Decision Resources, one of the world's leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that while approximately 70 percent of surveyed physicians' newly diagnosed patients have mild-to-moderate Alzheimer's disease, only 52.2 percent of first-line patients are prescribed an acetylcholinesterase inhibitor (AChEI). Instead, 28.1 percent of first-line patients are prescribed an antidepressant. The new report entitled Treatment Algorithms in Alzheimer's Disease finds that 65.8 percent of these patients take antidepressants as a monotherapy in this line.
First-line prescribing of antidepressants is largely driven by primary care physicians; 45 percent of surveyed primary care physicians indicate they prescribe antidepressants first line as a monotherapy, compared with only 27 percent of surveyed neurologists.
"The prescribing of antidepressants as first line therapy for Alzheimer's disease not only underscores the relatively high rate of comorbidity between Alzheimer's disease and depression, but more importantly indicates that physicians and/or patients prioritize the treatment of depression in newly diagnosed Alzheimer's disease patients," said Matthew Winton, Ph.D., analyst with Decision Resources. "This is likely because physicians perceive that effective treatments exist for depression, but not for cognitive decline."
The report also finds that relatively long delays separate a patient's first diagnosis for Alzheimer's disease and the start of treatment. Patient-level claims data show that only 34.9 percent of patients begin first-line treatment for the disease within a year of their first diagnosis. Slow treatment initiation of newly diagnosed patients can be attributed to the unwillingness of patients to receive treatment.
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