Challenges of defining healthcare costs for people with mild cognitive impairment (MCI) based on the claim database analysis in Japan

Abstract

AbstractBackgroundThe earlier treatment for dementia is important when it is diagnosed. The annual healthcare costs for mild Alzheimer's disease (AD) has been reported to be approximately 250,000 JPY (equivalent to 2,400 USD) per person [1], but there were few cost studies associated with mild cognitive impairment (MCI). This study aimed to clarify the healthcare costs incurred for MCI using a medical claim database in order to find out the disease burden in the early stage of dementia.MethodAn administrative claim database of Diagnostic Procedure Combination provided by Medical Data Vision Co., Ltd. was used. Patients data with MCI (ICD‐10 code: F067) diagnosed between April 2008 and September 2018 were selected. The index date was the date of the first diagnosis of MCI, and the evaluation period was the period between the index date and the date of the diagnosis of dementia or the date of any dementia medication prescribed as the end of MCI stage. If no date was given above, the last day of visit to a psychiatric department or the date of death was taken. Patients diagnosed with dementia before the index date or patients with an evaluation period of fewer than 30 days were excluded. From the selected patients, we identified the evaluation period, actual treatment for MCI during that period, and treatment costs. Tableau (Tableau Software LLC. Seattle, WA, USA) was used for the analyses.ResultThe total number of patients with MCI whose medical costs could be assessed was 4,713. The mean and median duration of MCI were 574 and 351 days, respectively; most of these patients were later diagnosed with dementia. The mean annual healthcare costs per person were 118,257 JPY (median: 40,551. min: 0. max: 3,764,722.), in which monitoring or diagnostic examination was mainly claimed.ConclusionHealthcare costs associated with MCI were limited and lower than those associated with mild AD. [1] Kitamura S., Inoue S., Matsui D., Matsushita Y. Cost‐effectiveness analysis for memantine monotherapy in patients with moderate and severe Alzheimer’s disease. Japanese Journal of Geriatric Psychiatry 2014;25: 1361‐1373.