With the historic Food and Drug Administration (FDA) approval of treatments that slow the progression of Alzheimer’s in the early stages, the early detection and diagnosis of the disease is even more critical to ensure individuals receive the most benefit at the earliest point possible. An early and accurate diagnosis of Alzheimer’s or other dementia can also improve access to care and support services, enhance quality of life and reduce financial impact. But as many as half of the six million Americans living with Alzheimer’s today are not formally diagnosed. 

Current diagnosis of Alzheimer's relies largely on documenting cognitive decline, at which point Alzheimer’s has already caused significant brain damage. To address the gap in diagnosis, AIM and the Alzheimer’s Association are working with policymakers across the country, and progress is being made to advance state legislation that will ensure insurance coverage of biomarker tests.

Biological markers, more commonly known as “biomarkers,” offer one of the most promising paths to improve dementia detection, diagnosis and treatment. Methods for detecting biomarkers can include conducting imaging scans or collecting samples of bodily fluids like blood, saliva, or cerebrospinal fluid.

Currently, there are some FDA-approved biomarker tools, such as brain imaging, that can be used to help diagnose people with dementia symptoms. Other emerging biomarkers are promising but still under investigation, such as blood tests and genetic risk profiling. But continued progress around blood-based amyloid biomarkers is likely to lead to new diagnostic tools coming to market within the next couple of years.

However, insurance coverage for biomarker testing is failing to keep pace with these innovations and advancements in treatment. And existing health care disparities and challenges to obtaining a dementia diagnosis may be exacerbated if new biomarker testing opportunities cannot be accessed.

That’s why in October 2023, the Alzheimer’s Association joined a national state legislative coalition of patient advocates committed to ensuring insurance coverage for comprehensive biomarker testing. National coalition members include ACS-CAN, ALS Association and the Arthritis Foundation, among other organizations. 

As of January 2024, 14 states have enacted comprehensive legislation — Arizona, Arkansas (private pay only), California, Georgia, Illinois, Kentucky, Louisiana, Maryland, Minnesota, New Mexico, New York, Oklahoma, Rhode Island and Texas. 

By passing legislation to require appropriate coverage for biomarker testing, states can reduce the time it takes to receive a diagnosis and enable access to new disease-modifying treatments and care planning. Without this legislation, dementia diagnoses may take up to two years, increasing the long-term costs to the individual, family and the state. The Alzheimer’s Association is calling on state lawmakers in Colorado, Connecticut, Florida, Indiana, Iowa, Maine, Massachusetts, New Jersey, Ohio, Pennsylvania and West Virginia to take action. 

Learn more about AIM’s policy priorities in your state and how you can get involved in state advocacy.