Adapting prescribing criteria for amyloid-targeted antibodies for adults with Down syndrome.
Hampus HillerstromRichard FisherMatthew P JanickiBrian ChicoineBradley T ChristianAnna EsbensenLucille EsralewJuan ForteaSigan HartleyJason HassenstabSeth M KellerSharon Krinsky-McHaleFlorence LaiJohannes LevinMary McCarronEric McDadeAnne Sophie RebillatHerminia Diana RosasWayne SilvermanAndre StrydomShahid H ZamanHenrik ZetterbergPublished in: Alzheimer's & dementia : the journal of the Alzheimer's Association (2024)
Prior authorization criteria for Federal Drug Administration (FDA) approved immunotherapeutics, among the class of anti-amyloid monoclonal antibodies (mAbs), established by state drug formulary committees, are tailored for adults with late-onset Alzheimer's disease. This overlooks adults with Down syndrome (DS), who often experience dementia at a younger age and with different diagnostic assessment outcomes. This exclusion may deny DS adults access to potential disease-modifying treatments. To address this issue, an international expert panel convened to establish adaptations of prescribing criteria suitable for DS patients and parameters for access to Centers for Medicare & Medicaid Services (CMS) registries. The panel proposed mitigating disparities by modifying CMS and payer criteria to account for younger onset age, using alternative language and assessment instruments validated for cognitive decline in the DS population. The panel also recommended enhancing prescribing clinicians' diagnostic capabilities for DS and initiated awareness-raising activities within healthcare organizations. These efforts facilitated discussions with federal officials, aimed at achieving equity in access to anti-amyloid immunotherapeutics, with implications for national authorities worldwide evaluating these and other new disease-modifying therapeutics for Alzheimer's disease.
Keyphrases
- cognitive decline
- mild cognitive impairment
- primary care
- late onset
- drug administration
- healthcare
- affordable care act
- end stage renal disease
- adverse drug
- early onset
- newly diagnosed
- ejection fraction
- chronic kidney disease
- quality improvement
- peritoneal dialysis
- autism spectrum disorder
- mental health
- patient reported outcomes
- health insurance
- cancer therapy
- small molecule
- adipose tissue
- smoking cessation
- drug delivery
- clinical practice
- risk assessment
- global health
- human health
- clinical evaluation