Drug Treatments for Alzheimer’s Disease
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- Max, W. Mol Diag Ther (1999) 11: 363. doi:10.2165/00023210-199911050-00004
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The economic burden of caring for patients with Alzheimer’s disease may shift as a result of drug therapies. Drug therapies might affect the economic burden of care by permitting a delay in institutionalisation or by changing the quality of life of the patient and caregiver as informal care needs change. The adverse effects of drug therapy may also affect costs.
Two drugs are approved for Alzheimer’s disease in the US at present, and several others are used in Europe. These therapies improve cognition and slow the decline of the disease, but their effect on life expectancy is as yet unclear. Evidence suggests that in the short term these therapies may permit patients to live at home longer and require fewer hours of informal care. This shifts the burden of care from the state and private insurers, who pay for institutional care, to the family and physicians who care for patients at home. Whether this shift results in a reduction or merely a postponement of costs depends on how the therapy affects life expectancy and quality of life. Empirical evidence is at present inadequate to address this issue. Delaying institutionalisation reduces formal costs, at least in the short term, but informal care costs are increased in the long term as patients remain in their homes for longer. Furthermore, there is little evidence that drug therapies are effective for severely demented patients, who incur the highest costs.