ArticleBMC neurology2012
Evaluating the cost effectiveness of donepezil in the treatment of Alzheimer's disease in Germany using discrete event simulation.
Article in BMC neurology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 6 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- How relevant are social costs in economic evaluations? The case of Alzheimer's disease.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Pooled it
- Application of discrete event simulation in health care: a systematic review.BMC health services research · 2018Pooled it
- [Social costs of diseases: How relevant are they for economic evaluations?]Revista espanola de salud publica · 2018Pooled it
- Systematic Review of Model-Based Economic Evaluations of Treatments for Alzheimer's Disease.PharmacoEconomics · 2016Pooled it
- Does including informal care in economic evaluations matter? A systematic review of inclusion and impact of informal care in cost-effectiveness studies.PharmacoEconomics · 2015Pooled it
- The estimation of utility weights in cost-utility analysis for mental disorders: a systematic review.PharmacoEconomics · 2013Pooled it
- Causal effect of conventional anti-dementia drugs on economic burden: an orthogonal double/debiased machine learning approach.BMC geriatrics · 2025Article
- On spillovers in economic evaluations: definition, mapping review and research agenda.The European journal of health economics : HEPAC : health economics in prevention and care · 2024Review
- Early start of anti-dementia medication is associated with lower health and social care costs in Alzheimer´s patients: a Finnish nationwide register study.The European journal of health economics : HEPAC : health economics in prevention and care · 2023Article
- A decision support tool with health economic modelling for better management of DVT patients.Health economics review · 2022Article
- Effective Response to Hospital Congestion Scenarios: Simulation-Based Evaluation of Decongestion Interventions.International journal of environmental research and public health · 2022Article
- Discrete-Event Simulation Modeling in Healthcare: A Comprehensive Review.International journal of environmental research and public health · 2021Review
- Family and Caregiver Spillover Effects in Cost-Utility Analyses of Alzheimer's Disease Interventions.PharmacoEconomics · 2019Article
- Potential cost savings to be made by slowing cognitive decline in mild Alzheimer's disease dementia using a model derived from the UK GERAS observational study.BMC geriatrics · 2018Observational
- Combined Donepezil and Ethanolic Extract of Propolis Improved Memory Better Than Donepezil and Propolis Monotherapy in Wild TypeEvidence-based complementary and alternative medicine : eCAM · 2018Article
- Role of Donepezil in the Management of Neuropsychiatric Symptoms in Alzheimer's Disease and Dementia with Lewy Bodies.CNS neuroscience & therapeutics · 2016Review
- Evaluating disease-modifying agents: a simulation framework for Alzheimer's disease.PharmacoEconomics · 2014Article
- Cost-effectiveness analysis of the treatment of mild and moderate Alzheimer's disease in Brazil.Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)Article
- The Economic Impact of New Therapeutic Interventions on Neuropsychiatric Inventory (NPI) Symptom Scores in Patients with Alzheimer Disease.Dementia and geriatric cognitive disorders extraArticle
Corrections and comments
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Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious cost-effectiveness studies of cholinesterase inhibitors have modeled Alzheimer's disease (AD) progression and treatment effects through single or global severity measures, or progression to "Full Time Care". This analysis evaluates the cost-effectiveness of donepezil versus memantine or no treatment in Germany by considering correlated changes in cognition, behavior and function.
methodsRates of change were modeled using trial and registry-based patient level data. A discrete event simulation projected outcomes for three identical patient groups: donepezil 10 mg, memantine 20 mg and no therapy. Patient mix, mortality and costs were developed using Germany-specific sources.
resultsTreatment of patients with mild to moderately severe AD with donepezil compared to no treatment was associated with 0.13 QALYs gained per patient, and 0.01 QALYs gained per caregiver and resulted in average savings of €7,007 and €9,893 per patient from the healthcare system and societal perspectives, respectively. In patients with moderate to moderately-severe AD, donepezil compared to memantine resulted in QALY gains averaging 0.01 per patient, and savings averaging €1,960 and €2,825 from the healthcare system and societal perspective, respectively.In probabilistic sensitivity analyses, donepezil dominated no treatment in most replications and memantine in over 70% of the replications. Donepezil leads to savings in 95% of replications versus memantine.
conclusionsDonepezil is highly cost-effective in patients with AD in Germany, leading to improvements in health outcomes and substantial savings compared to no treatment. This holds across a variety of sensitivity analyses.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.