[Cost of illness in Alzheimer's disease].
OBJECTIVE
The aim of this analysis was to generate cost data of provider services, drug acquisition, hospitalization, nursing care services, and adjuvants for patients with Alzheimer's disease, as well as to describe the distribution and development of care levels.


METHODS
The analysis is based on anonymized data of patients with Alzheimer's disease who were insured by a large German statutory health insurance (Barmer Krankenkasse [BARMER]) in 2005 (n = 48,322). The study population was classified into three treatment groups: patients, who received memantine and no other antidementives, psychotropic drugs or hypnotics/sedatives (memantine group); patients who neither received memantine nor other antidementives, but psychotropic drugs and hypnotics/ sedatives (PHS group); and patients who received no antidementives or symptomatic therapy at all ("no dementia-specific AM"). Costs were fully assessed for patients in each treatment group and correlated with the care level.


RESULTS
In the memantine group, fewer patients needed care than in the other two groups. Total costs per patient averaged 7,028 Euros in the memantine group, 13,549 Euros in the PHS group, and 8,817 Euros in the group with no specific medication. Higher costs in the PHS group and in the group without drug treatment were mainly caused by a considerably higher rate of patients in need of care, of which nursing care made up the highest proportion. Fewer costs for medical treatment could not compensate the additional expenditures for nursing care. Patients in the PHS group had the highest average costs in all cost categories except for specific drug cost.


CONCLUSIONS
The results demonstrate that non-antidementive therapy for Alzheimer's disease causes higher costs especially in nursing care. The memantine group proved superior even though it had the highest costs in the specific drug category.
Kiencke
Peter
P
Institut für Empirische Gesundheitsökonomie, Am Ziegelfeld 28, 51399, Burscheid, Germany. peter.kiencke@ifeg.de
Rychlik
Reinhard
R
Grimm
Christine
C
Daniel
Dietmar
D
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy; D003362:Cost-Benefit Analysis; D004185:Disability Evaluation; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005851:Geriatric Nursing / Q000191:economics; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D006993:Hypnotics and Sedatives / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D008559:Memantine / Q000191:economics* / Q000627:therapeutic use; D009313:National Health Programs / Q000191:economics*; D018697:Nootropic Agents / Q000191:economics* / Q000627:therapeutic use; D011619:Psychotropic Drugs / Q000191:economics* / Q000627:therapeutic use; D012189:Retrospective Studies; D015996:Survival Rate
D006993:Hypnotics and Sedatives; D018697:Nootropic Agents; D011619:Psychotropic Drugs; D008559:Memantine