Alzheimer's Costs Could Overwhelm Medicare, Medicaid
16 million Americans will have the disease by 2050, experts predict
MONDAY, July 19, 2004 (HealthDayNews) -- The number of Medicare beneficiaries identified as having Alzheimer's disease soared 250 percent in the 1990s, and experts say that will translate into a huge jump in health-care costs.
Researchers at Duke University found the increase was highest (460 percent) among blacks. These figures essentially mean that people are getting care for what ails them, but it will not come cheap. And experts now suggest the degenerative neurological condition will become the top public health crisis of this century.
This was one of several studies detailing the costs associated with Alzheimer's disease presented at the International Conference on Alzheimer's Diseases and Related Disorders in Philadelphia, which runs from July 17 to July 22.
"Unless a prevention or cure is found soon, Alzheimer's disease will overwhelm our already stretched health-care system and bankrupt Medicare and Medicaid," Sheldon Goldberg, president and chief executive officer of the Alzheimer's Association, said in a prepared statement.
"Medicare expenditures for people with Alzheimer's are almost three times higher than the average for all beneficiaries. The cost to Medicare will rise 55 percent, to $50 billion, in less than 10 years, and the cost to Medicaid will soar by 80 percent, to $33 billion," he said.
The number of Americans with Alzheimer's is expected to increase from 4.5 million today to 16 million by 2050. The total current direct and indirect costs of the disease are estimated to be upward of $100 billion annually. One study presented at the conference found the total annual cost for formal dementia care in Europe was about $104 billion.
Another study looked at the cost of care during the 15 years after a person was first diagnosed with the disease, based on data for 1,557 patients between 1984 and 1999. The average annual cost for a man with Alzheimer's was $9,710; for a woman it was $16,327.
Why the discrepancy?
"Women spend a lot more time in nursing homes," speculated Henry Glick, lead author of the study and a health economist at the University of Pennsylvania School of Medicine. "Some people argue that when men have Alzheimer's, they have women or children who take care of them. Often, the man is gone when a woman develops symptoms."
Glick also found the disease costs more in its later stages than in its earlier stages.
"The really big costs per year are occurring once you've had this disease for 10 years," he said. "In women, it's $30,000 a year among survivors if you survive 10 years and in men it's $20,000. The message is not that we should let people die quickly but we have got to be aware that if you can keep people alive longer, then there's a chance that costs are going to be going up."
There are limits, however, to how much can be done for a person with Alzheimer's. "This should be a wake-up call. This is a horrible disease. It costs huge amounts of money. We don't have the answer," Glick said.
Duke researcher Shalini L. Kulasingam also found that Alzheimer's-related costs escalated as the disease became more severe, with direct medical costs for individuals in the advanced stages 60 percent to 200 percent higher than for those with mild Alzheimer's.
There have been surprisingly few studies on the costs associated with the severity of the disease. Precise information is important, Kulasingam said, because it "gives you a better idea of how you can allocate resources."
In researching the subject, however, Kulasingam found several obstacles to obtaining accurate information. One hurdle is the lack of consensus on how to define Alzheimer's severity or how to define costs. Many people define progression of the disease by changes in cognition, yet one study suggested declines in the ability to perform "activities of daily living" may drive up costs more, she said.
"If we knew which aspects of Alzheimer's dementia drive costs, we may be able to prioritize interventions that are easy to do and have a large impact on costs," Kulasingam said.
With the Alzheimer's Association currently asking for $1 billion in annual federal funding for research into the disease, this information takes on added significance.
For more on Alzheimer's disease, visit the Alzheimer's Association.