Alzheimer's Affects 5 Million
About 5.1 million Americans are living with Alzheimer's disease, according to a recent report from the Alzheimer's Association. While most people with the disease are over age 65, 200,000–500,000 people younger than 65 have early-onset Alzheimer's or other dementias. Without improvement in treatment, the group estimated that the prevalence of the disease could reach 11–16 million by 2050. Direct and indirect costs of Alzheimer's disease add up to more than $148 billion a year. Medicare's cost of caring for patients with Alzheimer's and other dementias is expected to climb from $91 billion in 2005 to more than $189 billion by 2015. But Harry Johns, president and CEO of the Alzheimer's Association, expressed hope. “There are currently nine drugs in phase III clinical trials for Alzheimer's, several of which show great promise to slow or stop the progression of the disease,” Mr. Johns said in a statement. “This, combined with advancements in diagnostic tools, has the potential to change the landscape of Alzheimer's.”
Alzheimer's Treatment Delays
Race and ethnicity may play a role in delays in diagnosis and treatment of Alzheimer's disease, according to an Alzheimer's Foundation of America survey. The survey found that 70% of African American and 67% of Hispanic caregivers were likely to dismiss the symptoms of Alzheimer's as old age, compared with 53% of caregivers of other races. Further, about 67% of African American caregivers and 63% of Hispanic caregivers said they did not know enough about the disease to recognize symptoms, compared with 49% of caregivers of other races. The stigma of a diagnosis was also a concern. For example, 36% of African American caregivers cited concerns about stigma as delaying diagnosis, compared with 22% of Hispanic caregivers and 18% of caregivers of other races. The survey, conducted by Harris Interactive and sponsored by Forest Pharmaceuticals Inc., included 655 adults who provide care for someone with the disease.
25% of Stays for Mental Health
One-quarter of all patients age 18 and over admitted to the hospital in 2004 had a mental health or a substance abuse disorder, according to the federal Agency for Healthcare Research and Quality. Almost 2 million admissions were primarily for a mental health or substance abuse issue. Another 6 million patients were admitted for another condition but were subsequently diagnosed with a mental health or substance abuse problem. Dual diagnoses accounted for 1 million of the 8 million total stays, and suicide attempts accounted for 179,000 admissions, with the majority involving patients aged 18–44 years. However, most of the mental health and substance abuse disorders were in older patients, with those over age 80 accounting for 21% of hospitals stays, mostly for dementia. Medicare covered half the inpatient stays, Medicaid paid 18%, and private insurers covered 24%. Eight percent of patients were uninsured. The AHRQ report can be found at
www.ahrq.gov/data/hcup/factbk10/
NIH Launches Addiction Study
In response to the growing prescription drug abuse, the National Institute on Drug Abuse is launching the multisite Prescription Opioid Addiction Treatment Study (POATS). The researchers will examine the efficacy of buprenorphine/naloxone (Suboxone) combined with either intensive or brief drug-counseling approaches. Investigators aim to enroll about 648 participants at 11 sites. “Opioid analgesics were designed to help people in pain, and we want to be sure that those who require them for legitimate reasons can continue to effectively manage their pain,” Dr. Nora D. Volkow, NIDA director, said in a statement. “However, we must also recognize the risk of addiction to pain medications and develop treatments for those who become addicted to them.”
Psych Drug Spending Soars
Spending on medications for mental health conditions surged 150% from 1997 to 2004, rising from $8 billion to $20 billion in that 7-year period, according to AHRQ. The agency said the largest increase was for antipsychotic agents, where spending rose from $1 billion to $4 billion by 2004. But spending for antidepressants dwarfed that total; from 1997 to 2004, spending more than doubled, from $5 billion to $12 billion. The number of overall prescriptions for mental health-related prescriptions rose from 142 million to 244 million; at least 33 million Americans were prescribed a psychotherapeutic drug in 2004. The data are in the AHRQ report, Trends in the Use and Expenditures for the Therapeutic Class Prescribed Psychotherapeutic Agents and All Subclasses, 1997 and 2004.
CMS Extends NPI Deadline
Physicians and other providers who fail to comply with the May 23 deadline to acquire and start using a National Provider Identifier will not be penalized if they can show they deployed a “contingency plan,” the Centers for Medicare and Medicaid Services announced. “Covered entities that have been making a good faith effort to comply with the NPI provisions may, for up to 12 months, implement contingency plans,” said CMS Acting Administrator Leslie Norwalk in a statement. The agency decided to create this grace period after it became clear that many entities would not be able to fully comply by the original deadline, she said. The new compliance guideline can be downloaded from the agency's Web site (