OBJECTIVES: We modelled scenarios exploring a range of future potential impacts on health and social care costs in the United Kingdom of disease modifying treatments (DMT) for Alzheimer’s disease (AD).

METHODS: A cohort Markov model was developed to predict the distribution of the UK population by five AD stages (from cognitively unimpaired to severe AD dementia) from 2020–2040, using national population projections and literature on AD prevalence and transition rates between AD stages. Published health and social care costs for each AD stage, supplemented by cost data from AD dementia patients in Northwest London (the Discover cohort), was applied to estimate direct health and social care costs. Parameter estimates on likely treatment rates and future care models (primary care vs specialty care follow up) were elicited from expert opinion. What-if scenarios for DMT access combining ranges of potential DMT efficacy estimates and access levels were modelled.

RESULTS: In the absence of DMT access, ~1 million people (1.5% prevalence) were projected to have AD dementia in the UK by 2040. Across the DMT access scenarios, cumulative health and social care cost savings of £4.4–12.9bn over 2020–2040 were estimated, based on projected reductions of 34k–98k people with AD dementia by 2040 (for restricted-access, medium-efficacy to high-access, high-efficacy scenarios respectively). The maximal cost savings of £12.9bn corresponded to £1.9bn annual savings. In medium-efficacy scenarios, moving from restricted-access to high-access doubled cumulative cost savings (£4.4bn to £10.1bn by 2040), demonstrating a potential high cost impact of improved access to DMT. Much larger cost savings under majority primary vs specialty care follow up (£10.1bn vs £0.4bn by 2040) were projected.

CONCLUSIONS: These results corroborate with previously published projections for AD and indicate high access levels to DMTs could substantially reduce the economic burden of AD on health and social care systems.