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Economic considerations of Alzheimer’s disease and related disorders

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Abstract

Economic analyses of geriatric syndromes are seldom performed. However, demographic and epidemiological imperatives have led to significant interest in the evaluation of AD-related costs. Over 300 papers devoted to economic considerations of Alzheimer’s disease have been published in peer-reviewed journals, within the last five years. In these papers, the chosen perspective (costs to society or to specific payers) is important. Analytical methods are still evolving and remain complex. Unresolved methodological issues will need to be addressed to further our understanding of long-term economic consequences. At present, it is clear that diagnostic and drug costs are low compared to the major cost of institutionalization. Thus, directing efforts at early diagnosis and delaying nursing home placement are two key cost-containment interventions. In this respect, the need to support informal care should not be underestimated.

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References

  1. Souetre E.J., Qing W., Vigoureux I.: Economic analysis of Alzheimer’s disease in outpatients: impact of symptom severity. In: Giacobini E., Becker R. (Eds.), Alzheimer’s disease: therapeutic strategies. Birkhauser, Boston, 1994, pp. 470–480.

    Chapter  Google Scholar 

  2. Kalache A.: Ageing world-wide. In: Ebrahim S., Kalache A. (Eds.), Epidemiology in old age. British Medical Society Publishing Group, London, 1996, pp. 22–31.

    Google Scholar 

  3. Khatchaturian Z.S., Radebaugh T.S.: Alzheimer Disease: Where are we now? Where are we going? Alzheimer Dis. Assoc. Disord. 12 (Suppl. 3): S24–S28, 1998.

    Google Scholar 

  4. Ritchie K., Kildea D.: Is senile dementia “age related” or “aging related”? Evidence from a meta-analysis of dementia prevalence in the oldest old. Lancet 346: 931–934, 1995.

    Article  CAS  PubMed  Google Scholar 

  5. Herrmann F.: Prevalence of Dementia in Switzerland (Unpublished data).

  6. Murray C.J., Lopez A.D.: Summary: the global burden of disease. Cambridge Mass., Harvard University Press, 1997, p. 43.

    Google Scholar 

  7. Henderson A.S., Jorm A.F.: Definition, and epidemiology of dementia. In: Maj M., Sartorius N. (Eds.), Dementia. John Willey & Sons LTD, Chichester, 2000, pp. 1–33.

    Chapter  Google Scholar 

  8. Whitehouse P.J.: Pharmacoeconomics of dementia. Alzheimer Dis. Assoc. Disord. 11 (Suppl. 5): S22–S33, 1997.

    PubMed  Google Scholar 

  9. Winblad B., Hill S., Beermann B., Post S.G., Wimo A.: Issues in the economic evaluation of treatment for dementia. Position paper from the International Working Group on Harmonization of Dementia Drug Guidelines. Alzheimer Dis. Assoc. Disord. 11 (Suppl. 3): 39–45, 1997.

    PubMed  Google Scholar 

  10. Wimo A., Ljunggren G., Winblad B.: Costs of dementia and dementia care: a review. Int. J. Geriatr. Psychiatry 12: 841–856, 1997.

    Article  CAS  PubMed  Google Scholar 

  11. Volz A., Monsch A.U., Zahno A., Wettstein A., Staehelin H.B.: Was kostete die Schweiz die Alzheimer-Krankheit 1998?: Eine praliminare. Analyse Praxis 89: 803–811, 2000.

    Google Scholar 

  12. Meerding W.J., Bonneux L., Polder J.J., Koopmanschap M.A., van der Mass P.J.: Demographic and epidemiological determinants of healthcare costs in the Netherlands: cost of illness study. BMJ 317: 111–115, 1998.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Ernst R.L., Hay J.W.: The U.S. economic and social cost of Alzheimer’s Disease revisited. Am. J. Public Health 84: 1261–1264, 1994.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Menzin J., Lang K., Friedman M., Neumann P., Cummings J.L.: The economic cost of Alzheimer’s Disease and related dementia to the California Medicaid Program (“Medi-Cal”) in 1995. Am. J. Geriatr. Psychiatry 7: 300–308, 1999.

    CAS  PubMed  Google Scholar 

  15. Neumann P., Kuntz K.M., Leon J.L., Araki S.S., Hermann R.C., Hsu M.A., Weinstein M.C.: Health utilities in Alzheimer’s Disease: a cross sectional study of patients and caregivers. Med. Care 37: 27–32, 1999.

    Article  CAS  PubMed  Google Scholar 

  16. Drummond M., Stoddart G.L., Torrance G.E.W.: Methods for the economic evaluation of health care programmes. Oxford University Press, Oxford, 1987.

