scholarly journals Comparative Value of Cholinesterase Inhibitors and Memantine in Persons with Moderate-to-Severe Alzheimer’s Disease in the United States: A Cost-Effectiveness Analysis

2021 ◽  
pp. 1-9
Author(s):  
Ismaeel Yunusa ◽  
Saud Alsahali ◽  
Amey Ranes ◽  
Tewodros Eguale
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cost Effectiveness ◽  
Treatment Strategy ◽  
Optimal Treatment ◽  
Transdermal Patch ◽  
Healthcare Perspective ◽  
The Us ◽  
The Cost ◽  
Optimal Treatment Strategy

Background: Pharmacological treatment of Alzheimer’s disease (AD) involves symptomatic improvement of cognition using cholinesterase inhibitor (ChEI) and memantine. The cost-effectiveness of these medications will guide decision-makers in making judicious use of scarce healthcare resources, particularly during the advanced disease stages. Objective: To evaluate the cost-effectiveness of ChEIs, memantine, and ChEI-memantine combinations in persons with moderate-to-severe Alzheimer’s disease. Methods: This pharmacoeconomic evaluation study used a state-transition Markov cohort model to simulate the costs and effectiveness of ChEI-memantine combinations compared with monotherapies of ChEI and memantine in persons with moderate-to-severe AD over a lifetime horizon with a 1-year cycle length from the US healthcare perspective. We estimated expected quality-adjusted life-years (QALYs), costs (in 2020 $US), net monetary benefits, and incremental cost-effectiveness ratios (ICERs). Results: In this study, donepezil monotherapy, galantamine-memantine combination, and rivastigmine transdermal patch formed the cost-effectiveness frontier. Findings suggests that rivastigmine transdermal patch is the optimal treatment strategy at a willingness-to-pay (WTP) threshold of $150,000/QALY (ICER = $93,307/QALY [versus donepezil monotherapy]). Results across subgroups by age and sex also suggest that the rivastigmine transdermal patch is the optimal treatment strategy with the highest net benefit. Conclusion: From the US healthcare perspective, we found that, for persons with moderate-to-severe AD at a WTP value of $150,000/QALY, the rivastigmine transdermal patch is the cost-effective treatment. Given that the transdermal patch is a preferred route of administration for persons with AD and their caregivers due to its convenience, our findings provide additional incentives for its use.

The cost-utility of the rivastigmine transdermal patch in the management of patients with moderate Alzheimer's disease in the US

2009 ◽  
Vol 36 (S 02) ◽  
Author(s):  
A Brennan ◽  
B Nagy ◽  
A Brandtmüller ◽  
SK Thomas ◽  
M Gallagher ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cost Utility ◽  
Transdermal Patch ◽  
The Us ◽  
The Cost

Assessing the cost-effectiveness of the rivastigmine transdermal patch for Alzheimer's disease in the UK using MMSE- and ADL-based models

2010 ◽  
Vol 26 (5) ◽  
pp. 483-494 ◽  
Author(s):  
Balázs Nagy ◽  
Alan Brennan ◽  
Ágnes Brandtmüller ◽  
Simu K. Thomas ◽  
Sean D. Sullivan ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cost Effectiveness ◽  
Transdermal Patch ◽  
The Uk ◽  
The Cost

The Cost-Effectiveness of Three Prevention Strategies in Alzheimer's Disease: Results from the Multidomain Alzheimer Preventive Trial (MAPT)

2021 ◽  
pp. 1-11
Author(s):  
N. Costa ◽  
M. Mounié ◽  
A. Pagès ◽  
H. Derumeaux ◽  
T. Rapp ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cost Effectiveness ◽  
Community Dwelling ◽  
Z Score ◽  
Prevention Strategies ◽  
Group Setting ◽  
The Cost ◽  
Preventive Trial ◽  
Score Point

BACKGROUND: To date, no curative treatment is available for Alzheimer’s disease (AD). Therefore, efforts should focus on prevention strategies to improve the efficiency of healthcare systems. Objective: Our aim was to assess the cost-effectiveness of three preventive strategies for AD compared to a placebo. Design: The Multidomain Alzheimer Preventive Trial (MAPT) study was a multicenter, randomized, placebo-controlled superiority trial with four parallel groups, including three intervention groups (one group with Multidomain Intervention (MI) plus a placebo, one group with Polyunsaturated Fatty Acids (PFA), one group with a combination of PFA and MI) and one placebo group. Setting: Participants were recruited and included in 13 memory centers in France and Monaco. Participants: Community-dwelling subject aged 70 years and older were followed during 3 years. Interventions: We used data from the MAPT study which aims to test the efficacy of a MI along PFA, the MI plus a placebo, PFA alone, or a placebo alone. Measurement: Direct medical and non-medical costs were calculated from a payer’s perspective during the 3 years of follow-up. The base case incremental Cost-Effectiveness Ratio (ICER) represents the cost per improved cognitive Z-score point. Sensitivity analyses were performed using different interpretation of the effectiveness criteria. Results: Analyses were conducted on 1,525 participants. The ICER at year 3 that compares the MI + PFA and the MI alone to the placebo amounted to €21,443 and €21,543 respectively, per improved Z score point. PFA alone amounted to €111,720 per improved Z score point. Conclusion: Our study shows that ICERS of PFA combined with MI and MI alone amounted to €21,443 and €21,543 respectively per improved Z score point compared to the placebo and are below the WTP of €50,000 while the ICER of PFA alone amounted to €111,720 per improved Z score point. This information may help decision makers and serve as a basis for the implementation of a lifetime decision analytic model.

scholarly journals PNL3 THE COST-EFFECTIVENESS OF QUETIAPINE FOR ALZHEIMER'S DISEASE IN COMMUNITY DWELLING PATIENTS

2005 ◽  
Vol 8 (3) ◽  
pp. 315
Author(s):  
D Getsios ◽  
I Proskorovsky ◽  
JJ Caro ◽  
J O'Brien ◽  
J Pesa ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cost Effectiveness ◽  
Community Dwelling ◽  
The Cost

The cost-effectiveness of donepezil therapy in Swedish patients with Alzheimer's disease: A Markov model

1999 ◽  
Vol 21 (7) ◽  
pp. 1230-1240 ◽  
Author(s):  
Linus Jönsson ◽  
Peter Lindgren ◽  
Anders Wimo ◽  
Bengt Jönsson ◽  
Bengt Winblad
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cost Effectiveness ◽  
Markov Model ◽  
The Cost
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