Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer's disease in Brazil
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
; 41(3): 218-224, May-June 2019. tab, graf
Article
in En
| LILACS
| ID: biblio-1011499
Responsible library:
BR1.1
ABSTRACT
Objective:
To perform a cost-effectiveness analysis of donepezil and rivastigmine therapy for mild and moderate Alzheimer's disease (AD) from the perspective of the Brazilian Unified Health System.Method:
A hypothetical cohort of 1,000 individuals of both sexes, aged >65 years, and diagnosed with AD was simulated using a Markov model. The time horizon was 10 years, with 1-year cycles. A deterministic and probabilistic sensitivity analysis was performed.Results:
For mild AD, the study showed an increase in quality-adjusted life years (QALYs) of 0.61 QALY/21,907.38 Brazilian reais (BRL) for patients treated with donepezil and 0.58 QALY/BRL 24,683.33 for patients treated with rivastigmine. In the moderate AD group, QALY increases of 0.05/BRL 27,414.96 were observed for patients treated with donepezil and 0.06/BRL 34,222.96 for patients treated with rivastigmine.Conclusions:
The findings of this study contradict the standard of care for mild and moderate AD in Brazil, which is based on rivastigmine. A pharmacological treatment option based on current Brazilian clinical practice guidelines for AD suggests that rivastigmine is less cost-effective (0.39 QALY/BRL 32,685.77) than donepezil. Probabilistic analysis indicates that donepezil is the most cost-effective treatment for mild and moderate AD.Key words
Full text:
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Index:
LILACS
Main subject:
Cholinesterase Inhibitors
/
Alzheimer Disease
/
Rivastigmine
/
Donepezil
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Health_economic_evaluation
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Journal subject:
PSIQUIATRIA
Year:
2019
Type:
Article