With the absence of disease-modifying treatments, the cumulative costs of care from 2010 to 2050 for people with Alzheimer’s will exceed $20 trillion, according to a new report from the Alzheimer’s Association. The advocacy group hopes to use the report to spur an increase in government research funding in this area because, it says, even therapies with the ability to delay the onset or slow the progression of the disease will have a dramatic impact on the economic toll of the disease.

 

“Given the magnitude and the impact of this disease, the government’s response to this burgeoning crisis has been stunningly neglectful,” says Harry Johns, president and CEO of the Alzheimer’s Association. “Alzheimer’s is an unfolding natural disaster. The federal government has sent a token response and has no plan.”

 

The number of Americans age 65 and older who have Alzheimer’s will increase from 5.1 million today to 13.5 million by 2050, based on a model developed by the Lewin Group for the Alzheimer’s Association.

 

Total costs of care for individuals with Alzheimer’s disease by all payers will soar from $172 billion in 2010 to more than $1 trillion in 2050, with Medicare costs increasing more than 600 percent, from $88 billion today to $627 billion in 2050. During the same time period, Medicaid costs will soar 400 percent, from $34 billion to $178 billion. One factor driving the exploding costs by 2050 is that nearly half (48 percent) 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 often necessary.

 

“We know that Alzheimer’s disease is not just ‘a little memory loss’—it is a national crisis that grows worse by the day,” says Johns. “Alzheimer’s not only poses a significant threat to millions of families, but also drives tremendous costs for government programs like Medicare and Medicaid.”

 

The new report does show, however, that Medicare and Medicaid can achieve dramatic savings, concurrent with a significant improvement in quality of life, with even incremental treatment improvements. Based on the Lewin Group model, the report explores two alternate scenarios: one in which a disease-modifying treatment could delay the onset of Alzheimer’s by five years, and another in which a hypothetical treatment could slow the progression of this condition.

 

“Today, there are no treatments that can prevent, delay, slow or stop the progression of Alzheimer’s disease,” says Johns. “While the ultimate goal is a treatment that can completely prevent or cure Alzheimer’s, we can now see that even modest improvements can have a huge impact.”

 

A treatment breakthrough that delays the onset of Alzheimer’s by five years, similar to the effect statins have on preventing heart disease, would result in an immediate and long-lasting reduction in the number of Americans with this condition and the cost of their care. Assuming such a breakthrough occurred in 2015, the number of people age 65 and older with Alzheimer’s would be reduced by 5.8 million in 2050, 43 percent less than the 13.5 million Americans who would have been expected to have the condition in that year would be free of the conditions.

 

It would also mean that the number of people in the severe stage of the disease would be much smaller—3.5 million instead of the expected 6.5 million, with concurrent annual Medicare savings of $33 billion in 2020, which would climb to $283 billion by mid-century; and Medicaid savings of $9 billion in 2020 that would rise to $79 billion by 2050.

 

Similarly, the impact of a treatment that slowed disease progression, such as we have managed to do with HIV/AIDS and several cancers, would result in far fewer people with Alzheimer’s disease in 2050 in the severe stage when care demands and costs are greatest. Assuming such a breakthrough occurred in 2015, then in 2020, the number of people age 65 and older with Alzheimer’s disease in the severe stage would drop from 2.4 million to 1.1 million. In 2050, the number of people in the severe stage would decline from an expected 6.5 million to 1.2 million.

 

Annual Medicare savings that would come with a treatment that slowed disease progression compared to current trends would be $20 billion in 2020 and jump to $118 billion in 2050. Similarly, Medicaid savings would amount to $14 billion in 2020 and jump to $62 billion in 2050.

 

 “The impact of Alzheimer’s disease–both in terms of lives affected and costs of care – is staggering. As government leaders contend with the best approaches to rein in Medicare and Medicaid costs, we know Alzheimer’s will place a massive strain on an already overburdened health care system,” said Robert J. Egge, vice president of public policy for the Alzheimer’s Association. “This report highlights that while we strive for the ideal – a treatment that completely prevents or cures Alzheimer’s disease – even more modest, disease-modifying treatments would provide substantial benefits to families and contribute to the solvency of Medicare and Medicaid.”