Generic placeholder image

Current Indian Science

Editor-in-Chief

ISSN (Print): 2210-299X
ISSN (Online): 2210-3007

Review Article

Cost-effectiveness of Dementia Medication

Author(s): Nikita Khera, Rojin G. Raj*, Ranjeet Kumar, Megha Bajaj, Bintoo Sharma, Harsh Tyagi and Josmy Maria Job

Volume 2, 2024

Published on: 08 December, 2023

Article ID: e2210299X259911 Pages: 6

DOI: 10.2174/012210299X259911231128112915

open_access

Abstract

Aim: This review has examined and organized the available research on dementia medication care costs. Although the accessible database in this area is growing and is still quite limited, there are many clear scientific methods.

Objective: The use of Memantine, a non-competitive antagonist with low to moderate affinity for the NMDA (N-methyl-D-aspartate) receptor, has been approved for the treatment of mild to moderately severe Alzheimer's disease (AD). The efficacy of cholinesterase inhibitors (ChEIs) in the treatment of dementia varies depending on the drug type and ease of administration. Numerous techniques have been employed to evaluate the quality of life (QOL) of individuals suffering from dementia. QOL data is a well-established measure of an intervention's effectiveness. Up to now, cost-effectiveness studies have concentrated on both pharmaceutical and non-pharmacological therapy. Each unit of QoL-AD improvement costs USD27.82578 at mean values.

Methods: Searches were conducted to observe studies of the pharmacoeconomic impact of dementia medications with the help of previous articles published in journals and collected from Google Scholar with name search dementia or Alzheimer's cross-referenced with pharmacoeconomic or costs and effectiveness.

Keywords: Alzheimer's disease (AD), Dementia, NMDA (N-methyl-D-aspartate), Quality of life (QOL), Cholinesterase inhibitors (ChEIs), Costeffectiveness, MMSE (Mini-Mental State Examination).

