Expected wait times for access to a disease-modifying Alzheimer's treatment in the United States.

Abstract

A 2017 study had analyzed the preparedness of the U.S. health care system to deliver a disease-modifying Alzheimer's treatment and predicted substantial wait times. We update the prediction with an improved model and newer data. The model tracks patients from initial evaluation, cognitive testing by a dementia specialist, confirmatory biomarker testing, and infusion delivery. All steps after initial evaluation are assumed to be capacity constrained. Model parameters and assumptions about care-seeking behavior were derived from the published literature and expert input. If patients were referred based on a brief cognitive test, wait times for specialist visits would reach around 50 months. If referral also required a positive blood-based biomarker test, wait times would be around 12 months. In both scenarios, wait times for confirmatory biomarker testing and infusion treatment would be limited. Better diagnostic tools at initial evaluation may reduce unnecessary delays in access to treatment.