Washington, DC (November 15, 2017) – The RAND Corporation issued a report today indicating that the U.S. health care system is not prepared to handle the expected large number of patients if additional Alzheimer’s therapies become available in the next several years. 

According to the report, a treatment could become available by 2020 but millions of people would have to wait an average of 18 months to receive a treatment, largely because of a shortage of neurologists qualified to make a diagnosis. RAND estimates that approximately 2.1 million patients would develop Alzheimer’s between 2020 and 2040 while on waiting lists for treatment. 

“There are many barriers to getting innovative Alzheimer’s drugs to people with or at risk of the disease,” said George Vradenburg, co-founder and Chairman of UsAgainstAlzheimer’s. “In a potentially game-changing week when Bill Gates has entered the Alzheimer’s space to accelerate a cure for this deadly disease, the RAND report highlights how unprepared the US health care system is for the arrival of an effective treatment. We applaud RAND for bringing this issue out of the shadows.” 

“Alzheimer’s is commonly diagnosed late and inaccurately. Most primary care physicians have no geriatric training, and the United States suffers from a shortage of geriatric specialists – these workforce issues will only grow as the Baby Boomer generation begins turning 75 at 10,000 people a day in just a few years. While our own work reports a promising pipeline of Alzheimer’s drugs, we too found a dangerous lack of readiness in the health system for these innovations. We must, in parallel and with a sense of urgency, begin to empower more physicians to detect cognitive impairment and accurately diagnose and treat this disease. This is a global issue as well, one even more pronounced in less developed countries where Alzheimer’s is on the rise and health care infrastructures are far less advanced than in the United States.”

In March 2016, ResearchersAgainstAlzheimer’s, a network of UsAgainstAlzheimer’s, issued an analysis which indicated that 17 drugs were on pace to launch in the next five years. While the analysis took a positive approach to the innovation pipeline, it also delineated areas that America’s health care system needs to improve upon before new Alzheimer’s treatments are approved, including:

1. Enhancing the training and numbers of front-line physicians, including in primary care, to diagnose and treat Alzheimer’s. In addition, the number of geriatricians needs to increase from 7,000 (current) to 30,000 by 2030. Unfortunately, fewer medical students are choosing geriatrics because geriatrics practice is not sustainable financially with a 100 percent Medicare payer mix. Neurologists and psychiatrists typically have a mix of payers.

2. Improving the accuracy of diagnosis. In some settings, up to half of all cases of Alzheimer’s disease are misdiagnosed, and there is currently a significant under-diagnosis of the disease in populations around the world. The lack of an Alzheimer’s diagnosis can also negatively impact the ability of patients to adhere to other chronic care protocols. Visits to memory care specialists in neurology, psychiatry or geriatrics is encouraged.

3. Improving communication between patients and physicians. Just 45 percent of people diagnosed with Alzheimer’s were informed of their diagnosis by a doctor, compared to 90 percent of people with cancer and cardiovascular disease who are informed of that diagnosis by their doctor.

4. Treating Alzheimer’s like the fatal disease that it is, rather than as routine clinical care. The average wait time to see a neurologist was 35 days, a 25 percent increase since 2010. In contrast, a study shows that the average wait time for a cardiologist is 16.8 days, about 50 percent less than the wait time to see a neurologist.

5. Addressing payment and reimbursement. There is no assurance that the Centers for Medicare and Medicaid Services (CMS) and other national health payment authorities and insurance providers will pay for or reimburse for Alzheimer’s treatments.

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Contact: Ranit Schmelzer, 202-538-1065, [email protected]