[1]
Multi-modal data analysis for alzheimer’s disease diagnosis: An ensemble model using imagery and genetic features. Ying, Q.; Xing, X.; Liu, L.; Lin, A-L.; Jacobs, N.; Liang, G., Eds.; 2021 43rd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC), 2021. IEEE
[2]
Koenig, L.N.; LaMontagne, P.; Glasser, M.F.; Bateman, R.; Holtzman, D.; Yakushev, I.; Chhatwal, J.; Day, G.S.; Jack, C.; Mummery, C.; Perrin, R.J.; Gordon, B.A.; Morris, J.C.; Shimony, J.S.; Benzinger, T.L.S. Regional age-related atrophy after screening for preclinical Alzheimer disease. Neurobiol. Aging, 2022, 109, 43-51.
[http://dx.doi.org/10.1016/j.neurobiolaging.2021.09.010] [PMID: 34655980]
[3]
2018 Alzheimer’s disease facts and figures. Alzheimers Dement., 2018, 14(3), 367-429.
[http://dx.doi.org/10.1016/j.jalz.2018.02.001]
[4]
Winblad, B.; Amouyel, P.; Andrieu, S.; Ballard, C.; Brayne, C.; Brodaty, H.; Cedazo-Minguez, A.; Dubois, B.; Edvardsson, D.; Feldman, H.; Fratiglioni, L.; Frisoni, G.B.; Gauthier, S.; Georges, J.; Graff, C.; Iqbal, K.; Jessen, F.; Johansson, G.; Jönsson, L.; Kivipelto, M.; Knapp, M.; Mangialasche, F.; Melis, R.; Nordberg, A.; Rikkert, M.O.; Qiu, C.; Sakmar, T.P.; Scheltens, P.; Schneider, L.S.; Sperling, R.; Tjernberg, L.O.; Waldemar, G.; Wimo, A.; Zetterberg, H. Defeating Alzheimer’s disease and other dementias: a priority for European science and society. Lancet Neurol., 2016, 15(5), 455-532.
[http://dx.doi.org/10.1016/S1474-4422(16)00062-4] [PMID: 26987701]
[5]
Sachs-Ericsson, N.; Blazer, D.G. The new DSM-5 diagnosis of mild neurocognitive disorder and its relation to research in mild cognitive impairment. Aging Ment. Health, 2015, 19(1), 2-12.
[http://dx.doi.org/10.1080/13607863.2014.920303] [PMID: 24914889]
[6]
Vuic, B.; Konjevod, M.; Tudor, L.; Milos, T.; Nikolac Perkovic, M.; Nedic Erjavec, G.; Pivac, N.; Uzun, S.; Mimica, N.; Svob Strac, D. Tailoring the therapeutic interventions for behavioral and psychological symptoms of dementia. Expert Rev. Neurother., 2022, 22(8), 707-720.
[http://dx.doi.org/10.1080/14737175.2022.2112668] [PMID: 35950234]
[7]
Dichter, M.N.; Quasdorf, T.; Schwab, C.G.G.; Trutschel, D.; Haastert, B.; Riesner, C.; Bartholomeyczik, S.; Halek, M. Dementia care mapping: Effects on residents’ quality of life and challenging behavior in German nursing homes. A quasi-experimental trial. Int. Psychogeriatr., 2015, 27(11), 1875-1892.
[http://dx.doi.org/10.1017/S1041610215000927] [PMID: 26138674]
[8]
Mukadam, N.; Anderson, R.; Knapp, M.; Wittenberg, R.; Karagiannidou, M.; Costafreda, S.G.; Tutton, M.; Alessi, C.; Livingston, G. Effective interventions for potentially modifiable risk factors for late-onset dementia: A costs and cost-effectiveness modelling study. Lancet Healthy Longev., 2020, 1(1), e13-e20.
[http://dx.doi.org/10.1016/S2666-7568(20)30004-0] [PMID: 36094185]
[9]
Wang, G.; Albayrak, A.; van der Cammen, T.J.M. A systematic review of non-pharmacological interventions for BPSD in nursing home residents with dementia: From a perspective of ergonomics. Int. Psychogeriatr., 2019, 31(8), 1137-1149.
[http://dx.doi.org/10.1017/S1041610218001679] [PMID: 30334500]
[10]
van der Flier, W.M.; Scheltens, P. Epidemiology and risk factors of dementia. J. Neurol. Neurosurg. Psychiatry, 2005, 76(Suppl 5)(Suppl. 5), v2-v7.
[http://dx.doi.org/10.1136/jnnp.2005.082867] [PMID: 16291918]
[11]
Quentin, W.; Riedel-Heller, S.G.; Luppa, M.; Rudolph, A.; König, H.H. Cost-of-illness studies of dementia: A systematic review focusing on stage dependency of costs. Acta Psychiatr. Scand., 2010, 121(4), 243-259.
[http://dx.doi.org/10.1111/j.1600-0447.2009.01461.x] [PMID: 19694634]
[12]
Gridley, K.; Brooks, J.; Birks, Y.; Baxter, K.; Parker, G. Improving care for people with dementia: Development and initial feasibility study for evaluation of life story work in dementia care. Health Serv. Deliv. Res., 2016, 4(23), 1-298.
[http://dx.doi.org/10.3310/hsdr04230] [PMID: 27559566]
