title: Implications of early treatment among Medicaid patients with Alzheimer's disease.
abstract: OBJECTIVE
  The objective of this study was to examine the effect of treatment timing on risk of institutionalization of Medicaid patients with Alzheimer's disease (AD) and to estimate the economic implications of earlier diagnosis and treatment initiation.
  
  
  METHODS
  New Jersey Medicaid claims data (1997-2009) were used retrospectively to study the effect of treatment on time to institutionalization. Observed Medicaid payments were used to calculate savings from delayed institutionalization, adjusting for cost offsets resulting from concurrent changes in use of other medical services.
  
  
  RESULTS
  Initiation of existing therapies at earliest symptomatic onset is predicted to delay institutionalization by 91 days, reducing Medicaid costs by $19,108/institutionalized patient. Incorporating an 18.5% cost offset from increased use of other medical services as well as drug costs associated with earlier treatment results in net savings of $12,687/patient. Projected annual Medicaid savings exceed $1 billion.
  
  
  CONCLUSIONS
  Earlier treatment leads to a small delay in institutionalization among AD patients, resulting in significant costs savings to Medicaid.
authors: Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors: David S
authors: DS
authors: Geldmacher
authors: Analysis Group, Inc., Boston, MA, USA. Electronic address: nkirson@analysisgroup.com.
authors: Noam Y
authors: NY
authors: Kirson
authors: Analysis Group, Inc., Boston, MA, USA.
authors: Howard G
authors: HG
authors: Birnbaum
authors: Analysis Group, Inc., Boston, MA, USA.
authors: Sara
authors: S
authors: Eapen
authors: Analysis Group, Inc., Boston, MA, USA.
authors: Evan
authors: E
authors: Kantor
authors: Analysis Group, Inc., Boston, MA, USA.
authors: Alice Kate
authors: AK
authors: Cummings
authors: Bayer HealthCare Pharmaceuticals, Wayne, NJ, USA.
authors: Vijay N
authors: VN
authors: Joish
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D017046:Cost Savings; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007326:Institutionalization / Q000191:economics* / Q000379:methods; D038801:International Classification of Diseases; D008297:Male; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data; D009515:New Jersey; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States
keywords: Alzheimer's disease; Early treatment; Long-term care; Medicaid costs; Risk of institutionalization