Current Capacity for Diagnosing Alzheimer’s Disease in Germany and Implications for Wait Times
Year: 2024
Type: article
Abstract: Background: Amyloid-targeting therapies for Alzheimer's disease (AD) might become available in Germany soon. The combination of a large pool of prevalent cases and a complex diagnostic process to determine eligibility for these treatments is likely to challenge health systems' capacity. Objective: To analyze Germany's healthcare system capacity to identify treatment-eligible patients in a timely and equitable manner. Methods: We modeled patients' diagnostic journey and projects wait times due to capacity constraints for AD specialist visits and PET scans from 2024 to 2043. Model parameters were derived from published data and expert input. Results: Wait times would be ∼50 months over the model horizon, if patients were referred to specialists based on a brief cognitive assessment in primary care. Wait times for patients with social health insurance are projected to be 1.9 times those of patients with private insurance, with peak wait times of around 76 and 40 months, respectively. Adding a blood test for the AD pathology as additional triage step would reduce wait times to below 24 months. Conclusions: In spite of having a well-resourced health system, Germany is projected to be unable to cope with the demand for biomarker-based AD diagnosis, if a disease-modifying AD treatment were introduced. As these treatments might become available by the end of 2024, decisive action, in particular dissemination of high-performing AD blood tests for triage in primary care, will be needed to prevent delays in access and potentially avoidable and inequitable disease progression.
Source: Journal of Alzheimer s Disease
DOI: 10.3233/jad-240728
Institutions: University of Southern California, Universitätsmedizin Göttingen, University of Göttingen, Heidelberg University, Central Institute of Mental Health, Medizinische Fakultät Mannheim, TUM Klinikum, Technical University of Munich, University of Cologne, University Hospital Cologne, German Center for Neurodegenerative Diseases, LMU Klinikum, Munich Cluster for Systems Neurology, Imperial College London, Ludwig-Maximilians-Universität München, University of Sheffield, Universitätsmedizin Rostock, University of Rostock, University of Siegen, Universitätsmedizin Greifswald, Universität Greifswald
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4402697841