[13]
Jeste, D.V.; Blazer, D.; Casey, D.; Meeks, T.; Salzman, C.; Schneider, L.; Tariot, P.; Yaffe, K. ACNP White Paper: Update on use of antipsychotic drugs in elderly persons with dementia. Neuropsychopharmacology, 2008, 33(5), 957-970.
[http://dx.doi.org/10.1038/sj.npp.1301492] [PMID: 17637610]
[14]
Bassil, N.; Grossberg, G.T. Novel regimens and delivery systems in the pharmacological treatment of Alzheimer’s disease. CNS Drugs, 2009, 23(4), 293-307.
[http://dx.doi.org/10.2165/00023210-200923040-00003] [PMID: 19374459]
[15]
Fortunato, S.; Forli, F.; Guglielmi, V.; De Corso, E.; Paludetti, G.; Berrettini, S.; FetonI, A.R. A review of new insights on the association between hearing loss and cognitive decline in ageing. Acta Otorhinolaryngol. Ital., 2016, 36(3), 155-166.
[http://dx.doi.org/10.14639/0392-100X-993] [PMID: 27214827]
[16]
Haake, A.; Nguyen, K.; Friedman, L.; Chakkamparambil, B.; Grossberg, G.T. An update on the utility and safety of cholinesterase inhibitors for the treatment of Alzheimer’s disease. Expert Opin. Drug Saf., 2020, 19(2), 147-157.
[http://dx.doi.org/10.1080/14740338.2020.1721456] [PMID: 31976781]
[17]
Cooper, C.; Lodwick, R.; Walters, K.; Raine, R.; Manthorpe, J.; Iliffe, S.; Petersen, I. Observational cohort study: Deprivation and access to anti-dementia drugs in the UK. Age Ageing, 2016, 45(1), 148-154.
[http://dx.doi.org/10.1093/ageing/afv154] [PMID: 26582758]
[18]
Schneider, L.S.; Dagerman, K.S.; Higgins, J.P.; McShane, R. Lack of evidence for the efficacy of memantine in mild Alzheimer disease. Arch. Neurol., 2011, 68(8), 991-998.
[http://dx.doi.org/10.1001/archneurol.2011.69] [PMID: 21482915]
[19]
Schneider, L.S.; Mangialasche, F.; Andreasen, N.; Feldman, H.; Giacobini, E.; Jones, R.; Mantua, V.; Mecocci, P.; Pani, L.; Winblad, B.; Kivipelto, M. Clinical trials and late-stage drug development for A lzheimer’s disease: an appraisal from 1984 to 2014. J. Intern. Med., 2014, 275(3), 251-283.
[http://dx.doi.org/10.1111/joim.12191] [PMID: 24605808]
[20]
Matsunaga, S.; Kishi, T.; Iwata, N. Memantine monotherapy for Alzheimer’s disease: A systematic review and meta-analysis. PLoS One, 2015, 10(4), e0123289.
[http://dx.doi.org/10.1371/journal.pone.0123289] [PMID: 25860130]
[21]
Keiski, M. Memantine: A safe and tolerable NMDA antagonist with potential benefits in traumatic brain injury. New therapeutics for traumatic brain injury., 2017, 253-271.
[22]
Valis, M.; Herman, D.; Vanova, N.; Masopust, J.; Vysata, O.; Hort, J.; Pavelek, Z.; Klimova, B.; Kuca, K.; Misik, J.; Zdarova Karasova, J. The concentration of memantine in the cerebrospinal fluid of Alzheimer’s disease patients and its consequence to oxidative stress biomarkers. Front. Pharmacol., 2019, 10, 943.
[http://dx.doi.org/10.3389/fphar.2019.00943] [PMID: 31555132]
[23]
Winblad, B.; Jones, R.W.; Wirth, Y.; Stöffler, A.; Möbius, H.J. Memantine in moderate to severe Alzheimer’s disease: A meta-analysis of randomised clinical trials. Dement. Geriatr. Cogn. Disord., 2007, 24(1), 20-27.
[http://dx.doi.org/10.1159/000102568] [PMID: 17496417]
[24]
Nakamura, Y.; Kitamura, S.; Homma, A.; Shiosakai, K.; Matsui, D. Efficacy and safety of memantine in patients with moderate-to-severe Alzheimer’s disease: Results of a pooled analysis of two randomized, double-blind, placebo-controlled trials in Japan. Expert Opin. Pharmacother., 2014, 15(7), 913-925.
[http://dx.doi.org/10.1517/14656566.2014.902446] [PMID: 24673497]
[25]
Rinne, J.O.; Wesnes, K.; Cummings, J.L.; Hakulinen, P.; Hallikainen, M.; Hänninen, J.; Murphy, M.; Riordan, H.; Scheinin, M.; Soininen, H.; Rouru, J. Tolerability of ORM-12741 and effects on episodic memory in patients with Alzheimer’s disease. Alzheimers Dement. (N. Y.), 2017, 3(1), 1-9.
[http://dx.doi.org/10.1016/j.trci.2016.11.004] [PMID: 29067315]
[26]
