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Alzheimer's disease: guidelines for treatment and pharmacoeconomic impact

Alzheimer's disease (AD), as the most common cause of dementia, worldwide has the potential to become one of the most overwhelming public health concerns of this century. The important reason is because the aging population will increase the overall prevalence of AD worldwide. Caring for these patients will increase costs to health care systems, caregivers, and the society in general. These costs increase with the severity of AD, with nursing home care being the most costly stage of care. According to the estimated prevalence, the total worldwide societal costs of dementia were estimated to 422 billion USD in 2009. Studies indicate that slowing the progression of AD and delaying institutionalization will have a dramatic impact on overall societal costs for managing AD. Drugs currently available may slow the rate of cognitive decline and provide benefits for delayed deterioration of daily living activities. These treatments have the potential to offer cost savings for families, insurers, and health care systems. This is important for the process of preparing guidelines for AD treatment from the national insurance point of view. This is a reason that each country needs to develop pharmacoeconomic guidelines according to their own specific situation. As an example we have presented AD guidelines from the National Institute for Health and Clinical Excellence (NICE), a body with considerable international influence in guidelines preparation. NICE reviewed the data available on clinical and cost effectiveness of the available current treatment for AD. Further, guidelines and data from other countries and international societies have been taken into account and analysed for the preparation of Croatian guidelines. According to the analysis, the number of possible patients with AD who could be treated with antidementive drugs is between 6 and 10 thousand patients (30% of diagnosed patients with mild to moderate AD). It is also important when assessing the therapy that it is necessary to recognize the integrated burden of the disease, including its interaction with co-morbidities and the burden on caregivers, and to consider the consequences of competing treatment strategies from a societal perspective. Our study support usage of the most widely used antidementia drugs as a confirmed treatment for the clinical and pharmacoeconomical aspect in this patient population and the guidelines have been proposed accordingly.

Alzheimer's disease; guidelines; pharmacoeconomics

Cited by Scopus