The Cost of Treatment of Alzheimer’s Disease in The Netherlands
- 67 Downloads
Objective: To examine the potential economic impact of treatment of Alzheimer’s disease.
Design: Regression-based simulation estimation of the long term costs of Alzheimer’s disease under a number of treatment scenarios. Data from an epidemiological study conducted in Rotterdam, The Netherlands, was used to simulate disease progression. Comparison of the costs and effectiveness experienced by the patients were used to measure the impact of treatment.
Patients and intervention: 2 theoretical cohorts of patients with Alzheimer’s disease, one of which receives standard treatment, while the other receives a treatment which slows cognitive decline as measured by the Mini-Mental State Examination (MMSE).
Main outcome measures and results: Under one of the scenarios examined, the baseline cost of Alzheimer’s disease was 97 866 euro (EUR; 1996 values) per patient over 10 years’ follow-up; the cost was almost EUR100 000 under all scenarios. Life expectancy following onset was about 4.5 years and MMSE decline was approximately 2 points per year for a typical prevalent (existing) patient and almost twice as much for incident (newly diagnosed) patients (1.82 vs 3.42 points per year, respectively). Slowing the rate of cognitive decline results in a slightly increased life expectancy, with more time being spent at home and less in a nursing home. Total costs (excluding those of therapy) will decrease, but savings will be modest and may well be less than the cost of therapy. Under the same scenario, total savings were EUR1571 per patient which corresponds to an annual break-even cost of just EUR453. Decisions regarding the initiation or termination of therapy will affect both the number of patients treated and the costs and potential savings of treatment.
Conclusions: The savings made in treating Alzheimer’s disease will almost certainly be small in comparison with total costs and may well be offset by the cost of the treatment itself. Simulation models can be used to estimate the effect of therapy on the costs of care and can be useful tools in clinical decision-making and allocation of resources. These results show the need for further research into the costs and effects of treatment of Alzheimer’s disease.
KeywordsNursing Home Cognitive Decline Caregiver Burden Rotterdam Study Prevalent Patient
This study was supported by Bayer AG, Leverkusen, Germany. We are grateful to Ms Annabelle Shakespeare and Dr Pierre-Phillippe Sagnier of Bayer AG and to 3 anonymous referees for their helpful insights and suggestions.
- 8.Ruitenberg A, Kalmijn S, de Ridder MAJ, et al. Natural history of Alzheimer’s disease. The Rotterdam Study. Neuroepidemiology. In pressGoogle Scholar
- 11.Centraal Bureau voor de Statistiek (CBS). Statistiek van de bejaardenoorden 1995. SDU-Uitgeverij/CBS Publikaties, ‘s-Gravenhage 1997’. [Central Bureau of Statistics. Statistics on homes for the aged. Den Haag: SDU Publishers/CBS Publications, 1997]Google Scholar
- 12.Ministerie van Volksgezondheid, Welzijn en Sport (VWS). Jaaroverzicht Zorg (JOZ) 1998. Den Haag: SDU Uitgeveri, 1999. [Ministry of Public Health, Welfare and Sport. Yearly overview of care 1998. Den Haag: SDU Publishers, 1998Google Scholar
- 13.Landelijke Vereniging voor Thuiszorg/Nationaal Ziekenhuisinstituut (LVT/NZi). Jaarboek Thuoiszorg 1996. Bunnik: LVT, 1997. [National Association for Home Care/National Institute for Hospitals. Yearly overview of home care 1996. Bunnik: LVT, 1997Google Scholar
- 14.Nationaal Ziekenhuisinstituut (NZi). Financiële statistiek 1996. Utrect: NZi, 1997. [Care/National Institute for Hospitals. Financial statistics 1996. Utrecht: NZi, 1997]Google Scholar