The Research Speaks, but Will Congress Listen in Its Fight Against Alzheimer’s Disease?

Care planning, according to new research, can control costs and improve quality of life for the millions of Americans with Alzheimer’s disease, reminding Congress that progress toward a treatment, prevention or cure is critical not just for the millions of Americans living with the disease but also for the nation’s economy.

The Senate Appropriations Committee took a major step forward in June toward enhancing care for the estimated 5.4 million Americans with Alzheimer’s by including the Health Outcomes, Planning, and Education for Alzheimer’s Act (S. 857) in 2017 spending legislation. The bill also includes nearly $1.3 billion to fund Alzheimer’s research at the National Institutes of Health.

On the heels of this important milestone, global scientific findings presented last week at the Alzheimer’s Association International Conference 2016 added to the urgency for Congress to increase federal research funding.

The new research demonstrates that diagnosis, treatment and care planning may lower costs, increase survival and reduce the burden of Alzheimer’s disease on individuals, families and the health care system. Three findings stand out:

• One in 7 hospital admissions of people with Alzheimer’s in 2013 were potentially avoidable, at a cost to Medicare of $2.6 billion. Tufts Medical Center researchers found that the suboptimal care management that patients with Alzheimer’s and related dementias receive for co-morbidities such as diabetes and heart disease leads to hospitals stays that could be prevented with better ambulatory care and effective treatment, improving patient outcomes and lowering costs.
• The Medicare Annual Wellness Visit offers an important opportunity to detect cognitive impairment and track changes over time. Unfortunately, only 11 percent of Medicare beneficiaries nationally had an AWV in 2013, raising doubts among some about its value in detecting cognitive impairment. But Allina Health, a large Midwest health system, reported a 44 percent uptake for Medicare AWVs in 2013, demonstrating that AWVs can be implemented on a broad scale and sustained over time.
• There is an economic benefit to ensuring Alzheimer’s patients receive medications that for a limited time may help lessen symptoms, such as memory loss and confusion. The study by Merck researchers showed that medically treated patients cost the healthcare system less than those who are not; they also had lower mortality rates during the study compared to untreated patients. This compelling argument refutes the false assumption that because Alzheimer’s is incurable and progressive treating it and other dementias is an unjustified cost drain on our healthcare system.

Alzheimer’s disease is a national health crisis. It is the sixth leading cause of death, and at a cost of approximately $236 billion a year, almost half of that borne by Medicare, it is America’s most expensive disease.  The crisis will only widen as the number of people living with Alzheimer’s, which has no cure or treatment, will triple and costs will quadruple as baby boomers age.

These new studies also point out why passage of the HOPE for Alzheimer’s Act is equally vital.

The HOPE for Alzheimer’s Act would require Medicare to pay for a care planning session for patients and their caregivers that includes an explanation of Alzheimer’s; its expected progression; the creation of a patient-centered care plan for managing it and any co-morbidities; information about treatment options; and a discussion of community resources. This is likely to lead to more early diagnoses, because the lack of time and ability to counsel patients about care planning and options is one of the reasons many physicians do not diagnose Alzheimer’s to begin with — or do not disclose a diagnosis once it is made.

A care planning benefit through Medicare could save more than $692 million in federal spending over a 10-year period, according to a study by former Congressional Budget Office staff at Healthsperien.

Increasing access to a diagnosis and a plan for care are simple ways that Congress can have a profound effect in the fight against Alzheimer’s disease. Throwing brakes on out-of-control costs and improving  quality of life, the Hope for Alzheimer’s Act provides new hope not only for those who may develop Alzheimer’s tomorrow, but also for those living with it today.

Maria C. Carrillo, PhD, and Robert Egge are the chief science officer and chief public policy officer of the Alzheimer’s Association, respectively.