Economic impacts of introducing diagnostics for mild cognitive impairment Alzheimer's disease patients

Introduction: Disease-modifying treatments for Alzheimer's disease (AD) are likely to be offered only to patients with molecular evidence for Alzheimer pathology and expanded to patients with prodromal AD. We calculated the potential future costs of expanding the number of positron emission tomography (PET) and cerebrospinal fluid (CSF) tests in the United Kingdom. Methods: We conducted a focused literature review and consulted experts to obtain information on the current use of PET and CSF to diagnose prodromal AD, staffing and equipment requirements for these tests, and associated costs. Results: We estimate annual costs of 100,000 extra amyloid PET scans and 100,000 extra CSF tests at £113 million and £48 million, respectively; these costs are likely to be higher in the first year. Discussion: The budgetary impacts are not insignificant but are small in comparison to the likely market price of any disease-modifying treatments or to the probable costs of missed or inaccurate diagnosis.