Pharmacotherapy for people with Alzheimer's disease: A Markov-cycleevaluation of five years' therapy using donepezil
A. Stewart
Bok Engelsk 1998
| Utgitt | 1998
|
|---|---|
| Omfang | Side 445- 453
|
| Opplysninger | This article combines data from a clinical trial of donepezil withcosting figures to evaluate expected direct costs of care over 5years after diagnosis of Alzheimer's disease (AD) for patients aged75 years and over at diagnosis. A Markov model simulates theprogression of elderly persons through changing levels of severity.The model compares three treatment regimes for each of two patientgroups: mild AD at start of treatment; moderate AD at start oftreatment. Patients are followed until 5 years after the start of thetreatment. Despite the acquisition costs, use of donepezil isapproximately cost-neutral for both 5 mg and 10 mg treatment groupsand for patients initially at either mild or moderate states ofillness. Expected costs are slightly higher than for the placebogroup, but higher expenditure on drugs is partly offset by lowercosts of care consequent on treated patients not declining as rapidlyas those untreated. The model showed that donepezil patients spentless time in the state of severe dementia, where costs of care arehigher. Sensitivity analysis on key assumptions demonstrated thatexpected costs were highly dependent on discount rate and, moresignificantly, on the mortality rate. (C) 1998 John Wiley & Sons,Ltd.
|
| Emner |
