Dr. Sharon Cohen
Neurologist, & Medical Director, Toronto Memory Program
Adam Morrison
Senior Director of Public Policy & Partnerships, Alzheimer Society of Ontario
As Ontario works to better prioritize public access to new medicines, disease-modifying Alzheimer’s medicines must be prioritized.
Alzheimer’s disease is on the rise amongst the Canadian population. “The numbers are growing,” says Dr. Sharon Cohen, a neurologist specializing in Alzheimer’s disease (AD) and Medical Director of the Toronto Memory Program, Canada’s largest memory clinic for AD and the largest clinical research site for AD. “This is an all-too-common disease affecting many Canadians.”
The Organisation for Economic Co-operation and Development reports that over 35 million people worldwide had dementia in 2010. According to Statistics Canada, approximately 750,000 Canadians are living with AD or another form of dementia, with this projected to increase to 1.7 million by 2050. Approximately 299,000 Ontarians live with dementia, two thirds due to AD. “By the end of this decade, we expect we’ll have an additional 100,000 Ontarians living with dementia and by 2050 we could be tripling that amount,” says Dr. Cohen.
Health care system challenges
The pipeline from a new medicine’s development to its inclusion on Canadian public formularies is often painstakingly slow. “It takes a long time — often up to two years — for medications that are already approved by Health Canada to get cost coverage, which is really tragic, especially for progressive diseases like AD,” says Dr. Cohen.
This delays access for patients without private insurance. It can also mean that by the time a new treatment is covered, their disease may have progressed past the point of eligibility, losing a crucial window for early intervention.
Premier Doug Ford recently addressed this issue, vowing to improve timelines. “Canada currently ranks last in the G7 in the time it takes to approve and provide patients access to innovative and often life-saving medicines,” he said. “This needs to change.”
Prioritizing public access
Canada currently has two disease-modifying AD treatments going through the approval process at Health Canada. Prioritizing public access to these innovative treatments is important for patients and caregivers alike. Since the new medicines don’t just treat AD symptoms but in fact slow the progression of the disease, there’s a huge opportunity to relieve the burden on caregivers and to keep AD patients active, engaged members of their communities, families, and even workplaces for longer.
Reducing ER visits, hospital stays, and long-term care could save society millions.
There are challenges, however. “Early detection and diagnosis are crucial for making effective use of the new disease-modifying treatments,” says Adam Morrison, Senior Director of Public Policy and Partnerships at the Alzheimer Society of Ontario. “In Ontario, people often wait years for a formal dementia diagnosis.”
“We do have the technology now to diagnose very early — amyloid-PET scans, spinal fluid assessment, and, soon, blood tests,” says Dr. Cohen. “The problem is that we don’t have cost coverage for these tests and we don’t have enough availability.”
The impact of new treatments
Long wait times to see a dementia specialist, delayed referrals, and patient stigma also contribute to diagnostic delays. The result is that patients are being left behind, especially those who live in rural or remote areas or who have cultural or language barriers.
As Ontario works to better prioritize public access to new medicines, it’s clear timely access to AD treatments would have broad impacts not only on patients and care partners but on Canada’s society and economy at large.
“Reducing ER visits, hospital stays, and long-term care could save society millions,” says Dr. Cohen. Morrison adds, “175,000 care partners provide 4.8 million hours of weekly care, costing tax payers about $30 billion annually.” According to a study commissioned by the Alzheimer Society of Ontario, Ontario could save nearly $10 billion over 20 years in avoided costs with the introduction of disease-modifying AD treatments.
Advocating for change
Speeding up access timelines to treatments in order to improve the lives of patients and society requires strong partnerships and collaboration between clinicians, policymakers, and industry.
“These partnerships are vital to success,” says Dr. Cohen. “We learn from each other and not all goals are going to be attained all at once, so we have to be working together to prioritize the immediate groups who need urgent access and then expand from there.”
Canadians can raise their voices to advocate for equitable access to all innovative treatments, helping to drive change. “We need all hands on deck to push and to advocate,” says Dr. Cohen. “Share your personal stories and your experience,” encourages Morrison. “Make your voice heard. And get educated. The Alzheimer Society of Ontario’s Advocacy College is a great place to get started and to learn about grassroots advocacy.”
This article was made possible with support from Lilly Canada.
