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Average Drug Costs for Dementia Patients Triple Those of General Medicare Population, Says New Report

  [ 229 votes ]   [ Discuss This Article ] • June 20, 2003

Persons with Alzheimer's disease and other dementias use more prescription drugs than other Medicare beneficiaries, costing them to spend three times more money then other beneficiaries, according to new data released today by the Alzheimer's Association.

"This report confirms what every family and clinician knows - that prescription drugs are a critical component of care for people with Alzheimer's disease or vascular dementia," said Stephen McConnell, senior vice president of the Alzheimer's Association. "The cost of these drugs is nearly three times higher than for Medicare beneficiaries without Alzheimer's disease, and they come on top of heavy out-of-pocket expenses for personal care and long-term care - a formula for financial ruin"

Over 70 percent of people with Alzheimer's or vascular dementia in this data analysis had at least one other chronic medical condition, and 50 percent had two or more additional chronic conditions.

"As Congress debates Medicare prescription drug proposals this week, these data make a clear and compelling argument that Congress needs to provide a drug benefit to people living with Alzheimer's disease," said McConnell.

The data is based on a review of medical records of a sample of community-dwelling patients with Alzheimer's and/or vascular dementia seen at the Memory Disorders Clinic at the Johns Hopkins University Hospital. Calculations are based on conservative assumptions - lowest appropriate dosage, use of generics if available, and average wholesale price (AWP). Elderly persons who do not have prescription drug coverage may pay more than the AWP as well as a dispensing fee.

The Hopkins data on use of prescription drugs in persons with Alzheimer's was compared with data published in Health Affairs, March-April 2000 on prescription drug use and cost for all Medicare beneficiaries.

The findings show that each month 88 percent of those with Alzheimer's disease take at least one prescription drug, on average, compared to 82 percent of all Medicare beneficiaries, who fill at least one prescription per year. Sixty-eight percent of people with Alzheimer's take at least two prescriptions each month, and 35 percent take four or more.

Alzheimer's patients pay a mean of $246.46 for their monthly prescriptions, or $2958 per year, contrasted with $1099 per year for all Medicare beneficiaries. People with Alzheimer's disease need drugs not just for treatment of their Alzheimer's, but also for treatment of behavioral symptoms associated with the disease and for coexisting medical conditions, such as cancer, diabetes, coronary heart disease and congestive heart failure.

"We now have four FDA approved drugs for the treatment of Alzheimer's disease, with more in clinical testing that could be available to consumers in the next few years," said McConnell. "The Alzheimer's Association advocates a prescription drug benefit that will assure access to these and other needed medications for all Medicare beneficiaries."

As the Medicare prescription drug benefit debate takes shape, the Alzheimer's Association will support proposals that meet the following principles:

Provide universal coverage for beneficiaries in a manner that preserves and strengthens the existing Medicare program. A new prescription drug benefit should not sacrifice protections that Medicare beneficiaries with chronic care needs have now.

Assure beneficiaries with Alzheimer's disease access to the full range of drugs they need, with appropriate cost and utilization controls.

Provide sufficient subsidies for low-income beneficiaries to assure that they have access to the benefit.

Balance the need to continue the search for new and more effective drug treatments with the need to assure that those treatments are affordable for beneficiaries and the Medicare program.
"We understand that Congress faces considerable budgetary and programmatic challenges in crafting a Medicare prescription drug benefit," said McConnell. "But millions of Americans are also challenged by the lack of Medicare prescription drug coverage. Congress needs to act now to solve this problem.”

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