Epidemiology and economic burden of Lewy body dementia in the United States

Abstract

Objective

To describe the trends in epidemiology, healthcare resource use (HCRU), and costs associated with Lewy body dementia (LBD), dementia with Lewy bodies (DLB), and Parkinson’s disease dementia (PDD) in the United States.

Methods

This retrospective study used administrative claims data for Medicare fee-for-service (2010–2018) and commercially-insured beneficiaries (2010–2017). The annual prevalence and incidence were calculated among the Medicare beneficiaries by dividing the number of prevalent or incident LBD, DLB, and PDD patients by the total eligible population of that calendar year. Baseline patient characteristics, HCRU, and costs over time were described for Medicare and commercially insured patients with continuous health plan enrollment for ≥12 months before and ≥24 months after first cognitive impairment (CI) diagnosis.

Results

From 2010 to 2016, the incidence and prevalence rates of LBD among Medicare beneficiaries ranged from 0.21%–0.18% and 0.90%–0.83%, respectively. Of 9019 Medicare patients with LBD who met other inclusion criteria, 4796 (53.2%) had DLB and 4223 (46.8%) had PDD. The mean age was 78 years and the mean Charlson Comorbidity Index score was 1.6. On average, patients with LBD incurred $18,309 in medical costs during the 1-year pre-diagnosis and $29,174 and $22,814 at years 1 and 5 after diagnosis, respectively. The main cost drivers were inpatient and outpatient visits. Similar trends were observed for DLB and PDD as well as for commercially-insured patients.

Conclusions

Our findings highlight the substantial epidemiological and economic burden across the LBD spectrum and underscore a high unmet need for effective treatments to improve patient outcomes.

Keywords:

• Dementia with Lewy bodies
• epidemiology
• healthcare costs
• healthcare resource use
• Lewy body dementia
• and Parkinson’s disease dementia

Transparency

Declaration of funding

This study was funded by Eli Lilly.

Declaration of financial/other relationships

JC and KB are employees of Eli Lilly and are minor stockholders. UD, NK, MG, and HL are employees of Analysis Group, Inc., which received consulting fees from the study sponsor to conduct this research. HCC and BW were employees of Analysis Group, Inc. at the time this study was conducted. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

JC, KB, UD, NK, and MG contributed to the study design. Formal analyses were conducted by HCC, BW, and HL. All authors contributed to the critical interpretation of data as well as drafting/editing the manuscript, have approved the final version of this manuscript, and take responsibility for the integrity of this research study.

Acknowledgements

Medical writing assistance was provided by Gloria DeWalt, PhD, who was an employee of Analysis Group, Inc. at the time this study was conducted.

Data availability statement

The datasets analyzed during the current study are not publicly available, as they are subject to a data use agreement between Analysis Group, Inc. and the Centers for Medicare & Medicaid Services and OptumHealth.