Table 4.
Potential cost and caregiver time savings by slowing disease progression (as measured by MMSE)
| Outcome | Patient group | MMSE LSMC from baseline to 36 months | Coefficient of MMSE change from baseline to 36 months (SE) | % Increase in total outcome over 36 months relative to no progression (95% CI) | Increase in total outcome over 36 months relative to no progression (95% CI) | Total outcome savings over 36 months compared with observed progression |
| Total caregiver time (RUD) | MCI | –2.1 (observed progression) | –502.8(74.7) | 27.1% (19.1% 35.1%) | 1050.0 (740.3, 1359.6) | NA |
| –1.7 (20% slowing) | 21.7% (15.3% 28.1%) | 840.0 (592.3, 1087.7) | 210.0 | |||
| –1.6 (25% slowing) | 20.3% (14.3% 26.3%) | 787.5 (555.2, 1019.7) | 262.5 | |||
| –1.5 (30% slowing) | 19.0% (13.4% 24.6%) | 735.0 (518.2, 951.7) | 315.0 | |||
| MILD AD | –4.1 (observed progression) | –467.1 (80.4) | 23.0% (15.1% 30.8%) | 1929.1 (1271.0, 2587.1) | NA | |
| –3.3 (20% slowing) | 18.4% (12.1% 24.6% | 1543.2 (1016.8, 2069.7) | 385.8 | |||
| –3.1 (25% slowing) | 17.2% (11.4% 23.1%) | 1446.8 (953.2, 1940.3) | 482.3 | |||
| –2.9 (30% slowing) | 16.1% (10.6% 21.6%) | 1350.3 (889.7, 1811.0) | 578.7 | |||
| Total societal cost | MCI | –2.1 (observed progression) | –0.046 (0.019) | 10.2% (1.8% 19.3%) | $8,504 ($1,479, $16,108) | NA |
| –1.7 (20% slowing) | 8.1% (1.4% 15.2%) | $6,736 ($1181, $12,656) | $1,767 | |||
| –1.6 (25% slowing) | 7.5% (1.3% 14.1%) | $6,300 ($1107, $11,811) | $2,204 | |||
| –1.5 (30% slowing) | 7.0% (1.2% 13.1%) | $5,865 ($1,033, $10,974) | $2,638 | |||
| MILD AD | –4.1 (observed progression) | –0.024 (0.008) | 10.6% (4.0% 17.5%) | $12,795 ($4,881, $21,206) | NA | |
| –3.3 (20% slowing) | 8.4% (3.2% 13.8%) | $10,132 ($3,889, $16,687) | $2,663 | |||
| –3.1 (25% slowing) | 7.8% (3.0% 12.9%) | $9,475 ($3,643, $15,580) | $3,320 | |||
| –2.9 (30% slowing) | 7.3% (2.8% 11.9%) | $8,821 ($3,396, $14,481) | $3,974 |
AD, Alzheimer’s disease; CI, confidence interval; GLM, generalized linear model; LSMC, least squares mean change (from MMRM model); MMSE, Mini-Mental State Examination; MCI, mild cognitive impairment; MILD AD, mild dementia due to AD; NA, not applicable; RUD, Resource Utilization in Dementia questionnaire; SE, standard error. Patients with both MMSE and outcomes measured at baseline visit and 36 month visit (outcome analysis set) were included in the analyses (total over 36 months). The general linear model was performed for total caregiver time. The GLM with log link and gamma distribution was performed for total societal cost. Separate models were fitted for MCI and MILD AD, respectively. All models included baseline MMSE, change in MMSE from baseline to 36 months, age, number of comorbidities, and study partner relationship. Caregiver time capped at 540 hours/month.