1. Indianapolis Discovery Network for 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

2. 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.

3. 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.

4. www.indydiscoverynetwork.com Usual Care Model for Patients with Alzheimer Disease

5. www.indydiscoverynetwork.com Decision – Tree Model for Patients with Alzheimer Disease

6. www.indydiscoverynetwork.com Alzheimer's Disease Total Cost 2010 – 2050

7. www.indydiscoverynetwork.com Direct Annual Savings with PREVENT Implementation 2010 – 2050

8. www.indydiscoverynetwork.com Savings with PREVENT 2010 – 2050

9. www.indydiscoverynetwork.com Scenario 1: Potential annual savings – (Miraculous Vaccine) the incidence will be reduced by 1%

10. www.indydiscoverynetwork.com Scenario 2: Potential annual savings - long term care stay will be reduced by 1 year

11. www.indydiscoverynetwork.com Scenario 3: Potential annual savings – under scenario 1 and scenario 2

12. www.indydiscoverynetwork.com 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.

13. www.indydiscoverynetwork.com 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.

14. www.indydiscoverynetwork.com Direct Cost per capita = ∑ n i=1 Pi xQi Where P = unit cost, Q = resource utilization, and i =1–n (where n = number of cost items)

15. www.indydiscoverynetwork.com 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.