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NEUROLOGY 2004;63:644-650
© 2004 American Academy of Neurology

Economic evaluation of donepezil in moderate to severe Alzheimer disease

H. Feldman, MD, S. Gauthier, MD, J. Hecker, MD, B. Vellas, MD PhD, M. Hux, MSc, Y. Xu, PhD, E.M. Schwam, PhD, S. Shah, RPh MPH and V. Mastey, MS for the Donepezil MSAD Study Investigators Group*

From the Division of Neurology (Dr. Feldman), UBC Hospital, Clinic for Alzheimer’s Disease and Related Disorders, Vancouver, BC; Alzheimer Disease Research Unit (Dr. Gauthier), McGill Centre for Studies in Aging, Verdun, QC, Canada; Department of Rehabilitation and Aged Care (Dr. Hecker), Repatriation General Hospital, Daw Park, SA, Australia; Toulouse University Alzheimer’s Center (Dr. Vellas), Toulouse, France; Innovus Research Inc. (M. Hux), Burlington, ON, Canada; and Clinical Data Operations (Dr. Xu) and Outcomes Research (S. Shah and V. Mastey), Pfizer Global Pharmaceuticals (Dr. Schwam), Pfizer Inc., New York, NY.

Address correspondence and reprint requests to Dr. Howard Feldman, Division of Neurology, UBC Hospital, S192-2211 Wesbrook Mall, Vancouver, BC V6T2B5, Canada; e-mail: hfeldman{at}interchange.ubc.ca

Objective: To investigate the costs to society of Alzheimer disease (AD) care in a multinational, randomized, placebo-controlled trial of donepezil in patients with moderate to severe AD.

Methods: A total of 290 patients with AD (screening standardized Mini-Mental State Examination score 5 to17) were randomized to receive either donepezil (n = 144; 5 mg/day for 28 days, followed by 10 mg/day as per clinician’s judgment) or placebo (n = 146) for 24 weeks. The authors collected data on patient and caregiver health resource utilization prospectively using the Canadian Utilization of Services Tracking questionnaire. Costs were calculated for patients and caregivers in each group based on resource utilization multiplied by the unit prices for each resource. A cost (the average Ontario minimum wage for 1998 [Can $6.85 per hour]) was assigned to unpaid time that caregivers spent assisting the patient with activities of daily living (ADL).

Results: Patient and caregiver demographics at baseline were similar across the two groups. After adjusting for baseline total cost per patient, the mean total societal cost per patient for the 24-week period was donepezil, Can $9,904 (US $6,686) and placebo, Can $10,236 (US $6,910). This net cost saving of Can $332 (US $224) included the average 24-week cost of donepezil treatment. Most of the cost-saving with donepezil treatment was due to less use of residential care by patients, and caregivers spending less time assisting patients with ADL.

Conclusion: This cost-consequence analysis reveals economic benefits of treatment of moderate to severe AD with donepezil.

Received August 8, 2003. Accepted in final form May 5, 2004.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the August 24 issue to find the title link for this article.

*Members of The Donepezil MSAD Study Investigators Group are listed in the Appendix on pages 649–650.

The following authors have or have had a financial relationship with Pfizer Inc. and Eisai Co. Ltd.: Dr. Feldman has received grant support, has acted as consultant, and has been involved in CME activities for which he has received honoraria in excess of $10,000. Drs. Gauthier and Hecker have also received honoraria. Dr. Xu owns stock. Dr. Schwam and Ms. Shah own stock in excess of $10,000.


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Neurology 2004 63: 604-605. [Full Text]  



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Correspondence:

Read all Correspondence

Economic evaluation of donepezil in moderate to severe Alzheimer disease
Hein PJ van Hout, et al.
Neurology Online, 2 Dec 2004 [Full text]
Reply to van Hout et al
Howard Feldman, et al.
Neurology Online, 2 Dec 2004 [Full text]

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