Dementia is a devastating condition for the people affected, their family and friends, and for health systems. About 5.5% of people aged over 60 had dementia across all OECD countries in 2009, but prevalence rates soar to nearly one every two people aged 90 years and older. This is not a challenge for OECD countries alone. An estimated 58% of the 36 million people living with dementia in 2010 worldwide are from middle and lower-income countries. There is no known cure for dementia, nor effective therapies to slow down its progression. Efforts to develop reliable diagnostic techniques and effective treatments have exposed weaknesses in the way that health systems, researchers and companies interact. There is a need to change the way public and private stakeholders collaborate at national and global levels to address this issue. Furthermore, health and long-term care systems struggle to offer the coordinated response – in terms of information systems, quality protocols and workers’ skills -- needed to deliver high-quality services to this vulnerable population group. Addressing the challenges posed by dementia has now become a major endeavour at international level. A landmark G8 meeting on dementia, held in London in December 2013 concluded with a call for countries to accelerate research and its transformation in innovative care and health services, strengthening big and linked data systems for improving the prevention and treatment of dementia, and reforming health and social care systems to improve quality of life for people with dementia. By Mark Pearson, Deputy Director, Directorate for Employment, Labour and Social Affairs, and Dirk Pilat, Deputy Director, Directorate for Science, Technology and Industry, OECD.

1. ADDRESSING
DEMENTIA: TOWARDS A
NEW INNOVATION
MODEL
Mark Pearson, Deputy Director, ELS
Dirk Pilat, Deputy Director, STI
5 February 2014

2. Main messages
• Dementia, affecting a growing number of
people globally, is untreatable today
• The human and economic costs of dementia
are likely to escalate unless:
– Health and care systems deliver more
prevention, high-quality and integrated services
– Better use is made of data to prevent and treat
dementia
– Incentives for innovation and regulation are
improved

3. THE ‘CHALLENGE’

5. Rising burden
• 5.5% of people aged over 60 had dementia across all
OECD countries in 2009
• Some evidence of stable or declining age-specific
prevalence rates,
• But global numbers (36 million) are predicted to triple by
2050 without a cure
• As common among older people in developing and
emerging economies as it is in developed countries.
• Large economic and social cost for families and friends
(USD 604 billion globally); still a relatively small
expenditure for health systems

6. Broken innovation model
• Late trails that
failed
• Little transfer
of biomedical
innovation to
point of care
• Risks and
rewards for
innovators not
aligned

7. Escalating R&D Cost
Costs of bringing a
successful drug to
market estimated
between
USD 1.3 – 1.7B
2013

8. Inappropriate caring model
•
•
•
Inappropriate use of drugs for behavioural and psychotic symptoms of dementia
Little investment in prevention and healthy lifestyles
Too often dementia patients are hospitalised (45 days ALOS across the OECD)

9. First ever G8 Summit on dementia
mobilised international commitment

10. THE ‘OECD RESPONSE’

11. Healthy Ageing and Dementia
- Key Factors
Source: adapted, OECD/HUGO Workshop on “Integrating Omics and Policy for Grand Challenges: Healthy Ageing”, 13 April 2013, Singapore, presentation from
Richard Johnson (CEO, Global Helix LLC; National Academy of Sciences Board on Life Sciences; Advisory Council, Global Coalition on Ageing, BIAC).
11

12. Delivering better health and care
• Key goal of dementia strategies in many OECD countries
(France, the U.K., Germany, Australia)
• Several initiatives, for example
• Local initiatives on integration of health and social care (e.g., 14
integrated care pilots in the UK )
• Mobilisation of citizens (e.g., UK dementia friends, modelled
upon Japan Dementia Friendly Fujinomiya).
• Data linkages (clinical, records, institutional, biological, etc) to
improve dementia care (e.g., Ontario)
• BUT
– Little scaling up and cross-country learning;
– issues to address eg the balance between data protection and use

13. Encouraging coordinated policies
Governance & Regulation
Research & Innovation
Collaborative Research & Business Models
Uptake and Demand Factors
13

14. Improving the environment for
innovation
Stronger Public Private
Partnerships
Open Science for greater
International Collaboration
Modernising regulatory
pathways
Big Data

15. Harnessing the Potential of Big Data
Kaiser Permanente
Electronic health records
stores 9 million patients 30 petabytes(*) with 2
petabytes added each year
New discovery
programs
New models
of care
European Bioinformatics
Institute is storing 20
petabytes of data
* [1 petabyte = 1 million
gigabytes]
Multidisciplinary
collaborations
Crowd-sourcing

16. For further information
Online:
www.oecd.org/health
www.oecd.org/sti/biotechnology
www.oecd.org/sti/nano
OECD brochure on dementia:
http://www.oecd.org/sti/addressing-dementia-the-oecd-response.pdf
Contact:
health.contact@oecd.org – Mark.pearson@oecd.org
sti.contact@oecd.org – Dirk.pilat@oecd.org