Doctors Prefer Aricept & Namenda for Alzheimer's
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BURLINGTON, Mass.-- New research by Decision Resources found that doctors prefer Aricept® (generic: donepezil) and Namenda® for treating Alzheimer's.
Decision Resources is one of the world’s leading research and advisory firms focused on pharmaceutical and healthcare issues.
Aricept® is the brand name for the medication donepezil. It works as an acetylcholinesterase inhibitor (AChEI) and is made in the USA by Eisai/Pfizer. See the "We Recommend" section below for a list of generic manufacturers.
Namenda® is the brand name for the medication memantine. It works as an N-methyl-D-aspartate (NMDA) receptor antagonist. It is made in the USA by Forest Laboratories.
The researchers found that these two medications lead all other therapies by a wide margin in the treatment of newly diagnosed Alzheimer’s disease patients.
According to analysis from Treatment Algorithms in Alzheimer’s Disease:
AChEIs are the most frequently prescribed therapy for the treatment of Alzheimer’s disease, with donepezil capturing the majority of patient share in the class. Meanwhile, Namenda®, which is approved for the treatment of moderate to severe Alzheimer’s disease in the United States, is often prescribed in combination with AChEI therapy.
AdvertisementThe analysis finds that Namenda® captures a modest 15.9 percent patient share in the first line but increases to 40.9 percent in the second line among newly diagnosed patients moving to each line of therapy within a year of treatment initiation.
The analysis also finds that in the treatment of Alzheimer’s disease, polypharmacy increases across the lines of therapy, from modest polypharmacy in the first line (118.4 percent total patient share) to 176.3 percent in the second line and 188.5 percent in the third line.
“Often, Alzheimer’s disease patients initiate treatment with an AChEI and will receive AChEI therapy continually; other therapies are added if the disease progresses or if comorbid conditions such as depression are present,” said Decision Resources Analyst Georgiana L. Kuhlmann, S.M.
This seems to say that a doctor will typically start a person with Alzheimer's on Aricept® (donepezil) right away. They can be expected to keep the person on Aricept® continually and then add Namenda® as an additional therapy at a later stage.
Another insight in this study is that Doctors seem to frequently prescribe Namenda® "off-label." Namenda® is approved by the FDA for treating mid-stage and advanced-stage Alzheimer's, also known as moderate-to-severe Alzheimer's. If a doctor prescribes it for early-stage Alzheimer's, the doctor is choosing to go beyond the FDA approval on the label. A doctor is allowed to do this and it is called an "Off-Label Prescription."
The researchers noted that, “While the increase in patient share for Namenda® in the second-line reflects its frequent off-label use as an adjunctive therapy to an AChEI in the milder stages of the disease, it could also reflect the worsening of patients’ disease, and as Namenda® is approved for the treatment of moderate to severe Alzheimer’s disease, physicians may feel it is appropriate to prescribe Namenda® as a monotherapy at that time.”
Explanation of terms: Taking just one medication like Aricept® is referred to as a "monotherapy." Taking more than one pharmaceutical at the same time, such as Aricept® together with Namenda®, is called "polypharmacy".
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About Treatment Algorithm Insight Series
Through examination of patient-level claims data, Decision Resources provides exceptional insight into physicians' prescribing trends and the factors that drive therapy product choice, from diagnosis through multiple courses of treatment, for a specific disease. Beginning in 2011, Treatment Algorithms analysis will be updated quarterly to provide ongoing trending of product utilization by line of therapy and new therapy initiations.
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About Decision Resources
Decision Resources (www.decisionresources.com) is a world leader in market research publications, advisory services and consulting designed to help clients shape strategy, allocate resources and master their chosen markets. Decision Resources is a Decision Resources, Inc. company. Decision Resources, Inc. is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources, Inc. at www.DecisionResourcesInc.com.
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