System Readiness For Disease-Modifying Therapies For Alzheimer’s Disease In Ireland – Challenges And Opportunities

Abstract Background The emergence of disease-modifying therapies (DMTs) for Alzheimer’s disease (AD) represents a major shift in treatment, offering hope for patients while presenting considerable challenges for healthcare systems. In Ireland, memory clinics vary widely in service provision, often constrained by limited resources and restricted access to diagnostic biomarkers. The Irish National Dementia Office’s New Model of Care for Dementia offers a guiding framework, but the rollout of DMTs will require urgent investment in specialist staff, diagnostic infrastructure, and coordinated service pathways. This presentation discusses how DMTs could be integrated across diverse Irish healthcare settings using virtual patient pathways. Methods Facilitated multidisciplinary workshops, including Patient and Public Involvement (PPI), generated implementation recommendations using a health system readiness framework focused on resources, structures, relationships, and values. Two online surveys, based on the theoretical framework of acceptability, were conducted with 1,000 members of the public and 77 healthcare professionals to assess DMT acceptance and willingness to pay. Descriptive and multivariate analyses were applied. Results A hub-and-spoke model emerged as a scalable solution for Ireland, with Regional Specialist Memory Services (RSMS) acting as central hubs and Memory Assessment and Support Services (MASS) as spokes in less urban areas. Defined criteria for referral, eligibility, administration, and monitoring were developed. Survey results revealed higher acceptance among clinicians (65%) than the public (48%), with optimism about efficacy tempered by concerns about safety, costs, and system capacity. Conclusion Successful integration of DMTs in Ireland will depend on strategic investment, upskilling, and coordinated planning. The proposed service model and findings offer a roadmap for equitable and effective implementation, balancing clinical promise with real-world constraints. Clear pathways, robust infrastructure, and stakeholder engagement will be essential to ensure ethical, accessible delivery of these transformative therapies.