Solanezumab May Become The 1st Alzheimer's-Modifying Treatment

Learn why neurologists wish they could prescribe experimental solanezumab to 15% of their Alzheimer's patients. Solanezumab is Eli Lilly's exciting, maturing attempt to create a vaccine that dissolves Alzheimer's plaque.

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Surveyed U.S. neurologists would prescribe Eli Lilly's emerging anti-beta-amyloid monoclonal antibody solanezumab to 15% of their mild to moderate Alzheimer's patients.

Solanezumab has been through a number of trials where it helped, though it did not meet all expectations. It is currently undergoing new and ongoing trials to fine-tune how it can help people with Alzheimer's.

Encouraging Results

Interviewed thought leaders are encouraged by a slowing of cognitive decline observed in solanezumab-treated mild AD patients, pooled across two completed, placebo-controlled, Phase III studies, as well as the drug's safety profile, particularly with regard to a low risk of amyloid-related imaging abnormalities.

The report also includes insights from a survey of U.S. managed care organization pharmacy directors, two-thirds of whom indicate they would reimburse a new disease-modifying therapy for the treatment of mild to moderate AD that was priced at a significant premium to current brands ($25/day), if such an agent offered a 200 percent improvement on cognitive decline over donepezil (Eisai/Pfizer's Aricept, other brands, generics). Payers expecting not to cover such a therapy mostly cite insufficient benefits as the reason, suggesting that—for some payers—greater therapeutic gains would be needed to justify the value of a drug offered at such a considerable cost.

Filling an Unmet Need

Drugs offering a greater effect on cognition and those offering a greater effect on function compared with current treatments remain the top unmet needs in the treatment of mild to moderate Alzheimer's disease (AD), according to surveyed U.S. and European neurologists. Currently available therapies alleviate some cognitive and functional symptoms associated with AD over the short-term, but do not slow disease progression, thus underscoring the remaining unmet need for more efficacious alternatives, which could be either symptomatic or disease-modifying.

"With a new Phase III trial ongoing in mild AD, solanezumab retains the potential to become the first disease-modifying therapy approved for the treatment of this debilitating disease, a landmark achievement," said Decision Resources Senior Business Insights Analyst Alana Simorellis, Ph.D. "We expect solanezumab likely would be priced much higher than symptomatic brands today, which could present challenges to usage and market access, depending on the level of its clinical benefits. Even with limited uptake, however, we expect premium pricing and a growing patient population could easily drive blockbuster sales for solanezumab in the AD market over the next decade."

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