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I had a look for data on the aducanumab studies and found this https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/alz.12213 Judging from the results, they would be lucky if the decrease in the CDR-SB score with treatment is 25% less than with placebo. This isn't a lot, although you might be able to convert it into something like delaying the effect by 3 months every year. Given the high price of the drug this isn't going to satisfy any reasonable cost-benefit analysis. You would also have to compare it to Aricept which works, and being off patent is cheap. I expect their sample size calculations were done assuming a larger clinical difference than they found, but I can't find a protocol to check. Something that I read was that the FDA decided to approve on the basis of the effect on the plaque, which given that there is no data linking this to cognitive decline it is not sensible.

For the vaccines there was always going to be very good real world data. For example in Australia we recently had a super spreader event. It was roughly the 6 vaccinated subjects were not infected, of the 30 something unvaccinated there were 30 infected. We've given up having birthday parties for the moment.

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