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
Artigo
em Inglês
| LILACS
| ID: biblio-1011499
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.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Inibidores da Colinesterase
/
Doença de Alzheimer
/
Rivastigmina
/
Donepezila
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Guia de Prática Clínica
/
Avaliação Econômica em Saúde
/
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Assunto da revista:
Psiquiatria
Ano de publicação:
2019
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Instituto de Psiquiatria/BR
/
Laboratório de Ciências Radiológicas (IBRAG)/BR
/
Universidade Federal Fluminense (UFF)/BR
/
Universidade do Estado do Rio de Janeiro (UERJ)/BR
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