Abstract
A retrospective cohort control study of three populations, 65 years of age or older, at the same institution estimated the incremental cost of Alzheimer's disease (AD). The AD population of the ambulatory Alzheimer's Disease Center (ADC) (n = 640) was matched by age, gender, ethnicity, and address to one with AD from the general internal medicine practice (AD-GM) (n = 419) and to a control group without AD (n = 5331) from the same general medicine practice. Medicare costs of all care for all diagnoses were obtained for 1998 and 1999. Mean per person annual Medicare costs were $19,418 for ADC, $18,753 for AD-GM, and $12,085 for the control group. Incremental cost for ADC population was $7,333 and $6,668 for AD-GM population compared with the control group. Incremental cost was $665 (9.1 percent) higher for ADC than AD-GM. Higher non-AD hospitalizations and length of stay (LOS) by AD populations were the main cost drivers.
Keywords: cost of Alzheimer's disease, cost of dementia, economics, cost of illness
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References
- Brookmeyer R, Gray S, Kawas C: Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. Am J Public Health.1998; 88(9): 1337-1342. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jorm AF, Korten AE, Henderson AS: The prevalence of dementia: A quantitative integration of the literature. Acta Psychiatr Scand. 1987; 76(5): 465-479. [DOI] [PubMed] [Google Scholar]
- Lobo A, Launer LJ, Fratiglioni L, et al.: Prevalence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurology. 2000; 54 (11 Suppl 5): S4-S9. [PubMed] [Google Scholar]
- Ritchie K, Kildea D, Robine JM: The relationship between age and the prevalenceof senile dementia: A meta-analysis of recent data. Int J Epidemiology.1992; 21(4): 763-769. [DOI] [PubMed] [Google Scholar]
- Trabucchi M: An economic perspective on Alzheimer's disease. J Geriatr Psychiatry Neurol.1999; 12(1): 29-38. [DOI] [PubMed] [Google Scholar]
- Ernst RL, Hay JW: Economic research on Alzheimer disease: A review of the literature. Alzheimer Dis Assoc Disord.1997; 11(Suppl 6): 135-145. [PubMed] [Google Scholar]
- Meek PD, McKeithan K, Schumock GT: Economic considerations in Alzheimer's disease. Pharmacotherapy. 1998; 18(2 Pt 2): 68-73. [PubMed] [Google Scholar]
- Ernst RL, Hay JW: The US economic and social costs of Alzheimer's disease revisited. Am J Public Health.1994; 84(8): 1261-1264. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Leon J, Cheng CK, Neumann PJ: Alzheimer's disease care: Costs and potential savings. Health Aff.1998; 17(6): 206-216. [DOI] [PubMed] [Google Scholar]
- Menzin J, Lang K, Friedman M, et al.: The economic cost of Alzheimer's disease and related dementias to the California Medicaid Program (“Medi-Cal”) in 1995. Am J Geriatr Psychiatry. 1999; 7(4): 300-308. [PubMed] [Google Scholar]
- Rice DP, Fox PJ, Max W, et al.: The economic burden of Alzheimer's disease care. Health Aff.1993; 12(2): 164-176. [DOI] [PubMed] [Google Scholar]
- Schumock GT: Economic considerations in the treatment and management of Alzheimer's disease. Am J Health Syst Pharm. 1998; 55(Suppl 2): S17-S21. [DOI] [PubMed] [Google Scholar]
- Max W, Webber P, Fox P: Alzheimer's disease: The unpaid burden of caring. J Aging Health. 1995; 7(2): 179-199. [DOI] [PubMed] [Google Scholar]
- Gutterman EM, Markowitz JS, Lewis B, et al.: Cost of Alzheimer's disease and related dementia in managed-medicare. J Am Geriatr Soc. 1999; 47(9): 1065-1071. [DOI] [PubMed] [Google Scholar]
- Taylor DH, Sloan FA: How much do persons with Alzheimer's disease cost Medicare? J Am Geriatr Soc.2000; 48(6): 639-646. [DOI] [PubMed] [Google Scholar]
- Brummel-Smith KV: Alzheimer's disease and managed care: How much will it cost? J Am Geriatr Soc.1998; 46(6): 762-770. [DOI] [PubMed] [Google Scholar]
- McCormick WC, Hardy J, Kukull WA, et al.: Healthcare utilization in costs in managed care patients with Alzheimer's disease during the last few years of life. J Am Geriatr Soc.2001; 49(9): 1156-1160. [DOI] [PubMed] [Google Scholar]
- Walsh EG, Wu B, Mitchell JB, et al.: Cognitive function and acute care utilization. J Gerontol B Psychol Sci Soc Sci.2003; 58(1): S38-S49. [DOI] [PubMed] [Google Scholar]
- Charlson ME, Pompei P, Ales KL, et al.: A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987; 40(5): 373-383. [DOI] [PubMed] [Google Scholar]
- Duan N: Smearing estimate: A nonparametric retransformation method. J Am Statistical Assoc. 1983; 78: 605-610. [Google Scholar]
- Winblad B, Wimo A: Assessing the societal impact of acetylcholinesterase inhibitor therapies. Alzheimer Dis Assoc Disord.1999; 13 (Suppl 2): S9-S19. [PubMed] [Google Scholar]
- Reisberg B, Doody R, Stoffler A, et al.: Memantine in moderateto-severe Alzheimer's disease. N Engl J Med. 2003; 348: 1333-1341. [DOI] [PubMed] [Google Scholar]
- Husereau D, Wolfson C, Shukla VK: Drug Treatments for Alzheimer's Disease: Efficacy, Outcome Measurements and Cost-Effectiveness. Technology Overview no. 4. Ottawa: Canadian Coordinating Office on Health Technology Assessment, 2001. [Google Scholar]
- Bloom BS, de Pouvourville N, Straus WL: Cost of illness of Alzheimer's disease: How useful are current estimates? Gerontologist. 2003; 43(2): 158-164. [DOI] [PubMed] [Google Scholar]
- Weiner M, Powe NR, Weller WE, et al.: Alzheimer's disease under managed care: Implications from Medicare utilization and expenditure patterns. J Am Geriatr Soc.1998; 46(6): 762-770. [DOI] [PubMed] [Google Scholar]
- Fillit H, Hill J: The costs of vascular dementia: a comparison with Alzheimer's disease. J Neurol Sci.2002; 203-204: 35-39. [DOI] [PubMed] [Google Scholar]
- Taylor DH Jr, Schenkman M, Zhou J, et al.: The relative effect of Alzheimer's disease and related dementias, disability, and comorbidities on cost of care for elderly persons. J Gerontol B Psychol Sci Soc Sci.2001; 56(5): S285-S293. [DOI] [PubMed] [Google Scholar]