Quantifying and Describing the Natural History and Costs of Alzheimer's Disease and Effects of Hypothetical Interventions

Anders Wimo*, Ron Handels, Bengt Winblad, Christopher M Black, Gunilla Johansson, Stina Salomonsson, Maria Eriksdotter, Rezaul K Khandker

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: A long-term horizon is necessary when the socioeconomic consequences and the potential effects of interventions in Alzheimer's disease (AD) are estimated.

OBJECTIVES: To illustrate the potential societal costs of AD across the disease continuum and to illustrate the potential cost-effectiveness of a hypothetical intervention with disease modifying treatment (DMT).

METHODS: Based on the Swedish dementia registry, a Markov model was used to simulate a virtual cohort of 100,000 people with mild cognitive impairment (MCI) due to AD (AD-MCI) in Sweden for 40 years starting at the age of 60. A simulated hypothetical intervention assumed a 25% reduction in progression rate during AD-MCI and mild AD-dementia. A comprehensive set of sensitivity analyses was included.

RESULTS: The cumulative risk to develop dementia was 96%. The mean simulated survival was 19.0 years. The net present value for a person year with dementia was 252,843 SEK (about 29,500 US$). The cost effectiveness model illustrated how the hypothetical scenario of a 25% reduction in progression to AD-dementia would require 41 AD-MCI patients to be treated to prevent one case of AD-dementia (2,447 avoided AD-dementia cases of 100,000 with AD-MCI). Most scenarios illustrated hypothetical cost effectiveness (based on a willingness to pay level of 600,000 SEK (70,000 US$) per gained QALY), but not cost savings.

DISCUSSION: Lifetime societal costs of AD are substantial. A future DMT may be potentially cost-effective given assumed treatment effects and costs, but cost savings are unlikely.

Original languageEnglish
Pages (from-to)891-902
Number of pages12
JournalJournal of Alzheimer's Disease
Volume75
Issue number3
DOIs
Publication statusPublished - 2020

Keywords

  • Alzheimer's disease
  • cost analysis
  • cost effectiveness
  • costs
  • dementia
  • disease-modifying treatment
  • economics
  • MILD COGNITIVE IMPAIRMENT
  • ASSOCIATION WORKGROUPS
  • DIAGNOSTIC GUIDELINES
  • NATIONAL INSTITUTE
  • MODIFYING TREATMENT
  • DEMENTIA
  • RECOMMENDATIONS
  • PREVALENCE
  • IMPACT
  • DEFINITION

Cite this