Disease progression and costs of care in Alzheimer's disease patients treated with donepezil: a longitudinal naturalistic cohort.

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. 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. 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. The proposed methods for representing AD progression and economic outcomes can be used in micro-simulation models for the economic evaluation of new treatments.

Citation

Anders Gustavsson, Linus Jönsson, Johan Parmler, Niels Andreasen, Carina Wattmo, Åsa K Wallin, Lennart Minthon. Disease progression and costs of care in Alzheimer's disease patients treated with donepezil: a longitudinal naturalistic cohort. The European journal of health economics : HEPAC : health economics in prevention and care. 2012 Oct;13(5):561-8

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PMID: 21822729

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