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'Money and Leadership' Sought As Alzheimer's Crisis Looms


 

Alzheimer's disease advocates and federal officials are calling for measures to combat what is being called a “looming avalanche” of Alzheimer's disease in the United States.

Alzheimer's disease prevalence in this country is projected to skyrocket in the next 40 years, from 4.5 million to more than 13 million. The national health infrastructure is not equipped for this, said Robert Egge of the Center for Health Transformation.

“Because of our national strategy—or rather the lack of it—we are not on the right footing to get a handle on this before it hits,” Mr. Egge commented in an interview.

The Center for Health Transformation, a health policy think tank founded by former Speaker of the House Newt Gingrich, advocates a national AD strategic plan that would tackle the impending epidemic just as national policy spearheaded the response to HIV/AIDS and the possibility of an avian flu epidemic. That kind of bold commitment is precisely what's long overdue for AD,” said Mr. Egge, director of the center's Alzheimer's disease project.

Such a plan would address two facets of the problem: money and leadership, Mr. Egge said. “We simply don't have anyone at the executive level focused on [AD], and without that, it's hard to imagine how we can get an overall organized approach. Secondly, we need to examine the amount of money we're spending now on treating the disease, compared [with] what we are investing to overcome it.”

The numbers are distressing, he and Mr. Gingrich wrote in a recent commentary. AD is the third most expensive medical condition in the U.S., costing $100 billion annually in Medicare and Medicaid dollars. “Without medical breakthroughs, as the Boomers pass through their elder years, federal spending on AD care will increase to more than $1 trillion per year by 2050, in today's dollars. That is more than 10% of America's current gross domestic product,” they wrote (Alzheimers Dement. 2007;3:239–42).

A national AD strategy would build the case for making substantial national investments in research for both early detection and pharmacotherapy, and urge the Food and Drug Administration to accelerate new drug evaluation, Mr. Gingrich and Mr. Egge wrote. A strategic plan also should help caregivers, perhaps by providing some kind of financial support to those who save Medicare money by keeping a patient at home as long as possible.

The Alzheimer's Association has joined the Center for Health Transformation in taking the first steps toward building a national plan. In mid-July, the two entities announced the formation of a study group cochaired by Mr. Gingrich and former Sen. Bob Kerrey (D-Neb.). The group will consist of nonpartisan, independent health policy experts and is charged with evaluating the nation's efforts to combat the disease and recommend strategies for addressing shortcomings.

The Center for Health Transformation is not the only one nipping at government heels over the Alzheimer's epidemic. Sen. Barbara Mikulski (D-Md.) has introduced two bills to address several of the same issues: shoring up research dollars and assisting families.

The Alzheimer's Breakthrough Act of 2007 (S. 898) would double National Institutes of Health funding for AD research to $1.3 billion in 2008; the Alzheimer's Family Assistance Act (S. 897) would provide a $3,000 annual tax credit for families caring for a member with a chronic condition like AD, and includes a long-term care tax deduction as well. Both bills have a House companion and have been referred to committee.

Sen. Mikulski also has held three hearings on the issue. Dr. Samuel Gandy, chairman of the Alzheimer's Association Medical and Scientific Advisory Council, was among the experts who testified.

With a number of promising drug therapies on the horizon, it's more important than ever to push for increased research money, Dr. Gandy told the committee. “Within the next 3 years, it is all but certain that we will have disease-modifying drugs that will fundamentally change the nature of Alzheimer's. For millions of Americans, a diagnosis will no longer be a death sentence, but [rather be] the beginning of a manageable chronic illness.”

The promises of research are a direct result of federal funding support, he said. But NIH funding for Alzheimer's research has declined every year since 2003, and the proposed fiscal year 2008 federal budget contains yet another cut.

Doubling federal research dollars would improve this situation, said Jennifer Zeitzer, associate director of federal policy for the Alzheimer's Association. “It's a very significant request, but that's what the scientific community believes needs to be done to bring these new drugs to market,” she said in an interview. “This would really speed up the time to when prevention becomes a reality, and to when we can detect and treat symptoms before they become disabling.”

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