Drug Therapy within a Year of Diagnosis


Forest Laboratories’ Namenda Experiences Increasing Use in Later Lines of Therapy Among Newly Diagnosed Patients, According to U.S. Longitudinal Patient-Level Claims Data from Decision Resources

Decision Resources, one of the world’s leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds through examination of U.S. patient-level claims data that less than half of newly diagnosed Alzheimer’s disease patients began drug therapy within a year of diagnosis. According to Treatment Algorithms in Alzheimer’s Disease, on average, it took 72 days for a newly diagnosed Alzheimer’s disease patient to begin drug therapy.
“Physicians recommend patients initiate Alzheimer’s disease therapy as early as possible in the course of the disease in order to maximize the benefits of treatment, so delays in not starting drug treatment within a year of diagnosis are most likely patient-driven,” said Director Nicole Westphal, Ph.D. 
“For patients who do begin treatment within the first year of diagnosis, delays may be attributed to the fact that they may first see a primary care physician about their Alzheimer’s disease symptoms. While primary care physicians are increasingly comfortable diagnosing and treating the disease, many will still refer a patient to a specialist for confirmation of the diagnosis which may delay treatment initiation.”
The analysis also finds acetylcholinesterase inhibitors (AChEIs) are the most commonly prescribed drug class across the first three lines of therapy for newly diagnosed patients. Additionally, Forest Laboratories’ N-methyl-D-aspartate (NMDA) receptor antagonist Namenda has been experiencing increasing use in later lines of therapy among newly diagnosed patients, capturing approximately one-third of patient share in the second and third lines of therapy. Within these lines of therapy, more than three-quarters of Namenda’s use is in combination with another Alzheimer’s disease therapy.

The analysis is part of the Treatment Algorithms Insight Series, which through examination of U.S. longitudinal patient-level claims data, provides exceptional insight into physicians’ prescribing trends, from diagnosis through multiple courses of treatment, for a specific disease. Quarterly data analysis reveals progression rates of patients through each line of therapy, the share each brand commands by line of therapy and add-versus-switch patterns to key brands. In addition to examining the treatment algorithm of recently treated patients, Treatment Algorithms in Alzheimer’s Disease also reviews historical patient-level claims data for recently treated patients defined as patients treated for Alzheimer’s disease in the fourth quarter of 2011.

About Decision Resources
Decision Resources (www.decisionresources.com) is a world leader in market research publications, advisory services and consulting designed to help clients shape strategy, allocate resources and master their chosen markets. Decision Resources is a Decision Resources Group company.

About Decision Resources Group
Decision Resources Group is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources Group at www.DecisionResourcesGroup.com.

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Original content Bob DeMarco, the Alzheimer's Reading Room