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Report: Current Symptomatic Agents Will Remain Mainstays of Alzheimer’s Treatment Through 2021

Expensive new therapies expected to put financial strain on healthcare systems (Oct. 22)

Decision Resources, a research and advisory firm based in Burlington, Mass., reports that, through 2021, the key driver of growth in the Alzheimer’s disease (AD) drug market will be the launch of two premium-priced disease-modifying agents — the anti–beta-amyloid monoclonal antibody solanezumab (Eli Lilly) and the intravenous immune globulin (IVIG) product Gammagard (Baxter).

The company forecasts that solanezumab will be the first disease-modifying therapy to launch for AD in the major pharmaceutical markets — the U.S., the U.K., France, Germany, Italy, Spain, and Japan — and will attain “blockbuster” status in its first full year on the market, largely because of its substantial price premium over current agents.

In addition, the company predicts that increasing rates of polypharmacy will contribute modestly to market growth over the forecast period, as surveyed experts unanimously agreed that disease-modifying therapies will often be prescribed in combination with approved symptomatic agents — which will remain the mainstays of AD treatment — in order to achieve optimal clinical benefit. Moreover, a burgeoning drug-treated population is expected to contribute to market expansion through 2021.

In the coming years, the availability of amyloid-imaging agents — such as Amyvid (florbetapir, Eli Lilly), flutemetamol (GE Healthcare), and florbetaben (Piramal Healthcare) — will allow earlier diagnosis of AD. The use of these diagnostic tools, combined with the greater efficacy that emerging therapies are expected to offer over current therapies, will increase both diagnosis and drug-treatment rates, the company says.

“At present, the AD market is comprised solely of symptomatic therapies of modest efficacy that do not affect disease progression,” said analyst Georgiana Kuhlmann. “A therapy that truly alters the course of AD is a significant unmet need, but failures of potentially disease-modifying therapies in the last 5 years have tempered the enthusiasm of many experts for emerging therapies. Nonetheless, an effective and safe disease-modifying therapy would profoundly alter the AD treatment landscape, and experts are cautiously optimistic that one will launch within the next decade.”

The company also anticipates that payers’ cost sensitivity will constrain the AD market — the combination of a rapidly expanding prevalent population and the launch of expensive new drugs and diagnostic tools will put significant financial pressure on healthcare systems. In the opinion of the survey participants, reimbursement authorities will likely impose restrictions on the use of expensive disease-modifying therapies by limiting their use to specific patient subsets (most likely those patients in the mildest stages of the disease) and/or by implementing cost controls, such as prior authorization.

Source: Decision Resources, October 22, 2012.

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