Perry, G.; Lee, H.; Lee, H.P.; Zhu, X.; Smith, M.A.; Rolston, R.K.; Marlatt, M.W.; Castellani, R.J.; Nunomura, A.; Casadesus, G.; Clark, T.A. Oxidative stress and its implications for future treatments and management of Alzheimer disease. Int. J. Biomed. Sci., 2010, 6(3), 225-227.
[http://dx.doi.org/10.59566/IJBS.2010.6225] [PMID: 21765811]
[27]
Bond, M.; Rogers, G.; Peters, J.; Anderson, R.; Hoyle, M.; Miners, A.; Moxham, T.; Davis, S.; Thokala, P.; Wailoo, A.; Jeffreys, M.; Hyde, C. The effectiveness and cost-effectiveness of donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer’s disease (review of Technology Appraisal No. 111): A systematic review and economic model. Health Technol. Assess., 2012, 16(21), 1-470.
[http://dx.doi.org/10.3310/hta16210] [PMID: 22541366]
[28]
Bezerra da Silva, C.; Pott, A.; Elifio-Esposito, S.; Dalarmi, L.; Fialho do Nascimento, K.; Moura Burci, L.; de Oliveira, M.; de Fátima Gaspari Dias, J.; Maria Warumby Zanin, S.; Gomes Miguel, O.; Dallarmi Miguel, M. Effect of donepezil, tacrine, galantamine and rivastigmine on acetylcholinesterase inhibition in Dugesia tigrina. Molecules, 2016, 21(1), 53.
[http://dx.doi.org/10.3390/molecules21010053] [PMID: 26760993]
[29]
Ferris, S.; Farlow, M. Language impairment in Alzheimer’s disease and benefits of acetylcholinesterase inhibitors. Clin. Interv. Aging, 2013, 8, 1007-1014.
[http://dx.doi.org/10.2147/CIA.S39959] [PMID: 23946647]
[30]
Stefanacci, R.G. The costs of Alzheimer’s disease and the value of effective therapies. Am. J. Manag. Care, 2011, 17(13)(Suppl. 13), S356-S362.
[PMID: 22214393]
[31]
Orrell, M.; Yates, L.A.; Burns, A.; Russell, I.; Woods, R.T.; Hoare, Z.; Moniz-Cook, E.; Henderson, C.; Knapp, M.; Spector, A.; Orgeta, V. Individual cognitive stimulation therapy for dementia (iCST): Study protocol for a randomized controlled trial. Trials, 2012, 13(1), 172.
[http://dx.doi.org/10.1186/1745-6215-13-172] [PMID: 22998983]
[32]
Christopher, M.; Holweg, M. Supply chain 2.0 revisited: A framework for managing volatility-induced risk in the supply chain. Int. J. Phys. Distrib. Logist. Manag., 2017, 47(1), 2-17.
[http://dx.doi.org/10.1108/IJPDLM-09-2016-0245]
[33]
Noyes, K.; Holloway, R.G. Evidence from cost-effectiveness research. NeuroRx, 2004, 1(3), 348-355.
[http://dx.doi.org/10.1602/neurorx.1.3.348] [PMID: 15717037]
[34]
Knapp, M.; Thorgrimsen, L.; Patel, A.; Spector, A.; Hallam, A.; Woods, B.; Orrell, M. Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis. Br. J. Psychiatry, 2006, 188(6), 574-580.
[http://dx.doi.org/10.1192/bjp.bp.105.010561] [PMID: 16738349]
[35]
Meads, D.M.; Martin, A.; Griffiths, A.; Kelley, R.; Creese, B.; Robinson, L.; McDermid, J.; Walwyn, R.; Ballard, C.; Surr, C.A. Cost-effectiveness of dementia care mapping in care-home settings: Evaluation of a randomised controlled trial. Appl. Health Econ. Health Policy, 2020, 18(2), 237-247.
[http://dx.doi.org/10.1007/s40258-019-00531-1] [PMID: 31701483]
[36]
Cohen, D.J.; Reynolds, M.R. Interpreting the results of cost-effectiveness studies. J. Am. Coll. Cardiol., 2008, 52(25), 2119-2126.
[http://dx.doi.org/10.1016/j.jacc.2008.09.018] [PMID: 19095128]
[37]
Prince, M; Bryce, R; Albanese, E; Wimo, A; Ribeiro, W; Ferri, CP The global prevalence of dementia: A systematic review and metaanalysis. Alzheimer's & dementia. Alzheimers Dement., 2013, 9(1), 63-75. e2
[http://dx.doi.org/10.1016/j.jalz.2012.11.007]
[38]
Gunningberg, L.; Hommel, A.; Bååth, C.; Idvall, E. The first national pressure ulcer prevalence survey in county council and municipality settings in Sweden. J. Eval. Clin. Pract., 2013, 19(5), 862-867.
[http://dx.doi.org/10.1111/j.1365-2753.2012.01865.x] [PMID: 22640165]
[39]
Zucchella, C.; Sinforiani, E.; Tamburin, S.; Federico, A.; Mantovani, E.; Bernini, S.; Casale, R.; Bartolo, M. The multidisciplinary approach to Alzheimer’s disease and dementia. A narrative review of non-pharmacological treatment. Front. Neurol., 2018, 9, 1058.
[http://dx.doi.org/10.3389/fneur.2018.01058] [PMID: 30619031]
[40]
