, Volume 20, Issue 9, pp 629–637 | Cite as

Assessment of Health Economics in Alzheimer’s Disease (AHEAD)

Treatment with Galantamine in Sweden
  • Frances B. Garfield
  • Denis Getsios
  • J. Jaime Caro
  • Anders Wimo
  • Bengt Winblad
Original Research Article


Background: Like other developed countries with aging populations, Sweden is expecting large increases in the prevalence of Alzheimer’s disease and corresponding escalations in the cost of care for patients with this disease. Galantamine, a new acetylcholinesterase inhibitor and nicotinic modulator, has proved effective in managing patients with Alzheimer’s disease in clinical trials.

Objective: To estimate the long-term health and economic impact of galantamine from the perspective of the public health payer in Sweden.

Design and setting: The Assessment of Health Economics in Alzheimer’s Disease (AHEAD) model compares galantamine treatment with no pharmacologic treatment. It consists of a module based on trial data followed by a projection module that uses the trial results to predict the time until patients require full-time care (FTC) or until their death. Forecasts were made for up to 10 years. The model was customised to Sweden by using Swedish resource use profiles obtained from the literature.

Results: Galantamine is predicted to reduce the time patients require FTC by almost 10%. Approximately 5.6 patients with mild-to-moderate disease would need to be treated to avoid one year of FTC. This would result in savings averaging 27 436 Swedish kronas (SEK) [3131 euros (EUR)] per patient over 10 years (1998 values). To avoid one year of FTC, 3.9 patients with moderate disease would need to be treated, with savings averaging SEK49 019 (EUR5594) per patient over 10.5 years. Sensitivity analyses of key parameters, such as proportion of patients needing FTC treated in the community, cost of care in an institution, cost of FTC care in the community, the price of galantamine, and the discount rate, found savings with galantamine would occur under most circumstances.

Conclusion: Galantamine can increase the time before patients require FTC, and may also lead to savings as treatment costs are offset by reductions in other healthcare expenditures and the costs associated with FTC.


Nursing Home Rivastigmine Tacrine Galantamine Nursing Home Care 



This research was supported in part by an unrestricted grant from Janssen Research Foundation. Anders Wimo and Bengt Winblad have been acting as consultants to most pharmaceutical companies who have developed antidementia drugs (e.g. Parke-Davis, Pfizer, Novartis, Janssen-Cilag, HMR/Aventis, Merz). They have no employment, stocks or research grants from these companies.


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Copyright information

© Adis International Limited 2002

Authors and Affiliations

  • Frances B. Garfield
    • 1
  • Denis Getsios
    • 2
  • J. Jaime Caro
    • 1
    • 3
  • Anders Wimo
    • 4
  • Bengt Winblad
    • 4
  1. 1.Caro Research InstituteMassachusettsUSA
  2. 2.Caro ResearchMontrealCanada
  3. 3.Division of General Internal Medicine, Royal Victoria HospitalMcGill UniversityMontréalCanada
  4. 4.Division of Geriatric MedicineNeurotec, Karolinska InstitutetStockholmSweden

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