Professor Martin Knapp
Director, Personal Social Services Research Unit (PSSRU) & Professor of Social Policy London School of Economics
Investing in the uptake of novel drugs that delay the onset of dementia, or slow down its progression, could reduce the social and economic impact of dementia.
As the number of people with dementia in Britain continues to grow – research conducted by Dementia UK forecasts a 40 per cent increase to over one million by 2025 – so does the impact of the disease on individuals, society and the economy.
“Work carried out in this area has identified three main forms of economic impact,” says Professor Martin Knapp, a health economist at the London School of Economics and Political Science (LSE). “There are the costs related to the use of healthcare services by people with dementia, which are carried out by the National Health Service. There are the social care costs, both publicly and privately funded, associated with the use of care homes. And there are the implicit costs of the unpaid care provided by family carers, including both out-of-pocket payments and the economic value of the time spent providing support and personal care.”
Potential of disease-modifying drugs
There is general consensus that reducing these costs requires new interventions. Benefits could be derived, for example, from breakthrough drugs that can delay the onset of dementia, or slow down its progression. In addition to improving quality of life for patients and carers, these could generate significant savings, largely as a result of delayed nursing home admission, says Professor Knapp, who is Director of the Personal Social Services Research Unit (PSSRU) at LSE.
A 2014 PSSRU report he coauthored concluded that if, for instance, a drug to delay dementia onset by 12 months was available to everyone today, the UK could save £1.5 billion annually. This figure would rise to £4.9 billion if dementia could be delayed by 36 months.
Improving carer support
Of course, adds Professor Knapp, there would be a shift of the cost burden from formal to unpaid care, as a result of prolonging the period over which families can look after their loved ones at home. Improving support for carers is thus really important.
Interventions would also be required to facilitate the actual uptake of innovative disease-modifying drugs. Professor Knapp says these agents “will likely be costly, which could limit access for those who can’t afford them. Further, they will likely be effective in certain patient subgroups with a particular genetic profile. So, we need new treatments that work and are affordable, as well as accurate genetic, or other diagnostic, tests that allow to identify which patients will be more likely to benefit from a certain drug.”
Hope for the future
Current dementia treatments can slow down cognitive decline, but their effect is relatively small, adds Professor Knapp. The hope is that something else will come along that will have a bigger impact. Investing in the uptake of a really dramatic new treatment could reduce the cost of dementia and make a better life for those living with it.