Preparedness of China's health care system to provide access to a disease‐modifying Alzheimer's treatment

Abstract

INTRODUCTIONAlthough the majority of patients with Alzheimer's disease (AD) reside in low‐and middle‐income countries, little is known of the infrastructure in these countries for delivering emerging disease‐modifying treatments.METHODSWe analyze the preparedness of China, the world's most populous middle‐income country, using desk research, expert interviews and a simulation model.RESULTSOur findings suggest that China's health care system is ill‐prepared to provide timely access to Alzheimer's treatment. The current pathway, in which patients seek evaluation in hospital‐based memory clinics without a prior assessment in primary care, would overwhelm existing capacity. Even with triage using a brief cognitive assessment and a blood test for the AD pathology, predicted wait times would remain over 2 years for decades, largely due to limited capacity for confirmatory biomarker testing despite adequate specialist capacity.DISCUSSIONClosing this gap will require the introduction of high‐performing blood tests, greater reliance on cerebrospinal fluid (CSF) testing, and expansion of positron emission tomography (PET) capacity.