Eli Lilly, neurologist urge Michigan action on Alzheimer’s diagnosis, blood biomarker coverage and education

Laura Cohen, a vice president with Eli Lilly and Company, and Dr. Kara Leahy, director of cognitive disorders at Memorial Healthcare in Owosso, presented to the House Health Policy Committee on Alzheimer’s disease diagnostics, new treatments and state policy options to expand timely care.

Cohen framed the changes in the field: current U.S. estimates put about 6.7 million people living with Alzheimer’s disease, she said, and that number is expected to rise to about 14 million by 2050. Cohen also cited state figures, saying roughly 200,000 Michiganders are living with Alzheimer’s and that direct care costs for the state total about $1.7 billion annually; unpaid family caregiving contributes at least another $17 billion a year in lost labor and informal care, she said.

Dr. Leahy told committee members that clinical practice has shifted markedly in the past three years: “We went from a disease that is a terminal illness with little to no treatments, to now, an illness that can be diagnosed with good diagnostic tests that test the biology of the disease,” she said. She described long wait times for specialty evaluation, examples of patients who missed treatment windows because diagnosis occurred late, and the difficulty of access in rural areas. “An early diagnosis means better outcomes for patients, just like a cancer diagnosis now,” she said.

Diagnostic advances discussed included amyloid PET imaging, cerebrospinal fluid testing and the growing availability of blood‑based biomarkers that can screen for Alzheimer’s pathology. Dr. Leahy said she uses a blood biomarker in her clinic as a screening tool; she noted the test can be confirmed with an amyloid PET scan if positive. She said the laboratory test list price can be about $1,400 but that many patients qualify for company financial assistance and often pay $50–$100 out of pocket.

Speakers and committee members discussed coverage differences between Medicare and commercial insurance. Cohen and Dr. Leahy said the Centers for Medicare & Medicaid Services covers certain diagnostic tests and the new therapeutic options for Medicare beneficiaries, but commercial coverage is inconsistent. Cohen cited an introduced state bill, House Bill 5970, that would require certain commercial plans to cover blood biomarker testing for diagnostic use and noted that about 20 states have enacted similar coverage measures.

Policy recommendations presented to the committee included: - Investing in public health education to reduce stigma, encourage early conversations about memory loss and direct people to primary care and diagnostic pathways; - Updating the state Alzheimer’s plan regularly to keep pace with rapidly evolving diagnostics and treatments; - Considering coverage of blood biomarker tests and greater alignment in commercial‑insurance coverage with Medicare; and - Supporting designated treatment centers of excellence, modeled on programs in other states, to build capacity for diagnosis and treatment.

Committee members asked about prevention and modifiable risk factors. Dr. Leahy said the largest modifiable risk factor is diabetes and encouraged public health messaging that “what’s good for your heart is good for your head,” citing blood pressure control, cholesterol, smoking cessation and diet as areas to target. She also described genetic testing use (ApoE) to help assess treatment risk–benefit and to identify patients who may need closer attention.

Committee members asked about early‑onset cases, costs, test availability and the role of nutrition and poverty in disease risk. Dr. Leahy recommended greater public awareness, earlier screening in primary care and expanded access to diagnostics and specialists across the state. Cohen and Dr. Leahy said they are available for follow‑up and encouraged the committee to consider legislation and public‑health investments to improve early diagnosis and treatment access.