TRANSPERS researchers publish JAMA paper on payer coverage considerations for new Alzheimer’s disease tests

In a paper published today in JAMA, researchers at UCSF TRANSPERS address considerations of payer coverage for an emerging technology: new blood tests for Alzheimer’s disease that could help diagnose the condition earlier and more easily. As noted in a recent highly publicized study, these tests are promising, but insurers do not currently cover them, and thus, patients may have to pay over $1000 out-of-pocket.

TRANSPERS researchers Patricia Deverka, Grace Lin, and Kathryn Phillips assessed the critical considerations for payer coverage for these blood tests. There needs to be proof not only that the test results are indicative of brain changes associated with Alzheimer’s, but also that using them improves medical decision-making. Both primary care providers and dementia specialists will need clear guidelines on when to use these tests and how to interpret the results.

Current ways to diagnose Alzheimer’s, like brain scans and spinal fluid tests, can be expensive or uncomfortable. These new blood tests could make diagnosis simpler, especially since most people don't have easy access to specialists such as neurologists. This is an important consideration since historically, there has been widespread under and misdiagnosis of the condition, particularly among racial and ethnic minorities.

Earlier diagnosis is also critical to determine whether patients are candidates for recently approved disease-modifying therapies, which are indicated for patients with mild Alzheimer’s. If blood tests are shown to have clinical utility, payer coverage will be crucial in ensuring equitable access and improving disparities in Alzheimer’s diagnosis and care, especially for underserved populations.

TRANSPERS is in the Department of Clinical Pharmacy at UCSF and is affiliated with the Philip R. Lee Institute for Health Policy Studies.