Alzheimer’s: the new plan seeks stable funding in the budget

Strengthening early intervention and support for patients and their families, relying on secure funding to move beyond a system of ad-hoc funding: the new National Dementia Plan 2027–2031, presented yesterday in Rome by the Minister for Health, Orazio Schillaci, on World Alzheimer’s Day, aims to mark a turning point in the face of the growing crisis affecting over 6 million people in Italia – 10 per cent of the population, including patients and carers. ‘We are working on a funding proposal for the forthcoming Budget Bill, to strengthen public health responses focused on prevention, diagnosis, treatment and support for people with dementia and their families,’ announced Schillaci. Negotiations with the Ministry of Economy and Finance (MEF) are ongoing, but the aim is to secure funding for the Plan in the forthcoming budget – to be drawn from the National Health Fund, for which the Ministry of Health has requested an additional 5 billion this year – amounting to 500 million over three years: 100 million in 2027, 150 million in 2028 and 250 million in 2029, whilst from 2030 the aim is to secure 80 million per year. Schillaci pointed out that the Alzheimer’s Fund had already been ‘renewed and increased by nearly 35 million for the period 2024–2026’. However, given that costs currently stand at 23.5 billion a year – 63 per cent of which is borne by families – experts and associations, who, together with the regions and the National Institute of Health, formed the Ministry’s Dementia Working Group from which the Plan emerged, are calling for guarantees. First and foremost, they are seeking assurances regarding the possibility of implementing the new strategy nationwide, ‘to be submitted to the Unified Conference by October’, Schillaci noted. The plan is aimed at at least 1.2 million people with dementia, of whom around 600,000 have Alzheimer’s and 900,000 have mild neurocognitive disorder; as the population ages, this figure is set to rise to 2.2 million by 2050.

Meanwhile, the Plan – which will require strengthening the ‘staffing’ section – regards dementia as a ‘public health priority’, and therefore one to be incorporated into all the regions’ health and social care policies. And ‘it incorporates the seven areas of action from the World Health Organisation’s global strategy, structuring them around prevention, diagnosis and treatment, inclusion, support for carers, information systems and research’, noted Rocco Bellantone, President of the Higher Institute of Health (ISS). Key priorities include reducing the risk of developing the condition – almost 40 per cent of cases in Italia today are attributable to eleven modifiable risk factors – combating stigma and promoting ‘Dementia-Friendly Communities’. Furthermore: the strengthening of specialist centres (CDCDs) across the country, dedicated care pathways for patients (two in three still lacked these in 2023) and training for carers. But also a centralised register of research projects, for which funding will be increased and stabilised. A rigorous monitoring system will then be put in place: “We want to know not only how much is being done, but whether the quality of care and people’s quality of life are actually improving,” Schillaci clarified.

Not only that: for the first time in Italy, there is an estimate of the costs and potential savings expected from the full implementation of the new strategy. “For a truly effective plan, at least 2 billion would be needed,” explained Teresa Di Fiandra, ISS adviser to the Alzheimer’s and Dementia Fund. However, she added, “with a reduction in cases of dementia, institutionalisations and the use of antipsychotics, savings of over 1.2 billion could be achieved for the National Health Service and 664 million 500 thousand euros for families”.

These are figures that patient organisations are watching closely; their primary demand is for funding to be stabilised: ‘The time-limited funding used so far is unable to meet an ongoing need, because those receiving a diagnosis today will require services for the next ten or fifteen years, and certainly not just for the 36 months that a project lasts,’ warn Katia Pinto, president of Alzheimer Italia, and Mario Possenti, the organisation’s secretary-general. Patrizia Spadin, President of the Italian Alzheimer’s Association (Aima), is also partly critical of the Plan’s overall structure: “It neither reorganises nor innovates, and above all, it overlooks the issue of new treatments, on which a large part of patients’ expectations are focused. As if this were not what we are all waiting for – the one huge innovation that will change the future for patients and the system itself.” There are currently 158 drugs under evaluation in over 192 clinical trials worldwide, eight of which are in ‘Phase III’ and set to reach the finish line in 2026.