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Economic evaluation of donepezil in moderate to severe Alzheimer disease.

Abstract

OBJECTIVE

To investigate the costs to society of Alzheimer disease (AD) care in a multinational, randomized, placebo-controlled trial of donepezil in patients with moderate to severe AD.

METHODS

A total of 290 patients with AD (screening standardized Mini-Mental State Examination score 5 to 17) were randomized to receive either donepezil (n = 144; 5 mg/day for 28 days, followed by 10 mg/day as per clinician's judgment) or placebo (n = 146) for 24 weeks. The authors collected data on patient and caregiver health resource utilization prospectively using the Canadian Utilization of Services Tracking questionnaire. Costs were calculated for patients and caregivers in each group based on resource utilization multiplied by the unit prices for each resource. A cost (the average Ontario minimum wage for 1998 [Can 6.85 dollars per hour]) was assigned to unpaid time that caregivers spent assisting the patient with activities of daily living (ADL).

RESULTS

Patient and caregiver demographics at baseline were similar across the two groups. After adjusting for baseline total cost per patient, the mean total societal cost per patient for the 24-week period was donepezil, Can 9,904 dollars (US 6,686 dollars) and placebo, Can 10,236 dollars (US 6,910 dollars). This net cost saving of Can 332 dollars (US 224 dollars) included the average 24-week cost of donepezil treatment. Most of the cost-saving with donepezil treatment was due to less use of residential care by patients, and caregivers spending less time assisting patients with ADL.

CONCLUSION

This cost-consequence analysis reveals economic benefits of treatment of moderate to severe AD with donepezil.

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  • Authors+Show Affiliations

    ,

    Division of Neurology, UBC Hospital, Clinic for Alzheimer's Disease and Related Disorders, Vancouver, BC, Canada. hfeldman@interchange.ubc.ca

    , , , , , , , ,

    Source

    Neurology 63:4 2004 Aug 24 pg 644-50

    MeSH

    Activities of Daily Living
    Aged
    Alzheimer Disease
    Ambulatory Care
    Australia
    Canada
    Caregivers
    Cholinesterase Inhibitors
    Cost of Illness
    Cost-Benefit Analysis
    Counseling
    Donepezil
    Drug Costs
    Female
    France
    Health Resources
    Home Care Services
    Home Nursing
    Hospitalization
    Humans
    Indans
    Institutionalization
    Male
    Middle Aged
    Nootropic Agents
    Nursing Homes
    Piperidines
    Prospective Studies
    Surveys and Questionnaires

    Pub Type(s)

    Clinical Trial
    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15326236

    Citation

    Feldman, H, et al. "Economic Evaluation of Donepezil in Moderate to Severe Alzheimer Disease." Neurology, vol. 63, no. 4, 2004, pp. 644-50.
    Feldman H, Gauthier S, Hecker J, et al. Economic evaluation of donepezil in moderate to severe Alzheimer disease. Neurology. 2004;63(4):644-50.
    Feldman, H., Gauthier, S., Hecker, J., Vellas, B., Hux, M., Xu, Y., ... Mastey, V. (2004). Economic evaluation of donepezil in moderate to severe Alzheimer disease. Neurology, 63(4), pp. 644-50.
    Feldman H, et al. Economic Evaluation of Donepezil in Moderate to Severe Alzheimer Disease. Neurology. 2004 Aug 24;63(4):644-50. PubMed PMID: 15326236.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Economic evaluation of donepezil in moderate to severe Alzheimer disease. AU - Feldman,H, AU - Gauthier,S, AU - Hecker,J, AU - Vellas,B, AU - Hux,M, AU - Xu,Y, AU - Schwam,E M, AU - Shah,S, AU - Mastey,V, AU - ,, PY - 2004/8/25/pubmed PY - 2005/3/25/medline PY - 2004/8/25/entrez SP - 644 EP - 50 JF - Neurology JO - Neurology VL - 63 IS - 4 N2 - OBJECTIVE: To investigate the costs to society of Alzheimer disease (AD) care in a multinational, randomized, placebo-controlled trial of donepezil in patients with moderate to severe AD. METHODS: A total of 290 patients with AD (screening standardized Mini-Mental State Examination score 5 to 17) were randomized to receive either donepezil (n = 144; 5 mg/day for 28 days, followed by 10 mg/day as per clinician's judgment) or placebo (n = 146) for 24 weeks. The authors collected data on patient and caregiver health resource utilization prospectively using the Canadian Utilization of Services Tracking questionnaire. Costs were calculated for patients and caregivers in each group based on resource utilization multiplied by the unit prices for each resource. A cost (the average Ontario minimum wage for 1998 [Can 6.85 dollars per hour]) was assigned to unpaid time that caregivers spent assisting the patient with activities of daily living (ADL). RESULTS: Patient and caregiver demographics at baseline were similar across the two groups. After adjusting for baseline total cost per patient, the mean total societal cost per patient for the 24-week period was donepezil, Can 9,904 dollars (US 6,686 dollars) and placebo, Can 10,236 dollars (US 6,910 dollars). This net cost saving of Can 332 dollars (US 224 dollars) included the average 24-week cost of donepezil treatment. Most of the cost-saving with donepezil treatment was due to less use of residential care by patients, and caregivers spending less time assisting patients with ADL. CONCLUSION: This cost-consequence analysis reveals economic benefits of treatment of moderate to severe AD with donepezil. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/15326236/Economic_evaluation_of_donepezil_in_moderate_to_severe_Alzheimer_disease_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=15326236 DB - PRIME DP - Unbound Medicine ER -