ORLANDO, Jun 06 (Reuters Health) - Alzheimer's is the third most costly
disease to society, estimated to cost as much as $100 billion a year, yet most
health plans do not have programs in place to manage the disease, a geriatrics
expert told managed care executives on Tuesday.
"The majority of managed care organizations have nothing on the table at
this time for Alzheimer's disease," said Dr. Howard M. Fillit, executive
director of the Institute for the Study of Aging in New York, and a clinical
professor of geriatrics and medicine at Mount Sinai Medical Center.
Speaking at a session of the American Association of Health Plans' 2000
Managed Care Institute and Display Forum, Fillit attributed health plans' lack
of attention to the disease to difficulty in diagnosing it as well as
administrative barriers having to do with coding and claims. Dementia is often
unrecognized by physicians and uncoded by hospital staff, he explained.
Fillit contends that plans are missing out. "There's a lot of opportunity
for care management in this disease and a lot of impact on co-morbidities,"
other illnesses in Alzheimer patients, he said.
Citing a study of managed Medicare claims, Fillit said that the average
annual claim for Alzheimer's disease was $13,687. And as the number of
co-morbidities increased, so did costs.
In another study, managed care organizations did less well than academic
medical centers in managing Alzheimer's costs. "This is just evidence that
managed care organizations are not well managing this disease," he said.
Fillit argued for early diagnosis, citing opportunities for new treatments
and care management. In a study published in 1999, Fillit and colleagues looked
at the effects of the Alzheimer's drug donepezil on costs and utilization among
managed Medicare patients. Use of the drug offset costs by 65%, not including
improvement in patients' function and the quality of life of patients and their
caregivers, he said. Another study of veterans' claims substantiated the
potential cost saving.
Those studies may not be the definitive word on how drug intervention
impacts care, he noted. But to take " the nihilistic point of view...that this
disease cannot be treated is certainly wrong," he said.
