Costs of diagnosing early Alzheimer's disease in three European memory clinic settings: Results from the precision medicine in Alzheimer's disease project

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2024-07-18 DOI:10.1002/gps.6126

Anders Wimo, Bjørn-Eivind Kirsebom, Santiago Timón-Reina, Ellen Vromen, Per Selnes, Jaka Bon, Andreja Emersic, Milica Gregoric Kramberger, Andreja Speh, Pieter Jelle Visser, Bengt Winblad, Tormod Fladby

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引用次数: 0

Abstract

Objectives

The implementation of disease-modifying treatments for Alzheimer's Disease (AD) will require cost-effective diagnostic processes. As part of The Precision Medicine In AD consortium (PMI-AD) project, the aim is to analyze the baseline costs of diagnosing early AD at memory clinics in Norway, Slovenia, and the Netherlands.

Methods

The costs of cognitive testing and a clinical examination, apolipoprotein E, magnetic resonance imaging (MRI), cerebrospinal fluid (CSF), positron emission tomography and blood-based biomarkers (BBM), which are used in different combinations in the three countries, were analyzed. Standardized unit costs, adjusted for GDP per capita and based on Swedish conditions were applied. The costs were expressed in euros (€) as of 2019. A diagnostic set comprising clinical examination, cognitive testing, MRI and CSF was defined as the gold standard, with MRI mainly used as an exclusion filter.

Results

Cost data were available for 994 persons in Norway, 169 in Slovenia and 1015 in the Netherlands. The mean diagnostic costs were 1478 (95% confidence interval 1433–1523) € in Norway, 851 (731–970) € in Slovenia and 1184 (1135–1232) € in the Netherlands. Norway had the highest unit costs but also the greatest use of tests. With a uniform diagnostic test set applied, the diagnostic costs were 1264 (1238–1291) €, in Norway, 843 (771–914) € in Slovenia and 1184 (1156–1213) € in the Netherlands. There were no major cost differences between the final set of diagnoses.

Conclusions

The total costs for setting a diagnosis of AD varied somewhat in the three countries, depending on unit costs and use of tests. These costs are relatively low in comparison to the societal costs of AD.

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欧洲三家记忆诊所诊断早期阿尔茨海默病的成本：阿尔茨海默病精准医疗项目的结果

目标针对阿尔茨海默病（AD）实施疾病改变疗法需要具有成本效益的诊断过程。作为阿兹海默病精准医疗联盟（PMI-AD）项目的一部分，该项目旨在分析挪威、斯洛文尼亚和荷兰记忆诊所诊断早期阿兹海默病的基线成本。方法分析了认知测试和临床检查、载脂蛋白 E、磁共振成像 (MRI)、脑脊液 (CSF)、正电子发射断层扫描和血液生物标记物 (BBM) 的成本，这三个国家采用了不同的组合。根据人均 GDP 调整后的标准化单位成本以瑞典的情况为基础。截至 2019 年的成本以欧元（€）表示。由临床检查、认知测试、核磁共振成像和脑脊液组成的诊断集被定义为金标准，核磁共振成像主要用作排除过滤器。结果挪威、斯洛文尼亚和荷兰分别有 994 人、169 人和 1015 人的成本数据。挪威的平均诊断成本为1478欧元（95%置信区间为1433-1523），斯洛文尼亚为851欧元（731-970），荷兰为1184欧元（1135-1232）。挪威的单位成本最高，但使用的检测项目也最多。在采用统一诊断检测组的情况下，挪威的诊断费用为 1264（1238-1291）欧元，斯洛文尼亚为 843（771-914）欧元，荷兰为 1184（1156-1213）欧元。最终诊断结果之间的成本差异不大。结论根据单位成本和检测项目的使用情况，三个国家确诊 AD 的总成本存在一定差异。与注意力缺失症的社会成本相比，这些成本相对较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.