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Indianapolis Discovery Network for Dementia Forecasting the Future Impact of Early Detection and...
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ndianapolis Discovery Network or Dementia www.indydiscoverynetwork. com Forecasting the Future Impact of Early Detection and Management Program for Alzheimer Disease Rabia Jermoumi, PhD Associate Professor, Economics Consultant, Regenstrief Institute, Inc
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Transcript of Indianapolis Discovery Network for Dementia Forecasting the Future Impact of Early Detection and...
Indianapolis Discovery Network for Dementia
www.indydiscoverynetwork.com
Forecasting the Future Impact of Early Detection and Management Program for Alzheimer Disease
Rabia Jermoumi, PhDAssociate Professor, Economics
Consultant, Regenstrief Institute, Inc
www.indydiscoverynetwork.com
Objective
To forecast the costs and benefits of implementing an early Alzheimer’s Disease (AD) detection and management program called PREVENT in a primary care practice over the period 2010-2050.
www.indydiscoverynetwork.com
PREVENT
• PREVENT is a collaborative care model which have been successfully resulted in significant improvement in the quality of care and life of dementia patients and their caregivers within a primary care environment.
• PREVENT resulted in reduction of NPI score by 5.6 points.
• In addition to both direct costs (e.g., physician visits, medications, hospital care, paid home care, and nursing home services) and indirect costs (unpaid care giving), PREVENT will cost an additional $1,000 per patient.
www.indydiscoverynetwork.com
Usual Care Model for Patients with Alzheimer Disease
US population65+
20% no PCP visit
80% visit PCP
Diagnosed with AD
Unrecognized
AD prevalence
No AD
Cost
Cost
Cost
Cost
Cost
Negative
US population65+
20% no PCP visit
80% visit PCP
Diagnosed with AD
Unrecognized
AD prevalence
No AD
Cost
Cost
Cost
Cost
Cost
Negative
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Decision – Tree Model for Patients with Alzheimer Disease
US population65+
20% no PCPvisit
80% visit PCP
Refuse screening
Screen for AD
Screen negative
Screen positive
Refuse clinical Assessment
Clinical Assessment
Other
AD
AD prevalence
No ADAD prevalence
No AD
AD prevalence
No AD
True negative
False negative
Cost
Cost Cost
Cost
Cost
Cost
Cost
Cost
Cost
Cost
US population65+
20% no PCPvisit
80% visit PCP
Refuse screening
Screen for AD
Screen negative
Screen positive
Refuse clinical Assessment
Clinical Assessment
Other
AD
AD prevalence
No ADAD prevalence
No AD
AD prevalence
No AD
True negative
False negative
Cost
Cost Cost
Cost
Cost
Cost
Cost
Cost
Cost
Cost
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Alzheimer's Disease Total Cost 2010 – 2050
0
40
80
120
2010 2015 2020 2025 2030 2035 2040 2045 2050
An
nu
al C
os
ts (
$B
illio
ns
)
Usual Care
PREVENT
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Direct Annual Savings with PREVENT Implementation 2010 –
2050
0
5
10
15
20
25
30
2010 2015 2020 2025 2030 2035 2040 2045 2050
An
nu
al S
av
ing
s (
$B
illio
ns
)
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Savings with PREVENT 2010 – 2050
0
5
10
15
20
25
30
2011 2025 2050
An
nu
al S
av
ing
s (
$B
illio
ns
)
Long Term Care
Hospital Care
Unpaid Care
Total
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Scenario 1: Potential annual savings – (Miraculous Vaccine) the incidence will be reduced by 1%
0
10
20
30
40
50
2011 2025 2050
An
nu
al S
av
ing
s (
$B
illio
ns
)
Long Term Care
Hospital Care
Unpaid Care
Total
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Scenario 2: Potential annual savings - long term care stay will be reduced by 1 year
0
10
20
30
40
50
2011 2025 2050
An
nu
al S
av
ing
s (
$B
illio
ns
)
Long Term Care
Hospital Care
Unpaid Care
Total
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Scenario 3: Potential annual savings – under scenario 1 and scenario 2
0
10
20
30
40
50
2011 2025 2050
An
nu
al S
av
ing
s (
$B
illio
ns
)
Long Term Care
Hospital Care
Unpaid Care
Total
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In Conclusion
At varying rates of effectiveness and in constant dollars, implementing an early detection and management program (PREVENT) for AD in primary care is cost effective for the American Society. This model estimates that direct annual savings are 4 billion dollars in 2010, 22 billion dollars in 2025, and 29 billion dollars in 2050.
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In Conclusion
The main key results of this study are:• Early diagnosis and treatment of
Alzheimer’s may result in cost savings.• Reducing behavioral and psychological
issues are the primary reasons for cost savings.
• There are many opportunities for managed care organizations to improve care of patients with Alzheimer’s disease.
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Direct Cost per capita = ∑ni=1Pi xQi
Where P = unit cost, Q = resource utilization, and i =1–n (where n = number of cost items)
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Methodology• First, the direct costs of AD over the period 2010-
2050 were estimated using a gross costing method in which we will total utilization of important types of care and then multiply this utilization by a unit cost for each type of care.
• Second, the cost of identifying an AD patient is estimated using the results of a screening and diagnostic regime reported by Boustani et al. The predictions of the benefits of early intervention and the predicted costs of the diagnostic programs permit an estimate of the overall net benefits and financial savings that would result from the implementation of an early stage diagnostic and treatment program.
• Third, projections of potential net benefits over the period 2010-2050 are estimated.
