The Center for Medicare and Medicaid Services (CMS) has made a bad decision. In the teeth of Washington's historic budget battle, CMS has decided not to fund a new imaging technology that could lead to the earlier detection of Alzheimer’s.
Given the current economic environment, this is not a terribly surprising move. But as the population ages at an unprecedented rate, and with cases of Alzheimer’s skyrocketing in parallel, CMS has traded a small, short-term gain for a huge, long-term loss.
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The technology in question is a new imaging tool developed by Eli Lilly called Amyvid. The imaging agent, used in brain imaging scans, has gotten FDA approval - no easy task - and can estimate the density of beta-amyloid neuritic plaque through PET scans. These plaques are present in patients with Alzheimer’s, so detecting their presence could lead doctors to make earlier diagnoses of the disease.
Early diagnosis would open countless new doors for researchers and drug developers, as well as enable families more time to prepare for this terrible disease.
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It is truly a loss to individuals, families, and societies that potential Alzheimer’s breakthroughs are not gaining support of such a critical payer as CMS. While it makes sense for CMS to begin a general modus operandi of belt-tightening - especially given the outlays committed to health and retirement benefits - pulling back from an investment in Alzheimer’s treatment and prevention is a move that mortgages the future for the present. It's a decision that profoundly misunderstands the idea that spending on health can be an investment, not unlike our view of spending on childhood education.
According to Alzheimer’s Disease International, the cases of Alzheimer’s around the globe are projected to double every 20 years through mid-century – and rates of Alzheimer’s correlate to increases in longevity, of course. Our treatments and cures are not up to the challenge and early detection would provide a valuable piece of the puzzle. This is not the U.S.’s challenge alone. In Europe, Japan and China, Alzheimer’s skyward trajectory is crystal clear.
Perhaps more than any other disease, Alzheimer’s demonstrates that spending on health is not cost but investment. Already Alzheimer’s consumes $604 billion annually - or roughly 1 percent of global GDP. And its toll on the family and informal caregiver is profound. New research finds that half of all people with dementia require personal care, while an incredible 80 percent of all people in nursing homes have dementia.
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As people live longer in the U.S., concern for our health as a nation demands better ways to treat and prevent Alzheimer’s. The current fisticuffs over the budget and the debt ceiling up on Capitol Hill is a distraction from the fiscal and economic imperatives that result from such huge challenges as Alzheimer’s.
The dog and pony show over the rollout of Obamacare is not much better. The Affordable Care Act essentially keeps throwing 20th century solutions at 21st century problems. A new demographic structure is emerging – and the president’s health law does not adequately account for the new ratio of old-to-young that will prevail in the coming decades. As a result, the law does not sufficiently enable priorities that are aligned to healthy, active aging. It continues the policies that presume aging to include disability and dependency.
In a time when reaching across the aisle is akin to treason, investing in Alzheimer’s should be one thing on which both parties can agree. Costs are already overwhelming and the prevalence of this disease is poised to swell. Health care spending is one of the trickiest, most decisive questions of modern life – yet for all the hard questions to answer, investing in Alzheimer’s should be a no-brainer.
