Support programs for caregivers of individuals with dementia may offer substantial benefits at a fraction of the cost of newly approved Alzheimer’s drugs, according to a recent study. Researchers found that providing supportive care to families navigating dementia yielded greater value, measured by both healthcare cost reduction and improved quality of life, compared to the use of pharmaceutical interventions alone.
The findings, published on February 5 in Alzheimer’s &. Dementia: Behavior & Socioeconomics of Aging, highlight the critical role of care coordination as the number of Americans living with Alzheimer’s disease and related dementias continues to rise. Currently, an estimated 6.7 million Americans are affected by these conditions.
The challenge lies in the scarcity of dementia specialists. This often leaves primary care physicians, already burdened with numerous responsibilities, to manage the complex needs of patients and their families. To address this gap, programs like the one developed at the University of California, San Francisco (UCSF), pair caregivers with dedicated care navigators. These navigators provide monthly phone support, answering questions about medications, behavioral changes, and sleep disturbances, and connecting families with a broader network of specialists, including clinicians, nurses, pharmacists, and social workers.
“These collaborative care models shift from crisis-oriented care, where families don’t know what to expect, to more proactive, calmer care, where the caregiver is supported in helping their loved one,” explains Katherine Possin, a clinical psychologist at UCSF who directs the Care Ecosystem program. This program is currently utilized by over 50 health systems and community-based organizations across the United States. Similar initiatives exist at institutions like UCLA, and the U.S. Centers for Medicare & Medicaid Services (CMS) began piloting a federal dementia care model in 2024, offering financial incentives to organizations that enroll Medicare patients in these programs.
While the benefits of both collaborative care and emerging Alzheimer’s therapies are supported by prior research, directly comparing these interventions in a large-scale, long-term clinical trial would be impractical and prohibitively expensive. To overcome this limitation, researchers led by Kelly Atkins, formerly of UCSF and now a clinical neuropsychologist at Monash University in Melbourne, Australia, employed a mathematical modeling approach.
The team created a simulated population of 1,000 individuals aged 71, mirroring the characteristics of participants in a previous trial of the Alzheimer’s drug lecanemab (Leqembi). Participants were assigned to one of three scenarios: 18 months of lecanemab treatment, participation in a collaborative care program, or a combination of both. The model then predicted the long-term outcomes for each intervention, factoring in national data on mortality rates, quality of life, and the costs associated with varying stages of dementia.
The results indicated that lecanemab extended patients’ lives by an average of 0.17 years and delayed entry into long-term care by the same amount. In contrast, collaborative care programs did not significantly impact lifespan but provided an additional 0.34 years of independent living before requiring nursing home care. Combining lecanemab with collaborative care further delayed the need for institutionalization by 0.16 years.
Importantly, the study considered the scalability and cost-effectiveness of each intervention. Approximately 1 million Americans with Alzheimer’s disease meet the criteria for lecanemab, while over 6 million individuals with dementia could potentially benefit from collaborative care programs. The annual cost of lecanemab is $26,500, although individual patient costs may vary depending on insurance coverage.
When scaled to the U.S. Population, the model estimated that 18 months of collaborative care would result in a net savings of $300 billion in healthcare costs, while 18 months of lecanemab treatment would cost $39.5 billion. These figures encompass total costs and savings associated with dementia care, including medical procedures and long-term care expenses, over the remaining lifespan of the treated population.
“It makes perfect sense,” says Josh Helman, a physician in Florida who focuses on preventative approaches to Alzheimer’s disease. “Putting resources into coordinating care for dementia patients can save health care dollars long-term, as opposed to waiting for side effects later on or having to pay for expensive memory care.”
However, some experts caution against drawing definitive conclusions from computer simulations. Daniel Press, a neurologist at Beth Israel Deaconess Medical Center in Boston, emphasizes the need for prospective data collection – tracking real-world outcomes over time – “to sort out whether that model leads to benefits for patients and their families.”
The UCSF researchers hope their study will underscore the importance of reforming dementia care as new Alzheimer’s drugs enter the market. “Let’s face it, dementia [care] is not the part where the health system is making a lot of money,” Possin says. “It’s hard to get the business folks in medicine to pay attention to making changes, and improvements.”
