Department of Neurology, UZ Brussel, Laarbeeklaan 101, 1090 Brussel, Belgium.
Acta Neurol Belg. 2012 Jun;112(2):141-5. doi: 10.1007/s13760-012-0062-9. Epub 2012 Apr 4.
Until more effective and especially disease-modifying treatments for Alzheimer's disease (AD) are available, the therapeutic arsenal consists of cholinesterase inhibitors for mild to moderate dementia and memantine for moderate to severe dementia. Health economic data make an important contribution to the planning of healthcare services and the estimation of the cost of drug reimbursement. As such, for cholinesterase inhibitors it is claimed that the direct cost of the drug itself is eclipsed by the cost savings associated with delaying institutionalisation or delaying the time of progression into a more severe disease state. The present manuscript reviews several factors contributing to the costs of AD, gives an overview of available studies claiming the cost-effectiveness of current AD treatments, highlights strengths and weaknesses of the aforementioned studies, and discusses the impact of (early) identification and treatment of AD. It is concluded that there still is a need for long-term follow-up data from prospective cohort studies before the cost-effectiveness of cholinesterase inhibitors for AD can be confirmed.
在针对阿尔茨海默病（AD）的更有效、尤其是更能改变疾病进程的治疗方法问世之前，治疗方法包括用于轻中度痴呆的胆碱酯酶抑制剂和用于中重度痴呆的美金刚。健康经济学数据为医疗服务规划和药物报销费用估算做出了重要贡献。因此，据称，对于胆碱酯酶抑制剂，药物本身的直接成本可以通过与延缓入院或延缓疾病进展到更严重阶段相关的成本节约来抵消。本文综述了导致 AD 成本增加的几个因素，概述了声称现有 AD 治疗具有成本效益的现有研究，并强调了上述研究的优缺点，并讨论了 AD 的（早期）识别和治疗的影响。结论是，在胆碱酯酶抑制剂治疗 AD 的成本效益能够得到证实之前，还需要来自前瞻性队列研究的长期随访数据。
