The Health Sciences Authority recently approved two Alzheimer’s disease drugs, Donanemab and Lecanemab, with prices ranging from over US$20,000 to over US$30,000. Neurologists say that with the government’s approval for local use of these two drugs, prices could drop by 30% to 50%.
New drug acts like a vacuum cleaner to clear out protein buildup in the brain
Dr. Lee Kim-yan, a consultant neurologist at Mount Elizabeth Hospital, began introducing these drugs to treat patients through a special channel in mid-2023. He explained that the primary effect of these two drugs is to help Alzheimer’s patients clear protein deposits in the brain that cannot be removed on their own, acting like a vacuum cleaner to remove beta-amyloid (amyloid-β), thereby restoring normal brain function. However, these two drugs are only effective for patients with early-stage Alzheimer’s disease, slowing the progression of dementia. They are not suitable for all dementia patients and cannot cure the disease.
Even new drugs cannot cure the disease completely; the risks of using drugs still need to be assessed.
Dr Lee Xin Er, a consultant psychiatrist at Private Space Medical, has not prescribed these two medications. She believes the use of these medications should be assessed on an individual basis, with careful consideration of potential side effects. Dr Lee Xin Er also noted that she has learned that some patients may experience side effects such as cerebral hemorrhage or vascular damage after using them.
Dr Lee Xin Er admits that there is indeed a risk of brain swelling or bleeding during treatment. Therefore, when considering whether to use these medications, he pays special attention to whether the patient has other medical conditions, such as poorly controlled hypertension or poor heart function. If these problems are present, he generally does not recommend the use of these two drugs.
However, Dr Lee Xin Er added: “Further analysis found that the incidence of brain swelling, cerebral hemorrhage or hemorrhagic complications in Asian patients was very low, and the incidence of truly serious adverse reactions was less than 5%.”
Dr Lee Xin Er has prescribed lencaneluzumab to a total of 26 patients. No obvious side effects have occurred in the past two years, but long-term observation is needed to better understand the efficacy of this drug.
Early detection of dementia: Be alert to these signs
Alzheimer’s disease is a type of dementia, and these two medications are only effective for early-stage Alzheimer’s. So how can one detect the possibility of dementia early? Dr Lee Xin Er advises seeking medical attention and professional testing as soon as possible if suspicion arises. While seniors may consider forgetfulness normal with age, any symptoms that interfere with daily life, such as forgetting the way home, warrant prompt professional help.
Dr Lee Xin Er also reminds that maintaining a good daily routine, exercising more, ensuring adequate sleep, and actively participating in social activities and stimulating brain function are the only ways to effectively prevent dementia.
In response to queries from Channel 8 News, the Ministry of Health said it is evaluating the clinical efficacy and cost-effectiveness of the two drugs to determine whether to provide subsidies in the future.
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