Costs of Early Stage Alzheimer’s Disease in the United States: Cross-Sectional Analysis of a Prospective Cohort Study (GERAS-US)1

Robinson, Rebecca; Rentz, Dorene M.; Andrews, Jeffrey Scott; Zagar, Anthony; Kim, Yongin; Bruemmer, Valerie; Schwartz, Ronald L.; Ye, Wenyu; Fillit, Howard

doi:10.3233/jad-191212

Cited by 48 publications

(79 citation statements)

References 38 publications

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“…This review identified few studies evaluating the broader economic burden of MCI likely due to AD, probably because of the recent introduction of this term and the difficulty to establish this diagnosis (57). These studies demonstrated that individuals with MCI likely due to AD require social care and informal care more than their age-matched peers; and that this is further increased in those with mild AD dementia (32,45). A similar trend is seen with caregiver health care costs when they are included in the estimation of total costs.…”

Section: Discussionmentioning

confidence: 99%

“…Another study demonstrated that, compared to MCI, significantly more individuals with mild AD were pushed to an income below the federal poverty level. Patients' employment rates were found to significantly drop from 21.4% to 9.4%; and the number of employed adults who reduced their work significantly rose from 3.2% to 13.8% (32). In the broader AD population, a significant relationship between dependency and household income has not been found (44).…”

Section: Impact Of Ad On Other Socioeconomic Aspectsmentioning

confidence: 91%

“…Ten publications reported results from the GERAS I (18, 24-28), GERAS II (29,30), and extensions of the GERAS to Japan (31) and the USA (32). The remaining 20 publications included the ECO, EVOCOST and Codep-AD studies from Spain (33)(34)(35)(36); the ECAD from Ireland (17,37); one multinational study (38); a clusterrandomized observational study from China (39, 40); and others from France (41), Germany (42), Sweden (43), and the USA (44)(45)(46)(47)(48).…”

Section: Characteristics Of Individual Studiesmentioning

confidence: 99%

“…Overall, adults with MCI likely to be due to AD were included in 3 studies (17,32,37,42); their outcomes were reported separately from adults with AD in the GERAS-US (32).…”

Section: Characteristics Of Individual Studiesmentioning

confidence: 99%

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Major Cost Drivers in Assessing the Economic Burden of Alzheimer’s Disease: A Structured, Rapid Review

Kließ¹,

Martins²,

Connolly

2021

J Prev Alz Dis

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Background: Alzheimer’s Disease is the most common cause of dementia, affecting memory, thinking and behavior. Symptoms eventually grow severe enough to interfere with daily tasks. AD is predicted to increase healthcare spending and costs associated with formal and informal caregiving. The aim of this study was to identify and quantify the contribution of the different cost components associated with AD. Methods: A structured literature review was conducted to identify studies reporting the economic burden of Alzheimer`s Disease beyond the healthcare setting. The search was conducted in Medline, Embase and EconLit and limited to studies published in the last 10 years. For each identified cost component, frequency weighted mean costs were calculated across countries to estimate the percentage contribution of each component by care setting and disease severity. Results obtained by each costing approach were also compared. Results: For community-dwelling adults, the percentage of healthcare, social care and indirect costs to total costs were 13.9%, 17.4% and 68.7%, respectively. The percentage of costs varied by disease severity with 26.0% and 10.4% of costs spent on healthcare for mild and severe disease, respectively. The proportion of total spending on indirect costs changed from 60.7% to 72.5% as disease progressed. For those in residential care, the contribution of each cost component was similar between moderate and severe disease. Social care accounted on average for 85.9% of total costs. Conclusion: The contribution of healthcare costs to the overall burden was not negligible; but was generally exceeded by social and informal care costs.

