[Cost-effectiveness of galantamine in a german context].
OBJECTIVE
The application of acetylcholinesterase (AChE) inhibitors seems to be constrained in the German health care system. We investigate the cost-effectiveness of the AChE inhibitor Galantamine for patients with Alzheimer's disease (AD) in a German context.


METHODS
A Markov model as the decision theoretic framework is applied to compare two treatment scenarios (Placebo vs. Galantamine). The incremental cost-utility ratio based on different sources of data is calculated as decision criteria.


RESULTS
In the base case, the application of the AChE inhibitor Galantamine is a dominant scenario with cost savings along with gained quality adjusted life years. It is not cost saving from the perspective of third party payers in Germany. Results are sensitive regarding assumptions about efficacy of the drug and mortality in the analysed cohort.


CONCLUSIONS
The German reimbursement system places an obstacle to the application of Galantamine. Further research is needed to tackle uncertainties in the model.
Happich
Michael
M
GSF-Forschungszentrum für Umwelt und Gesundheit, Institut für Gesundheitsökonomie und Management im Gesundheitswesen, Neuherberg. michael.happich@gsf.de
Schweikert
Bernd
B
Mühlbacher
Axel
A
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy / Q000191:economics* / Q000401:mortality; D002800:Cholinesterase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D018450:Disease Progression; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D005702:Galantamine / Q000191:economics* / Q000627:therapeutic use; D005858:Germany; D006801:Humans; D008297:Male; D008390:Markov Chains; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D009313:National Health Programs / Q000191:economics*; D018697:Nootropic Agents / Q000191:economics* / Q000627:therapeutic use; D011594:Psychometrics / Q000706:statistics & numerical data; D019057:Quality-Adjusted Life Years; D013223:Statistics as Topic; D015996:Survival Rate
D002800:Cholinesterase Inhibitors; D018697:Nootropic Agents; D005702:Galantamine