20.500.12556/RUL-181337 Estimates of current capacity for diagnosing and implementation of new treatment Alzheimer’s disease in Slovenia Background: The limited efficacy of current symptomatic treatments for Alzheimer’s disease (AD) leads many patientsto forgo medical help. However, new disease-modifying treatments (DMTs), such as donanemab and lecanemab, showpotential to change this. Objective: To model the impact of these treatments on Slovenia’s healthcare system by analyzing patient flow underboth current and enhanced capacities, assuming DMT availability. Methods: The study estimates 76,923 potential DMT candidates aged 65 years and older with mild cognitive impairmentor mild AD. Using data from Slovenia’s three specialized centers for cognitive disorders, a Markov model simulated fivefive-year scenarios: baseline, real-life, real-life with capacity enhancement, biomarker integration, and biomarker integra-tion with capacity enhancement. Results: Waiting times for specialist evaluation would increase from the current 3–12 months to 1.8 years. The primarybottleneck is lumbar puncture with cerebrospinal fluid (CSF) analysis, during which 64% of patients would become ineli-gible for DMT. The shortest waiting time to receive DMT occurs in the biomarker integration with capacity enhancementscenario, at 4 years, reducing ineligibility to 7%. Conclusions: Current specialized outpatient facilities are limited, causing significant bottlenecks, especially in CSF ana-lysis. Severe waiting times under current capacities mean many patients would progress to moderate or severe dementiaor die before receiving treatment. Plasma biomarkers offer a promising triage approach to guide patients toward lumbarpuncture or other confirmatory diagnostics, potentially easing this critical bottleneck. Substantial infrastructure and work-force improvements are essential to ensure timely and equitable access to DMTs in Slovenia. Alzheimer’s disease dementia disease-modifying treatment healthcare organization mild cognitive impairment true false true Angleški jezik Ni določen Članek v reviji 2026-04-02 04:53:28 2026-04-02 08:31:15 2026-07-15 07:59:13 0000-00-00 00:00:00 2026 0 0 9 str. Vol. 10 Mar. 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.894 2542-4823 10.1177/25424823261424524 273270275 RAZ_Zupanic_Eva_2026.pdf RAZ_Zupanic_Eva_2026.pdf 1 31EF49DAA9B56AACC6BDFDA6551D1A6F 0b398ff3b74d7a16359b752d3b5fc5342f37682cc9fe5f981cbc16cc686cd94a 296a3af7-2e5e-11f1-b0ab-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=231724 https://journals.sagepub.com/doi/epdf/10.1177/25424823261424524 1 f71ce338-2e3e-11f1-b0ab-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=231713 Medicinska fakulteta 0 0 0