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Section: Discussionmentioning

confidence: 99%

Section: Impact Of Ad On Other Socioeconomic Aspectsmentioning

confidence: 91%

Section: Characteristics Of Individual Studiesmentioning

confidence: 99%

“…Overall, adults with MCI likely to be due to AD were included in 3 studies (17,32,37,42); their outcomes were reported separately from adults with AD in the GERAS-US (32).…”

Section: Characteristics Of Individual Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Major Cost Drivers in Assessing the Economic Burden of Alzheimer’s Disease: A Structured, Rapid Review

Kließ¹,

Martins²,

Connolly

2021

J Prev Alz Dis

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“…A recent literature review of multinational studies found that informal care costs represent approximately 60% of total costs for patients with early stages of AD, increasing to 72.5% for patients with severe AD [32]. Although cognitive function has been identified as the main driver of societal costs of patients with AD [33], both cognitive decline and physical disability were found to be predictors of increased informal care costs [34]. Moreover, the need for social and informal care is already higher in patients with mild cognitive impairment likely due to AD than age-matched controls and increasing further in patients with AD dementia [32].…”

Section: Accepted Manuscript 1) Do Qalys Undervalue Treatments For Older Patients?mentioning

confidence: 99%

Modelling the value of innovative treatments for Alzheimer’s disease in the United States

Makin

Neumann

Peschin

et al. 2021

Journal of Medical Economics

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Evaluation of the Cost-effectiveness of Drug Treatment for Alzheimer Disease in a Simulation Model That Includes Caregiver and Societal Factors

et al. 2021

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IMPORTANCEThe possibility of widespread use of a novel effective therapy for Alzheimer disease (AD) will present important clinical, policy, and financial challenges. OBJECTIVE To describe how including different patient, caregiver, and societal treatment-related factors affects estimates of the cost-effectiveness of a hypothetical disease-modifying AD treatment. DESIGN, SETTING, AND PARTICIPANTS In this economic evaluation, the Alzheimer Disease Archimedes Condition Event Simulator was used to simulate the prognosis of a hypothetical cohort of patients selected from the Alzheimer Disease Neuroimaging Initiative database who received the diagnosis of mild cognitive impairment (MCI). Scenario analyses that varied costs and quality of life inputs relevant to patients and caregivers were conducted. The analysis was designed and conducted from June 15, 2019, to September 30, 2020. EXPOSURES A hypothetical drug that would delay progression to dementia in individuals with MCI compared with usual care. MAIN OUTCOMES AND MEASURES Incremental cost-effectiveness ratio (ICER), measured by cost per quality-adjusted life-year (QALY) gained. RESULTSThe model included a simulated cohort of patients who scored between 24 and 30 on the Mini-Mental State Examination and had a global Clinical Dementia Rating scale of 0.5, with a required memory box score of 0.5 or higher, at baseline. Using a health care sector perspective, which included only individual patient health care costs, the ICER for the hypothetical treatment was $192 000 per QALY gained. The result decreased to $183 000 per QALY gained in a traditional societal perspective analysis with the inclusion of patient non-health care costs. The inclusion of estimated caregiver health care costs produced almost no change in the ICER, but the inclusion of QALYs gained by caregivers led to a substantial reduction in the ICER for the hypothetical treatment, to $107 000 per QALY gained in the health sector perspective. In the societal perspective scenario, with the broadest inclusion of patient and caregiver factors, the ICER decreased to $74 000 per added QALY. CONCLUSIONS AND RELEVANCEThe findings of this economic evaluation suggest that policy makers should be aware that efforts to estimate and include the effects of AD treatments outside those on patients themselves can affect the results of the cost-effectiveness analyses that often underpin assessments of the value of new treatments. Further research and debate on including these factors in assessments that will inform discussions on fair pricing for new treatments are needed.

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Costs of Early Stage Alzheimer’s Disease in the United States: Cross-Sectional Analysis of a Prospective Cohort Study (GERAS-US)1

Cited by 48 publications

References 38 publications

Major Cost Drivers in Assessing the Economic Burden of Alzheimer’s Disease: A Structured, Rapid Review

Major Cost Drivers in Assessing the Economic Burden of Alzheimer’s Disease: A Structured, Rapid Review

Modelling the value of innovative treatments for Alzheimer’s disease in the United States

Evaluation of the Cost-effectiveness of Drug Treatment for Alzheimer Disease in a Simulation Model That Includes Caregiver and Societal Factors

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