Preparing Primary Care Centers for New Wave of Alzheimer Agents: Nicole Fowler, PhD, MHSA


The director of research for internal medicine and geriatrics at Indiana University School of Medicine provided perspective on navigating challenges with newly approved treatments for Alzheimer disease, and using resources efficiently. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

"Most of the people who could be eligible for this treatment [lecanemab] are primary care patients who aren’t even sure they have a problem. There’s no subjective complaints, no clinical complaints, they’ve never sort of through about doing a test that uncovers that they have amyloid in their brain."

The FDA’s recent decision to convert lecanemab’s (Leqembi; Eisai) approval to traditional opened the door for broader access and coverage of the therapy to an aging population that’s projected to include nearly 13 million people with Alzheimer disease (AD) by 2050.1 With the approval comes questions about how the drug, an antiamyloid therapy given every 2 weeks, will be safety and effectively administered to individuals in need. Patients can qualify for national coverage if they are enrolled in Medicare and have a diagnosis of mild cognitive impairment or mild AD that is supported by documentation of amyloid-ß plaque in the brain.

The qualifying patients also must have a consultation with a provider who participates in an eligible registry and who can offer appropriate clinical team involvement and follow-up care. A recent statement from the Centers for Medicare and Medicaid (CMS) noted that those who have Medicare should have a conversation with their providers to determine the suitability of the therapy for their care plan.2

With the emergence of novel therapeutics, the importance of early identification of people at risk of developing AD is more critical than ever. At the 2023 Alzheimer’s Association International Conference (AAIC), held June 16-20, in Amsterdam, Netherlands, Nicole Fowler, PhD, MHSA, and colleagues presented data on the DAVOS Alzheimer’s Collaborative DIGITAL Demonstration Project. This initiative helps clinicians better understand the feasibility, acceptability, and implementation of digital cognitive screening tools, like the Linus Health Digital Clock and Recall (DCR) test, in primary care settings.3

Fowler, director of research for internal medicine and geriatrics at Indiana University School of Medicine, sat down with NeurologyLive® prior to the meeting to discuss her presentation, and the challenges primary care institutions face with a newly approved therapy. She spoke on ways to efficiently use resources available, and the need to identify appropriate patients as early as possible. In addition, she spoke on the already available evidence-based treatments clinicians should continue to use in the management of patients with AD.

Click here for more coverage of AAIC 2023.

1. Alzheimer’s disease facts and figures. Alzheimer’s Association. Accessed July 14, 2023.
2. Statement: Broader Medicare Coverage of Leqembi Available Following FDA Traditional Approval. News Release. Centers for Medicare & Medicaid Services. Published July 6, 2023. Accessed July 14, 2023.
3. Swartzell K, Willis D, Hammers D, et al. Implementation of cognitive screening in primary care: DIGITAL-Indiana University Health System and Indiana University- A Davos Alzheimer’s Collaborative flagship site program. Presented at: AAIC 2023; June 16-20; Amsterdam, Netherlands.
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