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An economic evaluation of donepezil in mild to moderate Alzheimer's disease : Results of a 1-year, double-blind, randomized trial

Wimo, Anders ; Winblad, Bengt ; Engedal, K. ; Soininen, Hilkka ; Verhey, Frans ; Waldemar, Gunhild ; Wetterholm, Anna Lena ; Mastey, Vera ; Haglund, Anders and Zhang, Richard , et al. (2003) In Dementia and Geriatric Cognitive Disorders 15(1). p.44-54
Abstract

The costs and consequences of donepezil versus placebo treatment in patients with mild to moderate Alzheimer's disease (AD) were evaluated as part of a 1-year prospective, double-blind, randomized, multinational clinical trial. Patients received either donepezil (n = 142; 5 mg/day for 28 days followed by 10 mg/day according to the clinician's judgement) or placebo (n = 144). Unit costs were assessed in 1999 Swedish kronas (SEK) and converted to US dollars (USD). Donepezil-treated patients gained functional benefits relative to placebo on the Progressive Deterioration Scale (p = 0.042) and Instrumental Activities of Daily Living scale (p = 0.025) at week 52. Caregivers of donepezil-treated patients spent an average of 400 h less annually... (More)

The costs and consequences of donepezil versus placebo treatment in patients with mild to moderate Alzheimer's disease (AD) were evaluated as part of a 1-year prospective, double-blind, randomized, multinational clinical trial. Patients received either donepezil (n = 142; 5 mg/day for 28 days followed by 10 mg/day according to the clinician's judgement) or placebo (n = 144). Unit costs were assessed in 1999 Swedish kronas (SEK) and converted to US dollars (USD). Donepezil-treated patients gained functional benefits relative to placebo on the Progressive Deterioration Scale (p = 0.042) and Instrumental Activities of Daily Living scale (p = 0.025) at week 52. Caregivers of donepezil-treated patients spent an average of 400 h less annually providing care than caregivers of placebo-treated patients. Mean annual healthcare costs were SEK 137,752 (USD 16,438) per patient for the donepezil group and SEK 135,314 (USD 16,147) in the placebo group. With the average annual cost of donepezil at SEK 10,723 (USD 1,280) per patient, the SEK 2,438 (USD 291) cost difference represented a 77% cost offset. When caregiver time and healthcare costs were included, mean annual costs were SEK 209,244 (USD 24,969) per patient in the donepezil group and SEK 218,434 (USD 26,066) in the placebo group, a total saving associated with donepezil treatment of SEK 9,190 (USD 1,097) per patient [95% CI of SEK -43,959 (USD -5,246), SEK 25,581 (USD 3,053); p = 0.6]. The positive effects on the efficacy outcome measures combined with no additional costs from a societal perspective indicate that donepezil is a cost-effective treatment, representing an improved strategy for the management of patients with AD.

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author collaboration
publishing date
type
Contribution to journal
publication status
published
keywords
Alzheimer's disease, Caregiver time, Donepezil, Economic evaluation, Societal costs
in
Dementia and Geriatric Cognitive Disorders
volume
15
issue
1
pages
44 - 54
publisher
Karger
external identifiers
  • scopus:0037211443
  • pmid:12457078
ISSN
1420-8008
DOI
10.1159/000066669
language
English
LU publication?
no
id
b0ef37cb-e8f5-41b9-89e9-c7c6a0ff757b
date added to LUP
2018-11-11 07:03:35
date last changed
2020-05-06 05:47:32
@article{b0ef37cb-e8f5-41b9-89e9-c7c6a0ff757b,
  abstract     = {<p>The costs and consequences of donepezil versus placebo treatment in patients with mild to moderate Alzheimer's disease (AD) were evaluated as part of a 1-year prospective, double-blind, randomized, multinational clinical trial. Patients received either donepezil (n = 142; 5 mg/day for 28 days followed by 10 mg/day according to the clinician's judgement) or placebo (n = 144). Unit costs were assessed in 1999 Swedish kronas (SEK) and converted to US dollars (USD). Donepezil-treated patients gained functional benefits relative to placebo on the Progressive Deterioration Scale (p = 0.042) and Instrumental Activities of Daily Living scale (p = 0.025) at week 52. Caregivers of donepezil-treated patients spent an average of 400 h less annually providing care than caregivers of placebo-treated patients. Mean annual healthcare costs were SEK 137,752 (USD 16,438) per patient for the donepezil group and SEK 135,314 (USD 16,147) in the placebo group. With the average annual cost of donepezil at SEK 10,723 (USD 1,280) per patient, the SEK 2,438 (USD 291) cost difference represented a 77% cost offset. When caregiver time and healthcare costs were included, mean annual costs were SEK 209,244 (USD 24,969) per patient in the donepezil group and SEK 218,434 (USD 26,066) in the placebo group, a total saving associated with donepezil treatment of SEK 9,190 (USD 1,097) per patient [95% CI of SEK -43,959 (USD -5,246), SEK 25,581 (USD 3,053); p = 0.6]. The positive effects on the efficacy outcome measures combined with no additional costs from a societal perspective indicate that donepezil is a cost-effective treatment, representing an improved strategy for the management of patients with AD.</p>},
  author       = {Wimo, Anders and Winblad, Bengt and Engedal, K. and Soininen, Hilkka and Verhey, Frans and Waldemar, Gunhild and Wetterholm, Anna Lena and Mastey, Vera and Haglund, Anders and Zhang, Richard and Miceli, Robert and Chin, Warren and Subbiah, Ponni},
  issn         = {1420-8008},
  language     = {eng},
  month        = {01},
  number       = {1},
  pages        = {44--54},
  publisher    = {Karger},
  series       = {Dementia and Geriatric Cognitive Disorders},
  title        = {An economic evaluation of donepezil in mild to moderate Alzheimer's disease : Results of a 1-year, double-blind, randomized trial},
  url          = {http://dx.doi.org/10.1159/000066669},
  doi          = {10.1159/000066669},
  volume       = {15},
  year         = {2003},
}