We've never had better tools to reach people with Alzheimer's disease in time for meaningful impact. Yet most people still cannot access a timely and accurate diagnosis earlier in the disease when intervention matters most. With collaboration among industry, health systems, payers, providers, and our government, we can build a system that translates medical innovations into timely, effective support for patients and their families. 

Decades of research from academia, the Alzheimer’s disease community, and the life sciences industry has started to pay off with new Food and Drug Administration (FDA)-cleared diagnostics and FDA-approved disease-modifying treatments. But today, for all the progress made, most people are still diagnosed too late—when they have reached the advanced stages of disease and options for planning, support, and care are limited. More concerning, as approved care options become available for early-stage symptomatic Alzheimer’s disease, there is also evidence that the health system fails to confirm whether dementia cases are caused by Alzheimer's disease. 

Fewer than 1 percent of patients diagnosed with Alzheimer’s disease or a related dementia received amyloid testing, according to a medical claims analysis commissioned by Lilly examining 6.5 million medical claims from 2021 to 2024. These findings, which took place before several Medicare coverage and reimbursement improvements for diagnostics took effect, still underscore just how difficult it can be for patients to navigate the care landscape. 

Strengthening primary care is essential to counter this. People are most likely to start the conversation about memory and thinking concerns there, but 98 percent of primary care physicians don’t conduct a cognitive assessment unless they’re asked. Fortunately, new models of care are emerging to show what’s possible. 

The University of Kansas (KU) Medical Center’s Brain Health Care Accelerator shortens the path from screening to treatment by integrating cutting-edge tools into primary care workflows. The program supports primary care physicians in evaluating dementia and referring patients for further in-depth testing. This model can be used as a guide for other major health systems to implement in their regions, as KU demonstrated during a poster presentation at the Alzheimer’s Association International Conference in Toronto in July. 

Policymakers can build on these efforts by advancing new care models that prioritize early detection and accurate diagnosis. Preserving cognitive function aims to address estimated health and long-term care costs, which will hit $1 trillion by 2050 without action. 

Science is outpacing our health-care system’s ability to deliver for patients.

In September, updates were made to the Clinical Laboratory Fee Schedule to ensure Alzheimer's disease blood biomarker tests are adequately paid starting in 2026. Earlier in the summer, a set of highly anticipated new blood biomarker clinical practice guidelines were issued at the Alzheimer’s Association International Conference. 

The Centers for Medicare and Medicaid Services (CMS) can also do more to unlock access to medicines. Just as CMS enhanced access to diagnosis by removing restrictive coverage requirements for amyloid PET scans, it should take all amyloid-targeting therapies out of its Coverage with Evidence Development program. This delays access to FDA-approved therapies by requiring physicians to register patients in a database to obtain coverage for treatment. This creates delays for patients during a critical period when early intervention can have the greatest impact. In rural and underserved areas, this additional administrative burden can disincentivize physicians from offering approved care. 

As federal policymakers consider ways to better enhance access, state policymakers are taking a leadership role in raising the bar for Alzheimer's disease care access. Illinois became the first state to mandate coverage for both FDA-cleared Alzheimer's disease diagnostics and FDA-approved anti-amyloid therapies. Other states are following its lead, and many are passing bills to provide coverage for blood biomarker tests for symptomatic Alzheimer’s disease. 

Science is outpacing our health-care system’s ability to deliver for patients. Multisectoral collaboration at this juncture can accelerate new models that strengthen primary care and drive early and accurate diagnosis. This will ensure patients benefit from innovation at a time when it can have the greatest impact.