Abstract
BackgroundAlzheimer's disease is the leading cause of dementia and affects about 25 million people worldwide. Recent studies have evaluated the effect of early interventions for dementia, but few studies have considered private time and transportation costs associated with the intervention. This study assessed the total economic costs associated with a multifaceted intervention for mild Alzheimer's disease, including an estimate of the ratio of public to private costs.MethodsThe study sample comprised 163 dyads of patients and caregivers who received a multifaceted intervention of counselling sessions, courses and informational packages. The typical duration of the intervention was 7 months. A micro-costing approach was applied using prospectively collected data on resource utilisation that included estimates of participant time and transportation. Precision estimates were calculated using a bootstrapping technique and structural uncertainty was assessed with sensitivity analysis.ResultsThe direct intervention cost was estimated at EUR 1,070 (95% CI 1,029;1,109). The total cost (including private costs) was estimated at EUR 2,020 (95% CI 1,929;2,106) i.e. the ratio of private to public costs was almost 1:1.ConclusionIntervention for mild Alzheimer's disease can be undertaken at a relatively low cost to public funds. However, policy planners should pay attention to the significant private costs associated with an intervention, which may ultimately pose a threat to equity in access to health care.Trial registrationCurrent Controlled Trials ISRCTN74848736.
Highlights
Alzheimer's disease is the leading cause of dementia and affects about 25 million people worldwide
Sample and study design The study sample of 163 dyads of patients and their caregivers was selected from a multi-centre, randomised, controlled trial examining the efficacy of multifaceted intervention aimed at patients and their caregivers
Baseline characteristics A total of 163 dyads were included, but only 157 dyads received the intervention; three dyads dropped out due to the intervention being too demanding for caregivers, one dyad dropped out due to the intervention being too demanding for the patient, one dyad dropped out because the patient was hospitalised due to comorbidity, and one dyad dropped out because the patient died before the intervention started
Summary
Alzheimer's disease is the leading cause of dementia and affects about 25 million people worldwide. This study assessed the total economic costs associated with a multifaceted intervention for mild Alzheimer's disease, including an estimate of the ratio of public to private costs. Recent estimates suggest that 24.3 million people worldwide have dementia and that every year 4.6 million new cases occur [1]. US estimates are generally higher but, due to methodological differences, wide variation is demonstrated across studies [5,6]. None of these studies included valuation of reduced quality of life experienced by the person with dementia or the caregiver, i.e. cost estimates represent minimum values
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