Prudent calls for cuts in federal spending make no sense when they extend into the work of medical research that will reduce the personal and financial burden of disease. Yet, fiscal conservatives are calling for a reduction of $1 billion dollars or more in this year’s proposed National Institutes of Health budget.
As the director of Emory University’s Alzheimer’s Disease Research Center, which relies heavily on NIH funding, I certainly have a personal bias toward more research into earlier diagnosis, earlier treatment, and eventually prevention or cure. But, to enlighten our representatives in Washington, let me make the clear economic argument for more research dollars, an investment I believe will save taxpayers billions of dollars in the long run.
The cost of caring for patients with Alzheimer’s Disease already exceeds $200 billion per year, making it among the most costly diseases. Medicare spends three times as much on people with AD when compared with other Medicare recipients. Medicaid spends nine times more on the average AD patient. Unlike treating a heart attack or cancer with an operation or chemotherapy, Alzheimer’s requires increasingly costly care for the rest of a patient’s life.
Inflation is driving these costs higher each year and, as our baby boomers age, the number of Alzheimer’s cases is rapidly increasing. Today, there are more than five million people in the United States with the disease: 1 in 8 older 65, and nearly 1 in 2 older than 85. Without a major medical breakthrough, by the year 2030 there will be an estimated 7.7 million Americans with Alzheimer’s. The cost of caring for them will be climbing toward a trillion dollars per year, enough to bankrupt Medicare. It only makes sense to attack the problem with more research.
Yet, this year the federal government (through the NIH) plans to invest a mere $450 million to fight AD, well below the $645 million allocation in 2007. Compare these dollar figures to $6 billion for cancer, $4 billion for heart and $3 billion for HIV/AIDS research.
It seems like a “no-brainer” to make a similar priority investment in Alzheimer’s disease research now.
Is there hope in our research? Yes. At Emory, we are breaking new ground with tests to detect the earliest signs of Alzheimer’s, called mild cognitive impairment, five to 10 years before the onset of major symptoms. We are already working with some of these early stage patients to rehabilitate their memory. Among our current promising clinical trials is one in which genetic material is injected into the brain to slow the course of the disease, and another that is working toward an Alzheimer’s vaccine.
These efforts require enormous investments in scientific manpower and hi-tech equipment. But, in recent years, only 3 percent of the most worthy projects in Alzheimer’s research have received federal funding, sadly leaving 97 percent of the medical community’s promising ideas unfunded.
This isn’t some else’s problem. In Georgia, there are an estimated 200,000 people suffering from Alzheimer’s and many more on the verge of getting it. And locally, there is an added disheartening circumstance. Studies suggest that our significant African-American population is twice as likely to be struck by Alzheimer’s as the rest of the population, in part because cardiovascular disease, hypertension and diabetes, which are unusually prevalent among African-Americans, are major risk factors for AD.
Unfortunately, federal funding of NIH and specifically Alzheimer’s research is considered “discretionary spending,” which is the current focus of all Congressional budget cutting.
But common sense dictates the investment in AD research should be increased significantly. Even before we achieve a possible prevention or cure, by merely learning how to delay the onset of the disease by five years, for example, federal spending on care could be cut by almost half. Given these facts, it simply doesn’t make sense to continue on our current path, spending only one penny on research for every $400 spent on caring for patients with severe dementia.
Dr. Allan Levey is chairman of Emory University’s Department of Neurology and director of Emory’s Alzheimer’s Disease Research Center.
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