TY - JOUR
T1 - Cost-Effectiveness of One Year Dementia Follow-Up Care by Memory Clinics or General Practitioners: Economic Evaluation of a Randomised Controlled Trial
AU - Meeuwsen, Els
AU - Melis, Rene
AU - van der Aa, Geert
AU - Goluke-Willemse, Gertie
AU - de Leest, Benoit
AU - van Raak, Frank
AU - Scholzel-Dorenbos, Carla
AU - Verheijen, Desiree
AU - Verhey, Frans
AU - Visser, Marieke
AU - Wolfs, Claire
AU - Adang, Eddy
AU - Rikkert, Marcel Olde
PY - 2013/11/25
Y1 - 2013/11/25
N2 - 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.
AB - 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.
U2 - 10.1371/journal.pone.0079797
DO - 10.1371/journal.pone.0079797
M3 - Article
C2 - 24282511
SN - 1932-6203
VL - 8
JO - PLOS ONE
JF - PLOS ONE
IS - 11
M1 - e79797
ER -