Estimating demand for potential disease-modifying therapies for Alzheimer's disease in the UK

TY - JOUR

T1 - Estimating demand for potential disease-modifying therapies for Alzheimer's disease in the UK

AU - Laurell, Axel A S

AU - Venkataraman, Ashwin V

AU - Schmidt, Tatjana

AU - Montagnese, Marcella

AU - Mueller, Christoph

AU - Stewart, Robert

AU - Lewis, Jonathan

AU - Mundell, Clare

AU - Isaacs, Jeremy D

AU - Krishnan, Mani S

AU - Barber, Robert

AU - Rittman, Timothy

AU - Underwood, Benjamin R

N1 - Publisher Copyright: Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists.

PY - 2024/6/18

Y1 - 2024/6/18

N2 - BACKGROUND: Phase three trials of the monoclonal antibodies lecanemab and donanemab, which target brain amyloid, have reported statistically significant differences in clinical end-points in early Alzheimer's disease. These drugs are already in use in some countries and are going through the regulatory approval process for use in the UK. Concerns have been raised about the ability of healthcare systems, including those in the UK, to deliver these treatments, considering the resources required for their administration and monitoring.AIMS: To estimate the scale of real-world demand for monoclonal antibodies for Alzheimer's disease in the UK.METHOD: We used anonymised patient record databases from two National Health Service trusts for the year 2019 to collect clinical, demographic, cognitive and neuroimaging data for these cohorts. Eligibility for treatment was assessed using the inclusion criteria from the clinical trials of donanemab and lecanemab, with consideration given to diagnosis, cognitive performance, cerebrovascular disease and willingness to receive treatment.RESULTS: We examined the records of 82 386 people referred to services covering around 2.2 million people. After applying the trial criteria, we estimate that a maximum of 906 people per year would start treatment with monoclonal antibodies in the two services, equating to 30 200 people if extrapolated nationally.CONCLUSIONS: Monoclonal antibody treatments for Alzheimer's disease are likely to present a significant challenge for healthcare services to deliver in terms of the neuroimaging and treatment delivery. The data provided here allows health services to understand the potential demand and plan accordingly.

AB - BACKGROUND: Phase three trials of the monoclonal antibodies lecanemab and donanemab, which target brain amyloid, have reported statistically significant differences in clinical end-points in early Alzheimer's disease. These drugs are already in use in some countries and are going through the regulatory approval process for use in the UK. Concerns have been raised about the ability of healthcare systems, including those in the UK, to deliver these treatments, considering the resources required for their administration and monitoring.AIMS: To estimate the scale of real-world demand for monoclonal antibodies for Alzheimer's disease in the UK.METHOD: We used anonymised patient record databases from two National Health Service trusts for the year 2019 to collect clinical, demographic, cognitive and neuroimaging data for these cohorts. Eligibility for treatment was assessed using the inclusion criteria from the clinical trials of donanemab and lecanemab, with consideration given to diagnosis, cognitive performance, cerebrovascular disease and willingness to receive treatment.RESULTS: We examined the records of 82 386 people referred to services covering around 2.2 million people. After applying the trial criteria, we estimate that a maximum of 906 people per year would start treatment with monoclonal antibodies in the two services, equating to 30 200 people if extrapolated nationally.CONCLUSIONS: Monoclonal antibody treatments for Alzheimer's disease are likely to present a significant challenge for healthcare services to deliver in terms of the neuroimaging and treatment delivery. The data provided here allows health services to understand the potential demand and plan accordingly.

UR - https://www.scopus.com/pages/publications/85183017406

U2 - 10.1192/bjp.2023.166

DO - 10.1192/bjp.2023.166

M3 - Article

C2 - 38235531

SN - 0007-1250

VL - 224

SP - 198

EP - 204

JO - The British journal of psychiatry : the journal of mental science

JF - The British journal of psychiatry : the journal of mental science

IS - 6

ER -