The Sagewell Newsletter: January 2022

Aduhelm: The Alzheimer’s Drug Medicare Dilemma

For anyone who has suffered through dementia with a friend or family member, the news of a possible treatment option is what you hope for every day. The arguments on both sides of Biogen’s new drug, Aduhelm, are in some ways as complex as the disease itself. Price and questions about its effectiveness could prevent it from reaching the marketplace. With so many emotionally fueled narratives in the press, here’s an unbiased, bird’s eye view of where it all stands:

• Aduhelm is a monoclonal antibody treatment administered through monthly infusions. It is thought to reduce a protein that creates plaques in the brains of people with Alzheimer’s.

• Although the drug has been given approval by the FDA, government officials have yet to decide whether it will be covered under Medicare. Until now, Medicare almost always covers FDA approved medications.

• The high price tag for Aduhelm, coming in at $28,200 a year, is one of the main reasons Medicare may reject it, but additional costs are also associated. Patients must undergo regular MRIs to monitor for serious health implications like brain swelling or bleeding.

• One of the largest Medicare Part B premium increases for 2022 was made in anticipation of Aduhelm’s approval and the possibility that it would be covered by Medicare.

• The FDA approved Aduhelm through a special program called “accelerated approval”, an expedited process for new drugs that treat serious illnesses with little to no available treatments. The approval assumed that the drug’s ability to reduce a protein in the brain would result in the slowing of cognitive decline, but the medical community is divided.

• There is a significant risk profile associated with Aduhelm that make some health organizations feel it isn’t worth the hype. The American Academy of Neurology says, “many beneficiaries would pay thousands of dollars of out-of-pocket costs for a drug with substantial risks and without proven clinical benefit.”

The acceptance or denial of Aduhelm by Medicare is larger than the sum of its parts—it will set a precedent for any drugs of its class that are in development.

A decision on whether Aduhelm will be covered fully or in-part by Medicare is slated to be finalized by mid-April of this year. It’s impact on dementia patients and their caregivers cannot be under- stated. Americans could be as divided as the medical community: some families needing more safety assurances and others welcoming what is their only chance of hope. And until Spring, we wait.

Why Pet Ownership in Retirement is on the Rise

Retirement can be the time to appreciate having less responsibilities. Jobs and kids no longer set the pace of your schedule and hobbies and travel plans can finally take center stage. For some of us, this new reality is exactly what we’ve been waiting for, but for others, it can feel a bit like the old adage “be careful what you wish for”. If you’re finding your day-to-day routine could use a little more fulfillment, maybe you should consider adopting an adult or senior pet.

Although taking care of a pet can be too much for some older adults, for the vast majority that isn’t the case. Any animal rescue worth its salt has one mission and that’s to match each animal to the right home. Animal shelters have evolved so much in the role they play in finding you the perfect companion. Consider these things if you think adopting a pet could add joy to your retirement:

• Through a Rescue’s application process, you communicate what you’re looking for and in-turn they help select the dog or cat that fits your lifestyle. They’ll find you a walking buddy, a couch potato, or a combination of both.
• Just 15 minutes bonding with an animal sets off a chemical chain reaction in the brain, lowering levels of cortisol and increasing serotonin. The result: heart rate, blood pressure and stress levels immediately drop.
• Over the long-term, people with pets often have lower cholesterol levels, less depression, and may even experience less heart disease and stroke.

More and more animal rescues devoted to older adults and animals are popping up across the country, like Pets for Seniors based in Illinois and Vintage Pet Rescue in Rhode Island. Start at your local animal shelter or ask around for referrals. Remember that as long as you’re matched with the right dog or cat, your best days as a pet owner might just be ahead of you.

Because There Wasn’t Enough Fraud: Enter Counterfeit Vaccination Cards

Federal criminal charges have been filed for the first time against a homeopathic doctor in Napa, CA who played a role in falsifying vaccination cards to make it appear clients received two doses of the Moderna vaccine. Julie A. Mazi, 41, is accused of spreading fear about COVID vaccines and instead sold her clients “homeoprophylaxis immunization pellets” that would provide life-long immunity to the virus. Homeoprophylaxsis involves exposing someone to diluted amounts of a disease, which supposedly stimulates the immune system and creates immunity. The National Institute of Health confirmed that this claim is “absolutely false”. Deputy Attorney General Lisa O. Monaco issued a statement saying,

“This defendant allegedly defrauded and endangered the public by preying on fears and spreading misinformation about FDA-authorized vaccinations, while also peddling fake treatments that put people’s lives at risk”.

Mazi allegedly provided her clients with official vaccine cards along with valid Moderna vaccine lot numbers and advice about how to choose believable dates the vaccines were given.

A complaint made to the Department of Health and Human Services Office is what spawned the investigation.

How finding ways to Give Back Can Ease Grief

After losing my mother after a long illness, I learned just how layered and complex grief really is. Until then, I think I only under- stood it as the all-consuming pain that comes from missing the person you love so much. And at the core, of course that is what it all comes back to. But I also realized grief is the day-to-day void that results from no longer being able to provide care or find small ways to offer happiness, which is painful in its own way.

I was stuck in a loop wishing I could just do one more thing for my mother. As if that was my panacea and the only thing that could make me feel better. As a caregiver, I constantly had opportunities to do things for her, but as anyone who has been in my shoes knows, you don’t think about it in terms of what you’re giving. You only think about your loved one’s quality of life and how you can improve it. After losing her, I kept thinking how I wished I could make her favorite dish one more time or I’d hear a song and think how sorry I was I had forgotten about that one and couldn’t play it for her now. This is the part of grief that can be eased by giving.

To honor my mother, and selfishly to turn some of my sadness to joy, I reached out to a local nursing home where my mother once worked and asked if they had any interest in receiving Christmas gifts for their residents. The activities director was very enthusiastic and so began my shopping spree and planning for my gift drive. I bought things my mother would have wanted and heard her guiding my gift choices. I wrapped them all with care to ensure a thoughtful presentation and created a numbered spreadsheet with gift descriptions so that they could be distributed appropriately. I brought snacks that I was told they liked and filled little nylon holiday bags with chocolates. Every day I worked on it I knew it really was more for me than it was for them. I may not have been able to buy my mother new slippers for Christmas, but I knew someone was opening the same ones my mother would have liked and for a just a minute might smile knowing a stranger cared.

I can’t wait for the volunteer program to open again when the pandemic improves because I’ll be volunteering as a visitor to just sit and talk or play games. And I can guarantee I’ll be playing my mother’s favorite songs and finding new ones to play for her.

Don’t Forget to Set a Retirement Goal with your RA

Now is the time to start thinking about retirement goals that you’d like to pursue this year. Your Retirement Advocate is ready to support you!

Here are some goals to consider if you could use a few suggestions, but keep in mind your goal(s) can be almost anything that’s important to you.

• Find ways to optimize your monthly budget and leverage assets you already own.

• Learn more about Medicare Advantage options.

• Take a serious look at savings opportunities for anything from insurance to local savings programs.

• Determine a long-term care strategy that includes how you’ll pay.

As always, you can talk retirement with Sagewell anytime. We look forward to helping you find more ways to make this new year a happy one!