No safety data were collected.  Study limitations included the unavailability of AD severity information and the AD inclusion criteria, which may have resulted in excluding some AD patients. Finally, while the non-type 2 diabetes cohort was not matched to the type 2 diabetes cohort, the regression model controlled for any differences in various demographic characteristics and comorbidities.

Oral #O3-04-01: Utilization and Expenditures Associated with Long Term Care in Medicaid Alzheimer's Disease Patients Compared to a Matched Non-AD Medicaid Cohort (Mucha L, et al.)

A new, large, multi-state Medicaid claims database study aimed to analyze the differences in long term care (LTC) utilization and expenditures among Medicaid patients with and without AD.  The study compares records of AD Medicaid patients (13,927 AD participants) matched with non-AD Medicaid patients.

Patients with AD aged 50 years and older were retrospectively identified after their first instance of AD-related dementia and a second AD claim or a prescription for an AD treatment.  In this study, LTC was defined as non-home chronic care including, nursing homes and skilled nursing facilities, among others. Resource utilization and reimbursement amounts for LTC occurring in the first year were measured.

In this study, AD patients were more likely to have an LTC claim; higher total expenditures; and a higher percent of their expenditures represented by LTC claims.  This study also showed that LTC expenditures for AD patients were 61 percent higher than those of the matched cohort.  This study highlights the importance of institutional care costs for AD patients to the Medicaid programs, as well as the potential value of any therapies that might help delay or avoid need for institutionalization.  A limitation of this research is that claims data are collected for payment and not for research; and thus are subject to possible coding errors.  However, the impact of potential coding errors was minimized because patients were required to have two or more diagnosis codes for AD on separate service dates or an AD diagnosis code in conjunction with at least one claim for medication used to treat AD.

Poster #P3-014: Quantifying Caregiver Out-Of-Pocket Expenses and Time Spent Caregiving (Racketa J, et al.)

Since caregiver out of pocket expenditures (OOPE) have not been well documented, this comprehensive Internet-based survey aimed to estimate the cost per AD patient within the community-dwelling (CD) and long-term care (LTC) setting by evaluating caregiver time and OOPE.  Data from 987 caregivers were included in this analysis, of which, 901 provided care for CD patients and 86 provided care for patients in LTC.

Caregivers were asked to report their monthly AD-related OOPE as well as hours spent providing care each week.  OOPE included AD patient medical costs; supportive services such as day care, transportation, and home health aids; caregiving support services; nursing home care; home modifications; and legal fees.

This study highlights that the financial burden placed on U.S. caregivers of AD patients is significant in both CD and LTC; however, in this study, the average monthly OOPE for caregivers is higher for LTC vs. CD setting at $1,039 ($202 SE) and $374 ($53 SE), respectively.  This study also found that caregivers spent an average of 68.2 (1.8 SE) hours per week providing care to CD patients compared to 24.8 (3.4 SE) for LTC patients.  As AD progresses and requires LTC, considerable costs are passed on to the caregiver.  Study limitations included the fact that OOPE were self-reported by caregivers.  In addition, patient OOPE were estimated by the caregiver, but not reported in this study.

SOURCE Pfizer Inc.