Health Canada Approval of Exelon™ Patch
Statement from the Alzheimer Society of Canada
The Alzheimer Society of Canada is pleased that starting today, people living with Alzheimer's disease and their caregivers will have another treatment option.
Exelon™ Patch (also known as Rivastigmine Transdermal Patch) is now available in Canada. It is the first-ever transdermal patch approved for the treatment of symptoms in people with mild to moderate Alzheimer's disease.
The Exelon Patch is the latest treatment in a class of drugs known as cholinesterase inhibitors (ChEIs). In the brains of people with Alzheimer's disease there is a progressive degeneration of nerve cells, particularly of the cells that make acetylcholine, a chemical thought to be important for learning and memory. Because of this, people with Alzheimer's disease have lower brain levels of acetylcholine. It is believed that ChEIs work by reducing the breakdown of acetylcholine and thus increasing the amount of the chemical in the brain.
In addition to the Exelon Patch, there are three other ChEIs already approved for use in Canada in a capsule form, including Aricept™, Exelon™ and Reminyl™. It is important to note that these drugs are intended to treat some of the disease symptoms, but do not stop, or attack, the underlying disease process. It is also important to note that not all people will respond to these drugs.
Good news
Dr. Jack Diamond, Scientific Director of the Alzheimer Society of Canada, makes the following comments on the release of the Exelon Patch.
"It is good news that one of the class of drugs for the treatment of Alzheimer's disease known as ‘cholinesterase inhibitors', in this instance rivastigmine (Exelon), can be successfully administered by the transdermal ‘patch' method. Although the delivery of drugs through a patch stuck on the skin is not new, the problems have mostly been to ensure that the drug gets into the body at the desired rate, meaning that it fairly quickly reaches the desired level in the body, and is then maintained at that level for as long as possible.
Considerations like these have generally limited the usefulness of patch delivery for a variety of drugs. It seems that via the new Exelon patch, the drug gets into the body to reach required therapeutic levels at rates that approximately match those achieved by the conventional method of taking the drug in pill form by mouth. But the patch has other advantages.
Because it does not go directly first to the stomach, there are fewer gastrointestinal side effects - a big plus. Moreover it is claimed that patient "compliance" (consistent and reliable taking of the medication) is improved, even though the patch has to be changed daily. Moreover, caregivers can see for themselves that the patch is there and presumably working.
So all in all, the patch does seem to be a good thing. Since some cholinesterase inhibitors work better for certain people than others, it will be interesting to see if drug companies that produce other cholinesterase inhibitors also now try to use the patch approach."
Support for new treatments
The Alzheimer Society of Canada believes that Alzheimer's treatments provide real benefits to people living with the disease and their caregivers. These treatments can help people living with Alzheimer's disease retain their independence and ability to do everyday tasks for longer, reducing the number of hours of direct care that caregivers need to provide.
"It is very important to have new ways of treating people with Alzheimer's disease. People are going to respond differently to different medications. It's very important that clinicians and people who are being treated have access to new and innovative ways to deal with the disease," says Scott Dudgeon, Chief Executive Officer for the Alzheimer Society of Canada.
Cost
The price of Exelon Patch is $4.29 per day. Currently, it is not covered under any public formularies. Novartis, the maker of the medication, is preparing submissions for public formularies and private payer plans, however, they cannot speculate yet about the medications' inclusion.
As with all new medications, each province and private insurance plan will give Exelon Patch careful consideration. We are hopeful, however, that the provincial governments and private payer plans will cover the cost of Exelon Patch under their respective funding mechanisms.
For information
Exelon Patch can only be obtained with a prescription from a doctor after a diagnosis of Alzheimer's disease has been made. It is important to remember that not all medications work for all people, and you should talk to your doctor for more information on this and other treatment options.
Download the information sheet on the Exelon patch
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Information on other approved Alzheimer's disease treatments
Information on current Clinical Trials
Current Research into Alzheimer's and related diseases
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