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An Exploratory Study

Richard L. Ernst, PhD; Joel W. Hay, PhD; Catharine Fenn, PhD; Jared Tinklenberg, MD; Jerome A. Yesavage, MD

Arch Neurol. 1997;54(6):687-693.

Abstract
Objective
To estimate the dollar savings in costs attainable from drug or other treatments for Alzheimer disease (AD) that stabilize or reverse patients' cognitive decline.

Methods
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.

Results
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.

Conclusion
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.

Author Affiliations
From the Department of Pharmaceutical Economics and Policy, School of Pharmacy, University of Southern California, Los Angeles (Drs Ernst and Hay); and the Department of Veterans Affairs Medical Center and Stanford University, Palo Alto, Calif, and the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif (Drs Fenn, Tinklenberg, and Yesavage).

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