Presentation (CTI)

OBJECTIVES: Besides its devastating effect on patients’ independence, memory and identity, Alzheimer’s Disease (AD) poses a growing societal and economic challenge in the Netherlands, with cases expected to nearly double by 2050. The disease not only drives healthcare costs, currently 10.6% of total expenditures, but also places a heavy burden on formal care infrastructure and informal caregivers. The availability of both formal and informal care capacity is often overlooked in health technology assessment. This study assesses the broader societal impact of AD and evaluates how Amyloid-Targeting Therapies (ATTs) may alleviate pressure on formal and informal care in the Netherlands.
METHODS: A Markov-model based analysis compared two patient groups: one receiving best supportive care (BSC) and the other treated with ATT. Each group included 9,500 patients eligible for ATT, with 70% in mild cognitive impairment (MCI) and 30% in mild AD. Data on disease progression, care hours, and patient characteristics were used to estimate care needs over time. Sensitivity analyses assessed model uncertainty.
RESULTS: ATTs were shown to slow disease progression, keeping patients longer in less care-intensive stages. Compared to BSC, ATTs reduced peak demand for formal and informal carers by 208 (18%) and 1,163 (18%), respectively. Peak care demand was delayed by 1.5 years. Over a lifetime horizon, ATT use reduced formal and informal care needs by 1,400 and 8,439 years, respectively.
CONCLUSIONS: By shifting care demand to less intensive stages and delaying peak pressure, ATTs offer a promising strategy to reduce the care burden of AD and improve sustainability of the Dutch healthcare system. These broader societal benefits, particularly the relief of informal caregiver strain, underscore the importance of including care capacity in health technology assessments for AD interventions and healthcare decision-making around personalised-medicine in clinical practice.