title: The clinical and economic burden of newly diagnosed Alzheimer's disease in a medicare advantage population.
abstract: BACKGROUND
  Alzheimer's disease (AD) represents a serious public health issue affecting approximately 5.4 million individuals in the United States and is projected to affect up to 16 million by 2050. This study examined health care resource utilization (HCRU), costs, and comorbidity burden immediately preceding new diagnosis of AD and 2 years after diagnosis.
  
  
  METHODS
  This study utilized a claims-based, retrospective cohort design. Medicare Advantage members newly diagnosed with AD (n = 3374) were compared to matched non-AD controls (n = 6748). All patients with AD were required to have 12 months of continuous enrollment prior to AD diagnosis (International Classification of Diseases, Clinical Modification [ICD-9] 331.0), during which time no diagnosis of AD, a related dementia, or an AD medication was observed. Non-AD controls demonstrated no diagnosis of AD, a related dementia, or a prescription claim for an AD medication treatment during their health plan enrollment. Medical and pharmacy claims data were used to measure HCRU, costs, and comorbidity burden over a period of 36 months (12 months pre-diagnosis and 24 months post-diagnosis).
  
  
  RESULTS
  The HCRU and costs were greater for AD members during the year prior to diagnosis and during postdiagnosis years 1 and 2 compared to controls. The AD members also displayed greater comorbidity than their non-AD counterparts during postdiagnosis years 1 and 2, as measured by 2 different comorbidity indices.
  
  
  CONCLUSIONS
  Members newly diagnosed with AD demonstrated greater HCRU, health care costs, and comorbidity burden compared to matched non-AD controls.
authors.affiliation: Competitive Health Analytics, Inc, Louisville, KY 40202, USA. bsuehs6@humana.com
authors.forename: Brandon T
authors.initials: BT
authors.lastname: Suehs
authors.forename: Cralen D
authors.initials: CD
authors.lastname: Davis
authors.forename: Jose
authors.initials: J
authors.lastname: Alvir
authors.forename: Derek
authors.initials: D
authors.lastname: van Amerongen
authors.forename: Nick C Patel
authors.initials: NC
authors.lastname: Pharmd
authors.forename: Ashish V
authors.initials: AV
authors.lastname: Joshi
authors.forename: Warachal E
authors.initials: WE
authors.lastname: Faison
authors.forename: Sonali N
authors.initials: SN
authors.lastname: Shah
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review / Q000191:economics / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D020398:Medicare Part C / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Alzheimer’s disease; comorbidity burden; cost of care; health care resource utilization; medicare