Shanbhag, S.; Dahiya, M.; Croucher, R. The impact of periodontal therapy on oral health-related quality of life in adults: A systematic review. J. Clin. Periodontol., 2012, 39(8), 725-735.
[http://dx.doi.org/10.1111/j.1600-051X.2012.01910.x] [PMID: 22694297]
[41]
Harrison, J.K.; Noel-Storr, A.H.; Demeyere, N.; Reynish, E.L.; Quinn, T.J. Outcomes measures in a decade of dementia and mild cognitive impairment trials. Alzheimers Res. Ther., 2016, 8(1), 48.
[http://dx.doi.org/10.1186/s13195-016-0216-8] [PMID: 27866472]
[42]
Smith, S.; Lamping, D.; Banerjee, S.; Harwood, R.; Foley, B.; Smith, P.; Cook, J.; Murray, J.; Prince, M.; Levin, E.; Mann, A.; Knapp, M. Measurement of health-related quality of life for people with dementia: Development of a new instrument (DEMQOL) and an evaluation of current methodology. Health Technol. Assess., 2005, 9(10), 1-93, iii-iv.
[http://dx.doi.org/10.3310/hta9100] [PMID: 15774233]
[43]
Andrieu, S.; Coley, N.; Rolland, Y.; Cantet, C.; Arnaud, C.; Guyonnet, S.; Nourhashemi, F.; Grand, A.; Vellas, B. Assessing Alzheimer’s disease patients’ quality of life: Discrepancies between patient and caregiver perspectives. Alzheimers Dement., 2016, 12(4), 427-437.
[http://dx.doi.org/10.1016/j.jalz.2015.09.003] [PMID: 26602086]
[44]
Duong, S; Patel, T; Chang, F. Dementia: What pharmacists need to know. Can Pharm J, 2017, 150(2), 118-129.
[45]
Borson, S.; Frank, L.; Bayley, P.J.; Boustani, M.; Dean, M.; Lin, P.J.; McCarten, J.R.; Morris, J.C.; Salmon, D.P.; Schmitt, F.A.; Stefanacci, R.G.; Mendiondo, M.S.; Peschin, S.; Hall, E.J.; Fillit, H.; Ashford, J.W. Improving dementia care: The role of screening and detection of cognitive impairment. Alzheimers Dement., 2013, 9(2), 151-159.
[http://dx.doi.org/10.1016/j.jalz.2012.08.008] [PMID: 23375564]
[46]
Kim, S.K.; Park, M. Effectiveness of person-centered care on people with dementia: A systematic review and meta-analysis. Clin. Interv. Aging, 2017, 12, 381-397.
[http://dx.doi.org/10.2147/CIA.S117637] [PMID: 28255234]
[47]
Cooper, C.; Mukadam, N.; Katona, C.; Lyketsos, C.G.; Ames, D.; Rabins, P.; Engedal, K.; de Mendonça Lima, C.; Blazer, D.; Teri, L.; Brodaty, H.; Livingston, G. Systematic review of the effectiveness of non-pharmacological interventions to improve quality of life of people with dementia. Int. Psychogeriatr., 2012, 24(6), 856-870.
[http://dx.doi.org/10.1017/S1041610211002614] [PMID: 22244371]
[48]
Bowling, A.; Rowe, G.; Adams, S.; Sands, P.; Samsi, K.; Crane, M.; Joly, L.; Manthorpe, J. Quality of life in dementia: A systematically conducted narrative review of dementia-specific measurement scales. Aging Ment. Health, 2015, 19(1), 13-31.
[http://dx.doi.org/10.1080/13607863.2014.915923] [PMID: 24881888]
[49]
Moyle, W.; Fetherstonhaugh, D.; Greben, M.; Beattie, E. Influencers on quality of life as reported by people living with dementia in long-term care: A descriptive exploratory approach. BMC Geriatr., 2015, 15(1), 50.
[http://dx.doi.org/10.1186/s12877-015-0050-z] [PMID: 25903463]
[50]
Sosa-Ortiz, A.L.; Acosta-Castillo, I.; Prince, M.J. Epidemiology of dementias and Alzheimer’s disease. Arch. Med. Res., 2012, 43(8), 600-608.
[http://dx.doi.org/10.1016/j.arcmed.2012.11.003] [PMID: 23159715]
[51]
Wimo, A.; Jönsson, L.; Winblad, B. An estimate of the worldwide prevalence and direct costs of dementia in 2003. Dement. Geriatr. Cogn. Disord., 2006, 21(3), 175-181.
[http://dx.doi.org/10.1159/000090733] [PMID: 16401889]
[52]
Oxford, AE; Stewart, ES; Rohn, TT Clinical trials in Alzheimer’s disease: a hurdle in the path of remedy. Int. J. Alzheimer's Dis., 2020, 2020
[http://dx.doi.org/10.1155/2020/5380346]
[53]
Schneider, L.S. A critical review of cholinesterase inhibitors as a treatment modality in Alzheimer’s disease. Dialogues Clin. Neurosci., 2022.
[54]
2022. Evidence and Experience in Psychiatry Available at: https://epdf.tips/dementia0b8ab5cd318021def4e1645b3d82f03a61615.html

© 2024 Bentham Science Publishers | Privacy Policy