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Relationship between global severity of patients with Alzheimer’s disease and costs of care in Spain; results from the co-dependence study in Spain

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Abstract

Objective

The objectives of this analysis were to examine how patients’ global severity with Alzheimer’s disease (AD) relates to costs of care and explore the incremental effects of global severity measured by the clinical dementia rating (CDR) scale on these costs for patients in Spain.

Methods

The Codep‐EA study is an 18-multicenter, cross-sectional, observational study among patients (343) with AD according to the CDR score and their caregivers in Spain. The data obtained included (in addition to clinical measures) also socio-demographic data concerning the patient and its caregiver. Cost analyses were based on resource use for medical care, social care, caregiver productivity losses, and informal caregiver time reported in the resource utilization in dementia (RUD). Lite instrument and a complementary questionnaire. Multivariate regression analysis was used to model the effects of global severity and other socio-demographic and clinical variables on cost of care.

Results

The mean (standard deviation) costs per patient over 6 months for direct medical, social care, indirect and informal care costs, were estimated at €1,028.1 (1,655.0), €843.8 (2,684.8), €464.2 (1,639.0) and €33,232.2 (30,898.9), respectively. Dementia severity, as having a CDR score 0.5, 2, or 3 with CDR score 1 being the reference group were all independently and significantly associated with informal care costs. Whereas having a CDR score of 2 was also significantly related with social care costs, a CDR score of 3 was associated with most cost components including direct medical, social care, and total costs, all compared to the reference group.

Conclusions

The costs of care for patients with AD in Spain are substantial, with informal care accounting for the greatest part. Dementia severity, measured by CDR score, showed that with increasing severity of the disease, direct medical, social care, informal care and total costs augmented.

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Acknowledgments

The authors would like to thank all the health care professionals of the study centers and study participants in the project. This study was sponsored by Pfizer Inc and Janssen Alzheimer Immunotherapy Research and Development, LLC. J. Darba is employed by the University of Barcelona and was involved as an external advisor hired by Pfizer Inc and Janssen Alzheimer Immunotherapy Research and Development. L. Kaskens is an employee of BCN Health Economics & Outcomes Research SL, who was paid consultants to Janssen Alzheimer Immunotherapy Research and Development, LLC and Pfizer Inc. Josep Darbà’s and Lisette Kaskens’ contributions included the design of the study, conducting the statistical analysis, and interpretation of the data, and writing the manuscript. Josep Darbà is guarantor of the manuscript. Loretto Lacey was an employee of Janssen Alzheimer Immunotherapy Research and Development, LLC, and Pfizer Inc. Loretto Lacey’s contributions included designing the study, definition of the study objective and analysis strategy, and reviewing the manuscript.

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Authors and Affiliations

  1. Department of Economics, Universitat de Barcelona, Diagonal 690, 08034, Barcelona, Spain

    J. Darbà

  2. BCN Health Economics & Outcomes Research SL, Barcelona, Spain

    L. Kaskens

  3. Janssen Alzheimer Immunotherapy Research and Development, LLC and Pfizer Inc, Dublin, Ireland

    L. Lacey

Authors
  1. J. Darbà
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  2. L. Kaskens
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  3. L. Lacey
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Corresponding author

Correspondence to J. Darbà.

Additional information

L. Lacey is no longer affiliated with JANSSEN Alzheimer Immunotherapy.

Statistical analysis was conducted by BCN Health Economics & Outcomes Research SL.

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Darbà, J., Kaskens, L. & Lacey, L. Relationship between global severity of patients with Alzheimer’s disease and costs of care in Spain; results from the co-dependence study in Spain. Eur J Health Econ 16, 895–905 (2015). https://doi.org/10.1007/s10198-014-0642-0

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