Revolutionizing disease management for Alzheimer's through digital

Executive Summary

In 2020, Alzheimer's disease patients in the United States numbered 5.8 million and rising. Experts expect the number of cases to triple by 2060, leading to 14 million Americans living with this disease. While Alzheimer's disease impacts the lives of patients and their loved ones in numerous ways, it's also the sixth most common cause of death for American adults, and the fifth most common for adults 65 and over in the United States.¹

This disease places a heavy physical and emotional burden on patients, but it also wreaks havoc on caregivers and families attempting to pay for treatments. And the growing shortage of geriatric care providers exacerbates these challenges.

The financial burden is also large. The projected cost of treating Alzheimer's in 2022 was $321 billion, and it's only getting more expensive.² Estimates put the annual cost of treating the disease somewhere between $379 billion to over $500 billion by 2040.³ This year, the average annual cost of healthcare treatment for a Medicare beneficiary age 65 or older with dementia—including Alzheimer's patients—was estimated to be $41,757.⁴

The many challenges Alzheimer’s poses for patients, caregivers and providers also create opportunities for biopharma companies to support everyone involved in the treatment journey with digital disease management solutions. When we conducted a survey of digital health leaders with HealthXL, we found that 61% of respondents believe disease management is the most promising use case in Software as a Medical Device (SaMD) right now. Our market analysis also found that neuroscience is a top-five therapy area for SaMD activity.

By exploring the challenges and opportunities in this white paper, innovators can discover ways to improve Alzheimer's care with apps, interfaces and portals.

White paper Sa MD most promising use cases in Sa MD resource version v24

Digital enables more engaging patient experiences by increasing therapy compliance, improving disease and medical tracking and, as importantly, building connections among patients and with healthcare providers. The data collected with digital can be used to deliver more personalized therapies."

– Brad Gescheider, former Global Head, Digital Innovation and Patient Services, Immunology at Sanofi, Chief Commercial Officer, Woebot Health

1  Centers for Disease Control and Prevention. Alzheimer’s Disease and Related Dementias. Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion. Last reviewed October 26, 2020.
2  Alzheimer’s Association. 2022 Alzheimer’s Disease Facts and Figures. 2022.
3  Centers for Disease Control and Prevention. Alzheimer’s Disease and Related Dementias. Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion. Last reviewed October 26, 2020.
4  Alzheimer’s Association. 2022 Alzheimer’s Disease Facts and Figures. 2022.

Challenges in treating Alzheimer's disease

The key challenges in the successful management of Alzheimer's disease lie in the difficulties with adherence and persistence over time. As the disease progresses and the patient's symptoms worsen, responsibility for care shifts from the patient to their caregiver. The nature of this disease means that caregiver and patient challenges are inextricably linked, and both demographics need support as they track symptoms. Early detection is key, and care teams need to collaborate in order to treat the patient effectively.

The most important challenges in the Alzheimer's disease sphere can be broken down into three categories:

Patient challenges: As a patient’s Alzheimer's disease progresses, their ability to keep track of their own treatment diminishes. It becomes increasingly difficult for them to manage their medications over time, and they need a competent caregiver to take over treatment management.

The steep decline can be extremely upsetting for the patient, so they depend on their caregiver to provide emotional support as well as logistical support. It's difficult for the patient to adjust to the lifestyle changes that come with this disease.⁵

Caregiver challenges: It's exceptionally difficult—both emotionally and financially—to provide support for an advanced dementia patient, especially when the caregiver is also juggling end-of-life planning for the patient.⁶ Two of the top five biggest caregiver challenges are managing daily activities and coping with the emotional toll of their role. Caregiver depression impacts the ability to effectively care for the Alzheimer's patient.⁷

Provider challenges: Providers often dismiss Alzheimer's disease symptoms, especially early symptoms, as normal parts of the aging process. This makes it difficult for patients to get an early diagnosis and quick intervention.⁸ In fact, 39% of Primary Care Providers (PCPs) are uncomfortable making an Alzheimer's diagnosis.⁹

Many Alzheimer's patients are elderly, which means they are likely to have other health struggles as well. Once a patient is diagnosed with Alzheimer's disease, providers may struggle to balance treatments for Alzheimer's with treatments for the patient's other chronic conditions.

