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Out-of-Pocket Expenses, Indirect Costs Increase With Alzheimer Disease Severity
Out-of-pocket (OOP) expenses for people with Alzheimer disease (AD) or mild cognitive impairment (MCI) in the United States ranged between $420 and $903 per patient per month, depending on disease severity, according to a study published online ahead of print in the Journal of Managed Care and Specialty Pharmacy.
“We assessed OOP expenses for patients with MCI and AD, which represent the parts of the direct costs that are fully borne by the patients and their families,” researchers wrote. “Most studies assessing direct costs of AD focus on Medicare and Medicaid costs only, but OOP expenses amounted to 24% of the total annual per person direct costs in 2021 and should therefore not be neglected.”
In addition to OOP expenses, researchers calculated indirect costs from unpaid caregiving and work impairment for US patients in the AD continuum. The study included 17,885 patients with MCI and 901 patients with AD from the Health and Retirement Study. Just over one-quarter of patients with MCI, and 0.9% with AD, were employed.
Although per-patient-per-month OOP expenses tended to increase with AD severity, indirect costs to employers, which ranged between $197 and $242 per patient per month, were similar across the AD continuum. Unpaid caregiving costs per patient per month increased from $72 with MCI to $1298 with severe AD, according to the study.
On the whole, OOP expenses and indirect costs together increased by disease severity. Total costs ranged from $869 with MCI to $2398 with severe AD per patient per month.
When researchers stratified patients with AD by nursing home status, insurance type, and income, they found higher income levels were associated with higher OOP expenses. Nursing home residency, meanwhile, was linked with lower indirect costs.
“Results highlight the need for early detection and effective interventions to reduce financial burden and socioeconomic disparities,” researchers advised.
Reference:
Monfared AAT, Hummel N, Chandak A, Khachatryan A, Zhang Q. Assessing out-of-pocket expenses and indirect costs for the Alzheimer disease continuum in the United States. J Manag Care Spec Pharm. Published online June 12, 2023. doi:10.18553/jmcp.2023.23013
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