July 20, 2004 (Philadelphia) -- The number of Medicare claims for treatment of Alzheimer's disease shot up by 250% during the 1990s and is expected to increase by 300% over the next 10 years.
And that is only the tip of the iceberg: Medicare spending on Alzheimer's disease is expected to triple from $62 billion in 2000 to $189 billion by 2015.
Most -- but not all -- of the bill for Alzheimer's disease care is paid by Medicare, which is the federal health insurance plan for the elderly. But Medicaid, the federal-state plan that provides health insurance to the poor, is also expected to see skyrocketing costs, says P. Murali Doraiswamy, MD, chief of the division of biological psychiatry at the Duke University Medical Center in Durham, N.C. He reported on the expected costs for Alzheimer's disease at the 9th International Conference on Alzheimer's Disease and Related Disorders.
Doraiswamy and colleagues estimated the future cost of Alzheimer's care by analyzing data from almost 30,000 Medicare claims filed from 1991 through 1999.
The Aging of America
Alzheimer's cases increased across all races due to both aging of the population -- those over 85 are the fasting growing segment of the population -- and new diagnostic approaches that are identifying more Alzheimer's cases. The sharpest increase was among blacks, in which the number of Alzheimer's claims increased by 460%, says Doraiswamy.
Moreover, late last week the Centers for Medicare and Medicaid issued a proposal that would allow Medicare to cover new, high-tech brain-imaging techniques that can be used to identify brain changes associated with Alzheimer's disease. The new imaging could be used to diagnose Alzheimer's disease if memory and thinking tests fail to confirm the diagnosis. While the new imaging tests are expensive, William Thies, PhD, vice president for medical and scientific affairs at the Chicago-based Alzheimer's Association, tells WebMD it is unlikely that they will drive up costs significantly since Medicare would only pay for the tests when other diagnostic tests are inconclusive.
Other researchers suggest that the real costs of treating Alzheimer's disease may not be as high as previously estimated. Henry Glick, PhD, assistant professor of medicine at the University of Pennsylvania School of Medicine, tells WebMD that many studies estimating the cost of Alzheimer's disease care are based on the costs at major research centers "where every patient is receiving every available treatment."
In that setting, treatment costs about $30,000 to $40,000 a year. But Glick says when he studied real-world data collected from a national sample of more than 1,557 patients followed over 15 years, he discovered that the "true" costs for Alzheimer's care are much lower: about $9,700 for a man and about $16,300 for a woman. He says the care for women is higher because women are more likely to require nursing home care, possibly because they have outlived spouses or family members who could care for them at home.
Glick adds that costs for Alzheimer's increase over time and if someone survives for 10 years after diagnosis, the annual care cost is likely to be between $20,000 and $30,000.
"But very few people survive that long. On average, a woman will survive for about six years, and care for those six years will be about $110,000. Men survive for about five years, and the cost of care is about half that of women," he says.
But even with these lower cost estimates, Glick says the bill for Alzheimer's care is considerable and will only increase over time. "That's why we should really be spending our money in research to find drugs to either prevent the disease or slow its progression."