Presentation (CTI)

OBJECTIVES: Alzheimer’s disease (AD) is the leading cause of dementia, imposing a significant economic burden in Japan. This study estimated direct healthcare costs for individuals with AD, stratified by disease severity from a Japanese public healthcare perspective.
METHODS: Individuals aged ≥40 years diagnosed with mild cognitive impairment (MCI) or AD dementia between January 2014 and October 2024 were identified using IQVIA Claims Plus2, a large-scale health insurance claims data covering all age groups in Japan. The index month was defined as the first recorded diagnosis of MCI or AD during the study period, excluding the last six-month. Patients were categorized into four mutually exclusive subgroups: MCI, and mild, moderate, or severe AD dementia, based on prescriptions and medical services during the six-month following the index month. Disease severity was assessed based on drug coverages and medical services reflecting those severities, rather than through clinical evaluation. Direct healthcare costs were estimated for commonly used medical services and prescriptions during the six-month post-index period. For the base case, costs were calculated for services and prescriptions used by ≥10% of patients in each subgroup, with sensitivity analyses applying alternative utilization thresholds.
RESULTS: A total of 858,650 individuals met eligibility criteria: 41,496 with MCI, and AD dementia with 551,883 (mild), 114,109 (moderate), and 11,318 (severe).. Mean age was 83.0 years; 34.1% were male. During follow-up, 26.0% were hospitalized, and outpatient visits averaged 15.6 per individual over six months. For base case, mean six-month healthcare costs were ¥147,930 (USD $986) for MCI, ¥114,283 ($762) for mild, ¥131,530 ($877) for moderate, for ¥536,754 ($3,578) with severe AD dementia (1 USD = 150 JPY).
CONCLUSIONS: Direct healthcare costs for AD in Japan rise sharply with severity from mild to severe stages, highlighting urgent need for early intervention and resource optimization.