PrecivityAD blood test cost

[Kathleen1]

Does anyone know the price for the new PrecivityAD blood test for amyloid & risk?

[circular]

Here’s more about this test. I’ll probably wait until full validation, which if successful may make it coverable by insurance, maybe at least with prior auth for higher risk patients.

https://www.prnewswire.com/news-release ... 36649.html

[Kathleen1]

I will probably wait as well, Circular. I expect most of us who carry an ApoE4 will have at least some amyloid. In fact, it would be interesting to see the results of that test on a hundred or so 65yr old or more asymptomatic folk carrying 1 or 2 copies of the gene.

[NF52]

Here’s more about this test. I’ll probably wait until full validation, which if successful may make it coverable by insurance, maybe at least with prior auth for higher risk patients....

Does anyone know the price for the new PrecivityAD blood test for amyloid & risk?

It's worth noting that this test does not "diagnose" AD. It provides a probability of whether a PET scan would show intermediate or elevated amyloid beta in the brain. Here's an explanation of how the PrecivityAD™ is interpreted from their website. (Bolded emphases is mine.)

A Low APS [Amyloid Positivity Score] (0 to 36) is consistent with a negative amyloid PET scan result and, thus, a low likelihood of amyloid plaques. Absence of amyloid plaques is inconsistent with an Alzheimer’s disease diagnosis and indicates other causes of cognitive symptoms should be investigated.

An Intermediate APS (37 to 57) does not distinguish between the presence or absence of amyloid plaques and indicates further diagnostic evaluation may be needed to assess the underlying cause(s) for the patient’s cognitive symptoms.

A High APS (58 to 100) is consistent with a positive amyloid PET scan result and, thus, a high likelihood of amyloid plaques. Presence of amyloid plaques is consistent with an Alzheimer’s disease diagnosis in someone who has cognitive decline, but alone is insufficient for a final diagnosis; clinical presentation and other factors should be considered along with APS.

https://precivityad.com/physicians

Having elevated amyloid doesn't mean that a person with normal cognition will go on to develop MCI or AD; it is, however, now viewed as a marker of "preclinical Alzheimer's disease" pathology, similar to someone with coronary plaques on a CAC scan. A positive blood test as part of a broad patient registry of people interested in clinical trials would allow researchers to discuss the options for further testing and a PET scan with possible participation in randomized clinical trials investigating drugs to remove amyloid beta oligomers or protofibrils from the brain.

Here is some data that shows that while amyloid beta is associated with ApoE4, it is never sufficient to diagnose Alzheimer's disease (as opposed to Alzheimer's risk). Bolded emphasis is mine:

The Anti-Amyloid Treatment in Asymptomatic Alzheimer disease (A4) Study is an ongoing prevention trial in clinically normal older individuals with evidence of elevated brain amyloid. The large number of participants screened with amyloid positron emission tomography (PET) and standardized assessments provides an unprecedented opportunity to evaluate factors associated with elevated brain amyloid. Data were was analyzed from 2018 to 2019 across 67 sites in the US, Canada, Australia, and Japan and included 4486 older individuals (age 65-85 years) who were ...clinically normal [Clinical Dementia Rating = 0] and cognitively unimpaired...
[Mean age was 71, 59% were women and 29% had positive Aβ+ ]
Conclusions and Relevance Among a large group of older individuals screening for an Alzheimer disease (AD) prevention trial, elevated brain amyloid was associated with family history [of dementia] (74%) and [at least one] APOE ε4 allele (58%) but not with multiple other previously reported risk factors for AD. Elevated amyloid was associated with lower test performance results and increased reports of subtle recent declines in daily cognitive function.

https://jamanetwork.com/journals/jamane ... ct/2763540

I happen to have met several folks in this A4 study who have had elevated amyloid for years and are doing just fine in their normal lives (and have spent more than 5 years in some cases contributing to this study, which is still seeking new participants.)

[circular]

I was thinking it might be useful not as an AD diagnostic but to track lifestyle changes? That info about how they would interpret the results is useful too.