Treated Patients With Alzheimer's Disease Experience Increased Survival, Reduced Costs

Laura Joszt

A new study, presented at the 2016 Alzheimer’s Association International Conference, suggested that treating people with Alzheimer’s disease may increase survival and reduce cost, even though the treatment does not change the underlying course of the disease.
The researchers followed 6553 individuals with Alzheimer’s—identified through Medicare fee-for-service claims—and followed the participants until death, disenrollment, or the end of the study period. Patients were assigned into either the treated or non-treated group based on whether they were prescribed an existing Alzheimer’s drug after their diagnosis.
“The new results support that early Alzheimer’s treatment—even with today’s first-generation therapies—has significant potential to benefit the person with the disease and the economy,” Maria C. Carrillo, PhD, chief science officer of the Alzheimer’s Association, said in a statement.
Patients who had never been treated had a death rate that was almost twice as high as the people who received treatment. In addition, non-treated patients had more comorbidities and were generally older. Plus, expenditures were higher for the people who did not receive a treatment.
In the first month following an Alzheimer’s diagnosis, average healthcare costs more than tripled for all participants in the study. However, those receiving a treatment had slightly lower costs ($5535) in the month of diagnosis compared with those who did not receive a treatment ($6711). According to the researchers, inpatient care was the biggest contributor to the cost increase and accounted for 30% of the total expenditures for both the treated and non-treated groups.
While patients receiving a treatment for dementia had an increase in pharmacy costs during the follow-up period, their total health expenditure was less than individuals who did not take medications approved for treating dementia ($2207 vs $2349 per patient per month).
“The arguments for early treatment are myriad, but this study shows greater survival and less all-cause healthcare costs among those receiving treatment for dementia,” said Christopher M. Black, MPH, from Merck Research Laboratories. “These results indicate that choosing not to treat, or even a delay in starting treatment, may lead to less favorable results. Early diagnosis and time to treatment should be a priority for policy makers, physicians, and the public.”
Another study presented at the conference found that more than 369,000 hospital admissions of people with Alzheimer’s in 2013 in the United States were potentially avoidable. Researchers used Medicare claims data and the associated expenditures for more than 2.7 million people diagnosed with Alzheimer’s or other dementia. Potentially avoidable hospitalization rates were examined for acute and chronic conditions.
The researchers found that 10% of people studied had at least potentially avoidable hospitalization. The 369,165 potentially avoidable hospitalizations accounted for $2.58 billion in Medicare expenditures. In addition, late-stage dementia and multiple chronic comorbidities were significantly associated with potentially avoidable hospitalizations.
“Case management programs for people with Alzheimer’s and other dementias should involve strategies to reduce avoidable hospitalizations in order to improve patient outcomes and lower costs,” said first author Pei-Jung Lin, PhD, from the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center.
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