ArticleMolecular diagnosis & therapy2012
Genetic testing in combination with preventive donepezil treatment for patients with amnestic mild cognitive impairment: an exploratory economic evaluation of personalized medicine.
Article in Molecular diagnosis & therapy, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Systematic Review of Model-Based Economic Evaluations of Treatments for Alzheimer's Disease.PharmacoEconomics · 2016Pooled it
- Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature.PloS one · 2016Pooled it
- Cost-effectiveness of a gene sequencing test for Alzheimer's disease in Ontario.Journal of community genetics · 2023Article
- Predicted Lifetime Health Outcomes for Aducanumab in Patients with Early Alzheimer's Disease.Neurology and therapy · 2021Article
- Cost Effectiveness of Mirabegron Compared with Antimuscarinic Agents for the Treatment of Adults with Overactive Bladder in Colombia.PharmacoEconomics - open · 2020Article
- Assessing cost-effectiveness of early intervention in Alzheimer's disease: An open-source modeling framework.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2019Article
- Family and Caregiver Spillover Effects in Cost-Utility Analyses of Alzheimer's Disease Interventions.PharmacoEconomics · 2019Article
- Using Cerebrospinal Fluid Biomarker Testing to Target Treatment to Patients with Mild Cognitive Impairment: A Cost-Effectiveness Analysis.PharmacoEconomics - open · 2018Article
- Economic evaluations of strategies targeting pre-diagnosis dementia populations: A systematic review.Alzheimer's & dementia (New York, N. Y.)Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the cost effectiveness of genetic screening for the apolipoprotein (APOE) ε4 allele in combination with preventive donepezil treatment in comparison with the standard of care for amnestic mild cognitive impairment (AMCI) patients in Canada.
methodsWe performed a cost-effectiveness analysis using a Markov model with a societal perspective and a time horizon of 30 years. For each strategy, we calculated quality-adjusted life-years (QALYs), using utilities from the literature. Costs were also based on the literature and, when appropriate, Ontario sources. One-way and probabilistic sensitivity analyses were performed. Expected value of perfect information (EVPI) analysis was conducted to explore the value of future research.
resultsThe base case results in our exploratory study suggest that the combination of genetic testing and preventive donepezil treatment resulted in a gain of 0.027 QALYs and an incremental cost of $1,015 (in 2009 Canadian dollars [Can$]), compared with the standard of care. The incremental cost-effectiveness ratio (ICER) for the base case was Can$38,016 per QALY. The ICER was sensitive to the effectiveness of donepezil in slowing the rate of progression to Alzheimer's disease (AD), utility in AMCI patients, and AD and donepezil treatment costs. EVPI analysis showed that additional information on these parameters would be of value.
conclusionUsing presently available clinical evidence, this exploratory study illustrates that genetic testing combined with preventive donepezil treatment for AMCI patients may be economically attractive. Since our results were based on a secondary post hoc analysis, our study alone is insufficient to warrant recommending APOE genotyping in AMCI patients. Future research on the effectiveness of preventive donepezil as a targeted therapy is recommended.
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