Proactively Harness Innovation and Collaboration to Promote the Prevention and Control of Dementia and Foster a Dementia-friendly Society

Dave A. Ricks

Chair and Chief Executive Officer

Eli Lilly and Company

Executive Summary

Dementia is a progressive neurodegenerative condition with insidious onset, high disability rate and mortality rate. As dementia progresses, the patients may eventually lose their memory, ability of thinking and independence, and consequently, causing huge demand for long-term and intensive healthcare and care services, with tremendous burden on patients, their families, the healthcare system and the society as a whole.

As the population continues to age and dementia becomes more prevalent, the next five years will be a critical period for dementia prevention and control. The release of the National Action Plan for Addressing Dementia in the Elderly (2024-2030) (hereafter as “the Action Plan”) signifies that the Chinese government fully recognizes the significant impact that dementia poses to the health of the elderly population and the socio-economic landscape. It also elevates the prevention and treatment of dementia and the development of a dementia-friendly society to the national strategic level.

To timely implement the Action Plan and address the existing challenges in dementia prevention and control - poor disease awareness, insufficient diagnostic and treatment capabilities, and low accessibility and affordability of diagnosis and medications - we need to make full preparations in areas such as institutional design, infrastructure construction, technological research and development, personnel capacity building, and resource coordination. Additionally, we must proactively promote early detection, diagnosis and treatment.

Lilly would like to propose the following three recommendations:

· Accelerate policy implementation and enhance societal disease awareness driven by innovative mechanisms, and build a consensus on the preventability and treatability of dementia

As the Action Plan involves multiple ministries, an efficient cross-ministerial coordination and tracking mechanism is required to ensure its effective implementation. It is also recommended to adopt a forward-looking and flexible approach in budget formulation, policy making and implementation to ensure infrastructural construction, personnel capacity building, industrial development, while also encouraging the rapid translation of emerging technological innovations into improved health outcomes and better lives of people living with dementia.

In addition, it is recommended to enhance public awareness across society through multiple channels about the disease and the emerging diagnostic and therapeutic technologies. This will help change the current misconceptions and reduce the stigma surrounding dementia and foster a consensus that dementia is preventable, treatable and manageable across the society.

· Establish systematic early screening mechanisms, improve the standardization of the diagnosis and treatment pathway and implement the comprehensive, synergized and seamless dementia prevention and control system

Early detection, diagnosis and treatment are key to dementia prevention and control. Primary care institutions should play a greater role in the early screening and intervention of dementia. It is recommended to strengthen the infrastructural readiness of primary care institutions, enhance the capabilities of primary healthcare personnel, promote the use of innovative, convenient and standardized screening tools, and establish national early screening mechanisms when time is opportune.

Moreover, based on the existing tiered medical system and the integration of medical and elderly care systems, interconnectivity and synergy among institutions should be strengthened to facilitate smooth two-way referral between primary care institutions and higher-level hospitals, as well as collaboration between medical institutions and elderly care institutions. A closed loop covering screening, diagnosis, treatment, rehabilitation and care should be established, following a structured process: screening conducted in the primary care or community setting, high-risk individuals referred to a primary brain health center, complex cases referred to a comprehensive brain health center, and rehabilitation and care assumed by primary care institutions or communities.

· Alleviate the economic burden of patients and the society by improving the development of the multi-layered insurance system and promoting silver economy

Based on the fundamental and leading role of the basic medical insurance, a comprehensive and sustainable multi-layered insurance system should be established, complemented by commercial health insurance and long-term care insurance. This will enhance the accessibility and affordability of advanced medical technologies, innovative medicines and high-quality care services, bringing hope to people with dementia and encouraging senior citizens to seek early diagnosis and treatment.

It is also recommended to promote the development of silver economy by increasing the supply of dementia-related technologies, products and individualized services, while leveraging economies of scale to reduce costs. This will bring tangible benefits to patients and a broader elderly population.

With the development of artificial intelligence, innovative biomarkers, and disease-modifying therapies such as amyloid targeting treatments, we are now more capable than ever of transforming dementia into a preventable and treatable disease.

As a global leading pharmaceutical company, Lilly has been dedicated to the research and development of innovative therapies and diagnostics for Alzheimer’s disease for nearly forty years. We fully support China's efforts to address dementia and are committed to collaborating with all stakeholders to improve the well-being of patients with Alzheimer’s disease and other dementias. Together, we aim to make meaningful contributions to dementia prevention and treatment and the creation of a dementia-friendly society in China.

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