Ernst R L, Hay J W, Fenn C, Tinklenberg J, Yesavage J A
Department of Pharmaceutical Economics and Policy, School of Pharmacy, University of Southern California, Los Angeles, USA.
Arch Neurol. 1997 Jun;54(6):687-93. doi: 10.1001/archneur.1997.00550180013006.
To estimate the dollar savings in costs attainable from drug or other treatments for Alzheimer disease (AD) that stabilize or reverse patients' cognitive decline.
Medical and other disease-related utilization data were collected from the caregivers of 64 patients diagnosed as having probable AD. The quantities of utilization were priced at national levels to generate measures of illness costs. Costs per patient were then estimated as regression functions of scores on the Mini-Mental State Examination (MMSE), which was used as an index of patient cognitive function. Potential savings in illness costs were estimated by comparing predicted costs at various baseline and intervention-level values of the patient's MMSE score.
The potential savings in illness costs attainable from treatment are small for mildly and very severely demented patients with AD. However, for moderately to severely demented home-dwelling patients having, say, an MMSE score of 7 at baseline, prevention of a 2-point decline in the score would save about $3700 annually, and a 2-point increase in an MMSE score rather than a 2-point decline would save about $7100.
Large savings in the costs of caring for moderately to severely demented home-dwelling patients with AD may be achievable from disease interventions that have minor effects on patients' cognitive status.
评估通过药物或其他治疗方法稳定或逆转阿尔茨海默病（AD）患者认知衰退所能节省的费用。
从64名被诊断为可能患有AD的患者的照料者处收集医疗及其他与疾病相关的使用数据。使用量按国家水平定价，以生成疾病成本的衡量指标。然后将每位患者的成本估计为简易精神状态检查表（MMSE）得分的回归函数，MMSE用作患者认知功能的指标。通过比较患者MMSE得分在不同基线和干预水平值时的预测成本，估计疾病成本的潜在节省情况。
对于轻度和极重度痴呆的AD患者，治疗所能节省的疾病成本潜力较小。然而，对于中度至重度痴呆的居家患者，例如基线MMSE评分为7分的患者，防止得分下降2分每年可节省约3700美元，MMSE得分增加2分而非下降2分可节省约7100美元。
对患者认知状态有轻微影响的疾病干预措施可能会大幅节省照料中度至重度痴呆居家AD患者的成本。
