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NICE Cost-Effectiveness Appraisal of Cholinesterase Inhibitors: Was the Right Question Posed? Were the Best Tools Used?

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Author Info

  • Denis Getsios

    (Caro Research Institute (now UnitedBiosource Corporation), Halifax, Nova Scotia, Canada)

  • Kristen Migliaccio-Walle

    (Caro Research Institute (now UnitedBiosource Corporation), Concord, Massachusetts, USA)

  • Jaime J. Caro

    (Caro Research Institute (now UnitedBiosource Corporation), Concord, Massachusetts, USA, Division of General Internal Medicine and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada)

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    Abstract

    The National Institute for Health and Clinical Excellence (NICE) recently issued updated guidance on the use of cholinesterase inhibitors in the treatment of Alzheimer's disease. NICE initially recommended that cholinesterase inhibitors no longer be used, but final guidance restricted treatment to patients with disease of a moderately severe stage. This decision was based largely on results from a heavily criticised economic evaluation that used an adaptation of the Assessment of Health Economics in Alzheimer's Disease (AHEAD) model. As the developers of the AHEAD model, we examined the appropriateness of NICE's economic analyses and presentation of results. We attempted to replicate NICE's results by modifying the original AHEAD model. Sensitivity analyses were then run using the modified AHEAD model to evaluate the extent of uncertainty in predictions. The AHEADNICE analyses resulted in an incremental cost-effectiveness ratio for galantamine of Lstg 82_000 per QALY gained (year 2003 values) from the perspective of the UK NHS and Personal Social Services. This was later revised to Lstg 46_000 per QALY, compared with

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    Bibliographic Info

    Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

    Volume (Year): 25 (2007)
    Issue (Month): 12 ()
    Pages: 997-1006
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    Handle: RePEc:wkh:phecon:v:25:y:2007:i:12:p:997-1006

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    Web page: http://pharmacoeconomics.adisonline.com/

    For corrections or technical questions regarding this item, or to correct its listing, contact: (Dave Dustin).

    Related research

    Keywords: Alzheimer's-disease; Cholinesterase-inhibitors; Cost-effectiveness; Health-policy; Modelling;

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