The first drug purporting to slow the advance of Alzheimer’s disease is likely to cost the U.S. health care system billions annually even as it remains out of reach for many of the lower-income seniors most likely to suffer from dementia.
Medicare and Medicaid patients will make up 92% of the market for lecanemab, according to Eisai Co., which sells the drug under the brand name Leqembi. In addition to the company’s $26,500 annual price tag for the drug, treatment could cost U.S. taxpayers $82,500 per patient per year, on average, for genetic tests and frequent brain scans, safety monitoring, and other care, according to estimates from the Institute for Clinical and Economic Review, or ICER. [Read more…] about Price tag for a questionable Alzheimer’s treatment: $109,000 per patient, per year. Unclear yet: For how many years?
Welcome to a new edition of SharpBrains e‑newsletter, featuring this time a range of interventions for brain/ cognitive/ mental health plus a few brain teasers to test our perception and cognitive skills.
- Huge (and mostly overlooked) red flag regarding newly approved “anti-Alzheimer’s” drugs: “To put it bluntly, if lecanemab doesn’t work in women it would be unethical to supply it to women. Recall this costly immunotherapy comes with substantive risks, including high incidence of ARIA and even death.”
- There’s even a petition circulating among scientists and doctors stating that “As the FDA prepares to determine if it will grant full approval for its widespread use, the available data suggests lecanemab is ineffective and may be harmful, making its use and cost unjustifiable.”
- “The arts can transform you like nothing else.”
- Capabilities > Knowledge
- “Not only could EEG ML predict treatment, but models trained on one therapy could predict the other. Not only could EEG ML predict responders, but it could also identify non-responders.…people for whom neither therapy works.”
- “They provide an alternative way of accessing support, which may be more convenient for some, the National Institute for Health and Care Excellence (NICE) says … NICE will look at the evidence from their use over the next few years to work out how cost-effective they are.”
- “Adults in the intervention group reported significantly greater reductions in ADHD symptoms following treatment than control participants; these differences were maintained at the 3?month follow-up … Further, no adults in the intervention group showed a meaningful increase in symptoms from baseline to follow-up while this happened for over 19% of adults in the control group.”
Last but not least, a few brain teasers and science tips for adults of any age:
- #8. Brain teaser to challenge your brain: The Blind Beggar
- #9. Quick brainteaser to test your mental rotation skills
- #10. What are cognitive abilities and how to boost them?
Have a great summer!
Attention-deficit/hyperactivity disorder (ADHD) appears to be somehow linked to risk of dementia and Alzheimer’s disease, a new multigenerational study has found.
Parents and grandparents of people with ADHD have a higher risk of Alzheimer’s and dementia than people with no ADHD in their family, Swedish researchers said.
Specifically, parents of an ADHD child have a 34% higher risk of dementia and 55% higher risk of Alzheimer’s, the results showed. Grandparents have about an 11% increased risk of either condition. [Read more…] about Study finds ADHD is associated with dementia
Welcome to a new edition of SharpBrains’ e‑newsletter, featuring this time nine scientific reports and industry developments to help promote lifelong brain and mental health.
“… venting likely doesn’t soothe anger as much as augment it. That’s because encouraging people to act out their anger makes them relive it in their bodies, strengthening the neural pathways for anger and making it easier to get angry the next time around. Studies on venting anger (without effective feedback), whether online or verbally, have also found it to be generally unhelpful … To get out of that, you can ask the person to step back and help you reframe your experience by asking, “How should I think about this differently?” or “What should I do in this situation?”
“The new company would find it pushing well beyond its current mindfulness focus to, “provide the full spectrum of proven, effective virtual support – from mindfulness and meditation, to text-based behavioral health coaching, to video-based therapy and psychiatry – for all types of patient populations.”
12 good tips for students and everyone else
Their independent review concludes that “given the lack of evidence of a robust and meaningful clinical benefit and the known safety signal, we recommend against offering this agent to patients with Alzheimer’s dementia (mild or otherwise) or mild cognitive impairment.”
A strong call to “learn how this regulatory failure occurred and to ensure that it doesn’t occur again”
Addressing the ongoing controversy about conservatorships, a USC Professor of Law, Psychology, and Psychiatry shares a great article to debunk these all-too-common myths
If you have not encountered the “Linda brain teaser” before, please give it a try! If you have, you’ll enjoy the new paper titled Tversky and Kahneman’s Cognitive Illusions: Who Can Solve Them, and Why?
Fascinating approach to gait training.
Neuralink vs. Paradromics vs. non-invasive platforms — quite a stimulating space to track
Wishing you and yours a happy and healthy back-to-school and month of September,
The SharpBrains Team
VA Health System Won’t Cover Biogen’s Alzheimer’s Drug (The Wall Street Journal):
The Department of Veterans Affairs won’t cover Biogen Inc.’s new Alzheimer’s drug, the latest rebuke of the controversial treatment since it was approved earlier this summer.