    Google Scholar 

  17. Nagaratnam N., Lewis-Jones M., Scott D., Palazzi L.: Behavioral and psychiatric manifestations in dementia patients in a community: caregiver burden and outcome. Alzheimer Dis. Assoc. Disord. 12: 330–334, 1998.

    Article  CAS  PubMed  Google Scholar 

  18. Cavallo M.C., Fattore G.: The economic and social burden of Alzheimer Disease on families in the Lombardy region of Italy. Alzheimer Dis. Assoc. Disord. 11: 184–190, 1997.

    CAS  PubMed  Google Scholar 

  19. Wimo A., Karlson G., Jonsson B., Winblad B.: The Health Economics of dementia. John Wiley & Son, London, UK, 1998.

    Google Scholar 

  20. Fox P.J.: Service use and cost outcomes for persons with Alzheimer Disease. Alzheimer Dis. Assoc. Disord. 11 (Suppl. 6): 125–134, 1997.

    PubMed  Google Scholar 

  21. Albert S.M., Sano M., Bell K., Merchant C., Small S., Stern Y.: Hourly care received by people with Alzheimer’s Disease: results from an urban community survey. Gerontologist 38: 704–714, 1998.

    Article  CAS  PubMed  Google Scholar 

  22. Knapp M., Wilkinson D., Wigglesworth R.: The economic consequences of Alzheimer’s disease in the context of new drug developments. Int. J. Geriatr. Psychiatry 13: 531–543, 1998.

    Article  CAS  PubMed  Google Scholar 

  23. Trabucchi M., Govoni S., Bianchetti A.: Socio-economic aspects of Alzheimer’s disease treatment. In: Giacobini E., Becker R. (Eds.), Alzheimer’s disease: therapeutic strategies. Birkhauser, Boston, 1994, pp. 459–463.

    Chapter  Google Scholar 

  24. Trabucchi M., Ghisla K.M., Bianchetti A.: CODEM: a longitudinal study on Alzheimer disease costs. In: Becker R., Giacobini E. (Eds.), Alzheimer’s disease: From molecular biology to therapy. Birkhauser, Boston, 1996, pp. 561–565.

    Google Scholar 

  25. Hux M.J., O’Brien B.J., Iskedjian M., Goeree R., Gagnon M., Gauthier S.: Relation between severity of Alzheimer’s disease and costs of caring. Can. Med. Assoc. J. 159: 457–465, 1998.

    CAS  Google Scholar 

  26. US Congress General Accounting Office: Alzheimer’s disease: estimates of prevalence in the United States [GAO pub. No.HEHS-98-16]. Washington, DC, US Government Printing Office, 1998.

    Google Scholar 

  27. Souetre E., Thwaites R.M., Yeardley H.L.: Economic impact of Alzheimer’s disease in the United Kingdom. Cost of care and disease severity for non-institutionalised patients with Alzheimer’s disease. Br. J. Psychiatry 174: 1–5, 1999.

    Google Scholar 

  28. Neumann P.J., Hermann R.C., Berenbaum P.A., Weinstein M.C.: Methods of cost-effectiveness analysis in the assessment of new drugs for Alzheimer’s Disease. Psychiatr. Serv. 48: 1440–1444, 1997.

    CAS  PubMed  Google Scholar 

  29. Busschbach J.J., Brouwer W.B., van der Donk A., Passchier J., Rutten F.F: An outline for a cost-effectiveness analysis of a drug for patients with Alzheimer’s disease. Pharmacoeconomics 13: 21–34, 1998.

    Article  CAS  PubMed  Google Scholar 

  30. Torrance G.W.: Utility approach to measuring health related quality of life. J. Chronic Dis. 40: 593–603, 1987.

    Article  CAS  PubMed  Google Scholar 

  31. Albert S.M., Del Castillo-Castaneda C., Sano M., Jacobs D.M., Marder K., Bell K., Bylsma F., Lafleche G., Brandt J., Albert M., Stern Y.: Quality of life in patients with Alzheimer’s Disease as reported by patients proxies. J. Am. Geriatr. Soc. 44: 1342–1347, 1996.

    CAS  PubMed  Google Scholar 

  32. Bootman J.L., Townsend R.J., McGhan W.F.: Principles of pharmacoeconomics, ed. 2. Harvey Whitney Books, Cincinnati, 1996.

    Google Scholar 

  33. Spilker B.: Adopting higher standards for quality of life trials. Quality of life and pharmacoeconomics in clinical trials, ed. 2. Lippincott-Raven, Philadelphia, 1996.

