Pharmacotherapy for people with Alzheimer's disease: A Markov-cycle evaluation of five years therapy using donepezil
Pharmacotherapy for people with Alzheimer's disease: A Markov-cycle evaluation of five years therapy using donepezil
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阿尔茨海默病患者的药物治疗：使用多奈哌齐五年治疗的马尔可夫循环评估
DOI：
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发表时间：
1998
影响因子：
5.6
通讯作者：
G. Dempsey
中科院分区：
文献类型：
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作者：
A. Stewart;Richard Phillips;G. Dempsey
本文结合多奈哌齐临床试验的数据和成本数据，评估75岁及以上诊断为阿尔茨海默病（AD）的患者在诊断后5年的预期直接护理成本。马尔可夫模型通过改变严重程度来模拟老年人的进展。该模型比较了两组患者每组的三种治疗方案：治疗开始时轻度AD；治疗开始时出现中度AD。患者随访至治疗开始后5年。尽管获得成本高，但对于5mg和10mg治疗组以及最初处于轻度或中度疾病状态的患者，多奈哌齐的使用几乎是成本中性的。预期成本略高于安慰剂组，但较高的药物支出部分被较低的护理成本所抵消，因为接受治疗的患者的下降速度不如未接受治疗的患者快。该模型显示，服用多奈哌齐的患者处于严重痴呆状态的时间更短，而这种状态的护理成本更高。对关键假设的敏感性分析表明，预期成本高度依赖于贴现率，更重要的是，依赖于死亡率。©1998 John Wiley & Sons, Ltd
This article combines data from a clinical trial of donepezil with costing figures to evaluate expected direct costs of care over 5 years after diagnosis of Alzheimer's disease (AD) for patients aged 75 years and over at diagnosis. A Markov model simulates the progression of elderly persons through changing levels of severity. The model compares three treatment regimes for each of two patient groups: mild AD at start of treatment; moderate AD at start of treatment. Patients are followed until 5 years after the start of the treatment. Despite the acquisition costs, use of donepezil is approximately cost‐neutral for both 5 mg and 10 mg treatment groups and for patients initially at either mild or moderate states of illness. Expected costs are slightly higher than for the placebo group, but higher expenditure on drugs is partly offset by lower costs of care consequent on treated patients not declining as rapidly as those untreated. The model showed that donepezil patients spent less time in the state of severe dementia, where costs of care are higher. Sensitivity analysis on key assumptions demonstrated that expected costs were highly dependent on discount rate and, more significantly, on the mortality rate. © 1998 John Wiley & Sons, Ltd.
一项关于痴呆症生存的对照研究。
影响因子：
--
作者：
Martin,DC;Miller,JK;Kapoor,W;Arena,VC;Boller,F
通讯作者：
Boller,F