Cost-utility of donepezil for the treatment of Alzheimer’s disease

บทคัดย่อ

Objective  To assess the cost-utility of donepezil in the treatment of mild to moderate Alzheimer compared with usual care in the perspectives of provider and society.

Materials and methods   Samples were 51 patients with mild to moderate Alzheimer’s disease who received donepezil for the first time of treatment. They received treatment at a memorial clinic in Chiang Mai Neurological hospital during 2003-2010. Costs comprising of donepezil, comorbidity, informal care, were collected. Effectiveness was measured as quality-adjusted life year (QALY) which was the multiplication of utility and life year. Utility was collected from 29 Alzheimer patients during April-June 2010 using EuroQOL questionnaire. The effect of donepezil was derived from literature review. All variables were plugged in the Markov model. Incremental cost-effectiveness ratio was calculated. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were also performed.

Results   For the societal perspective, donepezil alternative had 143,596 Baht higher cost and 0.498 better QALY than usual care resulting in ICER of 288,465 Baht per QALY. For the provider perspective, ICER was equal to 374,904 Baht per QALY.

Conclusion   Donepezil is not a cost-effective alternative with the willingness to pay of 120,000 Baht per QALY of Thailand.