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Cost-effectiveness of a collaborative dementia care management-Results of a cluster-randomized controlled trial
Bernhard Michalowsky1, Feng Xie2, Tilly Eichler3
1German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany; Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Canada.
Introduction:
The purpose of this study was to determine the cost-effectiveness of collaborative dementia care management (DCM).
Methods:
The cost-effectiveness analysis was based on the data of 444 patients of a cluster-randomized, controlled trial, conceptualized to evaluate a collaborative DCM that aimed to optimize treatment and care in dementia. Health-care resource use, costs, quality-adjusted life years (QALYs), and incremental cost per QALY gained were measured over a 24-month time horizon.
Results:
DCM increased QALYs (+0.05) and decreased costs (-569€) due to a lower hospitalization and a delayed institutionalization (7 months) compared with usual care. The probability of DCM being cost-effective was 88% at willingness-to-pay thresholds of 40,000€ per QALY gained and higher in patients living alone compared to those not living alone (96% vs. 26%).
Discussion:
DCM is likely to be a cost-effective strategy in treating dementia and thus beneficial for public health-care payers and patients, especially for those living alone.
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