TABLE 73Included economic evaluations of donepezil

ItemFeldman et al. (2004)160,169171Fuh et al. (2008)161Getsios et al. (2009)162,163Getsios et al. (2009)159Lopez-Bastida et al. (2009)164Lu et al. (2005)165Mesterton et al. (2009)166Teipel et al. (2007)168,172
Publication typeFull paperFull paperAbstractAbstractFull paperFull paperAbstractFull paper
Study purposeInvestigate costs to society of ADApply existing model to Taiwan (Province of China)Enhance method of modelling cost-effectivenessAssess cost-effectiveness of screening + treatmentAssess cost-effectiveness in SpainEstimate impact on health-care costsUpdate estimates of cost-effectiveness using recently collected dataApply existing model to Germany and extend time frame
Country settingCanada, France and AustraliaTaiwan (Province of China)UKUKSpainUSASwedenGermany
Base-year prices1998 CDN$2006 US$2007 GB£Not stated2006 €1999–2002 US$Not stated; SEK2004 €
Intervention/comparatorDonepezil 5–10 mg for 24 weeks vs placeboDonepezil vs no pharmacological treatmentDonepezil 10 mg vs standard careScreen and treat with donepezil 10 mg vs treat aloneDonepezil 5–10 mg vs no drug treatmentDonepezil vs no donepezilDonepezil for 1 year vs placeboDonepezil 10 mg for 1 year vs placebo
Study typeEconomic evaluation alongside RCTMarkov modelDiscrete-event simulation modelDiscrete-event simulation modelMarkov modelCase control studyMarkov modelMarkov model
Model duration/cycle lengthN/A5 years; 12 months10 years; N/A10 years; N/A0.5, 1, 1.5, 2 and 2.5 years; 1 monthN/A5 years; 6 months5 and 10 years; 12 months
No. of statesN/A4N/AN/A4N/A125
Study group – ADModerate-to-severe AD; MMSE 5–17Mild and moderate ADMild-to-moderately severe AD; MMSE 10–26Patients without AD, > 65 years and having memory complaints are screenedMild or moderate ADICD-9-CM diagnosis of dementiaMild-to-moderate ADMild-to-moderate AD
PerspectiveSocietalSocietalHealth-care system and societalHealth-care system and societalHealth service and societalHealth-care payerNot stated; implied societalSocietal
Discount rate p.a. (costs/ benefits)N/A3%; 3%3.5%; applied to ‘all outcomes’ (i.e. both benefits and costs)Not stated3%; 3%N/ANot stated5%; unclear whether or not applied to both benefits and costs
Industry roleFunded by manufacturersFunded by manufacturerCompany employee listed as authorCompany employee listed as authorFunded by Ministry of HealthFunded by manufacturerCompany employee listed as authorsGerman Centre of Gerontology. Statement of ‘no competing interests’
Study base-case ‘headline’ findingsDonepezil cost savingDonepezil cost-saving from societal perspectiveDonepezil highly cost-effectiveScreening and treating is cost-effectiveDonepezil cost-saving from societal perspective and cost-effective from health service perspective for mild AD. Not cost-effective for moderate ADReduced health-care costs associated with donepezil use in the Medicare-managed plan studiedDonepezil cost savingDonepezil may be cost-effective, but considerable uncertainties remain

CDN, Canadian; N/A, not assessed; p.a., per annum; SEK, Swedish kronor.

Note: the details of the ninth included study for donepezil by Pattanaprateep165 are provided in the table for rivastigmine.

From: 4, Assessment of cost-effectiveness

Cover of The Effectiveness and Cost-Effectiveness of Donepezil, Galantamine, Rivastigmine and Memantine for the Treatment of Alzheimer's Disease (Review of Technology Appraisal No. 111): A Systematic Review and Economic Model
The Effectiveness and Cost-Effectiveness of Donepezil, Galantamine, Rivastigmine and Memantine for the Treatment of Alzheimer's Disease (Review of Technology Appraisal No. 111): A Systematic Review and Economic Model.
Health Technology Assessment, No. 16.21.
Bond M, Rogers G, Peters J, et al.
Southampton (UK): NIHR Journals Library; 2012 Apr.
© 2012, Crown Copyright.

Included under terms of UK Non-commercial Government License.

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