Ealing, Hammersmith & Fulham NHS Trust Institute of Psychiatry Uxbridge Road UB1 3EU Southall, Middlesex.
Int J Psychiatry Clin Pract. 2003;7(1):45-7. doi: 10.1080/13651500310001068.
The absolute number of dementia cases is likely to increase due to the impending demographic changes. Several cost-of-illness studies of Alzheimer's disease, mainly from a societal perspective in developed countries, have demonstrated a huge economic burden. A substantial component of this huge economic burden is the direct costs of institutionalization and the indirect cost incurred by informal carers. This huge economic burden is of great interest because of the emergence of several cholinesterase inhibitors with proven efficacy in the treatment of Alzheimer's disease. Several cost-effectiveness studies of these drugs, based mainly on Markov modelling techniques and using data from population-based epidemiological studies and efficacy trials, have indicated that these drugs are cost-effective. A theoretical delay in placement into a residential or a nursing home and consequent cost savings may explain this cost-effectiveness. In the UK, although health authorities would fund the prescription of these drugs, social services would benefit from the cost savings; thus there is little financial incentive for health authorities to fund these drugs.
由于即将到来的人口结构变化，痴呆症病例的绝对数量可能会增加。几项针对阿尔茨海默病的疾病负担研究，主要从发达国家的社会角度出发，已经证明了其带来的巨大经济负担。造成这种巨大经济负担的一个重要原因是住院治疗的直接费用以及非正规护理人员的间接费用。由于几种已被证明对阿尔茨海默病治疗有效的胆碱酯酶抑制剂的出现，这种巨大的经济负担引起了广泛关注。几项基于马尔可夫模型技术并使用基于人群的流行病学研究和疗效试验数据的这些药物的成本效益研究表明，这些药物具有成本效益。理论上，这些药物可以延迟进入养老院或疗养院，从而节省成本，这可能是其具有成本效益的原因。在英国，尽管卫生当局会为这些药物的处方提供资金，但社会服务部门将从节省的成本中受益；因此，卫生当局没有什么经济动机来为这些药物提供资金。
