Medicaid

Price tag for a questionable Alzheimer’s treatment: $109,000 per patient, per year. Unclear yet: For how many years?

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The real costs of the new Alzheimer’s drug, Leqem­bi — and why tax­pay­ers will foot much of the bill (CBS News):

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?

September 17th @ UC Berkeley: Disrupting neurodegenerative diseases

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Quick heads-up about a great event next month for those based in the San Fran­cis­co Bay Area.

  • When: Tues­day, Sep­tem­ber 17, 2019 / 8:30 AM – 6:00 PM PDT
  • Where: Pauley Ball­room, UC Berkeley
  • What: 2019 UC Berke­ley Aging Research & Tech­nol­o­gy Sum­mit: Dis­rupt­ing Neu­rode­gen­er­a­tive Diseases

Alzheimer’s and neu­rode­gen­er­a­tive dis­eases are [Read more…] about Sep­tem­ber 17th @ UC Berke­ley: Dis­rupt­ing neu­rode­gen­er­a­tive diseases

The Future of Preventive Brain Medicine: Breaking Down the Cognition & Alzheimer’s Disease Alphabet Soup

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As the pres­i­dent and med­ical direc­tor of the Alzheimer’s Research and Pre­ven­tion Foun­da­tion (ARPF), it’s my job to stay on top of advances in the field of Alzheimer’s research. Recent­ly, a num­ber of arti­cles in the med­ical lit­er­a­ture have caught my atten­tion. They are focused on a par­tic­u­lar ques­tion that con­cerns most Baby Boomers like me: “Is mem­o­ry loss just a nor­mal part of aging?” [Read more…] about The Future of Pre­ven­tive Brain Med­i­cine: Break­ing Down the Cog­ni­tion & Alzheimer’s Dis­ease Alpha­bet Soup

Technology as the missing link to enable a brain-based model of brain care: interview with Dr. John Docherty

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Dr. John Docher­ty is an Adjunct Pro­fes­sor of Psy­chi­a­try at the Weill Med­ical Col­lege, Cor­nell Uni­ver­si­ty, Direc­tor of Post Grad­u­ate Edu­ca­tion there, and Chief Med­ical Offi­cer of Brain Resource. Trained as a clin­i­cal research fel­low in neu­ropsy­chophar­ma­col­o­gy at NIMH, he lat­er returned as Chief of the Psy­choso­cial Treat­ments Research Branch, respon­si­ble for all fed­er­al­ly sup­port­ed psy­choso­cial treat­ment research in men­tal health nation­wide. He over­saw the land­mark Nation­al Col­lab­o­ra­tive Study of the Treat­ment of Depres­sion and served as a mem­ber and Chair­man for over 10 years on the NIMH and then NIDA Treat­ment Research IRGs. Dr. Docher­ty has wide expe­ri­ence in suc­cess­ful­ly imple­ment­ing inno­va­tion in both clin­i­cal oper­a­tions and man­aged health care. He found­ed North­east Psy­chi­atric Asso­ciates in 1985. As Nation­al Med­ical Direc­tor for Nation­al Med­ical Enter­pris­es, he over­saw med­ical con­trol and qual­i­ty improve­ment in 74 hos­pi­tals in 34 states. He was the Exec­u­tive Vice-Pres­i­dent and Chief Med­ical Offi­cer for Mer­it Behav­ioral Care, which then cov­ered 30 mil­lion peo­ple. In 1998, he found­ed Com­pre­hen­sive Neu­ro­Science (CNS). Its Care Man­age­ment Tech­nolo­gies are cur­rent­ly imple­ment­ed in 17 state Med­ic­aid plans. Dr Docher­ty has received numer­ous hon­ors and awards and has authored over 100 sci­en­tif­ic publications.

(Edi­tor’s note: this inter­view with Dr. John Docher­ty was orig­i­nal­ly pub­lished in Sharp­Brains’ mar­ket report Trans­form­ing Brain Health with Dig­i­tal Tools to Assess, Enhance and Treat Cog­ni­tion across the Lifes­pan, pub­lished in July 2010)

Alvaro Fer­nan­dez: Dr. Docher­ty, it is a plea­sure to be with you today to dis­cuss the main theme of Sharp­Brains’ 2010 mar­ket report – how the con­ver­gence of sci­en­tif­ic find­ings and tech­nol­o­gy plat­forms and tools is reshap­ing how as a soci­ety and as indi­vid­u­als we will take care of cog­ni­tion and men­tal well­ness along the life­course, giv­ing birth to the emerg­ing dig­i­tal brain health and fit­ness mar­ket. Can you first briefly dis­cuss your career tra­jec­to­ry and your cur­rent role at Brain Resource?

