Is Korea Prepared for an Alzheimer’s Disease-Modifying Therapy? Assessing the Korean Healthcare System Infrastructure and the Effect of Blood-Based Biomarker Tests

Abstract

Background With the rapid demographic change in Korea, Alzheimer’s disease has become a primary concern. Recent developments in disease-modifying therapies provide hope that therapy may become available soon. The high disease prevalence and complex evaluation process will create challenges for the healthcare system already burdened by the current pandemic. This study examined the preparedness of the South Korean healthcare system to identify and treat patients when such a therapy becomes available. Methods We used a Markov model to simulate a stylized patient’s journey. Based on national data and expert input, we presented projections of the diagnosis and treatment wait times and respective queues of patients under treatment and no-treatment scenarios and further simulated the possible option of adopting a blood-based biomarker test. Results Under the current system, we estimated a peak waiting time of 14 months when a treatment became available, largely because of the limited number of dementia specialists. Adopting a blood-based biomarker test dramatically reduced the initial wait times by more than half. A disease-modifying therapy was estimated to avert 575,000 incident cases in the first 10 years after the treatment entered the market, and a blood-based test further avoided 86,000 additional cases. Conclusion South Korea’s healthcare infrastructure requires more preparation for the introduction of a disease-modifying therapy, with the primary capacity limitation being the low number of dementia specialists. The utilization of a blood-based test for Alzheimer’s disease biomarkers may be an effective solution.

Designing the next-generation clinical care pathway for Alzheimer’s disease

“…With biomarker-guided, pathway-based targeted therapies emerging, modeling studies predict that health care systems in many regions/countries will not be able to meet the demand of patients for diagnosis and treatment of AD [107][108][109][110] . In the United States, ~15 million individuals with MCI would need to be evaluated by specialists, undergo diagnostic testing and pursue treatment 107 .…”

“…Better care models and incentives are needed to increase a PCP's involvement in AD care. For example, cognitive screening is a mandatory requirement of the driver's license renewal process for older people in Japan, while walk-in clinics are available for screening and consultation in memory centers in Korea 110 . The emergence of telecare-enabled specialist support has helped to empower PCP sites in the United States 107 .…”

Pioneering the Early Diagnosis of Alzheimer’s Disease: Aβ Oligomers-Sensing Probe for Cerebrospinal Fluid Analysis in Patients

“…Recently, in vitro diagnostic technologies toward potential biomarkers of AD have been extensively investigated using antibody-based enzyme-linked immunosorbent assay (ELISA) for early diagnosis of AD [18][19][20][21] . Nevertheless, it has disadvantages of ELISA, such as the high-cost loss, complexity, and timeconsuming procedure compared to a small-molecule-based method.…”