Economic assessments of health and healthcare have become an integral part of policy decisions in the last decade. Increasingly, this trend is extending to medical decision-making in day-to-day patient-provider interactions. Alzheimer disease (AD) offers a potent example of the clinical and economic issues at stake with its diagnostic techniques, pharmacotherapies, and public health and policy implications. This review introduces basic economic concepts in examining the impact of AD and related care. It presents a summary of the latest economics research on cost estimates of AD and on economic evaluations of diagnostic and management interventions in terms of cost-of-illness and cost-effectiveness studies respectively. Empirical and conceptual issues about the interpretation of costs and the uses of evaluative methods are also discussed. We found that the economic costs attributable to AD care is highly variable mostly due to non-standardised methodologies and geographical variations in care patterns. There is, however, little doubt that the impact is substantial and is expected to worsen with the demographic, epidemiologic, technologic and economic transitions worldwide. There are comparatively fewer studies on the cost-effectiveness of interventions in AD. Most of the published work revolves around pharmacotherapeutics while relatively little has been done on diagnostics, patient care programmes and programmes for caregivers. We conclude that there are significant opportunities to strengthen research on standardised cost-of-illness analyses and new cost-effectiveness studies on a broader range of AD interventions.
Copyright 2003 S. Karger AG, Basel