Estimates of current capacity for diagnosing and implementation of new treatment Alzheimer’s disease in Slovenia

Županič, Eva (author), Stegnar, Gašper (author), Rakuša, Martin (author), Rus Prelog, Polona (author), Švab, Igor (author), Gregorič Kramberger, Milica (author)

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.

• Language: English
• Keywords: Alzheimer’s disease, dementia, disease-modifying treatment, healthcare organization, mild cognitive impairment
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2026
• Number of pages: 9 str.
• Numbering: Vol. 10
• PID: 20.500.12556/RUL-181337
• UDC: 616.894
• ISSN on article: 2542-4823
• DOI: 10.1177/25424823261424524
• COBISS.SI-ID: 273270275
• Publication date in RUL: 02.04.2026

Record is a part of a journal

• Title: Journal of Alzheimer's disease reports
• Publisher: Sage
• ISSN: 2542-4823
• COBISS.SI-ID: 175494659

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• Link: http://creativecommons.org/licenses/by-nc/4.0/
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