Razavi M, Herring WL, Maserejian N, Pemberton-Ross P, Nejati M. Economic burden of transitions to later stages of Alzheimer's disease in Europe: elevating the sense of urgency to treat. Poster presented at the AAIC 2023 Conference; July 16, 2023. Amsterdam, Netherlands.

BACKGROUND: Alzheimer's disease (AD) significantly impacts individuals, families, and society worldwide. In Europe, it affects approximately 10 million people, leading to considerable healthcare costs, caregiver burden, and reduced productivity.1 It is crucial to slow down AD progression in order to alleviate the rising burden of the disease.

METHODS: Two targeted reviews were conducted, one on the prevalence of individuals with biomarker-confirmed AD pathology and the other on the costs associated with AD by disease stage and care setting. The most recent prevalence1,2,3,4,5,6,7,8 and cost9,10,11,12,13,14,15,16,17,18 data were identified for selected countries, including the UK, France, Germany, Italy, Spain, Sweden, Netherlands, Finland, Switzerland, Estonia, and the Czech Republic. Regression-based or linear extrapolation methods were applied to fill the existing data gaps where appropriate. All costs were converted to USD and adjusted for inflation to reflect 2022 values.

RESULTS: The national costs associated with annual transitions across all AD stages were estimated to be ($11.4bn) in Germany, followed by France ($6.2bn), UK ($5.2bn), Spain ($3.7bn), Italy ($3.2bn), Switzerland ($1.9bn), Sweden ($1.4bn), Netherlands ($1.07bn), Finland ($0.8bn), Czech Republic ($0.7bn), and Estonia ($0.03bn). Early-stage progression, with the largest number of individuals transitioning from mild cognitive impairment (MCI) to mild AD, accounted for more than half of the total transitioning costs in the UK, Spain, Finland, Netherlands, Czech Republic, and Estonia. However, the highest cost burden varied across the countries. In Germany, Italy, and Switzerland, similar to previous estimates for the US,19 the highest burden was associated with late-stage progression from moderate to severe dementia, despite the relatively lower number of such transitions. This is likely due to the more expensive institutional care in these countries. Our findings further suggest that including the economic value of uncompensated caregiving substantially increases the total costs while leading to greater variability in estimates. The interpretation of these results should take into account data limitations and the assumptions made in the analysis.

CONCLUSIONS: The economic burden of AD increases as disease progresses. Total costs and the underlying components vary across health systems and regions. Nevertheless, universally, any treatment that slows down the disease progression could result in substantial costs savings.

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