The good news is that research is leading to improved drugs to treat the symptoms of Alzheimer’s disease and other neurological disorders — whether it’s insomnia or cognitive decline. But rising out-of-pocket drug prices means many Alzheimer’s patients are less inclined to take those drugs, a new study reports.
The study, published in Neurology, analyzed a private insurance claims database to examine just how challenging expensive drug prices are for dementia patients. The researchers focused on new cases of Alzheimer’s, dementia, Parkinson’s or peripheral neuropathy — a condition involving nerve damage and weakness in the hands or feet.
They found that while drugs for all of these conditions were similar in terms of efficacy, they had vastly different out-of-pocket costs. Rivastigmine, a cholinesterase inhibitor that’s used to treat dementia or cognitive decline, cost up to $79.30 for a 30-day supply compared to donepezil or Aricept, a similar drug that only cost $3.10 for the same amount.
These big gaps also occurred with peripheral neuropathy drugs, including pregabalin, which cost $65.70 compared to gabapentin which only cost $8.40.
High Drug Prices and Alzheimer’s Patients
To drill into how these huge price differences were impacting patients, the researchers examined 19,820 people with dementia who were taking these drugs. They found that a $50 increase in out-of-pocket costs was linked to a decrease in adherence to medication.
When donepezil cost about $3 for a 30-day supply, people with Alzheimer’s disease taking the drug filled their prescriptions 70 percent of the time. But for rivastigmine, which cost $100 for the same supply, patients filled their prescriptions only about 45 percent of the time. In other words, the higher the price, the less likely patients were to take their medication.
The researchers also found that black, Latino and Asian patients had even greater declines than white patients in sticking to medication when drug prices increased.
“These results are concerning, especially as we’ve seen the cost of prescription drugs continued to rise and an increasing amount of the cost being shifted to patients through out-of-pocket costs,” Dr. Brian Callaghan of the University of Michigan, an author of the study, said in a news release.
“Of course, if people do not follow their prescriptions correctly, they are less likely to benefit from the drug and see improvements in their condition, possibly leading to complications and higher costs later.”
Pricing Reform For the Future
While much of the research that’s been poured into finding an Alzheimer’s treatment that can slow progression of the disease has resulted in cancelled trials or disappointing results, some hopes remain. Biogen announced that it will start re-dosing past trial participants with aducanumab in March 2020, after resurrecting it in October 2019. And a new clinical trial at the University of Southern California (USC) aims to defeat beta-amyloid even before Alzheimer’s symptoms appear.
Even if these drugs are effective and are approved by the FDA, the financial burden will be another major hurdle ahead. Next week, 216 neurologists plan to attend the annual American Academy of Neurology (AAN), where they will meet with federal lawmakers to push for drug pricing reform.
“Increasingly, patients must absorb more and more of the costs for medications that are necessary to treat and manage chronic neurologic conditions,” Dr. James Stevens, President of the AAN, said in a news release.
“As a result, patients are struggling with financial burden, and some are rationing their medications,” he continued. “Reigning in these costs is crucial so we can continue to provide our patients with the highest quality neurologic care.”