The net cost of Alzheimer disease and related dementia: A population-basedstudy of Georgia Medicaid recipients

The objective of this study was to estimate the direct medical cost of Alzh eimer disease (AD) and related dementia to the Georgia Medicaid program. A retrospective, cross-sectional, matched control group design was used. AD c ases 50 years of age and older were identified by using International Class ification of Diseases (9th edition, Clinical Modification) diagnosis codes from 1994 Georgia Medicaid administrative claims files. Fur every case, thr ee age- and gender-matched non-AD controls were selected. Differences in av erage recipient Medicaid expenditures between cases and controls were estim ated using weighted least squares regression analysis, adjusting for age, S ender, race, Charlson comorbidity index, Medicare eligibility, and months o f Medicaid eligibility. A total of 8,671 AD cases were identified (prevalen ce, 4.4%). The average adjusted annual Medicaid expenditure per AD recipien t was $14,492 (U.S.), The net (i.e., excess) average annual Medicaid cost p er AD recipient (i.e., the difference in adjusted mean expenditures between cases and controls) was estimated to bt approximately $8,200. Excessive nu rsing home expenditures accounted for most of the additional cost of treati ng dementia (> 85%), although inpatient hospital, physician, outpatient, an d prescription drug expenditures also were higher among patients with AD. B ased on these estimates, Georgia Medicaid is projected to spend almost $70 million annually for AD and related dementia. The excessive cost attributab le to AD poses a significant burden to the Georgia Medicaid program.