New Research Presented at Alzheimer's Association International Conference on Alzheimer's Disease Indicates Alzheimer's Disease May Lead to Increased Comorbid Conditions and Economic Burden
HONOLULU, July 13 /PRNewswire-FirstCall/ -- Pfizer Inc.
(NYSE:PFE) , together with its collaborator on
the Alzheimer's Immunotherapy Program, Janssen Alzheimer
Immunotherapy, presented new research this week at the Alzheimer's
Association International Conference on Alzheimer's Disease 2010
(ICAD 2010) from two podium and four poster presentations. This
research indicates there may be potential for an increased risk of
comorbid conditions, such as seizures, stroke and type 2 diabetes,
with Alzheimer's disease (AD). These studies also provide new
findings about the burden of care and costs associated with AD for
patients and their caregivers.
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"These findings underscore the importance of advancing research
about the growing burden and costs of AD. We need to increase our
understanding of the needs of patients and caregivers, as well as
the economic costs of this disease," said Ronald Black, M.D.,
assistant vice president, Clinical R&D, on behalf of the
Alzheimer's Immunotherapy Program. "The Alzheimer's Immunotherapy
Program is committed to advancing such research as well as working
to develop new therapies to help fight this devastating
disease."
About the Oral and Poster Presentations
Oral #O2-06-04: Alzheimer's Disease is Associated with Increased
Incidence of Seizures Among Patients in the United Kingdom,
1988-2009 (Baker N, et al.)
This retrospective cohort study was designed to estimate the
incidence of seizures among AD patients and non-AD patients. The
study was conducted using anonymized electronic medical records of
14,838 AD patients aged 50 years or older and 14,838
sex-age-matched non-AD patients from nearly 400 primary practices
in the United Kingdom. AD patients were followed for an average of
2.3 years and non-AD patients were followed for 3.4 years.
The findings showed that people with AD have seizures at an
annual rate of nearly 1 percent, which is slightly more than 6-fold
higher (95 percent CI, 4.9-8.4) than persons of similar age and
gender without AD. The study also showed the risk for seizure among
those with AD was highest at younger ages and decreased with
increasing age. The incident rate of seizures among non-AD patients
increased slightly with age. In this study, no safety data related
to any particular product were collected. One of the limitations of
this study was the inability to assess AD severity. In addition,
events recorded in the electronic medical record were not
confirmed.
Poster #P3-078: The Incidence of Stroke is Increased Among
Patients with Alzheimer's Disease in the United Kingdom, 1988-2009
(Baker N, et al.)
This retrospective cohort study aimed to estimate the rate of
stroke among AD patients and non-AD patients. The study was
conducted using anonymized electronic medical records of 13,694 AD
patients aged 50 years or older and 13,694 sex-age-matched non-AD
patients from nearly 400 United Kingdom primary practices. The
patients with AD were followed for an average of 2.3 years and the
non-AD patients were followed for an average of 3.4 years.
The study found that the incidence of stroke in patients
diagnosed with AD is 1.6 (95 percent CI, 1.4-1.8) times greater
than that of non-AD patients. The increased incidence rate of
stroke comparing AD patients to non-AD patients was seen in all age
groups. Patients with AD and their caregivers should be educated on
the signs and symptoms of a stroke. In this study, no safety data
related to any particular product were collected. One of the
limitations of this study was the inability to assess AD severity.
In addition, events recorded in the electronic medical record were
not confirmed.
Poster #P3-087: Central Nervous System (CNS) Comorbidities and
Concomitant Drug Use in a Medicaid AD Population (Mucha L, et
al.)
This is the first multi-state study to use Medicaid records from
2000-2008 to examine the differences in CNS comorbidities and
concomitant drug use and costs. A total of 13,927 AD patients were
matched to non-AD patients by several key factors, including age,
gender and Medicare eligibility status, among others. AD patients
qualified for inclusion into the study after their first instance
of AD-related dementia and a second AD claim or a prescription for
an AD treatment. The primary outcomes measures were medical and
pharmacy utilization and costs during the first year.
