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A Framework for the Administration of Anti-amyloid Monoclonal Antibody Treatments in Early-Stage Alzheimer’s Disease

  • Michael H. Rosenbloom,
  • Tricia O’Donohue,
  • Domi Zhou-Clark,
  • Deepashni Mala,
  • Andrew Frazier,
  • Michael Tarrant,
  • Michelle Modrijan,
  • Melora Riveira,
  • Darla Chapman,
  • Yvonne Griffin,
  • Lauren Shakalis,
  • Thomas J. Grabowski

摘要

The US Food and Drug Administration (FDA) approval of lecanemab for early-stage Alzheimer’s disease (AD) represents an exciting new chapter in the management of neurodegenerative disease, but likewise presents numerous clinical, technical, and financial logistical challenges for both academic and non-academic medical institutions hoping to administer this drug. Minimal resources exist that provide guidance for establishing and maintaining a lecanemab treatment program at the institutional level. The current report aims to provide healthcare institutions a framework for the planning, onboarding, and longitudinal treatment of AD with anti-amyloid monoclonal antibody treatments. We present an implementation study involving three stages: (1) feasibility assessment, (2) operations and going live, and (3) monitoring assessment. We found that implementation of lecanemab in clinical practice was feasible due to the assignment of an enterprise-wide project manager to facilitate the planning phase, a cost analysis showing that lecanemab was financially sustainable, and the development of electronic medical record tools to support operational efficiency.