Tags

Type your tag names separated by a space and hit enter

Evaluating the cost effectiveness of donepezil in the treatment of Alzheimer's disease in Germany using discrete event simulation.

Abstract

BACKGROUND

Previous cost-effectiveness studies of cholinesterase inhibitors have modeled Alzheimer's disease (AD) progression and treatment effects through single or global severity measures, or progression to "Full Time Care". This analysis evaluates the cost-effectiveness of donepezil versus memantine or no treatment in Germany by considering correlated changes in cognition, behavior and function.

METHODS

Rates of change were modeled using trial and registry-based patient level data. A discrete event simulation projected outcomes for three identical patient groups: donepezil 10 mg, memantine 20 mg and no therapy. Patient mix, mortality and costs were developed using Germany-specific sources.

RESULTS

Treatment of patients with mild to moderately severe AD with donepezil compared to no treatment was associated with 0.13 QALYs gained per patient, and 0.01 QALYs gained per caregiver and resulted in average savings of €7,007 and €9,893 per patient from the healthcare system and societal perspectives, respectively. In patients with moderate to moderately-severe AD, donepezil compared to memantine resulted in QALY gains averaging 0.01 per patient, and savings averaging €1,960 and €2,825 from the healthcare system and societal perspective, respectively.In probabilistic sensitivity analyses, donepezil dominated no treatment in most replications and memantine in over 70% of the replications. Donepezil leads to savings in 95% of replications versus memantine.

CONCLUSIONS

Donepezil is highly cost-effective in patients with AD in Germany, leading to improvements in health outcomes and substantial savings compared to no treatment. This holds across a variety of sensitivity analyses.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • FREE Publisher Full Text
  • Authors+Show Affiliations

    ,

    B214 Baquba Building, Conington Road, SE13 7FF London, UK.

    , , ,

    Source

    BMC neurology 12: 2012 Feb 08 pg 2

    MeSH

    Alzheimer Disease
    Cholinesterase Inhibitors
    Cost-Benefit Analysis
    Donepezil
    Dopamine Agents
    Germany
    Humans
    Indans
    Memantine
    Piperidines
    Quality-Adjusted Life Years

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    22316501

    Citation

    Hartz, Susanne, et al. "Evaluating the Cost Effectiveness of Donepezil in the Treatment of Alzheimer's Disease in Germany Using Discrete Event Simulation." BMC Neurology, vol. 12, 2012, p. 2.
    Hartz S, Getsios D, Tao S, et al. Evaluating the cost effectiveness of donepezil in the treatment of Alzheimer's disease in Germany using discrete event simulation. BMC Neurol. 2012;12:2.
    Hartz, S., Getsios, D., Tao, S., Blume, S., & Maclaine, G. (2012). Evaluating the cost effectiveness of donepezil in the treatment of Alzheimer's disease in Germany using discrete event simulation. BMC Neurology, 12, p. 2. doi:10.1186/1471-2377-12-2.
    Hartz S, et al. Evaluating the Cost Effectiveness of Donepezil in the Treatment of Alzheimer's Disease in Germany Using Discrete Event Simulation. BMC Neurol. 2012 Feb 8;12:2. PubMed PMID: 22316501.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Evaluating the cost effectiveness of donepezil in the treatment of Alzheimer's disease in Germany using discrete event simulation. AU - Hartz,Susanne, AU - Getsios,Denis, AU - Tao,Sunning, AU - Blume,Steve, AU - Maclaine,Grant, Y1 - 2012/02/08/ PY - 2011/10/14/received PY - 2012/02/08/accepted PY - 2012/2/10/entrez PY - 2012/2/10/pubmed PY - 2012/6/19/medline SP - 2 EP - 2 JF - BMC neurology JO - BMC Neurol VL - 12 N2 - BACKGROUND: Previous cost-effectiveness studies of cholinesterase inhibitors have modeled Alzheimer's disease (AD) progression and treatment effects through single or global severity measures, or progression to "Full Time Care". This analysis evaluates the cost-effectiveness of donepezil versus memantine or no treatment in Germany by considering correlated changes in cognition, behavior and function. METHODS: Rates of change were modeled using trial and registry-based patient level data. A discrete event simulation projected outcomes for three identical patient groups: donepezil 10 mg, memantine 20 mg and no therapy. Patient mix, mortality and costs were developed using Germany-specific sources. RESULTS: Treatment of patients with mild to moderately severe AD with donepezil compared to no treatment was associated with 0.13 QALYs gained per patient, and 0.01 QALYs gained per caregiver and resulted in average savings of €7,007 and €9,893 per patient from the healthcare system and societal perspectives, respectively. In patients with moderate to moderately-severe AD, donepezil compared to memantine resulted in QALY gains averaging 0.01 per patient, and savings averaging €1,960 and €2,825 from the healthcare system and societal perspective, respectively.In probabilistic sensitivity analyses, donepezil dominated no treatment in most replications and memantine in over 70% of the replications. Donepezil leads to savings in 95% of replications versus memantine. CONCLUSIONS: Donepezil is highly cost-effective in patients with AD in Germany, leading to improvements in health outcomes and substantial savings compared to no treatment. This holds across a variety of sensitivity analyses. SN - 1471-2377 UR - https://www.unboundmedicine.com/medline/citation/22316501/Evaluating_the_cost_effectiveness_of_donepezil_in_the_treatment_of_Alzheimer's_disease_in_Germany_using_discrete_event_simulation_ L2 - https://bmcneurol.biomedcentral.com/articles/10.1186/1471-2377-12-2 DB - PRIME DP - Unbound Medicine ER -