Let's Pay Up For Alzheimer's

Caring for the boomers likely to be afflicted will cost far more than finding a cure now

By Newt Gingrich and Robert Egge

Alzheimer's disease is devastating. It strikes 1 in 10 Americans over age 65 and almost half of Americans over 85--the odds of developing Alzheimer's double every five years after 65. There are, so far, no cures, no remissions. While it is increasingly common to meet heart attack or cancer survivors, you won't meet an Alzheimer's survivor because there are none. Alzheimer's always ends in death. Perhaps that's why older Americans fear it more than cancer, heart disease, or any other malady.

Alzheimer's is also tragically predictable on a national level. More than 4 million Americans suffer from the brain-crippling disease. As U.S. baby boomers age, this number is set to triple in little more than a generation. And because Alzheimer's robs capabilities and independence, it's also very expensive. This year the federal government will spend more than $120 billion to support those struggling with it. (But of course, not even the most compassionate and skilled caregiver is able to replace what Alzheimer's takes away.)

The government's current $120 billion tab is only a foretaste of what awaits the nation. Without medical breakthroughs, as the boomers pass through their elder years, federal spending on Alzheimer's care will increase to more than $1 trillion per year by 2050 in today's dollars. That's more than 10% of America's current gross domestic product. With this amount of money on the table, the government simply will not be able to solve its looming fiscal problems if it fails to address the growing Alzheimer's epidemic.

INDEED, THE VALUE OF A medical breakthrough for Alzheimer's would be overwhelming; for instance, according to the Lewin Group, a research advance that delayed the onset of Alzheimer's by just five years would translate by 2050 into a 5.3 million (40%) reduction in disease prevalence and roughly $515 billion (44%) in annual savings for the Centers for Medicare & Medicaid Services.

But that prognosis is unlikely given our present course. Just compare how much Washington currently is spending to defeat this disease, primarily through the National Institutes of Health and the Food & Drug Administration, with the amount it now spends--through Medicare and Medicaid--to cope with the ruin Alzheimer's leaves behind: For every dollar the government spends to treat the impact of Alzheimer's, it devotes less than a penny toward finding a cure.

This penny-on-the-dollar approach might be called the Katrina Strategy for Alzheimer's. Policymakers long neglected the work of strengthening the levees that might have saved New Orleans from the worst of Katrina's impact, only to later spend more than a hundredfold the cost of fixing the levees to rebuild the broken city after the levees failed. This is exactly what we're doing with Alzheimer's.

Fiscal hawks in the Bush Administration and Congress, rightly concerned about spiraling debt, have been working to squeeze savings out of the NIH and the FDA. That's understandable but misguided. A broader strategic view that would save both lives and money suggests that we should be devoting far more attention to finding a breakthrough to end Alzheimer's. At a minimum we should provide increased, consistent funding to researchers investigating new approaches. We should also increase funding to the FDA--but with the charge that it dramatically reduce the time it takes to evaluate prospective Alzheimer's therapies. With more than 100 trials currently under way, the faster researchers learn which approaches produce the best results, the better they can focus their efforts.

The good news is that while the new Congress and the Administration have inherited this massive problem, they do have the power to quickly set things right. And this is certainly a bold, coherent agenda that both Republicans and Democrats should be able to embrace.

Can we find a cure? While there are no guarantees, recent advances offer grounds for optimism. Neuroscience researchers are making significant discoveries, and improved imaging technologies are giving us a much deeper understanding of the disease mechanism, and with it, potential solutions. But to capitalize on these advances, we need a new federal resolve to truly defeat Alzheimer's. As America's largest generation ages, we have no time to lose.

Views expressed in Outside Shot are solely those of contributors.

Newt Gingrich, the former House Speaker, is founder of the Center for Health Transformation. Robert Egge is a project director at the Center

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