Dr James Bice, Geriatrician from Melbourne, Victoria, will be presenting an overview of the pivotal clinical trials for the amyloid targeted therapies in light of the TGA approved indication in Australia. He will then share his experience on the establishment and early operational experience of Specialist Memory Services, with a focus on the implementation of Donanemab following its approval on 21 May 2025. Drawing on his background in geriatric medicine and cognitive disorders, he provides an outline of the clinic’s rationale for offering disease‑modifying therapy within a multidisciplinary, continuity‑of‑care model rather than a stand‑alone infusion centre.
Prior to approval, patients were commonly referred to clinical trials. Once the Amyloid targeting therapies were approved, significant planning was required, including credentialling, development of a model of care, safety protocols, consent processes, and communication pathways, with safety and accessibility identified as key priorities. Infusions were ultimately delivered through a private hospital partnership, balancing governance, emergency support, and patient experience.
His presentation will include practical considerations such as imaging partnerships, MRI and amyloid PET requirements, billing limitations, indemnity coverage, and out‑of‑pocket costs for patients, including infusions, imaging, medication, and associated travel, emphasizing the importance of clear patient communication, including a dedicated hotline, and shared early experience supervising approximately 50 infusions with minimal issues reported
Finally, his presentation aims to inform the audience on referral challenges, clinician hesitancy around genetic testing and amyloid PET, and future directions, emphasising that discussions about disease‑modifying therapies should be prioritised without assumptions about affordability, alongside consideration of clinical trials and emerging treatments.