    Google Scholar 

  34. Withehouse P.J.: Pharmacoeconomics of dementia. Alzheimer Dis. Assoc. Disord. 11 (Suppl. 5): S22–S33, 1997.

    Google Scholar 

  35. Ernst R.L., Hay J.W.: Economic research on Alzheimer Disease: a review of the literature. Alzheimer Dis. Assoc. Disord. 11 (Suppl. 6): 135–145, 1997.

    PubMed  Google Scholar 

  36. Schumock G.T.: Economic considerations in the treatment and management of Alzheimer’s Disease. Am. J. Health Syst. Pharm. 55 (Suppl. 2): S17–S21, 1998.

    PubMed  Google Scholar 

  37. Gutterman E.M., Markowitz J.S., Lewis B., Fillit H.: Cost of Alzheimer’s Disease and related dementia in managed medicare. J. Am. Geriatr. Soc. 47: 1065–1071, 1999.

    CAS  PubMed  Google Scholar 

  38. Weiner M., Powe N.R., Anderson G.F.: Medicare expenditures for beneficiaries with dementia of the Alzheimer’s type (Letter). J. Am. Geriatr. Soc. 47: 1276, 1999.

    CAS  PubMed  Google Scholar 

  39. Arnsberger P., Fox P., Zhang X.: Case manager-defined roles in the Medicare Alzheimer’s Disease Demonstration: relationship to client and caregiver outcomes. Care Manag. J. 1: 29–37, 1999.

    CAS  PubMed  Google Scholar 

  40. Wimo A., Wallin J.O., Lundgren K., Ronnback E., Asplund M., Mattson B., Krakau I.: Impact of day care on dementia patients - costs, well-being and relatives’ views. Fam. Pract. 7: 279–287, 1990.

    Article  CAS  PubMed  Google Scholar 

  41. Wimo A., Mattson B., Krakau I., Eriksson T., Nelvig A.: Cost-effectiveness analysis of day care for patients with dementia disorders. Health Econ. 3: 395–404, 1994.

    Article  CAS  PubMed  Google Scholar 

  42. Knopman D., Schneider L., Davis K., Talwalker S., Smith F., Hoover T., Gracon S.: Long term tacrine (Cognex) treatment: effects on nursing home placements and mortality. Neurology 47: 166–177, 1996.

    Article  CAS  PubMed  Google Scholar 

  43. Thal L.J., Thomas R.G., Sano M.: Tacrine and nursing home placement. Neurology 49: 897–899, 1997.

    Article  CAS  PubMed  Google Scholar 

  44. Leon J., Moyer D.: Potential cost savings in residential care for Alzheimer’s disease patients. Gerontologist 39: 440–449, 1999.

    Article  CAS  PubMed  Google Scholar 

  45. Lewin V.H.I.: National study of assisted living for the frail elderly: literature review update. Report prepared for HHS/ASPE under contract no. DHHS-100-94-0024. Research Triangle Institute, 1996.

    Google Scholar 

  46. Mollica R.L., Snow K.I.: State assisted living policy 1996. A report prepared for HHS/ASPE under contract no. DHHS- 100-94-0024 Portland, ME. National Academy for State Health Policy, 1996.

    Google Scholar 

  47. Neumann P.J., Herrmann R.C., Kuntz K.M., Araki S.S., Duff S.B., Leon J., Berenbaum P.A., Goldman P.A., Williams L.W., Weinstein M.C.: Cost-effectiveness of Donepezil in the treatment of mild or moderate Alzheimer’s Disease. Neurology 52: 1138–1145, 1999.

    Article  CAS  PubMed  Google Scholar 

  48. Fenn P., Gray A.: Estimating long-term cost savings from treatment of Alzheimer’s Disease. A modelling approach. Pharmacoeconomics 16: 165–174, 1999.

    Article  CAS  PubMed  Google Scholar 

  49. O’Brien B.J., Goeree R., Hux M., Iskedjian M., Blackhouse G., Gagnon M., Gauthier S.: Economic evaluation of Donepezil for the treatment of Alzheimer’s Disease in Canada. J. Am. Geriatr. Soc. 47: 570–578, 1999.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Geriatrics, Geneva University Hospitals, CH-1226, Thônex-Geneva, Switzerland

    J. P. Michel M.D., D. Zekry, R. Mulligan, E. Giacobini & G. Gold

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  1. J. P. Michel M.D.
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  2. D. Zekry
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  3. R. Mulligan
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  4. E. Giacobini
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  5. G. Gold
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Michel, J.P., Zekry, D., Mulligan, R. et al. Economic considerations of Alzheimer’s disease and related disorders. Aging Clin Exp Res 13, 255–260 (2001). https://doi.org/10.1007/BF03351484

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