Assessing the health and economic impact of galantamine treatment in patients with Alzheimer's disease in the health care systems of different countries.
BACKGROUND
Cholinesterase inhibitors have been shown to improve cognitive function and improve or maintain global function.


OBJECTIVE
To estimate the long-term economic impact of treating patients with Alzheimer's disease with galantamine in seven healthcare systems: Australia, Canada, Finland, New Zealand, Sweden, the Netherlands and the UK.


METHODS
The time until patients require full-time care (FTC), defined as the consistent requirement for a significant amount of care giving and supervision each day, and the associated costs were evaluated using the 'Assessment of Health Economics in Alzheimer's Disease (AHEAD)' model. Efficacy data were obtained from three clinical trials comparing galantamine with placebo and local cost and resource use data were determined for each country. Forecast costs reported in Euros (2001 value), were made for up to 10 years in each healthcare system. All costs were determined from a perspective somewhat broader than that of a comprehensive payer, including social services. Both benefits and costs were discounted at 3%.


RESULTS
Galantamine (16 mg/day) is predicted to delay the need for FTC by 6.8%, thus the cumulative cost of care over 10 years is expected to be reduced, and this offsets much or all of the cost of galantamine. Approximately five patients need to be treated to avoid 1 year of FTC. In each healthcare system, FTC was estimated to account for 61-92% of the cost. Savings were estimated for most of the countries. For those countries with an expected expense, there were reasonable costs per FTC month avoided (euro553, discounted) and costs per quality-adjusted life year gained (euro25,000).


CONCLUSIONS
In addition to the clinical benefits associated with galantamine treatment, the savings predicted from delaying FTC may offset the treatment costs.
Caro Research Institute, Concord, Massachusetts, USA.
Jaime
J
Caro
Maribel
M
Salas
Alexandra
A
Ward
Denis
D
Getsios
Kristen
K
Migliaccio-Walle
Frances
F
Garfield
D000544:Alzheimer Disease / Q000188:drug therapy* / Q000191:economics*; D044362:Australasia; D002170:Canada; D003362:Cost-Benefit Analysis / Q000191:economics; D003695:Delivery of Health Care / Q000191:economics*; D005060:Europe; D005702:Galantamine / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D008134:Long-Term Care / Q000191:economics; D018803:Models, Economic; D010919:Placebos / Q000191:economics
D010919:Placebos; D005702:Galantamine