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Economic Evaluation of Nonpharmacological Interventions for Dementia Patients and their Caregivers - A Systematic Literature Review

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  • Saha, Sanjib

    (Health Economics Unit, Department of Clinical Science (Malmö), Lund University, Sweden)

  • Gerdtham, Ulf-G.

    (Department of Economics, Lund University)

  • Toresson, Håkan

    (Clinical Memory Research Unit, Department of Clinical Science (Malmö), Lund University)

  • Minthon, Lennart

    (Clinical Memory Research Unit, Department of Clinical Science (Malmö), Lund University)

  • Jarl, Johan

    (Health Economics Unit, Department of Clinical Science (Malmö), Lund University, Sweden)

Abstract

Background: The rising prevalence of dementia represents an important public health issue. There is currently no available cure for dementia disorders, only symptom-relieving therapies which can be either pharmacological or non-pharmacological. The number of non-pharmacological interventions for patients with dementia disorders and their caregivers have been increasing in recent years without much knowledge on their cost-effectiveness. The objective is to review the existing evidence on cost-effectiveness of non-pharmacological interventions targeting patients with dementia disorders, their caregivers, and the patient-caregiver dyad. Method: A systematic search of published economic evaluation studies in English was conducted using specified key words in relevant databased and websites. Data extracted included methods and empirical evidence (costs, effects, ICER) and we assessed if the conclusions made in terms of cost-effectiveness were supported by the reported evidence. The included studies were also assessed for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results: We included seventeen studies in this review categorised into three groups: physical exercise, occupational therapy, and psychological/psychosocial treatment. In almost all the studies (except one), economic evaluation was performed for a randomised controlled trial alongside the non-pharmacological intervention or retrospectively. There was a considerable heterogeneity in methodological approaches, target populations, study time frames, and perspectives as well as types of intervention. This prevents an informative comparison between most of the studies. However, we found that physical exercise was the most-effective non-pharmacological interventions for patients with dementia. For occupational therapy and psychological/psychosocial interventions we found mixed results although the majority was not cost-effective. Conclusion: More economic evaluations studies are required in non-pharmacological interventions. However, the interventions need to have a strong study design with the intention to perform economic evaluation in parallel.

Suggested Citation

  • Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Nonpharmacological Interventions for Dementia Patients and their Caregivers - A Systematic Literature Review," Working Papers 2018:10, Lund University, Department of Economics.
  • Handle: RePEc:hhs:lunewp:2018_010
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 367-372, June.
    3. Moodie, Marjory & Haby, Michelle & Wake, Melissa & Gold, Lisa & Carter, Robert, 2008. "Cost-effectiveness of a family-based GP-mediated intervention targeting overweight and moderately obese children," Economics & Human Biology, Elsevier, vol. 6(3), pages 363-376, December.
    4. Elisabeth Fenwick & Karl Claxton & Mark Sculpher, 2001. "Representing uncertainty: the role of cost‐effectiveness acceptability curves," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 779-787, December.
    5. Elisabeth Fenwick & Bernie J. O'Brien & Andrew Briggs, 2004. "Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions," Health Economics, John Wiley & Sons, Ltd., vol. 13(5), pages 405-415, May.
    6. Mark J. Sculpher & Karl Claxton & Mike Drummond & Chris McCabe, 2006. "Whither trial‐based economic evaluation for health care decision making?," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 677-687, July.
    7. Marieke Krol & Jocé Papenburg & Job van Exel, 2015. "Does Including Informal Care in Economic Evaluations Matter? A Systematic Review of Inclusion and Impact of Informal Care in Cost-Effectiveness Studies," PharmacoEconomics, Springer, vol. 33(2), pages 123-135, February.
    8. McCabe, C & Claxton, K & Culyer, AJ, 2008. "The NICE Cost-Effectiveness Threshold: What it is and What that Means," MPRA Paper 26466, University Library of Munich, Germany.
    9. Henry Glick, 2011. "Sample Size and Power for Cost-Effectiveness Analysis (Part 1)," PharmacoEconomics, Springer, vol. 29(3), pages 189-198, March.
    10. Henry Glick, 2011. "Sample Size and Power for Cost-Effectiveness Analysis (Part 2)," PharmacoEconomics, Springer, vol. 29(4), pages 287-296, April.
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    1. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.

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    More about this item

    Keywords

    Dementia; Non-pharmacological interventions; Caregivers;
    All these keywords.

    JEL classification:

    • H43 - Public Economics - - Publicly Provided Goods - - - Project Evaluation; Social Discount Rate
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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