Early alzheimer disease round table project: Preparedness of the Belgian health system

Abstract

Disease modifying therapies (DMT) in the field of Alzheimer’s disease becoming accessible will require a transformation of Belgian health care practice. Early diagnosis is a crucial first step for these therapies as the maximal benefit outcome is expected if treatment is started as early as possible. This health policy-preparing paper resulting from a Belgian Early AD Round Table, complemented by an anonymized memory clinics survey and a computer simulation, was geared to investigate the Belgian healthcare system infrastructural preparedness to receive a DMT in the field of Alzheimer disease, which represents a high unmet clinical and societal need. Key summary recommendations include; • Conducting an awareness campaign towards the broader public as of a DMT becoming available; • Increasing GP awareness of implementation guidelines of the early-AD care and diagnostic pathway stressing multi-professional collaboration on diagnostic strategies; • To expedite patient diagnosis and treatment by considering reimbursement of CSF analysis, regardless of their use in symptomatic treatment or –even more so– DMT-available contexts; • CSF analysis cost-effectiveness is shown to require transversal budget impact analysis considering societal costs; • In the long run, to redesign the Belgian Memory Clinics Convention to act as the guardian of a national uniform quality AD health service offering; • To organically grow the present memory clinic-based loco-regional approach to AD treatment, which would result into a higher number of memory clinics acting upon a revised DMT-based health service offering; • To invest cost-effectively in the competence and skills of the informal caregiver; • To set up industry-independent societally funded national AD & dementia registries characterized as care registries and diagnosis/syndrome-specific quality of care registries. Please also consult the recommendations following the public presentation of these study results under Chapter 7 – Conclusions and Recommendations.