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American Journal of Geriatric Pharmacotherapy (AJGP) Reports on Expert Panel Recommendations for the Treatment of Alzheimer's Disease and Related Dementias in Managed Care

Posted on: Monday, 30 October 2006, 09:00 CST

NEW YORK, Oct. 30 /PRNewswire/ -- The consensus recommendations of a group of leading experts for the treatment of Alzheimer's disease and related dementias (ADRD) are published in a supplemental issue of the American Journal of Geriatric Pharmacotherapy (AJGP). The panel of experts was convened by the Alzheimer's Drug Discovery Foundation to develop the recommendations for use by practicing physicians, other providers, medical directors and pharmacy directors in the managed care setting.

"Since previous clinical guidelines for ADRD were published, new treatment options have been developed. These include memantine, a N-methyl-D-asparate (NMDA) antagonist approved for moderate to severe Alzheimer's disease. Along with the cholinesterase inhibitors, treatment is now available for all stages of the disease, and combination therapy with both classes of drugs can be utilized," said lead author and international expert Howard M. Fillit, MD, Executive Director, Alzheimer's Drug Discovery Foundation and Institute for the Study of Aging.

With more than 5.8 million individuals now enrolled in Medicare Advantage managed care plans, and a total of 30 million Medicare beneficiaries having some type of drug coverage, the appropriate use of treatments for ADRD clearly has important implications for managed care. Considerable research has shown that anti-dementia therapies, including cholinesterase inhibitors and memantine, can treat the cognitive, function and behavioral symptoms associated with Alzheimer's disease, improve medical management and reduce healthcare costs.

Overall, Alzheimer's disease is the third most costly illness to U.S. society after heart disease and cancer, with direct and indirect costs estimated to be over $100 billion. Studies have also shown that Alzheimer's disease generates considerable excess costs in managed care. "Several studies have shown the pharmacoeconomic value of anti-dementia therapy. ADRD patients in managed care that are treated with FDA approved Alzheimer's medications have lower rates of hospital utilization and generate less annual costs," said Dr. Fillit.

"Alzheimer's treatment and care management has proven value for patients and caregivers. The recommendations of the panel represent the current standard of quality of care for ADRD," stated Rachelle Doody, MD, PhD, Professor of Neurology in the Department of Neurology at Baylor College of Medicine, a respected clinical expert in Alzheimer's disease and panel member. "It is important that patients and caregivers discuss these treatment and care management options for Alzheimer's disease with their physician."

The Recommendations

All of the recommendations noted are based on scientific evidence, FDA approved use of treatments, and expert opinion. The panel recognized that physicians, patients and caregivers need an open dialogue about the risks and benefits associated with treatment. The 20 recommendations include:

* Treatment of Alzheimer's disease should be determined by the stage at the time of diagnosis. Patients first diagnosed in mild stage should be treated with a cholinesterase inhibitor, patients first diagnosed in the moderate stage should be treated with a combination of a cholinesterase inhibitor and memantine; for patients who progress from mild to moderate, memantine should be added; patients first diagnosed with severe Alzheimer's disease should be treated with memantine as first line treatment, and combination therapy of a cholinesterase inhibitor can be added * All patients should receive the same treatment options, regardless of their setting of care * Newly diagnosed patients should be re-evaluated within two months, and then monitored at least every six months thereafter, to ensure appropriate treatment and care management * Geriatric care management and counseling should be part of an integrated approach to treating patients with a diagnosis of Alzheimer's disease and their caregivers * Cholinesterase inhibitors and NMDA antagonists should continue to be distinguished as two separate classes of drugs under Medicare Part D formulary guidelines, as patients need access to both classes * Medicare managed care organizations (MCOs) should not discriminate against use of anti-dementia therapy through administrative burdens such as pre-authorization and appeals About Alzheimer's Disease

Alzheimer's disease is a progressive, degenerative disorder that attacks the brain's nerve cells, resulting in loss of memory, thinking and language skills, and behavioral changes. An estimated one in ten persons over age 65 and nearly half of those 85 or older have Alzheimer's disease. Alzheimer's disease currently strikes approximately five million Americans; published reports project that by 2050 this number could more than triple to more than 16 million people in the United States.

About The Alzheimer's Drug Discovery Foundation

The Alzheimer's Drug Discovery Foundation (ADDF) is a public charity established in 2004 to expand upon the programs initiated by the Institute for the Study of Aging (ISOA), a private foundation founded by the Estee Lauder family in 1998. The Foundation's mission is to accelerate drug discovery research for Alzheimer's disease (AD) through venture philanthropy. To date, ADDF and ISOA have awarded over $25 million for 155 drug discovery research programs and conferences worldwide. For more information, visit the ADDF website at http://www.alzdiscovery.org/.

Alzheimer's Drug Discovery Foundation Contact: Howard Fillit, MD, Executive Director (212) 935-2402 / hfillit@alzdiscovery.org

Alzheimer's Drug Discovery Foundation

CONTACT: Howard Fillit, MD, Executive Director of Alzheimer's DrugDiscovery Foundation, +1-212-935-2402, hfillit@alzdiscovery.org

Web site: http://www.alzdiscovery.org/

Source: PRNewswire

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