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Cost-effectiveness of donepezil in the treatment of mild or moderate Alzheimer's disease.
J Alzheimers Dis 2009; 16(2):399-407JA

Abstract

Available treatments for Alzheimer's disease (AD) need to be evaluated in order to determine whether the clinical benefits justify their additional costs. This study evaluated the cost-effectiveness of donepezil treatment compared with no-drug treatment of mild and moderate AD from the perspective of society and the health care system in Spain. A Markov model was designed to simulate the natural history of a cohort of patients with mild and moderate AD. Monthly transition probabilities were estimated from the international literature and donepezil clinical trials. Direct medical and non-medical costs and utilities were derived from Spanish studies. Local data on tolerance and medication withdrawal rates were incorporated into the model. Incremental cost-effectiveness ratios for a range of realistic treatment options were calculated. A probabilistic sensitivity analysis was carried out using a Monte Carlo approach with 10,000 iterations. In the baseline scenario (24 months, patients initially with mild AD) incremental cost-effectiveness for direct medical costs was 20,353 euro/QALY. When all costs were taken into account, donepezil treatment was the dominant strategy. Incremental cost-effectiveness ratios vary according to the selected perspective. For the baseline scenario, donepezil treatment is cost-effective with a probability of 95% for a threshold efficiency of 25,000 euro/QALY.

Authors+Show Affiliations

Evaluation and Planning Unit, Canary Islands Health Service, Spain. jlopbas@gobiernodecanarias.orgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19221429

Citation

López-Bastida, Julio, et al. "Cost-effectiveness of Donepezil in the Treatment of Mild or Moderate Alzheimer's Disease." Journal of Alzheimer's Disease : JAD, vol. 16, no. 2, 2009, pp. 399-407.
López-Bastida J, Hart W, García-Pérez L, et al. Cost-effectiveness of donepezil in the treatment of mild or moderate Alzheimer's disease. J Alzheimers Dis. 2009;16(2):399-407.
López-Bastida, J., Hart, W., García-Pérez, L., & Linertová, R. (2009). Cost-effectiveness of donepezil in the treatment of mild or moderate Alzheimer's disease. Journal of Alzheimer's Disease : JAD, 16(2), pp. 399-407. doi:10.3233/JAD-2009-0965.
López-Bastida J, et al. Cost-effectiveness of Donepezil in the Treatment of Mild or Moderate Alzheimer's Disease. J Alzheimers Dis. 2009;16(2):399-407. PubMed PMID: 19221429.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of donepezil in the treatment of mild or moderate Alzheimer's disease. AU - López-Bastida,Julio, AU - Hart,Warren, AU - García-Pérez,Lidia, AU - Linertová,Renata, PY - 2009/2/18/entrez PY - 2009/2/18/pubmed PY - 2009/6/18/medline SP - 399 EP - 407 JF - Journal of Alzheimer's disease : JAD JO - J. Alzheimers Dis. VL - 16 IS - 2 N2 - Available treatments for Alzheimer's disease (AD) need to be evaluated in order to determine whether the clinical benefits justify their additional costs. This study evaluated the cost-effectiveness of donepezil treatment compared with no-drug treatment of mild and moderate AD from the perspective of society and the health care system in Spain. A Markov model was designed to simulate the natural history of a cohort of patients with mild and moderate AD. Monthly transition probabilities were estimated from the international literature and donepezil clinical trials. Direct medical and non-medical costs and utilities were derived from Spanish studies. Local data on tolerance and medication withdrawal rates were incorporated into the model. Incremental cost-effectiveness ratios for a range of realistic treatment options were calculated. A probabilistic sensitivity analysis was carried out using a Monte Carlo approach with 10,000 iterations. In the baseline scenario (24 months, patients initially with mild AD) incremental cost-effectiveness for direct medical costs was 20,353 euro/QALY. When all costs were taken into account, donepezil treatment was the dominant strategy. Incremental cost-effectiveness ratios vary according to the selected perspective. For the baseline scenario, donepezil treatment is cost-effective with a probability of 95% for a threshold efficiency of 25,000 euro/QALY. SN - 1387-2877 UR - https://www.unboundmedicine.com/medline/citation/19221429/Cost_effectiveness_of_donepezil_in_the_treatment_of_mild_or_moderate_Alzheimer's_disease_ L2 - https://content.iospress.com/openurl?genre=article&issn=1387-2877&volume=16&issue=2&spage=399 DB - PRIME DP - Unbound Medicine ER -