U.S. Health Care System Unprepared to Move Future Alzheimer's Treatment into Rapid Clinical Use
Nov 15, 2017
Promising early-stage trial results provide hope that a therapy for Alzheimer's disease may become available that can prevent progression to full-blown dementia. But an important challenge will arise: A substantial backlog of existing cases with early-stage disease would have to be screened, diagnosed, and then potentially treated. This report assesses the preparedness of the U.S. health care system to handle the potential caseload.
Does not include Appendix
|PDF file||0.8 MB|
|PDF file||0.2 MB|
Alzheimer's disease is a progressive neurodegenerative disorder that leads to cognitive decline, dementia, and premature death. As the risk of developing Alzheimer's disease increases with age, the burden of Alzheimer's-related dementia will surge in industrialized countries with their graying populations. In the United States, for example, an estimated 5.5 million patients live with Alzheimer's-related dementia today, a number that is projected to increase to 11.6 million by 2040. Results from earlier clinical trials have led to the hypothesis that Alzheimer's dementia must be prevented rather than cured because no therapy has been able so far to reverse manifest dementia. If this new paradigm bears out in late-stage clinical trials, an important health systems challenge will arise, should one or more therapies become available: A substantial number of existing cases with early-stage disease would have to be screened, diagnosed, and then potentially treated as quickly as possible when a therapy first comes to market, in order to prevent progression to full-blown Alzheimer's dementia. This report assesses the preparedness of the U.S. health care system to handle the potential caseload. The authors used published data and expert interviews to develop a simulation model quantifying the match between health system capacity and expected demand. The report presents the results of the model and discusses their implications for patients. As many estimates in the model are subject to substantial uncertainty, the ambition of this report is not to provide an exact prediction of future capacity needs but to illustrate the magnitude of the potential problem.
This research was sponsored by Biogen, and conducted in RAND Health Advisory Services, the consulting practice of RAND Health.
This report is part of the RAND Corporation Research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.
This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit www.rand.org/pubs/permissions.
The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.