碩士 / 國立陽明大學 / 醫務管理研究所 / 101 / BACKGROUND
Few studies regarding the head-to-head cost-effectiveness analysis of medications treating for Alzheimer’s disease have been conducted in Asia. The goal of this study is to perform a comparative assessment of donepezil, rivastigimine and memantine on the costs and efficacy of AD patients in Taiwan.
METHODS
A four-state Markov model was built to simulate the disease progression of the AD patients’ life span (from seventy years of age to death). Transition probabilities and utilities between states’ data are from the published papers and the direct costs and the indirect costs at different stages derived from the local data in Taiwan. Analyses were run to evaluate outcomes for patients with mild AD from societal perspective. While all costs and outcomes have been discounted at 3% per annum.
RESULTS
The result of the Markov cohort simulation shows that for the life expectancy in the long-term, treating AD patients with donepezil in mild, moderate and severe states is the dominant strategy as it is more effective and economical than the alternatives. Specifically, treating patients with donepezil in mild, moderate and severe states, compared with no treatment strategy, yielded a 0.56 quality-adjusted life years (QALYs) and NT$ 1,007,074 increase per patient over the life time. And the ICER is NT$ 1,797,736.
CONCLUSIONS
It is concluded that treating AD patients with donepezil in mild, moderate and severe states is the medical treatment that might be a cost saving strategy for AD patients in Taiwan from the societal perspective.
| Identifer | oai:union.ndltd.org:TW/101YM005528009 |
| Date | January 2013 |
| Creators | Ti-Sheng Chen, 陳廸聖 |
| Contributors | Hui-Chu Lang, Jong-Ling Fuh, 郎慧珠, 傅中玲 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 92 |
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