Health System Readiness for Disease-Modifying Therapies for Alzheimer's Disease

Key Message

What Is the Issue?

• Dementia is a condition characterized by symptoms such as memory loss and difficulties with attention, language, and problem solving resulting from specific disruptions to brain function, reducing a person’s ability to perform everyday activities.
• Alzheimer disease (AD) is a chronic neurological degenerative disease and 1 of the most common causes of dementia, affecting an estimated 368,200 people in Canada in 2020. Mild cognitive impairment (MCI) is a clinical condition involving memory loss that can progress to dementia and is often due to underlying AD. It was estimated to affect around 917,000 people in Canada aged 60 and older in 2020.
• Disease-modifying therapies (DMTs) are being developed that target underlying pathologic processes of AD to slow disease progression, unlike contemporary treatments that focus on managing symptoms. A prominent target of these therapies is amyloid-beta, a protein known to contribute to amyloid plaques.
• Many of the anti–amyloid-beta DMTs are intended for people with early-stage AD, which includes MCI and mild dementia due to AD. However, DMTs demand more frequent health care visits and higher use of medical imaging for safe treatment and monitoring. This would greatly impact current care pathways for early-stage AD, necessitating an examination of health system readiness in Canada.

What Did Canada’s Drug Agency Do?

• Canda’s Drug Agency sought to examine health system readiness in Canada and care pathways for patients with early-stage AD in preparation for the potential use of anti–amyloid-beta DMTs by reviewing publicly available data and literature about health systems and AD treatment pathways for improving dementia care in Canada.