BACKGROUND/AIMS: Improved data and methods are needed for modeling disease progression in Alzheimer's disease (AD) for economic evaluation of treatments. The aim is to estimate prediction models for long-term AD progression and subsequently economic outcomes. METHODS: Three-year follow-up data on 435 patients treated with the cholinesterase inhibitor donepezil in clinical practise were analyzed. Regression models were estimated for long-term prediction of decline in cognitive function (ADAS-cog) and activities in daily living (ADL) ability, risk of institutionalization and costs of care. RESULTS: The cognitive deterioration was estimated at between 1.6 and 4 ADAS-cog points per every 6 months, increasing with disease severity. Cognitive function was an important predictor of ADL-ability, which itself was the most important predictor of the risk of institutionalization and costs of care. Combining all models in a cross-validation process generated accurate predictions of costs of care at each 6 months follow-up. CONCLUSION: The proposed methods for representing AD progression and economic outcomes can be used in micro-simulation models for the economic evaluation of new treatments.
BACKGROUND/AIMS: Improved data and methods are needed for modeling disease progression in Alzheimer's disease (AD) for economic evaluation of treatments. The aim is to estimate prediction models for long-term AD progression and subsequently economic outcomes. METHODS: Three-year follow-up data on 435 patients treated with the cholinesterase inhibitor donepezil in clinical practise were analyzed. Regression models were estimated for long-term prediction of decline in cognitive function (ADAS-cog) and activities in daily living (ADL) ability, risk of institutionalization and costs of care. RESULTS: The cognitive deterioration was estimated at between 1.6 and 4 ADAS-cog points per every 6 months, increasing with disease severity. Cognitive function was an important predictor of ADL-ability, which itself was the most important predictor of the risk of institutionalization and costs of care. Combining all models in a cross-validation process generated accurate predictions of costs of care at each 6 months follow-up. CONCLUSION: The proposed methods for representing AD progression and economic outcomes can be used in micro-simulation models for the economic evaluation of new treatments.
Authors: B Winblad; A Wimo; K Engedal; H Soininen; F Verhey; G Waldemar; A-L Wetterholm; A Haglund; R Zhang; R Schindler Journal: Dement Geriatr Cogn Disord Date: 2006-02-27 Impact factor: 2.959
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Authors: Andrew Clegg; Jackie Bryant; Tricia Nicholson; Linda McIntyre; Sofie De Broe; Karen Gerard; Norman Waugh Journal: Int J Technol Assess Health Care Date: 2002 Impact factor: 2.188
Authors: Ansgar Wübker; Sandra M G Zwakhalen; David Challis; Riitta Suhonen; Staffan Karlsson; Adelaida Zabalegui; Maria Soto; Kai Saks; Dirk Sauerland Journal: Eur J Health Econ Date: 2014-07-29
Authors: Roy W Jones; Jeremie Lebrec; Kristin Kahle-Wrobleski; Grazia Dell'Agnello; Giuseppe Bruno; Bruno Vellas; Josep M Argimon; Richard Dodel; Josep Maria Haro; Anders Wimo; Catherine Reed Journal: Dement Geriatr Cogn Dis Extra Date: 2017-03-20