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Alzheimer's Disease to Cost U.S. $20 Trillion over next 40 years

John Commins, for HealthLeaders Media, May 20, 2010

The cumulative care costs of Alzheimer's disease over the next 40 years will exceed $20 trillion unless treatments to modify or delay onset of the incurable disease are discovered, an Alzheimer's Association report said.

The report, Changing the Trajectory of Alzheimer's Disease: A National Imperative examines the outlook for Alzheimer's based on a model from the Lewin Group. It projects that the number of Americans age 65 and older who have Alzheimer's will increase from the 5.1 million today to 13.5 million by mid-century if nothing is done to address the disease.

"We know that Alzheimer's disease is not just ‘a little memory loss'—it is a national crisis that grows worse by the day," said Harry Johns, president and CEO of the Alzheimer's Association, in a media release. "Alzheimer's not only poses a significant threat to millions of families, but also drives tremendous costs for government programs like Medicare and Medicaid."

Total costs of care for individuals with Alzheimer's disease by all payers will increase from $172 billion this year to more than $1 trillion in 2050, with Medicare costs increasing more than 600%—from $88 billion today to $627 billion in 2050. Medicaid costs will rise 400%, from $34 billion to $178 billion.

By 2050 48% of the projected 13.5 million people with Alzheimer's will be in the severe stage of the disease—when more expensive, intensive around-the-clock care is needed.

The news is not all bad, however. The report shows that Medicare and Medicaid could see dramatic savings—and lives could be improved—with incremental treatment improvements.

The Lewin Group model projects two scenarios: one in which a disease-modifying treatment delays the onset of Alzheimer's by five years, and another in which a hypothetical treatment slows the progression of the disease.

Under the first model, if a treatment breakthrough that delays the onset of Alzheimer's by five years could be in place by 2015:

  • The number of Americans 65 and older with Alzheimer's would fall from 5.6 million to 4 million in 2020, and 5.8 million in 2050—43% of the 13.5 million Americans who would have been expected to have Alzheimer's in 2050 would be free of the condition.
  • In 2050, the number of people in the severe stage would also be much smaller with the treatment breakthrough—3.5 million instead of 6.5 million.
  • Annual Medicare savings compared to current trends would be $33 billion in 2020 and climb to $283 billion by mid-century, while annual Medicaid savings would increase from $9 billion in 2020 to $79 billion in 2050.

The second model that assumes a hypothetical treatment discovered in 2015 could slow the disease's progression projected that:

  • In 2020 the number of people 65 and older with Alzheimer's in the severe stage would drop from 2.4 million to 1.1 million.
  • In 2050, severe stage cases would fall from a projected 6.5 million to 1.2 million.
  • Annual Medicare savings compared to current trends would be $20 billion in 2020 and $118 billion in 2050, while Medicaid savings would be $14 billion in 2020 and $62 billion in 2050.

The Alzheimer Association is calling on the federal government for more Alzheimer's research funding. "Given the magnitude and the impact of this disease, the government's response to this burgeoning crisis has been stunningly neglectful," Johns said. "Alzheimer's is an unfolding natural disaster. The federal government has sent a token response and has no plan."


John Commins is a senior editor with HealthLeaders Media.

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