RACIAL AND ETHNIC DIFFERENCES IN DEMAND FOR NOVEL DEMENTIA THERAPIES: EVIDENCE FROM A NATIONAL SURVEY OF OLDER ADULTS' PREFERENCES ACROSS DEMENTIA DRUG ATTRIBUTES
Author(s)
Xinran Lu, MS1, Geoffrey Joyce, PhD1, Bryan Tysinger, PhD1, Mireille Jacobson, PhD1, J. Felipe Montano-Campos, PhD1, David A. Bennett, MD2, Julie Zissimopoulos, PhD1;
1University of Southern California, Los Angeles, CA, USA, 2Rush University, Chicago, IL, USA
1University of Southern California, Los Angeles, CA, USA, 2Rush University, Chicago, IL, USA
OBJECTIVES: To elicit preferences for dementia drug attributes and examine racial/ethnic variation to inform demand for current and future therapies.
METHODS: We conducted a survey of U.S. adults aged 50+ using the Understanding America Study in 2025. Respondents answered vignette-based questions rating hypothetical dementia therapies. A between-subject experiment randomized respondents to consider treatment for themselves or for a loved one. The primary outcome was a binary indicator of being "very likely" to use the treatment. Key covariates were administration mode (daily pill, self-injection, or intravenous infusion [IV]), presence of mild side effects, efficacy level (1- vs. 5-year symptom delay) and their interactions. We conducted survey-weighted logistic regression stratified by race/ethnicity and examined heterogeneity in effects of drug attributes by respondents’ characteristics.
RESULTS: Among 1,529 respondents (mean age 64; 63.4% female), 26.2% were Hispanic, 36.6% non-Hispanic Black, and 37.2% non-Hispanic White. Compared with daily pills, respondents were less likely to choose self-injection (average marginal effect: −2.1 percentage points [pp]) or IV therapy (−7.9 pp). Mild side effects substantially reduced use likelihood by 35.2 pp, while high efficacy increased it by 15.2 pp. Injection and IV attenuated the impact of side effects and low efficacy. While the likelihood of taking a daily pill was similar across racial/ethnic groups, non-Hispanic Black adults were less likely to choose injection or IV. The predicted probability of using an IV with side effects and 1-year symptom delay was 22% among non-Hispanic Black versus 40% among non-Hispanic White adults. Preferences did not differ by treatment recipient (self vs. loved one). Older adults and those with family dementia experience showed greater sensitivity to side effects and efficacy.
CONCLUSIONS: Demand for infusion-based dementia therapies is low, particularly among non-Hispanic Black persons, which may contribute to low uptake of current treatments. Injection or pill-based options may support higher use and reduce disease burden.
METHODS: We conducted a survey of U.S. adults aged 50+ using the Understanding America Study in 2025. Respondents answered vignette-based questions rating hypothetical dementia therapies. A between-subject experiment randomized respondents to consider treatment for themselves or for a loved one. The primary outcome was a binary indicator of being "very likely" to use the treatment. Key covariates were administration mode (daily pill, self-injection, or intravenous infusion [IV]), presence of mild side effects, efficacy level (1- vs. 5-year symptom delay) and their interactions. We conducted survey-weighted logistic regression stratified by race/ethnicity and examined heterogeneity in effects of drug attributes by respondents’ characteristics.
RESULTS: Among 1,529 respondents (mean age 64; 63.4% female), 26.2% were Hispanic, 36.6% non-Hispanic Black, and 37.2% non-Hispanic White. Compared with daily pills, respondents were less likely to choose self-injection (average marginal effect: −2.1 percentage points [pp]) or IV therapy (−7.9 pp). Mild side effects substantially reduced use likelihood by 35.2 pp, while high efficacy increased it by 15.2 pp. Injection and IV attenuated the impact of side effects and low efficacy. While the likelihood of taking a daily pill was similar across racial/ethnic groups, non-Hispanic Black adults were less likely to choose injection or IV. The predicted probability of using an IV with side effects and 1-year symptom delay was 22% among non-Hispanic Black versus 40% among non-Hispanic White adults. Preferences did not differ by treatment recipient (self vs. loved one). Older adults and those with family dementia experience showed greater sensitivity to side effects and efficacy.
CONCLUSIONS: Demand for infusion-based dementia therapies is low, particularly among non-Hispanic Black persons, which may contribute to low uptake of current treatments. Injection or pill-based options may support higher use and reduce disease burden.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
P30
Topic
Patient-Centered Research
Disease
SDC: Geriatrics, SDC: Neurological Disorders