Quantify Research, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
University of Exeter Medical School, University of Exeter, Exeter, UK.
Alzheimers Dement. 2017 Mar;13(3):312-321. doi: 10.1016/j.jalz.2016.12.005. Epub 2017 Jan 5.
Available data and models for the health-economic evaluation of treatment in Alzheimer's disease (AD) have limitations causing uncertainty to decision makers. Forthcoming treatment strategies in preclinical or early AD warrant an update on the challenges associated with their economic evaluation. The perspectives of the co-authors were complemented with a targeted review of literature discussing methodological issues and data gaps in AD health-economic modelling. The methods and data available to translate treatment efficacy in early disease into long-term outcomes of relevance to policy makers and payers are limited. Current long-term large-scale data accurately representing the continuous, multifaceted, and heterogeneous disease process are missing. The potential effect of disease-modifying treatment on key long-term outcomes such as institutionalization and death is uncertain but may have great effect on cost-effectiveness. Future research should give priority to collaborative efforts to access better data on the natural progression of AD and its association with key long-term outcomes.
现有的针对阿尔茨海默病(AD)治疗的健康经济评估数据和模型存在局限性,这给决策者带来了不确定性。在临床前或早期 AD 中即将出现的治疗策略需要对其经济评估相关的挑战进行更新。在对文献进行有针对性的回顾讨论 AD 健康经济建模中的方法学问题和数据差距的同时,补充了共同作者的观点。将早期疾病的治疗效果转化为决策者和支付者关注的长期结果的方法和数据有限。目前缺少准确代表疾病连续、多方面和异质性过程的长期大规模数据。疾病修饰治疗对诸如住院和死亡等关键长期结果的潜在影响尚不确定,但可能对成本效益产生重大影响。未来的研究应优先进行合作努力,以获取有关 AD 自然病程及其与关键长期结果关联的更好数据。