Cost effectiveness of memantine in Alzheimer’s disease in the UK

Cost effectiveness of memantine in Alzheimer’s disease in the UK

2010 J. Med. Econ

Rive, B. | Grishchenko, M. | Guilhaume-Goulant, C. | Katona, C. | Livingston, G. | Lamure, M. | Toumi, M. | Francois, C. | Volume: 13, Issue: 2, Pages: 371-380, Alzheimer Disease, analysis, Cost Savings, Cost-Benefit Analysis, Dopamine Agents, drug therapy, economics, Female, France, Great Britain, Health Services, Humans, Male, Markov Chains, Memantine, Meta-Analysis as Topic, methods, Models,Economic, mortality, Quality-Adjusted Life Years, therapeutic use, therapy, utilization,

OBJECTIVE: This analysis assesses the cost-effectiveness of memantine for the treatment of moderate-to-severe Alzheimer’s disease (AD) in the UK. METHODS: This cost-utility analysis was based on a Markov model. The model simulated 5-year progress of patients with AD until they need full-time care (FTC), defined as a patient becoming either dependent or institutionalised. Transition probabilities were based on a predictive equation, derived from the London and South-East Region epidemiological study. Resource use, utilities and mortality were obtained from the same study. Memantine efficacy was based on a meta-analysis of six large trials. The model compared memantine to its alternative in the UK, i.e. no pharmacological treatment or background therapy with acetylcholinesterase inhibitors. RESULTS: Memantine was found to delay the need to FTC by 6 weeks compared with current practice in the UK. It was associated with increased quality-adjusted life-years and cost savings to the healthcare system (probability of this outcome was 96%). The projections were made assuming that benefits from the 6-month treatment were sustained over time, which is regarded as the main limitation. The model underwent extensive sensitivity analyses, which confirmed the base-case findings. CONCLUSIONS: The model suggests that memantine delays the need for FTC and decreases cost. It can be regarded as a cost-effective choice in the management of moderate and severe AD

https://www.doi.org/10.3111/13696998.2010.491347