title: Memantine for treatment of moderate or severe Alzheimer's disease patients in urban China: clinical and economic outcomes from a health economic model.
abstract: OBJECTIVE
  To estimate the clinical and economic benefits of memantine treatment initiated in moderate Alzheimer's disease (AD) in China, compared with initiation in severe AD only.
  
  
  METHODS
  A Markov model with a 5-year time horizon simulated moderate patients' progression through health states. Two groups were compared: patients receiving memantine from the moderate stage (i.e., at model entry), continuing treatment when reaching the severe stage; patients initiating memantine only when they developed severe disease.
  
  
  RESULTS
  After 5 years, fewer patients receiving memantine from the moderate stage were severe (49%), dependent (59%) or aggressive (47%) compared with moderate patients who initiated treatment from severe stage only (58, 67 and 55%, respectively). Total cost of care was lower for treatment from moderate stage (67 billion RMB) when compared with treatment from severe stage (73 billion RMB).
  
  
  CONCLUSIONS
  In China, AD treatment with memantine from the moderate stage could result in substantial cost savings.
authors.affiliation: School of Public Health, Fudan University, Shanghai, China.
authors.forename: Shanlian
authors.initials: S
authors.lastname: Hu
authors.forename: Xin
authors.initials: X
authors.lastname: Yu
authors.forename: Shengdi
authors.initials: S
authors.lastname: Chen
authors.forename: Emilie
authors.initials: E
authors.lastname: Clay
authors.forename: Mondher
authors.initials: M
authors.lastname: Toumi
authors.forename: Dominique
authors.initials: D
authors.lastname: Milea
mesh_terms: D000544:Alzheimer Disease / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D002681:China; D017046:Cost Savings; D018450:Disease Progression; D018691:Excitatory Amino Acid Antagonists / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D008390:Markov Chains; D008559:Memantine / Q000191:economics / Q000627:therapeutic use*; D018803:Models, Economic; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014505:Urban Population
chemical_list: D018691:Excitatory Amino Acid Antagonists; D008559:Memantine
keywords: Alzheimer’s disease; aggression; cost-saving; disease burden; memantine; pharmacoeconomic