Congress has an opportunity to help millions of families confronting Alzheimer’s disease. It should not let Washington’s habit of delay squander that opportunity.
A new national poll of midterm voters found there is an enormous majority of Americans from both parties who support passage of the Alzheimer’s Screening and Prevention (ASAP) Act, which would expand access for early detection and treatment of the disease. According to the Lake Research Partners and The Tarrance Group poll, a full 77% of respondents said fighting Alzheimer’s is a high priority (including 85% of Democrats, 86% of independents, and 67% of Republicans).
The House Ways and Means Committee recently advanced the ASAP Act by a vote of 40-0. Republicans and Democrats agreed that Medicare needs a better pathway for covering new Alzheimer’s screening technologies. That is an important beginning.
However, a unanimous committee vote does not change the law. Congress needs to finish the job with a floor vote and send the bill to the President.
Consider what is at stake.
More than 7 million Americans are living with Alzheimer’s disease. Nearly 12 million family members and friends provide unpaid care for people with Alzheimer’s or other dementias. Behind those numbers are husbands and wives becoming full-time caregivers, adult children rearranging their lives, and families struggling with enormous emotional and financial burdens. This makes Alzheimer’s more than a healthcare problem. It is a family crisis affecting millions of Americans who never appear in the count of people diagnosed with the disease.
The good news is that scientific progress is creating new opportunities to intervene. Treatments can now slow Alzheimer’s progression in eligible patients with early symptoms. Yet there is an average delay of three-and-a-half years between the first signs of cognitive decline and a dementia diagnosis.
That delay is disastrous to patients and their families. Researchers at the University of Southern California’s Schaeffer Center recently modeled the benefits of starting treatment two years earlier. They projected a 32 percent increase in the lifetime value to patients, caregivers and society. Under a more optimistic assumption about the effectiveness of earlier treatment, that increase reached 71 percent.
The Food and Drug Administration (FDA) has already cleared blood tests that help doctors evaluate Alzheimer’s-related changes in people with cognitive symptoms. These are important advances, but diagnosing someone with symptoms is different from screening someone who has none. As science advances toward screening, Medicare should be ready to cover tests cleared for this additional use.
The challenge is that Medicare’s preventive-screening coverage generally depends on a favorable recommendation from the U.S. Preventive Services Task Force, followed by a federal coverage decision. That process can take more than a decade.
The ASAP Act would address this problem by creating a Medicare coverage pathway for qualifying Alzheimer’s blood screening tests. The FDA has already cleared four blood tests to help diagnose Alzheimer’s in patients showing signs of cognitive decline. Similar tests that have the potential to detect the disease before symptoms appear are moving quickly through clinical development. The bill would update Medicare so Americans can benefit from these new tools as the FDA clears them for screening.
The economic stakes are also enormous.
The Alzheimer’s Association projected that Alzheimer’s and other dementias would cost the country $384 billion in health and long-term care spending in 2025. That figure did not include the unpaid care provided by millions of relatives and friends.
The USC model projected presymptomatic treatment could cut annual Medicaid costs by 35 percent.
We should be building a system that helps people before they reach a crisis, rather than simply paying the enormous costs after their conditions have deteriorated.
The ASAP Act is a practical step toward that better system. It would prepare Medicare for advances in screening while giving Congress an opportunity to turn bipartisan agreement into meaningful reform.
Further, when people learned about the specifics of the ASAP Act, 89% support its passage (with Democrats, independents, and Republicans all over 83%).
The House should bring the ASAP Act to the floor, and Congress should send it to the President.
Families confronting Alzheimer’s deserve more than a unanimous committee vote. They deserve action.
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