title: Health economic effect of donepezil treatment for CDR 0.5 converters to Alzheimer's disease as shown by the Markov model.
abstract: The previous health economic simulation of donepezil based on the Markov model revealed the treatment for mild to moderate stage of Alzheimer disease (AD) to be cost-effective. Our aim was to examine the economic effect of donepezil treatment for mild cognitive impairment, from which about 15% convert to dementia per year. We constructed a new Markov model using three simulations. Namely, Simulation A hypothesized that mild AD patients, i.e., Clinical Dementia Rating (CDR) 1, received donepezil as in the previous study. Simulation B hypothesized that all CDR 0.5 subjects received donepezil, and Simulation C considered that only the CDR 0.5 converters to dementia received donepezil. We calculated the models as follows: Simulation B, supposes that the annual transition probabilities were reduced even from 15% to 10% by donepezil, however, the drug had a negative economic effect. By contrast, in Simulation C, the annual transition probability was reduced from only 15% to 12% by donepezil, there was a positive economic effect. Since it is necessary to reduce the annual transition probability from 15% to 12% in order to manifest a concomitant economic benefit, we consider that early detection of CDR 0.5 converters in the community is important for health policy planning.
authors.affiliation: Department of Geriatric Behavioral Neurology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, 980-8575 Sendai, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kasuya
authors.forename: Kenichi
authors.initials: K
authors.lastname: Meguro
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000517:prevention & control*; D003072:Cognition Disorders / Q000188:drug therapy*; D003362:Cost-Benefit Analysis; D000077265:Donepezil; D016527:Drug Costs; D017048:Health Care Costs; D006801:Humans; D007189:Indans / Q000191:economics* / Q000627:therapeutic use; D007564:Japan; D008390:Markov Chains; D010880:Piperidines / Q000191:economics* / Q000627:therapeutic use; D011306:Prescription Fees; D019057:Quality-Adjusted Life Years
chemical_list: D007189:Indans; D010880:Piperidines; D000077265:Donepezil