Presentation (CTI)

OBJECTIVES: Anti-amyloid therapies for early-stage Alzheimer’s disease (AD) have received regulatory approval in several countries, including within the European Union. Publications have raised concerns about the strain these therapies may place on healthcare systems, due to the costs associated with treating a large eligible patient population. We present an estimate of the eligible, treatable population in Finland, based on a detailed analysis of the patient journey.
METHODS: The patient journey was modeled on the diagnostic and treatment pathway for early-stage AD in Finland. Literature searches, including Finnish and internal studies as well as local registry data, were conducted to identify epidemiological inputs and estimate the proportion of patients likely to progress through each stage of the pathway. Given that current anti-amyloid therapies are not indicated for patients who are ApoE4 homozygotes, this subgroup was excluded.
RESULTS: The estimated patient population was derived from the total number of newly diagnosed memory disorder cases in Finland, reported as 23,263 in 2021 (Roitto 2023). This population was refined based on several clinical eligibility criteria, including confirmed diagnosis via MRI and CSF analysis, amyloid positivity, ApoE4 genotype, early-stage diagnosis, absence of anticoagulant use, and lack of significant vascular comorbidities. Overall, approximately 1.5% of the incident cases were estimated to be eligible for anti-amyloid therapy.
CONCLUSIONS: Compared with the incidence for patients with any memory diseases, the number of patients eligible for anti-amyloid therapy will be relatively small. As systems adapt to the clinical and operational demands of anti-amyloid therapies, this population is expected to expand. Strategic evaluation of diagnostic infrastructure, care pathways, and workforce readiness will be critical to realizing the full potential of these therapies.