New research out this month from the Alzheimer’s Association highlights both the clinical and the cost impact of collaborative care interventions on patients with Alzheimer’s disease. And when the results are modeled and scaled across the U.S. population, it suggests major gains in quality of life and billions of dollars in reduced health care spending.
As with so many things in health care, improved outcomes come from additive measures—in this case that means combining a collaborative care approach with appropriate medication (researchers selected lecanemab) for patients with likely Alzheimer’s disease for achieving optimal results.
This research uses the metric of quality-adjusted life years (QALYs) to quantify the clinical improvement of a population. This means not only counting years lived, but years lived in improved health status, for patients with neurocognitive challenges who received intervention. The research findings show that medication increased QALYs for patients; collaborative care did so by even more; and the combination was associated with nearly half a year of additional quality-adjusted life expectancy compared to usual care.
Patient outcomes and wellbeing always come first. Fortunately, collaborative care consistently delivers cost savings as well. Research shows that dementia has become one of the highest-cost conditions for Medicare and Medicaid, and the prevalence of the disease continues to grow. While the cost of medications such as lecanemab increases direct treatment expenditures (the currently announced annual cost is approximately $26,500 per patient per year), the combined approach of medication with collaborative care is estimated to cost approximately $140 to $240 per patient per month and, based on modeling, may offset downstream medical costs such as hospitalizations and emergency care utilization. This integrated approach was associated with net savings of several thousand dollars per patient.
These findings underscore that scaling an integrated approach—appropriate pharmacologic treatment combined with structured collaborative care—may produce meaningful improvements in both quality of life and cost efficiency at a population level.
The researchers put it this way: “With these advances and opportunities come important decisions for policymakers and health system leaders about how to allocate resources.” The article points out that recent work and additional funding has enabled the expansion of collaborative care pathways to help address dementia and Alzheimer’s. The Concert Health team supports patients dealing with forms of dementia and Alzheimer’s, which are so frequently accompanied by other behavioral health challenges.
We also deliver educational sessions and content to providers on topics specific to geriatric populations and neurocognitive disorders. We help practice teams with integrating primary and behavioral care to manage cognitive, psychiatric, and numerous medical comorbidities. Through a measurement-based care approach, we support providers in monitoring cognition and mood symptoms, managing neuropsychiatric symptoms such as agitation, and optimizing prescribing and deprescribing practices to reduce risks such as falls and delirium.
There are no guarantees in life, but by prioritizing evidence-based care models and addressing patient care disparities, we can make meaningful (and measurable) improvements for many patients dealing with Alzheimer’s disease.