The study found that a significantly (P<0.0001) higher number
of AD patients were diagnosed with any CNS condition compared to
the control group, including psychosis (57 percent vs. 4 percent),
depression (15 percent vs. 6 percent) and major depression (7
percent vs. 3 percent). Atypical antipsychotics were the most
commonly utilized drug class by AD patients and represented the
highest drug expenditure category for AD patients. This study
showed that, due to their prevalence, CNS comorbidities and
treatment among AD patients represent a substantial cost to the
healthcare system.
No safety data were collected. Study limitations included the
unavailability of AD severity information and the AD inclusion
criteria, which may have resulted in excluding some AD patients.
Also given changes to the Medicare D database, any patient over age
65 included in the study must have met the study criteria prior to
2006.
Poster #P3-061: The Contribution of Type 2 Diabetes to the
Burden of Alzheimer's Disease (Mucha L, et al.)
Many patients with AD also suffer from type 2 diabetes, but it's
unclear how type 2 diabetes may impact the burden of AD. This new,
large, multi-state Medicare claims database study examined the cost
and utilization differences between AD patients with and without
type 2 diabetes. AD patients were identified from a claims database
by the first instance of AD-related dementia and a second AD claim
or a prescription for an AD treatment. The presence of type 2
diabetes was then established based on medical and/or pharmacy
claims for insulin or oral hypoglycemics. The primary outcomes
measures were health care cost and utilization during the first
year.
The study showed that AD patients with type 2 diabetes have
significantly higher rates of other chronic conditions, greater
healthcare service use and higher healthcare costs than AD patients
without type 2 diabetes. Specifically, AD patients with type 2
diabetes had significantly higher rates (approximately 1.5-fold
higher) of hypertension, hyperlipidemia and decubitus ulcer than AD
patients without type 2 diabetes. AD patients with type 2 diabetes
also utilized more health care services, such as ambulatory,
inpatient emergency room, and skilled nursing facilities
(p<0.001 for all). In addition, in this study the average
annualized total healthcare costs for AD patients with type 2
diabetes were 33 percent higher than those of AD patients without
type 2 diabetes.
No safety data were collected. Study limitations included the
unavailability of AD severity information and the AD inclusion
criteria, which may have resulted in excluding some AD patients.
Finally, while the non-type 2 diabetes cohort was not matched to
the type 2 diabetes cohort, the regression model controlled for any
differences in various demographic characteristics and
comorbidities.
Oral #O3-04-01: Utilization and Expenditures Associated with
Long Term Care in Medicaid Alzheimer's Disease Patients Compared to
a Matched Non-AD Medicaid Cohort (Mucha L, et al.)
A new, large, multi-state Medicaid claims database study aimed
to analyze the differences in long term care (LTC) utilization and
expenditures among Medicaid patients with and without AD. The study
compares records of AD Medicaid patients (13,927 AD participants)
matched with non-AD Medicaid patients.
Patients with AD aged 50 years and older were retrospectively
identified after their first instance of AD-related dementia and a
second AD claim or a prescription for an AD treatment. In this
study, LTC was defined as non-home chronic care including, nursing
homes and skilled nursing facilities, among others. Resource
utilization and reimbursement amounts for LTC occurring in the
first year were measured.
In this study, AD patients were more likely to have an LTC
claim; higher total expenditures; and a higher percent of their
expenditures represented by LTC claims. This study also showed that
LTC expenditures for AD patients were 61 percent higher than those
of the matched cohort. This study highlights the importance of
institutional care costs for AD patients to the Medicaid programs,
as well as the potential value of any therapies that might help
delay or avoid need for institutionalization. A limitation of this
research is that claims data are collected for payment and not for
research; and thus are subject to possible coding errors. However,
the impact of potential coding errors was minimized because
patients were required to have two or more diagnosis codes for AD
on separate service dates or an AD diagnosis code in conjunction
with at least one claim for medication used to treat AD.
Poster #P3-014: Quantifying Caregiver Out-Of-Pocket Expenses and
Time Spent Caregiving (Racketa J, et al.)
Since caregiver out of pocket expenditures (OOPE) have not been
well documented, this comprehensive Internet-based survey aimed to
estimate the cost per AD patient within the community-dwelling (CD)
and long-term care (LTC) setting by evaluating caregiver time and
OOPE. Data from 987 caregivers were included in this analysis, of
which, 901 provided care for CD patients and 86 provided care for
patients in LTC.
