Abstract
Alzheimer's disease (AD), the most common cause of dementia and the sixth leading cause of death in the U.S., currently affects over 6 million Americans, with numbers projected to reach 13.8 million by 2060. These estimates primarily reflect direct healthcare costs, while indirect costs—such as lost productivity, reduced quality of life, and unpaid care provided by family members—are often overlooked. As new disease-modifying therapies emerge, they may help reduce the burden. Managed care organizations play a critical role in lowering costs and improving outcomes by promoting disease awareness, early diagnosis, multidisciplinary care coordination, and supporting caregivers. The burden of Alzheimer's disease and related dementias (ADRDs) is projected to increase significantly in the coming decades, particularly in low- and middle-income countries, due to population aging. Using a willingness-to-pay approach, the global, regional, and national economic impacts of ADRDs were estimated from 2019 to 2050, assuming no changes in current treatment or prevention measures.
Introduction
Alzheimer's disease (AD) is a progressive neurodegenerative disease that leads to cognitive decline and dementia, ranking as the sixth leading cause of death in the U.S. It disproportionately affects women, Black/African American individuals, and Hispanic individuals. Life expectancy after diagnosis averages 4 to 8 years, with some patients living up to 20 years. The prolonged illness contributes to a significant economic burden due to the need for increasing medical care, caregiver support, and long-term care, such as home health and nursing care.
Approximately 75% of patients over 80 are expected to live in nursing homes compared to 4% of the general population. While direct medical costs are covered by health insurance, indirect costs, including caregiving and out-of-pocket expenses, often fall on family members and are usually not factored into the total cost of care. The health impact on caregivers is also largely underestimated. Although current treatments do not halt disease progression, early detection and treatment can improve patient care, quality of life, and caregiver outcomes. Emerging therapies that delay disease progression could address an unmet need and potentially reduce healthcare costs by slowing cognitive decline.
Economic Burden
The progressive nature of Alzheimer's disease (AD), combined with the absence of disease-modifying therapies, imposes a significant economic and societal burden on the U.S. healthcare system. The total cost of treating AD and related dementias is expected to rise from $321 billion in 2022 to over $1 trillion by 2050. Medicare and Medicaid account for approximately two-thirds of these costs, with the remaining costs coming from out-of-pocket expenses, typically paid by patients and their families, private insurance, managed care organizations, and uncompensated care. This highlights the need for more comprehensive strategies to manage the growing financial impact .
Direct medical costs for Alzheimer's disease (AD) include physician visits, hospital admissions, medications, and long-term care. Nonmedical costs cover home healthcare, transportation, and adaptations for physical changes. The majority of care expenses come from long-term care and nursing home services, making them the primary contributors to the overall financial burden of the disease.
Costs for Medicare beneficiaries 65 and older estimated at $41,757 annually, nearly three times higher than for those without Alzheimer’s.
It imposes a significant economic and societal burden, with costs for Medicare beneficiaries 65 and older estimated at $41,757 annually, nearly three times higher than for those without Alzheimer’s. While Medicare covers medical care, long-term care costs are largely borne by Medicaid and families through out-of-pocket expenses. Caregivers face substantial financial strain, providing unpaid care valued at $271.6 billion annually, with lifetime care costs for a patient with dementia estimated at $412,936. The strain on caregivers, often women and low-income earners, results in higher rates of stress-related health issues, reduced workforce participation, and increased personal healthcare costs. As the population ages, the growing demand for long-term care will challenge the current system, underscoring the need for policies that support caregivers and enable patients to remain at home longer, alongside sustainable healthcare financing strategies.
Importance of Diagnosis
Early diagnosis and treatment of Alzheimer's disease (AD) are essential for improving quality of life (QOL) and reducing healthcare costs. Current barriers include limited access to specialized providers, expensive diagnostic methods like PET scans and cerebrospinal fluid testing, and inconsistent insurance coverage. Early detection facilitates timely intervention, engagement in clinical trials, and management of modifiable risk factors like cardiovascular disease, which can delay dementia onset and reduce associated costs. Studies show that early treatment improves survival, reduces institutionalization, and lowers healthcare costs. Economic models predict that future disease-modifying therapies could be cost-effective, extending life expectancy, decreasing long-term care costs, and alleviating caregiver burden, provided they are priced responsibly.
Conclusion
Alzheimer's disease (AD) represents a significant and growing public health challenge, characterized by profound economic and societal burdens that will escalate as the population ages. The current landscape reveals critical gaps in early diagnosis, treatment access, and caregiver support, which exacerbate the overall impact of the disease. Effective managed care strategies, including promoting awareness, enhancing access to specialized diagnostics, and implementing multidisciplinary care coordination, are vital to improving patient outcomes and alleviating the economic burden.Â
References
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