Why would Canada have the longest wait times for an Alzheimer’s treatment among the G7 countries? A policy analysis

Abstract

AbstractBackgroundThe emerging disease‐modifying Alzheimer’s treatments present a health system challenge because of the combination of a large prevalent patient pool and a complex diagnostic process. Analyses of system preparedness have projected Canada to have by far the longest and most protracted wait times for access among G7 countries.MethodPolicy analysis study using comparative health system data and 17 semi‐structured interviews with experts in Canada.ResultCompared to other G7 countries, Canada has a high number of family physicians, but low numbers of dementia specialists and imaging equipment per capita, leading to wait times even today. The capacity constraints result from limited investment in infrastructure and deliberate use of supply side restrictions for cost containment. Several options exist to alleviate those constraints in the short run, such as building on existing primary‐led memory care models, more flexible use of existing imaging devices, and utilization of novel diagnostic technology like digital and blood‐based biomarker tests.ConclusionCanada faces a unique challenge to make a disease‐modifying Alzheimer’s treatment accessible because of limited capacity for memory care. While opportunities exist to improve access, they are not likely to be realized fast enough in the absence of a deliberate planning effort.