Of course every mild AD patient in the country will not be starting aducanumab in March. Most drugs start out slow and build; aducanumab will be no exception. The numbers in figure 5 of the Rand report are silly. We get new patients in our office within 4-6 weeks not 14 months. The largest group of initial patients will come from existing patients in the neurology and geriatrics practices, where patients have already been screened (all our memory consults get MoCA tests on their first two visits). So time to identify is 0 months for many practices. Patients may need to get a PET scan and that may take a month. If the serum AD test becomes available, this step goes away.
Infusion will be easy for most large Neuro practices that already have in-house capacity. Our group could do at least 50 patients a month without any change in staffing but would need to expand or move staff around if we do more... we have already discussed logistics.
We never shut down. During Covid > 90% of our infusions have occurred on time (our group has > 200 infusions/month). Infusions have been at baseline since July.
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