Demographic and clinical characteristics of initial patients receiving amyloid-targeting treatments in the United States after regulatory approval

Introduction: Three treatments for Alzheimer's disease have been approved in the United States. Data are lacking on the characteristics of the initial treatment recipients.

Methods: We identified treatment recipients in the full Medicare fee-for-service data for 2021 to 2023. We compared their age, sex, race/ethnicity, dual eligibility, comorbidities, and median household income and educational attainment in their residence's ZIP Code Tabulation Area (ZCTA) to those of the overall Medicare population aged 65+.

Results: Treated patients were more likely to be non-Hispanic White (89% vs 82%) and less likely to be dually eligible (1% vs 8.8%). Average median household income ($97,136 vs $84,449) and proportion of residents with at least a bachelor's degree (41% vs 31%) were higher in treated patients' ZCTAs.

Discussion: The first patients receiving amyloid-targeting treatment represent a more privileged subset. While needing to be confirmed with more data, these results point to the need for efforts to make access more equitable.

Highlights: Little is known about the initial 924 patients receiving amyloid-targeting treatments in the United States from 2021 to 2023. They were more likely to be White and less likely to be dually eligible than the Medicare population. They resided in wealthier and more highly educated areas. Comorbidity burden was similar to that observed in clinical trials. Those initial results point to the need to improve equitable access to treatment.