Expected wait times for access to a disease‐modifying Alzheimer's treatment in the United States

INTRODUCTION: A 2017 study had analyzed the preparedness of the U.S. health care system to deliver a disease-modifying Alzheimer's treatment and predicted substantial wait times. We update the prediction with an improved model and newer data. METHODS: The model tracks patients from initial evaluation, cognitive testing by a dementia specialist, confirmatory biomarker testing, and infusion delivery. All steps after initial evaluation are assumed to be capacity constrained. Model parameters and assumptions about care-seeking behavior were derived from the published literature and expert input. RESULTS: If patients were referred based on a brief cognitive test, wait times for specialist visits would reach around 50 months. If referral also required a positive blood-based biomarker test, wait times would be around 12 months. In both scenarios, wait times for confirmatory biomarker testing and infusion treatment would be limited. DISCUSSION: Better diagnostic tools at initial evaluation may reduce unnecessary delays in access to treatment.