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New drug curbs delusions in Alzheimer's and dementia, being fast-tracked for approval based on trial results

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CitizenVectron

CitizenVectron

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https://www.ctvnews.ca/health/new-drug-curbs-delusions-in-parkinson-s-and-alzheimer-s-patients-study-1.4716005

 

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SAN DIEGO -- A drug that curbs delusions in Parkinson's patients did the same for people with Alzheimer's disease and other forms of dementia in a study that was stopped early because the benefit seemed clear.

 

If regulators agree, the drug could become the first treatment specifically for dementia-related psychosis and the first new medicine for Alzheimer's in nearly two decades. It targets some of the most troubling symptoms that patients and caregivers face -- hallucinations that often lead to anxiety, aggression, and physical and verbal abuse.

 

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The drug is pimavanserin, a daily pill sold as Nuplazid by Acadia Pharmaceuticals Inc. It was approved for Parkinson's-related psychosis in 2016 and is thought to work by blocking a brain chemical that seems to spur delusions.

 

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He consults for Acadia and helped lead the study, which included about 400 people with dementia and psychosis. All were given a low dose of the drug for three months, and those who seemed to respond or benefit were then split into two groups. Half continued on the drug and the others were given dummy pills for six months or until they had a relapse or worsening of symptoms. Neither the patients nor their doctors knew who was getting what.

 

Independent monitors stopped the study when they saw that those on dummy pills were more than twice as likely as those on the drug to relapse or worsen -- 28% versus nearly 13%.

 

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There were relatively few serious side effects -- 5% in the drug group and 4% in the others. Headaches and urinary tract infections were more common among those on the drug.

 

Huge news. Not a cure, but will provide big symptomatic relief for one of the worst parts of the disease.

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Jason

Jason

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3 minutes ago, Chairslinger said:

I'll start saving up now and maybe I can afford a couple of pills by the time I get it.

 

1 minute ago, TyphoidHater said:

 

Narrator: "he won't"

 

Or maybe he will, but he'll have forgotten why he was saving the money. 

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Jwheel86

Jwheel86

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1 hour ago, CitizenVectron said:

I would guess they price it around $100,000 a year, which would put it at $273 a pill.

 

The pricing model will be interesting since they can argue those on the drug are less likely to need memory care. That's how Novartis justified $2.1m for Zolgensma.

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CitizenVectron

CitizenVectron

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3 hours ago, sblfilms said:

The drug already exists in stores. It’s about $15 a pill on most insurance plans, $100 a pill cash.

 

Unfortunately, this will likely change. The example I always use is Campath, which was a drug used to treat a small number of cancer patients. It was priced at around $100,000 for a cancer dose. It was discovered that it also worked for MS (killing immune system), and it started to be prescribed off-label. The key thing is that only 5% of the dose was needed, meaning there was a treatment for MS that could be taken for $5,000/yr (only two doses ever needed). So what happened? The company pulled the drug from the market and re-introduced a new dosage under a new name (Lemtrada)...and it was now $100,000 per dose.

 

I expect the same thing will be done here, if they believe this is a bigger market.

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Guest

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1 hour ago, b_m_b_m_b_m said:

Remember when insulin and EpiPens didn't break the bank?

Old insulin types have been and remain very cheap ($20ish cash a month for a typical monthly dosage). I don’t think any of the more common new insulins have gone up in price much beyond inflation this decade. People like the new insulins more because you don’t really have to watch what you eat :p 

 

7 minutes ago, CitizenVectron said:

 

Unfortunately, this will likely change. The example I always use is Campath, which was a drug used to treat a small number of cancer patients. It was priced at around $100,000 for a cancer dose. It was discovered that it also worked for MS (killing immune system), and it started to be prescribed off-label. The key thing is that only 5% of the dose was needed, meaning there was a treatment for MS that could be taken for $5,000/yr (only two doses ever needed). So what happened? The company pulled the drug from the market and re-introduced a new dosage under a new name (Lemtrada)...and it was now $100,000 per dose.

 

I expect the same thing will be done here, if they believe this is a bigger market.

This isn’t what is happening with the drug in question from what I’ve seen, and your example isn’t the norm. There are tons of drugs in the market that get used for one purpose and then retrofitted for another under a different name, and some that just get recertified for a larger patient set under the same name. Like with me I have a really rare form of diabetes and take a medication that turns out really helps with weight loss. They sell it under a different name (and higher dosages) for weight loss patients. It actually costs the same per mL for the diabetes version and the weight loss version.

 

Not all drug companies take the most cynical of routes with every drug.

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b_m_b_m_b_m

b_m_b_m_b_m

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1 hour ago, sblfilms said:

Old insulin types have been and remain very cheap ($20ish cash a month for a typical monthly dosage). I don’t think any of the more common new insulins have gone up in price much beyond inflation this decade.

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By 2016, the average price per month rose to $450 — and costs continue to rise, so much so that as many as one in four people with diabetes are now skimping on or skipping lifesaving doses.

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According to a 2017 Lancet paper on insulin price increases, “Older insulins have been successively replaced with newer, incrementally improved products covered by numerous additional patents.” The result is that more than 90 percent of privately insured patients with Type 2 diabetes in America are prescribed the latest and costliest versions of insulin.

https://www.vox.com/2019/4/3/18293950/why-is-insulin-so-expensive

 

C'mon man

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43 minutes ago, b_m_b_m_b_m said:

https://www.vox.com/2019/4/3/18293950/why-is-insulin-so-expensive

 

C'mon man

That isn’t a refutation of what I said. The big price increases happened in the previous decade as the synthetic drugs became the favored therapy for diabetes because the new insulin reacts nearly instantly, so you can take just what you need for how much carbs/sugar you consumed.

 

This decade there hasn’t been the massive uptick in pricing, and the older insulins continue to fall in price. People just don’t like them because diet restrictions are tighter. Nobody is off insulin because they can’t afford any insulin at all, they ration the newer stuff because they don’t want to change their diets and use older insulins.

 

We need the synthetics to get cheaper though! They are about $50/month on most insurance plans, but $500/month cash and health outcomes are better with synthetic insulins because people are generally lacking the discipline to eat a diet that lowers their carb intake.

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