Murman DL, Colenda CC.

Department of Neurological Sciences, University of Nebraska Medical
Center, Omaha, Nebraska, USA.

The majority of patients with Alzheimer's disease (AD) will have
clinically significant neuropsychiatric symptoms during the course of
their disease. There is growing evidence that neuropsychiatric symptoms
increase direct costs of care in patients with AD, especially the costs
associated with formal long-term care and unpaid caregiving. For
example, we have estimated that a 1-point worsening of the
neuropsychiatric inventory score is associated with an incremental
increase of between $US247 and $US409 per year in total direct costs of
care based upon year 2001 US dollars, depending on the value of unpaid
caregiving.Although data are still limited, there have been a series of
well designed, controlled clinical trials that have established the
efficacy of several drugs used in the treatment of neuropsychiatric
symptoms in patients with AD. The economic impact of using efficacious
drugs to treat neuropsychiatric symptoms in patients with AD has not
been evaluated formally. To successfully complete formal economic
evaluations of these drugs there is a need for more research to refine
methods for determining the economic value of unpaid caregiving and to
collect more data concerning the incremental effects of
neuropsychiatric symptoms on QOL, costs of care and survival. The
current ongoing treatment trials that are collecting economic and QOL
data as a part of the trial will be able to perform cost-effectiveness
and cost-utility analyses of these new efficacious drugs. These
economic evaluations will provide important information for decision
makers who are formulating healthcare policy for the treatment of
patients with AD.