Meanwhile, innovative drugs for treating Alzheimer's disease are expensive, and biopharma companies need to capture real-world data (RWD) in order to make a case for reimbursement. Just because the provider identifies a treatment that will help their patient, that doesn't mean the patient can necessarily afford it.

5  National Institute on Aging. End-of-Life Care for People With Dementia. Last reviewed January 31, 2022.
6  National Institute on Aging. End-of-Life Care for People With Dementia. Last reviewed January 31, 2022.
7  Huang SS. Depression among caregivers of patients with dementia: Associative factors and management approaches. World Journal of Psychiatry. January 19, 2022.
8  Porsteinsson AP, Isaakson RS, Knox S, et al. Diagnosis of Early Alzheimer’s Disease: Clinical Practice in 2021. The Journal of Prevention of Alzheimer's Disease. June 9, 2021.
9  Identify Alzheimer's Disease Earlier. Evolving Alzheimer's Disease Care. Accessed Nov. 10. 2022.

Opportunities for digital in management of Alzheimer's disease

Disease modifying therapies (DMTs) can provide a ray of hope for patients and their caregivers. These therapies interfere with the process that causes cell death in Alzheimer's disease patients, thereby slowing the progression of the disease.¹⁰ Managing these therapies can be difficult, and biopharma companies hoping to ease this burden can support patients and their care teams by developing digital solutions.

An integrated disease management solution can address key pain points for patients, caregivers and providers alike in several ways:

Increase patient and caregiver engagement
Before a patient's Alzheimer's disease progresses too far, it's helpful for the patient to have an active role in managing their illness. Patient applications offer disease and treatment education to keep the patient informed and engaged. These apps may also include quality-of-life questionnaires, empowering the patient to share vital information with their providers.

A patient with Alzheimer's disease is likely managing multiple Alzheimer's treatments, as well as treatments for other diseases that are common among the elderly. A patient app can support infusion treatments with checklists, tracking and reminders for appointments and pre-infusion requirements. Connected devices can be utilized to track gait, heart rate and sleeping patterns, which may be analyzed by AI to track disease progression. Automated pill dispensers can provide a visual or audible cue when it’s time for medication and then dispense and record the correct dose.

Since Alzheimer's patients often become unable to keep track of their own treatments and progress, that responsibility falls to caregivers. A digital portal can make all the difference to an overwhelmed caregiver, empowering them to journal about the patient's symptoms and any side effects they're experiencing. The portal can also provide disease and treatment education, as well as checklists and tools to support treatments and ease patient anxiety and agitation. Caregivers can also access integrated emotional support services through the portal and communicate directly with the patient's providers, as well as manage patient data.

I do think that there is a tremendous opportunity for digital in neurology. SaMD can help measure cognition levels. It is such a cool ability to be able to run through a series of tests very quickly, within ten minutes, and get to a point where you can measure cognition level, so that you might identify someone suffering from a dementia state."

– Executive insight from market research

Improve provider tools and communication
Providers often struggle to get a full picture of an Alzheimer’s patient’s symptoms, reaction to treatments and quality of life when they depend on the patient and their caregiver to share this information during visits.

Digital tools can enable clinicians to have data-driven discussions with their patients about disease progression and treatment options can empower patients to make the right treatment decisions for their unique situations.

Secure, compliant communication tools can connect providers to both patients and other care team members, improving collaboration and streamlining care decisions. Well-designed digital health solutions can enable patient outreach, educational opportunities, telehealth, mental health support, remote patient monitoring and more. Care teams can improve adherence with integrated prior authorizations and automated smart reporting on missed doses. And algorithms hosted on a digital solution can enhance clinical decision support.
Generate invaluable Real-World Data
Biopharma increasingly relies on insights from real-world data (RWD) to optimize both R&D and commercialization. RWD can inform clinical development strategies, improve access and enable outcomes-based contracts with payers, enhance sales and marketing strategies, and substantiate the value proposition of your therapy.