Dr. John Docher­ty: Sure. The main theme of my work since the 1960s has remained the same, “How do we put knowl­edge into effec­tive use to improve men­tal health?” Over the last cen­tu­ry, med­i­cine made tremen­dous progress in gen­er­at­ing sci­en­tif­ic and clin­i­cal knowl­edge. Basic research dis­cov­ery sci­ence and clin­i­cal treat­ment devel­op­ment sci­ence have made great progress. With­in Psy­chi­a­try there was stan­dard set­ting advance in the 1960’s through the NIMH-VA coop­er­a­tive stud­ies to the method­ol­o­gy of assess­ing the effi­ca­cy of psy­chophar­ma­co­log­i­cal drugs. This work estab­lished prin­ci­ples adopt­ed for the study of med­ica­tions in the oth­er areas of med­i­cine. The study of psy­chother­a­py, how­ev­er, lagged in devel­op­ment. In my role of Chief of the Psy­choso­cial Treat­ments Branch of the NIMH , I helped con­tribute to the advance of that work by sup­port­ing the efforts of an extra­or­di­nary group of indi­vid­u­als led by Irene Waskow who car­ried out the TDCRP. This study estab­lished the method­olo­gies that made pos­si­ble the effec­tive sci­en­tif­ic study of the effi­ca­cy of psy­chother­a­pies. The evi­dence base and of such treat­ments as CBT, DBT, Moti­va­tion­al Enhance­ment Treat­ment and oth­er evi­dence-based psy­chother­a­pies derives direct­ly from this study and its sem­i­nal influ­ence. This was a con­tri­bu­tion to the sci­ence of Clin­i­cal Treat­ment Devel­op­ment research.

I would say that my major inter­est, how­ev­er, has been in the next step, the sci­ence of knowl­edge trans­fer. There has been and remains a long and cost­ly (in terms par­tic­u­lar­ly of unnec­es­sary suf­fer­ing) lag between the devel­op­ment of new knowl­edge and its com­mon and effec­tive use in practice.

In order the help the field moved for­ward, I have worked for the last 20 years in the devel­op­ment and imple­men­ta­tion of meth­ods to effec­tive­ly trans­fer knowl­edge into prac­tice. [Read more…] about Tech­nol­o­gy as the miss­ing link to enable a brain-based mod­el of brain care: inter­view with Dr. John Docherty

Cognitive Health News Round-Up

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Round-up of inter­est­ing recent news on cog­ni­tive health and fit­ness: the field is in motion.

1) Bay­crest cre­ates Cen­tre for Brain Fit­ness with $10-mil­lion Invest­ment from Ontario Gov­ern­ment (Cana­da NewsWire)

2) Cog­ni­tive tests are the best way to select med­ical stu­dents (EurekAlert)

3) High blood pres­sure hard on the aging brain (Reuters)

4) Alzheimer’s tests ben­e­fi­cial for seniors (Atlanta-Jour­nal Constitutional)

5) Demen­tia-Dread­ing Baby Boomers Spur Race to Invent Brain Games (Bloomberg)

6) Viv­i­ty Labs launch­es Fit Brains brain-train­ing game site (VentureBeat) 

7) Depres­sion and Alzheimer’s (NHS Choices)

For select­ed quotes and com­ments, [Read more…] about Cog­ni­tive Health News Round-Up

The Gregarious Brain and cognitive skills

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I find via Mind­Hacks that NYT Mag­a­zine has pub­lished a great arti­cle titled The Gre­gar­i­ous Brain, sub­ti­tled “Williams syn­drome — a genet­ic acci­dent that caus­es cog­ni­tive deficits-”. The writer, David Dobbs, does an spec­tac­u­lar job at explain­ing that syn­drome in the con­text of what cog­ni­tive skills are and how they evolved. Some sam­ple quotes:

  • “In the view of two of Bellugi’s fre­quent col­lab­o­ra­tors, Albert Gal­abur­da, a Har­vard Med­ical School pro­fes­sor of neu­rol­o­gy and neu­ro­science, and Allan Reiss, a neu­ro­sci­en­tist at the Stan­ford School of Med­i­cine, Nicki’s learned facil­i­ty at sports talk illus­trates a cen­tral les­son of Williams and, for that mat­ter, mod­ern genet­ics: genes (or their absence) do not hard-wire peo­ple for cer­tain behav­iors. There is no gene for under­stand­ing cal­cu­lus. But genes do shape behav­ior and per­son­al­i­ty, and they do so by cre­at­ing brain struc­tures and func­tions that favor cer­tain abil­i­ties and appetites more than others.”
  • “…This doesn’t mean that spe­cif­ic behav­iors are hard-wired. M.I.T. math majors aren’t born doing cal­cu­lus, and peo­ple with Williams don’t enter life telling sto­ries. As Allan Reiss put it: “It’s not just ‘genes make brain make behav­ior.’ You have envi­ron­ment and expe­ri­ence too. By envi­ron­ment, Reiss means less the atmos­phere of a home or a school than the end­less string of chal­lenges and oppor­tu­ni­ties that life presents any per­son start­ing at birth.”
  • (Talk­ing about when our ances­tors start­ed to live in larg­er groups) “But the big­ger groups imposed a new brain load: the mem­bers had to be smart enough to bal­ance their indi­vid­ual needs with those of the pack. This meant coop­er­at­ing and exer­cis­ing some indi­vid­ual restraint. It also required [Read more…] about The Gre­gar­i­ous Brain and cog­ni­tive skills