# Ensuring Access to Novel Alzheimer’s and Dementia Treatments: Evaluating Innovative Payment Approaches

> **NIH NIH R01** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2021 · $542,912

## Abstract

Project Summary/Abstract
Progress against Alzheimer's disease and related dementias (ADRD) has been frustratingly slow, but effective
treatments may be on the horizon. Given the scale of ADRD and its costs, even modest efficacy in delaying
progression could have substantial social benefits. However, the scale of the ADRD problem also presents a
financing challenge. How can we afford new therapies for large numbers of ADRD patients and those who are
pre-symptomatic? This problem is exacerbated by the likelihood that clinical benefits will vary with disease stage,
genotype, or other unknown factors. Payers are reluctant to pay high prices per dose for therapies, especially
when these benefits may accumulate much later in life. We will bring together experts in economics,
neuroscience, and ADRD care to identify and quantify alternative reimbursement strategies that ensure better
access. First, using a variant of the RAND/UCLA appropriateness methods, we will identify the most promising
ADRD interventions, quantify their likelihood of success and expected clinical benefit, and assess whether these
benefits are likely to vary across patient subgroups. Second, we will map clinical trial endpoints used in the
current ADRD pipeline to broader quality-of-life outcomes – e.g., functional status, disease incidence, and
mortality risk – that can be used to estimate societal consequences. Third, drawing on economic theory and the
exitant literature, we will develop novel reimbursement mechanisms for ADRD therapies and characterize how
they would be structured. Fourth, we will adapt the Future Elderly Model (FEM), a well-validated microsimulation
model, to study the long-term health and economic consequences of new ADRD technologies, and to study how
these consequences would vary with different pricing mechanisms. We will study both average outcomes and
changes in disparities across ADRD patients for alternative technology and pricing scenarios. Fifth, we will use
the microsimulation model to study impacts of technologies and pricing scenarios on the health and economic
outcomes of informal caregivers for ADRD patients. Finally, we will convene a workshop to disseminate our
findings to key marketplace and policy stakeholders, and to generate discussion about potential next steps.
Together, the proposed research will develop and evaluate innovative strategies to ensure that current and future
ADRD patients gain access to novel therapies.

## Key facts

- **NIH application ID:** 10176332
- **Project number:** 5R01AG062277-04
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** DANA P GOLDMAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $542,912
- **Award type:** 5
- **Project period:** 2018-09-30 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10176332

## Citation

> US National Institutes of Health, RePORTER application 10176332, Ensuring Access to Novel Alzheimer’s and Dementia Treatments: Evaluating Innovative Payment Approaches (5R01AG062277-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10176332. Licensed CC0.

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