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Disease progression and costs of care in Alzheimer's disease patients treated with donepezil: a longitudinal naturalistic cohort.
MedLine Citation:
PMID:  21822729     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Improved data and methods are needed for modeling disease progression in Alzheimer's disease (AD) for economic evaluation of treatments. The aim is to estimate prediction models for long-term AD progression and subsequently economic outcomes. METHODS: Three-year follow-up data on 435 patients treated with the cholinesterase inhibitor donepezil in clinical practise were analyzed. Regression models were estimated for long-term prediction of decline in cognitive function (ADAS-cog) and activities in daily living (ADL) ability, risk of institutionalization and costs of care. RESULTS: The cognitive deterioration was estimated at between 1.6 and 4 ADAS-cog points per every 6 months, increasing with disease severity. Cognitive function was an important predictor of ADL-ability, which itself was the most important predictor of the risk of institutionalization and costs of care. Combining all models in a cross-validation process generated accurate predictions of costs of care at each 6 months follow-up. CONCLUSION: The proposed methods for representing AD progression and economic outcomes can be used in micro-simulation models for the economic evaluation of new treatments.
Authors:
Anders Gustavsson; Linus Jönsson; Johan Parmler; Niels Andreasen; Carina Wattmo; Asa K Wallin; Lennart Minthon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-6
Journal Detail:
Title:  The European journal of health economics : HEPAC : health economics in prevention and care     Volume:  -     ISSN:  1618-7601     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101134867     Medline TA:  Eur J Health Econ     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
i3 Innovus, Klarabergsviadukten 90 Hus D, 111 64, Stockholm, Sweden, anders.gustavsson@i3innovus.com.
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