Early Alzheimer's drug could be difficult to access in northern Ontario, says geriatrician

A geriatrician from Sault Ste. Marie has concerns it will be more difficult for patients who live in northern Ontario to access a new drug to help treat early Alzheimer's disease.

On Jan. 6, the U.S. Food and Drug Administration (FDA) approved a drug called Leqembi that has shown some success at slowing cognitive decline in patients who are in the early stages of Alzheimer's disease.

Health Canada has not yet approved the drug, although some clinical trials are ongoing in Toronto.

Dr. Katriina Hopper, a geriatrician with the Sault Area Hospital, said if Health Canada approves the drug, it will be difficult for many patients to access it.

"I suspect that at first this drug may be limited to university centres as it is in the United States," Hopper said.

The drug needs to be administered twice a month through intravenous in a hospital setting, and also requires follow-up monitoring through MRIs.

Hopper said patients in larger urban centres like Toronto are more likely to have access to hospitals equipped to administer the drug and do the necessary follow-up.

She added there are only five or six geriatricians in all of northern Ontario. Two are in Sault Ste. Marie, one is in Sudbury and at least one more is located in Thunder Bay.

"I do anticipate that a lot of people will ask me about this medication," Hopper said.

"Unfortunately, many people who ask about medications like this are caring for loved ones who are in the moderate to severe stages of their disease and this new medication is really only for people in the earliest stages."

The medication also doesn't cure Alzheimer's disease. In clinical trials it has been found to decrease cognitive decline in patients with early Alzheimer's by 27 per cent over an 18-month period.

Hopper said besides new medications, there is more research around preventative care for people with dementia, and to reduce the risk of dementia.

"If I had to give one piece of advice, it's exercise," she said. "Exercise is the key to aging well and you can start at any time of your life."

Barriers to access

Kyle Fitzgerald, the director of public policy and government relations with the Alzheimer's Society of Ontario, said wait times to see a geriatrician in the province can range from 12 to 18 months.

Fitzgerald said if Leqembi is approved in Canada, the shortage of geriatricians will make it difficult for patients in Ontario to access the drug.

"So there is that bottleneck there as well in terms of not only physical infrastructure and MRI machines, infusion clinics, but also health human resources capacity because we simply don't have the specialist necessary to conduct assessments," he said.

A year's worth of the treatment is also projected to cost $35,000, which would make it inaccessible to most people if it doesn't end up being covered by the Ontario Health Insurance Plan (OHIP).