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Harry Johns

Harry Johns

Posted: May 20, 2010 02:14 PM

Changing the Trajectory of Alzheimer's

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Today, more than 5 million Americans are estimated to have Alzheimer's disease. What they are experiencing is not just a little memory loss. It is not normal aging. They have a progressive, degenerative, fatal disease for which there is as yet no cure. They and their families will tell you that Alzheimer's steals memories, judgment, independence and eventually lives. It robs individuals of years of highly anticipated life, spouses of lifetime companions and children of their parents and grandparents, while also stealing intense hours of caregiving, the health of many caregivers and the financial resources of millions.

There are currently no treatments that can prevent, delay, slow, or stop Alzheimer's. There are some drugs that help to improve the lives of many people - for a time - but none of them change the underlying course of the disease.

A new report released this week by the Alzheimer's Association called "Changing the Trajectory of Alzheimer's Disease: A National Imperative," shows just how much this disease also threatens the financial security of Medicare and Medicaid.

This year caring for people with Alzheimer's disease will cost Medicare and Medicaid $122 billion. By mid-century it will cost, in today's dollars, over $800 billion. When you factor in the costs to others--the out-of-pocket costs to patients and families, the costs to private insurance and HMOs, and the costs of uncompensated care to health care providers--cumulatively over the next 40 years and without taking into account inflation, caring for people with Alzheimer's disease will cost the American people $20 trillion. That's enough to pay off the entire U.S. federal debt today and then send a check for $20,000 to every man, woman and child in America with money left over.

In addition to the current projections, the new report also explores two hypothetical scenarios and their possible impact: what happens if we (1) delay Alzheimer's onset by several years and (2) slow progression of the disease.

Of course the ultimate goal is a treatment that can completely prevent or cure Alzheimer's, but the report illustrates that even more modest treatment gains on the way to those ultimate goals can have a dramatic impact on both the lives of people and the costs to Medicare and Medicaid.

A treatment that would delay Alzheimer's onset by five years - similar to some anti-cholesterol drugs that delay the onset of heart disease - could decrease the number of Americans with the disease by more than 40 percent in 2050. We could also save Medicare and Medicaid $362 billion, in today's dollars, in that year alone.

A treatment that would slow the progression of Alzheimer's - similar to the treatments we have today that slow the progression of HIV/AIDS - could reduce the number of people in the severe stage of the disease, when more expensive and intensive around-the-clock care is often necessary, by more than 80 percent in 2050. And, federal and state governments would save, again in today's dollars, $180 billion in 2050.

These are staggering numbers. Yet, despite the magnitude of this burgeoning health crisis, and the facts put forth by the Alzheimer's Association and others, the federal government's response has been stunningly neglectful. This year, the federal government will spend less than $500 million on Alzheimer research. This means that for every $100 in research spending by the federal government, we are spending more than $25,000 caring for people with Alzheimer's.

This is where we are today. Not only has the federal government done little about the existing and unfolding Alzheimer crisis, it has no idea what is going to be done about it. The federal government has no comprehensive plan for how to avoid this disastrous future. It has no plan for adequate strategic research to develop the treatments necessary to save lives and to save the trillions that will be spent through Medicare and Medicaid. It has no plan on how to care for 13.5 million - and as many as 16 million - Americans with the disease by mid-century. It has no plan to have the needed nursing home beds or to expand home- and community-based services.

Ten other nations have Alzheimer plans. More than half of our states are working on plans. But the federal government has no plan at all.

There is now bipartisan legislation before Congress that would set the needed planning process in motion. The National Alzheimer's Project Act would create an Office on Alzheimer's Disease within the Department of Health and Human Services so that there will be at least one person in the federal government who will come to work every morning with the sole responsibility of figuring out how to deal with the Alzheimer's crisis. It also sets up an inter-agency Advisory Council that will develop a comprehensive plan across the entire federal government.

The Alzheimer's Association's vision is a world without Alzheimer's. If we are going to get there from here, we need our federal government to have a plan.

Today. Please join us at www.alz.org/trajectory