Fireside Chat: Kara Brotemarkle - World Medical Innovation Forum

Summary

Kara Brotemarkle joined Tracy Batchelor MD for a conversation about what has to happen around an Alzheimer's therapy for it to deliver its full value.

Brotemarkle used the large number of people living with Alzheimer's disease who are never formally diagnosed to explain Genentech's focus on innovation beyond the molecule. Better therapies must be paired with better diagnostic pathways and easier ways for eligible patients to enter care.

Formulation matters too. Brotemarkle pointed to multiple sclerosis, where shorter subcutaneous administration can reduce time spent in infusion centers, lessen caregiver burden and free clinical capacity. Batchelor extended the discussion to the scientific challenge of getting large molecules across the blood-brain barrier, an issue with implications well beyond Alzheimer's disease.

The same systems question is now emerging around blood-based biomarkers. Easier testing will only help if reimbursement, interpretation and referral pathways evolve with it. The technology is one part of the solution. The care pathway has to be ready for what the technology finds

Speakers

Kara Brotemarkle, Global Head, Commercialization Strategy, Genentech
Tracy Batchelor MD, Chair, Department of Neurology, Mass General Brigham (Moderator)

Notes

Session Focus

The conversation centered on what Genentech means by innovating beyond the molecule: the diagnostic pathways, formulation choices and referral infrastructure that determine whether a therapy produces the outcomes it is capable of producing.

The Diagnostic Gap

Brotemarkle anchored the discussion in a single figure. More than half of people living with Alzheimer’s disease are never identified or diagnosed.

Her point followed directly. Bringing a therapy into a system with an underdeveloped diagnostic pathway, handing it over and wishing the system luck, means the outcomes patients could have had will not materialize. The molecule is necessary and not sufficient.

Formulation as an Adherence Decision

The practical expression of this runs through the patient journey, where formulation choices affect whether people stay on therapy at all.

She used multiple sclerosis as the template. A ten-minute subcutaneous injection replaces hours spent in an infusion chair. The benefits ripple outward: to the caregivers who accompany patients and lose the same hours, and to specialist capacity that is freed for other patients.

Crossing the Blood-Brain Barrier

Batchelor raised the question a neuro-oncologist would ask, about getting antibodies past the blood-brain barrier rather than having them sequestered in the vasculature.

Both agreed the implications extend well beyond Alzheimer’s disease to central nervous system therapy generally.

Preparing for Blood-Based Biomarkers

The conversation closed on FDA-approved blood-based biomarkers and the wave of newly identified patients they will bring.

Brotemarkle framed the readiness problem as a shared one between industry and health systems. Two things have to be in place: reimbursement, so patients can learn their status, and clear referral pathways for when a result lands on a primary care physician’s desk.

Key Takeaways

1. More than half of Alzheimer’s patients are never diagnosed, which caps what any therapy can achieve.

2. Formulation is an adherence strategy. Ten minutes versus hours changes whether patients stay on treatment.

3. Benefits extend past the patient to caregivers and to specialist capacity freed for others.

4. Blood-based biomarkers will surface patients faster than pathways can absorb them without reimbursement and referral design in place.