But it can be challenging and expensive to acquire high-quality, longitudinal RWD. Common data sources, like claims data, often lack the level of detail needed for clinical and commercial use cases. When useful data sets do exist, they can often cost upwards of $1M per year. The best digital health solutions in disease management generate and utilize a wealth of data at both the individual patient and population levels.

10 Cummings J, Fox N. Defining Disease Modifying Therapy for Alzheimer's Disease. The Journal of Prevention of Alzheimer's Disease. April 25, 2017.

BrightInsight’s digital Disease Management Solution

In order to ease these disease management challenges and take advantage of the wide range of opportunities in treatment of Alzheimer's disease, it’s important to take a strategic approach. Here are some benefits our Disease Management Solution can deliver:

Configurable, flexible functionality

Applications that are configurable to meet your unique needs are core to both accelerating speed-to-market and expanding your product portfolio over time. Ensure that your platform of choice supports:

Connected devices
Custom clinical surveys to capture electronic Patient Reported Outcomes (ePRO) and Quality of Life (QoL) tracking
Configurable notifications, reminders and alerts to prompt health interventions
Configurable care plans and educational resources to personalize the patient experience
Configurable user and administration controls and alerts to meet data privacy requirements
Robust clinician interfaces that integrate with the EHR

It’s also important to build on a platform that’s compliant with even the most highly regulated digital health SaMD classifications. This allows you to maintain compliance across geographies and over time, even as the product scales and evolves.

CLINICAL ASSESSMENTS

The Patient App records and confirms the date and time of clinical assessments and tracks the severity of symptoms on an ongoing basis. The app also captures the impact of the patient's symptoms on the caregiver’s level of distress.

This is great—when thinking of features, you have to think of the benefits. And in pharma you don’t have just one audience, you have the patient, the healthcare provider and pharma. Each has their own needs, and what you've outlined in these features addresses the needs of all three of those groups."

– Associate Head of Medicine, Head of Global Scientific Affairs, top 10 biopharma company

HEALTHCARE PROVIDER INTERFACES

Our Healthcare Provider Interfaces enable clinicians to see trend data directly within their EHR workflow to track how patients are responding to therapy and where any changes to the care plan may be needed.

Comprehensive, patient-centered tools

A patient app with tools that support patients throughout their disease management journey is a key differentiator. A great patient app solution helps patients recognize the impact of their actions through features like symptom tracking, patient-care team communication, automated medication and refill reminders, and integration with connected devices.

DAILY SYMPTOM LOG

Patients and their caregivers can track the frequency of symptoms they are experiencing with tools like daily symptom logs and quality of life surveys to help track the impact on daily living.

The best patient tools include personalized drug dosing algorithms to drive adherence and persistence, plus personalized education tools designed to empower patients and their caregivers.

MEDICATION AND APPOINTMENT REMINDERS

The BrightInsight Disease Management Solution imports a patient's Alzheimer's disease prescription directly from the EHR into their Patient App and medication reminders can be configured to support treatment persistence and adherence.

A real-world data engine with actionable insights

The most powerful digital health solutions allow for the secure, compliant capture and use of patient- and population-level data. On an individual level, analytics dashboards with usage and usability metrics, combined with algorithm hosting, aid clinical decision-making, increasing patient and caregiver adoption and engagement. On a broader level, data powers reimbursement management tools, demonstrating therapy value to payers and increasing therapy access.

ANALYTICS DASHBOARDS

Commercial and brand leaders leverage our Analytics Dashboards to harness unique data to drive product strategy and marketing tactics.

Deliver better disease management with BrightInsight

Go with the proven partner that top biopharma companies trust. When you team up with BrightInsight, you can accelerate time to market while future-proofing your disease management solutions for regulatory, security and privacy compliance.

By building their disease management solutions on top of the BrightInsight® Platform, top biopharma and medtech companies can address patient and provider pain points in treating Alzheimer's disease, and unlock a better path to adherence and persistence across a wide range of treatments. By enhancing the patient and caregiver experience, these companies can improve patient outcomes.

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The BrightInsight Disease Management Solution (DMS) is not a cleared or approved medical device. The use cases presented within this article are hypothetical use cases and do not make reference to a specific product, product claims or product branding.

Exploring challenges and opportunities

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