Caregivers were asked to report their monthly AD-related OOPE as
well as hours spent providing care each week. OOPE included AD
patient medical costs; supportive services such as day care,
transportation, and home health aids; caregiving support services;
nursing home care; home modifications; and legal fees.
This study highlights that the financial burden placed on U.S.
caregivers of AD patients is significant in both CD and LTC;
however, in this study, the average monthly OOPE for caregivers is
higher for LTC vs. CD setting at $1,039 ($202 SE) and $374 ($53
SE), respectively. This study also found that caregivers spent an
average of 68.2 (1.8 SE) hours per week providing care to CD
patients compared to 24.8 (3.4 SE) for LTC patients. As AD
progresses and requires LTC, considerable costs are passed on to
the caregiver. Study limitations included the fact that OOPE were
self-reported by caregivers. In addition, patient OOPE were
estimated by the caregiver, but not reported in this study.
Editors Note: The Alzheimer's Immunotherapy Program of Janssen
Alzheimer Immunotherapy and Pfizer Inc. also presented the
following abstracts at ICAD:
-- Oral #O3-05-01: Immunotherapy with Bapineuzumab Lowers CSF Tau Protein
Levels in Patients With Alzheimer's Disease (Blennow K, et al.)
-- Poster #P3-067: A Systematic Literature Review and Meta-analysis of
Apolipoprotein E E4 Prevalence in Alzheimer's Disease Patients (Crean
S, et al.)
-- Poster #P2-187: Longitudinal Changes in Functional Disability in
Alzheimer's Disease Patients (Arrighi M, et al.)
About Alzheimer's Disease
Alzheimer's disease (AD), the most common form of dementia, is a
fatal, degenerative brain disease that gradually destroys a
person's memory and ability to learn, reason, make judgments,
communicate and carry out daily activities, such as bathing and
eating. As AD progresses, individuals may also experience changes
in personality and behavior, such as anxiety, suspiciousness or
agitation, delusions or hallucinations.
Statistics on the prevalence and impact of AD vary depending on
how the disease is defined and methods used in gathering data.
Published reports estimate the worldwide prevalence of AD to be
26.6 million people. This number is projected to quadruple to 106.2
million people in 2050 with 1 in 85 persons living with the
disease. In the United States alone, recent estimates indicate as
many as 2.4 million to 5.3 million Americans have AD.
AD is among the most costly diseases worldwide. The annual cost
of dementia, including AD, has been estimated at $315 billion. In
the United States, the indirect and direct costs of caring for
people with AD are estimated to be more than $100 billion a year.
An aging global population will result in an increased burden on
people living with AD, caregivers and public health systems
worldwide.
About the Alzheimer's Immunotherapy Program
The Alzheimer's Immunotherapy Program of Janssen Alzheimer
Immunotherapy and Pfizer Inc. is an equal collaboration committed
to researching and developing selective products for the treatment
and/or prevention of neurodegenerative conditions, including
AD.
We believe that it is possible to reduce the burden of disease
through early intervention in the illness. The Alliance is
dedicated to delivering comprehensive and integrated solutions that
help address the needs of people impacted by AD.
The research of the Alliance focuses on the beta amyloid
hypothesis. Scientific evidence supports the idea that the
accumulation of beta-amyloid may play an important role in the
pathophysiology of AD. It is believed that preventing the
accumulation and/or promoting the removal of beta-amyloid may have
the potential to slow the progression of AD and help preserve
function in people with AD. This theory is being tested in clinical
trials.
Pfizer Inc: Working together for a healthier world(TM)
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health and well-being at every stage of life. We strive to set the
standard for quality, safety and value in the discovery,
development and manufacturing of medicines for people and animals.
Our diversified global health care portfolio includes human and
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Consistent with our responsibility as the world's leading
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more than 150 years, Pfizer has worked to make a difference for all
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us at www.pfizer.com
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CONTACT: Gwen Fisher, office, +1-484-865-5160, or mobile,
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Investor Relations, Suzanne
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Web Site: http://www.pfizer.com/
Posted: July 2010
