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The economic impact of galantamine vs placebo: an analysis based on functional capacity in a Swedish cohort study
Anders Wimo1, Maren Gaudig, Barbara Schäuble
1Aging Research Center, Dept NVS, Karolinska Institutet, Stockholm, Sweden. anders.wimo@ki.se
Objective:
To analyse the economic impact of galantamine, based on basic activities of daily living (ADL).
Methods:
Data were derived from Swedish patients enrolled in a 6-month placebo-controlled trial of galantamine (GAL-INT-1; n=80), and from the Kungsholmen-Nordanstig Project, a longitudinal study of 919 elderly persons in Sweden. Basic ADL were assessed using the Katz' Index of Independence in Activities of Daily Living (ADL) (number of ADL lost [dependency in 0, 1-2, 3-4, or 5-6 ADL]). Costs were appraised based on regression analysis and on costs directly linked to ADL. Six-month costs for galantamine and placebo were calculated.
Results:
In the regression analyses, each increase in a Katz stage was associated with an annual cost increase of SEK 81,415-83,683 (∼€8000). Results were similar using stage-specific costs. Overall, there was a small, non-significant numerical cost benefit for galantamine indicating cost neutrality.
Limitations:
The small number of Swedish patients in the GAL-INT-1 study, which was not powered for economic outcomes, limits the statistical power of the analysis. In addition, long-term outcomes are difficult to assess in persons with dementia because of practical and logistical problems.
Conclusions:
The benefits of galantamine in patients with AD can be achieved with no increase in cost. Combined with positive effects in terms of outcome, treatment with galantamine can be regarded as cost-effective using a cost-consequence approach.