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Alzheimer’s Disease: a new concern for plan sponsors?

By: Benefits by Design | Tuesday June 10, 2025

Updated : Tuesday June 3, 2025

Older man with grey hair holding his head, with a man using a walker on the left and three men on the right, one in a wheelchair.

Today, over 750,000 Canadians are living with Alzheimer’s Disease (AD). That number continues to grow as awareness and early detection improve. Alzheimer’s is a progressive condition that affects memory and thinking. Advances in research, diagnosis, and treatment offer more support than ever to individuals and families.

In this blog we will explore the stages of AD. We’ll look at recent trends in medication claims. Finally, we’ll examine what these changes mean for employers and benefit plan sponsors. With the right planning and care, there is hope for a better quality of life through every stage.

What is Alzheimer’s Disease?

Alzheimer’s disease is a chronic neurodegenerative disease that destroys brain cells, causing thinking ability and memory to decline over time. It is a fatal disease that eventually affects all aspects of a person’s life, how they think, feel and act. Alzheimer’s disease (AD) progresses through stages that indicate the severity of each situation. The four stages are:

Early stage – symptoms are mild. At this stage, individuals know they have AD and need only minimal help when they ask for it.

Middle stage – The symptoms will become more noticeable; they will begin to need more assistance to accomplish daily tasks.

Late stage – When they reach this stage, they will eventually become unable to communicate or look after themselves.

End of life – Their cognitive decline has progressed to the point where they will need 24-hour care.

Shifts in drug claiming trends

Since 2019 there has been a back-and-forth fluctuation of patients and claims for the use of Alzheimer’s disease (AD) medications. In 2019 there were just over 400 patients, and the claims were around $150,000. Then in 2020 the patients increased to just under 800 while the claims amount rose only slightly, to $156,000, suggesting an increase in AD diagnoses, and a decrease in the cost of medication. There was a slight decrease in the claims amount in 2021 as more people took advantage of the decreased price tag. The number of patients has steadily been increasing and has more than doubled since 2019. The claim’s paid amount has remained steady, hovering between $150,000-$156,000.

Rising number of claimants

The number of individuals who are being diagnosed with Alzheimer’s disease (AD), including early onset cases (more on that below) is steadily increasing due to several factors.

There have been advances in diagnostic testing which now allow for earlier, more accurate and less invasive detection of AD. This has led to the identification of more cases than ever before.

Another cause is the aging baby boomer generation, which continues to reach and surpass retirement age, naturally contributing to a higher volume of diagnoses.

Additionally, early onset AD, once considered rare, is now recognized and diagnosed more frequently, further increasing the number of claimants.

These trends suggest a growing impact on healthcare systems and insurance providers because more individuals are seeking support and treatments earlier in the disease progression.

Early onset Alzheimer’s Disease

Early onset Alzheimer’s disease, diagnosed before the age of 65, is becoming a critical concern for employers and benefits providers. There is approximately 16,000 Canadians under the age of 65 living with AD. Historically, healthcare providers typically diagnosed AD in older adults who had already exited the workforce, which resulted in minimal impact on employee benefit plans

However, earlier detection and a rise in diagnoses among younger individuals are changing this trend. The introduction of costly new medications designed to slow disease progression means that benefits plans may soon face significant financial strain. Employers must now consider how to adapt their coverage and support systems to accommodate this changing landscape, where working age individuals may now require long-term, high-cost AD care.

Why has early-onset Alzheimer’s been increasing?

Impact of new preventative care medications on plan sponsors

There have been recent breakthroughs in AD treatment which are reshaping the conversation around disease management and benefits planning. Pharmaceutical companies are developing new medications to delay the onset of symptoms, offering hope for improved quality of life and prolonged independence for patients.

However, these treatments often come with high price tags which can pose a challenge for plan sponsors. As more individuals receive earlier diagnoses and begin treatment while still covered under employer-sponsored plans, these plans face a growing financial burden.

Plan sponsors will need to proactively assess their coverage strategies and consider how to balance the innovative therapies with long-term sustainability.

Report: New drugs and their impact on employee benefit plans

Conclusion

As AD continues to affect a growing number of Canadians, our healthcare systems, insurance providers, and employers must adapt to meet the rising demand for support and treatment. New high-cost medications and earlier diagnosis are changing the landscape of benefits planning, requiring proactive strategies to ensure sustainability and quality of care. By understanding the trends and preparing for the future, you can better support those living with AD and the people who care for them.