Alzheimer's disease: An analysis of the diagnosed population and out-of-pocket cost exposure
Alzheimer’s disease is a progressive brain disease that results in a gradual decline in memory, thinking, behavior, function, and social skills. Due to the size of the prevalent population and potential financial impact of new therapies to both patients and U.S. payers, there is a need to better understand the currently diagnosed population, as it exists today. The purpose of this report is to:
- Estimate the Medicare and commercial population currently diagnosed with dementia due to Alzheimer’s disease or mild cognitive impairment using administrative claims data.
- Assess the Medicare Part A/B out-of-pocket cost exposure for diagnosed beneficiaries who may be considered for treatment with an amyloid-targeting therapy.
This analysis of cost exposure demonstrates that more than 98% of Medicare beneficiaries who may be considered for an amyloid-targeting therapy have coverage that limits or caps their out-of-pocket costs for Part A/B services and drugs. For most Medicare beneficiaries, the increase in out-of-pocket due to the addition of Part B costs associated with an amyloid-targeting therapy was less than $50 annually.
This report was commissioned by Eli Lilly and Company.