New Alzheimer’s Disease Treatments — The Eye of the Beholder

Mike Woods July 12, 2021

There has been a lot in the news lately about aducanumab (Aduhelm), a new monoclonal antibody treatment for Alzheimer’s disease.

Alzheimer’s disease is a neurological disease and is the most common cause of dementia. It causes destructive, progressive, and irreversible changes in the brain. A common feature is the accumulation of a protein called amyloid-β in the form of plaques and tau tangles. Both are thought to cause cell death, but they have not yet been shown to be the cause of Alzheimer’s disease.

Aducanumab (Aduhelm), a drug that reduces amyloid-β plaques, was approved by the FDA on June 7, 2021 for treatment of all stages of Alzheimer’s disease. The approval was quite controversial for several reasons.

Many experts are concerned that accelerated approval of aducanumab without convincing evidence is premature, especially since it was only tested on those with early Alzheimer’s disease but was approved for all stages. In fact, there is no evidence at all that aducanumab is effective in patients with advanced Alzheimer’s disease.
The government is now looking at the issue since Alzheimer’s disease primarily occurs in seniors and Medicare will be picking up most of the tab for a medication that may have little benefit.
The Boston Globe reported unofficial meetings between the manufacturer and an FDA director that may have influenced the decision.

The reason for the controversy can be confusing, so I will try and explain the different sides of the issue to help you understand what the fuss is about. There are basically three perspectives to consider when breaking down this issue.

Those who believe there was not enough good evidence that aducanumab improves patients with Alzheimer’s disease to approve the drug, especially for use in those with advanced disease.
Those who feel that the fact that there are no other available treatments justifies the use of aducanumab without convincing evidence and despite the known side-effects.
Those who are concerned that the healthcare system cannot afford the $58,000 yearly cost of medication, along with the cost of brain-imaging tests, infusions, and provider visits, especially if the benefits are only subtle.

The Evidence

Basing medical treatments on solid evidence is of major importance to healthcare providers. There are too many examples of unhelpful

Awareness, Health, Medication Adherence

Talk About Your Medicines to Improve Adherence

Evan O'Connor October 9, 2020

October has been observed as Talk About Your Medicines Month (TAYMM) for 35 years. Started by the BeMedWise Program at NeedyMeds (formerly known as the National Council on Patient Information [NCPIE]), the awareness month is an annual opportunity to spotlight safe medicine use with the goal of improved health outcomes. This year’s theme is Medication Adherence – On Track With Your Meds and Your Health. Medication adherence is a vital part of maintaining your health. Our goal is to empower patients to maximize the benefits while minimizing the risks of the medications they are taking, and provide the tools they need to talk about their medicines.

Medication adherence has been called America’s “other drug problem.” Nonadherence can lead to illness progression, severe complications, and preventable deaths. Nonadherence includes anything from delaying or not filling a prescription, skipping doses, splitting pills, to stopping a medication early. Not taking medication as directed can lead to poor health outcomes which then increases healthcare service utilization and overall healthcare costs.

NeedyMeds, Prescription Drugs

Seven Secrets to Medication Savings

Richard Sagall August 17, 2020

Anyone looking to save on medication costs, and that is probably you if you are reading this article, has seen the same methods listed in article after article. They include shopping around for the best price, switching to generics, splitting pills, applying to assistance programs, using a drug discount card or copay cards, etc.

I’ll explain some different ways to save you may not have seen before. They may be a little more complex than the methods listed above – and may require some conversations with your prescriber or pharmacist. In addition to the cost savings these methods will provide, they will also give you better understanding of your treatments and the medicines you take.

1. Treating the Symptom or Treating the Cause

When you are sick and feeling miserable, you want one thing – to feel better. Your healthcare provider may give you a medicine that lessens your symptoms – called symptomatic treatment. Examples include an antihistamine or a decongestant which may help with the runny or congested nose of a cold, an anti-diarrheal medicine may help with the runs associated with a stomach bug or an anti-itch medicine

Prescription Drugs

Affording Your Meds with Patient Assistant Programs

Richard Sagall July 20, 2020

by Richard Sagall, MD

It’s a choice no one should have to make – pay rent and buy food or get prescriptions filled. Yet all too often it’s a choice Americans, particularly working-age Americans, have to make.

Nearly 28 million Americans have no health insurance, and millions more have limited coverage. Many Americans just can’t afford healthcare, and, if they can, they don’t have the money to buy their medicines.

Prescription Assistance Programs

There is help available for many people who can’t afford their medicines. These programs, frequently called prescription assistance programs (PAPs) or patient assistance programs, are designed to help those in need obtain their medicines at no cost or very low cost.

Many, but not all, pharmaceutical companies have PAPs. The manufacturers who have programs do so for various reasons. Some believe that they have a social obligation to help those who can’t afford their products. Others believe it’s a good marketing tool. As one PAP director once told me, many people who can’t afford their medicines now will go on to obtain some type of coverage. And when they do get this

Medicine Safety

Acetaminophen Facts and Safety Information

Evan O'Connor April 7, 2020

Acetaminophen is the most common drug ingredient in the United States and is found in more than 600 different prescriptions and over-the-counter medicines, including pain relievers, fever reducers, and sleep aids as well as cough, cold, and allergy medicines. Over 50 million Americans use a medicine that contains acetaminophen each week. It is safe and effective when used as directed, but taking more than directed is an overdose and can lead to liver damage. The U.S. Food and Drug Administration (FDA) recommends taking no more than 4,000 milligrams (mg) of acetaminophen in a 24-hour period.

Here are four important steps to follow when taking any over-the-counter or prescription medicines:

Always read and follow the labels on your medicines. Never take more medicine than the label says.
Know if your medicine contains acetaminophen. It is important to check the active ingredients listed on the labels of all your medicines to see if they contain acetaminophen.
1. On over-the-counter medicine labels, the word “acetaminophen” is written on the front of the package or bottle, and is highlighted or in bold type in the active ingredient section of the Drug Facts label.
2. On prescription medicine labels, acetaminophen is sometimes listed as “APAP,” “acetam,” or other shortened versions of the word.
3. In other countries, acetaminophen may be called paracetamol. There is no therapeutic or chemical difference between acetaminophen and paracetamol.
Never take more than one medicine that contains acetaminophen at the same time. Always ask your healthcare provider or pharmacist if you have any questions about your medicines.
If you drink three or more alcoholic drinks a day or if you have liver disease, talk to your healthcare provider before taking acetaminophen as you may be at greater risk for liver damage. It is also important to talk to your healthcare provider before taking medicines containing acetaminophen if you are pregnant or breastfeeding, or if you take blood thinners.

It is advised that you stop taking acetaminophen
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