The VA decided not add the drug, called Aduhelm, to its formulary list of available medicines because of the drug’s risk of causing serious side effects and a lack of evidence that it improves cognitive function, an agency spokeswoman said. [Read more…] about Veterans Affairs won’t cover Biogen’s new “Alzheimer’s drug” given concerns over safety and lack of evidence
Welcome to a new edition of SharpBrains’ e‑newsletter, providing this time a summary of the saga around the FDA approval of aducanumab (Aduhelm) as a supposed treatment for Alzheimer’s Disease, plus a range of timely research findings and resources for lifelong brain health.
First, below are some key reads to navigate “probably the worst drug approval decision in recent U.S. history” — Dr. Aaron Kesselheim, the Professor of Medicine at Harvard Medical School who resigned rom the FDA Advisory Committee in protest.
“The Institute for Clinical and Economic Review (ICER) believes that the FDA, in approving aducanumab (Aduhelm by Biogen) for the treatment of Alzheimer’s disease, has failed in its responsibility to protect patients and families from unproven treatments with known harms.”
“The FDA’s approval of Aduhelm raises more questions and creates more problems than a new drug approval should. It’s time for governmental, professional, and advocacy entities to step in where Biogen and the FDA have failed and explain to patients, caregivers, and clinicians how this drug is not the “new day” in the fight against Alzheimer’s disease and needs to be approached cautiously, if at all.” — Dr. Sam Gandy, Professor of Neurology and Psychiatry at the Icahn School of Medicine at Mount Sinai, where he holds the Mount Sinai Chair in Alzheimer’s Research
“In short, while the amyloid hypothesis has faltered, the approval of aducanumab, which is based primarily on this theory, suggests that the theory may once again dominate research, and could reduce the chances of finding more promising treatments. For example, tau protein, which also accumulates in the brains of Alzheimer’s patients — long before the amyloid protein does — has been shown to be closely associated with the cognitive impairment resulting from the disease … we must not interrupt research on biomarkers and new therapeutic approaches.”
#4. US Senator Joe Manchin calls for a new FDA Commissioner to replace current (acting) one who “has repeatedly ignored public health concerns and shown a dereliction of duty” over opioids and aducanumab:
“I write today concerning the lack of permanent leadership at the Food and Drug Administration (FDA), and the continued tenure of Dr. Janet Woodcock as interim commissioner. Just last week, the FDA granted approval for Aduhelm (aducanumab), a treatment for Alzheimer’s, despite its advisory panel voting nearly unanimously against its approval, with no panel member voting in favor of approval”
(Let’s hope something useful emerges from this very unhealthy FDA decision. Quite disturbing, though, to notice the links between the opioid epidemic and the recent Aduhelm approval.)
“Under the broad label that FDA approved, the drug is available to all Alzheimer’s patients, and the agency did not place limits on treatment duration suggesting that patients could remain on the drug indefinitely. We are troubled by reports that those factors could lead the drug to command “somewhere between” the $37 billion we currently spend on Medicare Part B and the $90 billion we currently spend on Medicare Part D. This level of potential new spending, particularly for just one product with limited evidence of clinical efficacy thus far, tests the program’s resiliency.”
The stakes couldn’t be higher.
Now let’s review other important developments in June.
” … big do-it-yourself investing and trading venues like Vanguard Group, Fidelity Investments and Charles Schwab Corp. are strengthening some of the ways they detect possible signs of decline. Among other things, all three firms check for clients’ difficulty navigating security protocols or need for frequent password resets. In such cases, a designated family member might be informed.
Vanguard also checks client-call recordings for keywords—such as “confused” and “dementia”—that might signal trouble.”
“While retirement schemes like the 401(k) and similar programs in other countries are typically introduced to ensure the welfare of aging adults, our research suggests they need to be designed carefully to avoid unintended and significant adverse consequences. When people consider retirement, they should weigh the benefits with the significant downsides of a sudden lack of mental activity. A good way to ameliorate these effects is to stay engaged in social activities and continue to use your brains in the same way you did when you were working.
In short, we show that if you rest, you rust.”
“Digital mental health can be viewed as a way to extend the mental resources that we have,” said David Mohr, who directs the Center for Behavioral Intervention Technologies at the Northwestern University Feinberg School of Medicine. A step-care model, for example, would allow patients with milder symptoms to be treated via technology while reserving in-person care for patients who need something more.
“Pear is one of nine companies invited to participate in the U.S. Food and Drug Administration’s (FDA) Precertification Pilot Program. Pear has developed and commercialized the first three FDA-authorized PDTs, has 14 product candidates, and is scaling its platform for third-party product distribution opportunities. The Company’s three FDA-authorized products, reSET®, reSET‑O® and Somryst®, address large market opportunities with more than 20 million patients suffering from substance and opioid use disorders and more than 30 million from chronic insomnia, in the U.S. alone, respectively.”
“(Research findings) suggest that cognitive function may need to be monitored closely in individuals with affective disorders, as these individuals may be at particular risk of greater cognitive decline.”
#11. Smarter cars are coming soon … : Eye-tracking pioneer Smart Eye acquires MIT spin-off Affectiva to augment driver monitoring systems and more
Finally, a quick cognitive exercise. Given the universal beauty of math, you don’t need to speak Spanish to try this quick teaser: Brain teasers en español: ¿cuál es el número que falta en el cuarto triángulo?
Wishing you a happy and healthy summer,
The SharpBrains Team