Field Product Management, Lundbeck BV, Amsterdam, The Netherlands;
Neuropsychiatr Dis Treat. 2011;7:313-7. doi: 10.2147/NDT.S19239. Epub 2011 Jun 15.
The purpose of this study was to estimate the cost-effectiveness of memantine relative to standard care in patients with moderate-to-severe Alzheimer's disease in the Netherlands.
A country-adapted five-year Markov model simulated disease progression through a series of states, defined by dependency and disease severity. Transition probabilities were derived from trials, with utility and epidemiological data obtained from a longitudinal Dutch cohort. Cost-effectiveness was described in terms of quality-adjusted life years and time spent in a nondependent state or in a moderate severity state.
Memantine monotherapy versus standard care led to 0.058 quality-adjusted life years gained (1.207 versus 1.265), longer time in a nondependent state (from 1.602 to 1.751 years) and in a moderate state (from 2.051 to 2.141 years), and no additional costs (€113,927 versus €110,097). Robustness of results was confirmed through sensitivity analyses.
Memantine is dominant compared with standard care in the Netherlands. Results are consistent with similar economic evaluations in other countries.
本研究旨在评估美金刚相对于标准护理在荷兰中重度阿尔茨海默病患者中的成本效益。
经过一系列由依赖性和疾病严重程度定义的状态，对适应国情的五年期马尔可夫模型进行了疾病进展模拟。从试验中得出转移概率，使用效用和流行病学数据来自一项纵向荷兰队列研究。以质量调整生命年和无依赖性状态或中度严重状态的时间来描述成本效益。
美金刚单药治疗与标准护理相比，获得了 0.058 个质量调整生命年（1.207 比 1.265），无依赖性状态（从 1.602 年到 1.751 年）和中度状态（从 2.051 年到 2.141 年）的时间更长，且无额外成本（113927 欧元比 110097 欧元）。敏感性分析证实了结果的稳健性。
与标准护理相比，美金刚在荷兰具有优势。结果与其他国家的类似经济评估一致。
