Variations in Screening and Medication Takeup Rates for Alzheimer’s Disease
Author(s)
Adam Atherly, PhD1, Eric Ross, MD2, Rong Yan, MM3, Eline Van Den Broek-Altenburg, BA, MA, MSc, PhD4.
1Professor, Virginia Commonwealth University, Richmond, VA, USA, 2University of Vermont, Burlington, VT, USA, 3Virginia Commonwealth University, Richmond, VA, USA, 4University of Vermont, Larner College of Medicine, Burlington, VT, USA.
1Professor, Virginia Commonwealth University, Richmond, VA, USA, 2University of Vermont, Burlington, VT, USA, 3Virginia Commonwealth University, Richmond, VA, USA, 4University of Vermont, Larner College of Medicine, Burlington, VT, USA.
OBJECTIVES: Several new pharmacological treatments for Alzheimer’s Disease (AD) have been approved and more are on the horizon. The new medications have been criticized because of limited effectiveness and high costs. Beyond cost and effectiveness, there are substantial practical challenges to widespread adoption of new medications. Key among these is the need for early diagnosis of ADRD to maximize medication. In this study, we examine a) use of recommended screening tests for AD and b) initial take-up rates for AD medications, including the newly approved formulations and c) the relationship between screening and take-up.
METHODS: Data was from TriNetX, a database of de-identified electronic health records. AD was identified using ICD-10 codes. Screening tests for ADRD included PET and MRI scans. Medications include Cholinesterase Inhibitors , 2) Memantine 3) and three newer immunotherapy drugs (Lecanemab, Aducanumab, Donanemab). Differences were measured using Logistic Regression models with changes in marginal probabilities and Odds Ratios. Total Sample size was 590,844.
RESULTS: Both the use of screening tests and the use of AD medications were extremely low. Only 13.8% received any screening test and 38.0% used any AD medication. In the logistic models, younger individuals and those diagnosed with late-stage or unspecified-stage AD were more likely to receive recommended testing. Medication use was also more likely among younger individuals and was primarily among those diagnosed in stages other than late-stage AD. Both race and gender showed significant disparities: Black females had the lowest odds of receiving either recommended testing or any medication for AD. Use of the newer immunotherapy drugs was negligible (less than 0.5%).
CONCLUSIONS: Successful adoption of AD medications will require substantial practice changes, including an increased use of imaging and an increased proportion of persons with AD being diagnosed in an early disease stage. High variation in screening/medication rates suggest opportunities to improve overall care.
METHODS: Data was from TriNetX, a database of de-identified electronic health records. AD was identified using ICD-10 codes. Screening tests for ADRD included PET and MRI scans. Medications include Cholinesterase Inhibitors , 2) Memantine 3) and three newer immunotherapy drugs (Lecanemab, Aducanumab, Donanemab). Differences were measured using Logistic Regression models with changes in marginal probabilities and Odds Ratios. Total Sample size was 590,844.
RESULTS: Both the use of screening tests and the use of AD medications were extremely low. Only 13.8% received any screening test and 38.0% used any AD medication. In the logistic models, younger individuals and those diagnosed with late-stage or unspecified-stage AD were more likely to receive recommended testing. Medication use was also more likely among younger individuals and was primarily among those diagnosed in stages other than late-stage AD. Both race and gender showed significant disparities: Black females had the lowest odds of receiving either recommended testing or any medication for AD. Use of the newer immunotherapy drugs was negligible (less than 0.5%).
CONCLUSIONS: Successful adoption of AD medications will require substantial practice changes, including an increased use of imaging and an increased proportion of persons with AD being diagnosed in an early disease stage. High variation in screening/medication rates suggest opportunities to improve overall care.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD124
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Organizational Practices
Disease
Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas