Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in Brazil
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 wi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Associação Brasileira de Psiquiatria (ABP)
2018-11-01
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| Series: | Brazilian Journal of Psychiatry |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462018005009101&lng=en&tlng=en |
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| author | Luciana R. da Silva Cid M.M. Vianna Gabriela B.G. Mosegui Antônio A.F. Peregrino Valeska Marinho Jerson Laks |
| author_facet | Luciana R. da Silva Cid M.M. Vianna Gabriela B.G. Mosegui Antônio A.F. Peregrino Valeska Marinho Jerson Laks |
| author_sort | Luciana R. da Silva |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T08:39:31Z |
| format | Article |
| id | doaj.art-8dcf99a4a9b4482c91aaed972b2ef9b4 |
| institution | Directory Open Access Journal |
| issn | 1809-452X |
| language | English |
| last_indexed | 2024-12-11T08:39:31Z |
| publishDate | 2018-11-01 |
| publisher | Associação Brasileira de Psiquiatria (ABP) |
| record_format | Article |
| series | Brazilian Journal of Psychiatry |
| spelling | doaj.art-8dcf99a4a9b4482c91aaed972b2ef9b42022-12-22T01:14:18ZengAssociação Brasileira de Psiquiatria (ABP)Brazilian Journal of Psychiatry1809-452X2018-11-01010.1590/1516-4446-2017-0021S1516-44462018005009101Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in BrazilLuciana R. da SilvaCid M.M. ViannaGabriela B.G. MoseguiAntônio A.F. PeregrinoValeska MarinhoJerson LaksObjective: 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462018005009101&lng=en&tlng=enAlzheimer’s diseaseeconomic issuesadministrationgeriatric psychiatry |
| spellingShingle | Luciana R. da Silva Cid M.M. Vianna Gabriela B.G. Mosegui Antônio A.F. Peregrino Valeska Marinho Jerson Laks Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in Brazil Brazilian Journal of Psychiatry Alzheimer’s disease economic issues administration geriatric psychiatry |
| title | Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in Brazil |
| title_full | Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in Brazil |
| title_fullStr | Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in Brazil |
| title_full_unstemmed | Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in Brazil |
| title_short | Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer’s disease in Brazil |
| title_sort | cost effectiveness analysis of the treatment of mild and moderate alzheimer s disease in brazil |
| topic | Alzheimer’s disease economic issues administration geriatric psychiatry |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462018005009101&lng=en&tlng=en |
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