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Survey: Greater Efficacy Remains Top Unmet Need in Alzheimer’s Treatment

Solanezumab seen as next ‘blockbuster’ drug (September 23)

Decision Resources, a research and advisory firm located in Burlington, Mass., finds that drugs offering a greater effect on cognition and those offering a greater effect on function compared with current treatments remain the top unmet needs in the treatment of mild-to-moderate Alzheimer’s disease (AD), according to surveyed U.S. and European neurologists.

Currently available therapies alleviate some cognitive and functional symptoms associated with AD over the short-term but do not slow disease progression, thus underscoring the remaining unmet need for more efficacious alternatives, which could be either symptomatic or disease-modifying.

The report also finds that, based on a product profile presented, surveyed U.S. neurologists would prescribe the emerging anti–beta-amyloid monoclonal antibody solanezumab (Eli Lilly) to a median 15% of their patients with mild-to-moderate AD. Interviewed thought leaders are encouraged by a slowing of cognitive decline observed in solanezumab-treated patients with mild AD, pooled across two completed, placebo-controlled, phase III studies, as well as the drug’s safety profile, particularly with regard to a low risk of amyloid-related imaging abnormalities.

The report also includes insights from a survey of U.S. managed care organization (MCO) pharmacy directors, two-thirds of whom indicate they would reimburse a new disease-modifying therapy for the treatment of mild-to-moderate AD that was priced at a significant premium to current brands ($25/day), if such an agent offered a 200% improvement in cognitive decline over donepezil (Aricept, Eisai/Pfizer; other brands, generics). Payers expecting not to cover such a therapy mostly cite insufficient benefits as the reason, suggesting that — for some payers — greater therapeutic gains would be needed to justify the value of a drug offered at such a considerable cost.

“With a new phase III trial ongoing in mild AD, solanezumab retains the potential to become the first disease-modifying therapy approved for the treatment of this debilitating disease, a landmark achievement,” said analyst Alana Simorellis, PhD. “We expect solanezumab likely would be priced much higher than symptomatic brands today, which could present challenges to usage and market access, depending on the level of its clinical benefits. Even with limited uptake, however, we expect premium pricing and a growing patient population could easily drive blockbuster sales for solanezumab in the AD market over the next decade.”

Source: Decision Resources; September 23, 2013.

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