Earlier Alzheimer’s Treatment Could Increase Lifetime Benefits

EARLIER TREATMENT with donanemab could increase the lifetime benefits of Alzheimer’s care, according to a US modelling study examining the value of starting anti-amyloid therapy sooner.

The analysis suggests that treatment timing could influence how long patients retain independence and how much support they need. However, its estimates describe potential future benefits rather than outcomes observed in a trial comparing early and later treatment.

Why Treatment Timing Matters

Donanemab targets amyloid, a protein that accumulates in the brains of people with Alzheimer’s disease. It belongs to a treatment class intended to slow disease progression in eligible patients with early disease.

Identifying suitable patients involves more than recognising memory difficulties. Assessment can include cognitive testing, brain imaging and tests for biological markers. Other causes of cognitive symptoms also need consideration. These steps help establish whether Alzheimer’s is present and whether a particular treatment is appropriate.

Earlier diagnosis therefore creates an opportunity for assessment while patients may still meet treatment criteria. It does not mean that everyone with memory symptoms should receive anti-amyloid therapy.

Projecting Lifetime Benefits

Researchers used a microsimulation model to compare no treatment with donanemab initiated at the stage represented in its pivotal trial or two years earlier.

Starting sooner increased projected lifetime societal value by 32%, from $104,900 to $138,300 per person. This rose to 71% if treatment effects are also stronger (36% slowing) in earlier AD stages.

The calculations included better health-related quality of life, reduced unpaid caregiving and medical cost offsets.

These figures were estimates of benefits, rather than net savings. Drug costs and the costs of screening and monitoring were excluded.

Interpreting the Economic Findings

For patients and families, time spent living independently is an outcome that can matter beyond a change in a cognitive test score. A model can explore how slower decline might affect that time, alongside the demands placed on care partners.

Nevertheless, projections require assumptions. A treatment effect measured over a limited trial period cannot automatically be assumed to continue throughout a patient’s remaining life. Different assumptions about its duration can alter the estimated value substantially.

The study therefore provides a case for investigating timely diagnosis and treatment access, rather than proof that earlier prescribing will deliver the projected benefits for every patient.

Decisions about expanding care would also need to account for treatment safety, eligibility, delivery costs and the resources required for assessment. The findings highlight the potential value of earlier intervention while leaving its overall affordability and long-term clinical impact open to further evaluation.

Reference

Chapel J et al. The value of timely treatment with anti-amyloid therapy for Alzheimer’s disease. Alzheimer’s & Dementia. 2026. DOI:10.1002/alz.71819.