Cost-Effectiveness of One Year Dementia Follow-Up Care by Memory Clinics or General Practitioners: Economic Evaluation of a Randomised Controlled Trial

Els Meeuwsen*, Rene Melis, Geert van der Aa, Gertie Goluke-Willemse, Benoit de Leest, Frank van Raak, Carla Scholzel-Dorenbos, Desiree Verheijen, Frans Verhey, Marieke Visser, Claire Wolfs, Eddy Adang, Marcel Olde Rikkert

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objective: To evaluate the cost-effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared to general practitioners' care. Methods: A multicentre randomised trial with 175 community dwelling patients newly diagnosed with mild to moderate dementia, and their informal caregivers, with twelve months' follow-up. Cost-effectiveness was evaluated from a societal point of view and presented as incremental cost per quality adjusted life year. To establish cost-effectiveness, a cost-utility analysis was conducted using utilities based on the EQ-5D. Uncertainty surrounding the incremental cost-effectiveness ratio (difference in costs divided by difference in effects) was calculated by bootstrapping from the original data. Results: Compared to general practitioners' care, treatment by the memory clinics was on average (sic)1024 (95% CI: -(sic)7723 to (sic)5674) cheaper, and showed a non-significant decrease of 0.025 (95% CI: -0.114 to 0.064) quality adjusted life years. The incremental cost-effectiveness point estimate from the bootstrap simulation was (sic) 41 442 per QALY lost if one would use memory clinic care instead of general practitioner care. Conclusion: No evidence was found that memory clinics were more cost-effective compared to general practitioners with regard to post-diagnosis treatment and coordination of care of patients with dementia in the first year after diagnosis.
Original languageEnglish
Article numbere79797
Issue number11
Publication statusPublished - 25 Nov 2013

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