Cost and Non-Cost Barriers to Use of Novel AD Therapeutics among Older Adults

Project Summary The goal of this project is to assess the role of cost-associated barriers to new and future novel AD/ADRD therapeutics, with a particular focus on older adults with high AD/ADRD burden. Our work in the first (planning) phase of the project will include semi-structured interviews with a cohort of Latino adults at high risk for AD/ADRD that was created as part of the team’s ongoing work on representation in clinical trials. We will also interview an existing group of Latino patients with AD/ADRD and their caregivers. The interviews will inform a subsequent population-based survey to be fielded in the Understanding America Study, an online panel study housed at the University of Southern California. Both the interviews and the survey will elucidate cost and non-cost barriers to the use of new novel dementia therapeutics. The survey will more fully and systematically capture the contribution of environmental, sociocultural, behavioral, and biological factors to the demand for and use of these new medications for all older adults in the US. The second, implementation stage of our work will analyze existing Medicare claims and Encounter data to understand real world use patterns. We will then use the team’s well-established dynamic microsimulation to estimate the downstream impacts of use on cognitive and physical health, costs, and quality of life of older adults with dementia. The dynamic microsimulation model will be informed by the work conducted in all other parts of the project both in terms of parameter inputs and simulated scenarios.