Disease-modifying therapies (DMT) are becoming increasingly accessible in the treatment of Alzheimer’s disease. However, for them to be effective, early diagnosis is crucial. Is the Belgian healthcare infrastructure able to diagnose early enough? There is a high unmet clinical and social need for treatment for this disease. But adopting DMTs may require a transformation of Belgian healthcare practice. This health policy-preparing paper is the result of a Belgian Early Alzheimer Disease Round Table, as well as an anonymised memory clinics survey and a computer simulation. Through dialogue with all stakeholders, it presents workable solutions for expensive but curing therapies.
Worldwide, about 36 million people suffer from Alzheimer’s disease and other neurodegenerative disorders. This number is expected to double by 2030 to reach about 115 million being affected in 2050. This is if no cure can be found against this disease, or if we don’t succeed in preventing Alzheimer’s disease. Until now treatment focus has always been on dementia stages as early and ethically acceptable as possible, comprising mainly symptomatic treatment. However, there is currently no cure or treatment that can delay disease progression and durably improve clinical outcomes.
With Disease-modifying therapies (DMT) becoming available the importance of early diagnosis (and access) could become a critical first step in slowing down the evolution of the disease. They may also reduce costs as it could keep patients longer in the community care phase.
Professor Walter Van Dyck, Director of the Vlerick Healthcare Management Centre, brought all Belgian health agents together during round table discussions in the light of a DMT becoming accessible to the healthcare system. This policy paper describes the conclusions of three actionable domains: early Alzheimer’s disease awareness, early Alzheimer’s disease diagnosis, and symptomatic and DMT-based treatment. This is followed by the results of a simulation-based study which was set up as a thought experiment. Given the unavailability of sufficiently detailed Belgian epidemiological information, assumptions were made from individual interviews anonymously conducted with memory clinics heads in Belgium. The simulation serves as a quantitative test for the key preliminary conclusions from the three Round Tables held before.