Potential savings in the cost of caring for Alzheimer's disease - Treatment with rivastigmine

Objective: To estimate savings in the cost of caring for patients with Alzh eimer's disease (AD) during 6 months, 1 year and 2 years of treatment with rivastigmine. An intermediate objective was to estimate the relationship be tween disease progression and institutionalisation. Design and setting: We assessed the relationship between Mini-Mental State Examination (MMSE) score and institutionalisation using a piecewise Cox pro portional hazard model. To estimate cost savings from treatments lasting 6 months, 1 year and 2 years, estimates of the probability of institutionalis ation were integrated with data from two 6-month phase III clinical trials of rivastigmine and a hazard model of disease progression. Main outcome measures and results: Our data suggest that savings in the ove rall cost of caring for patients with mild and moderate AD can be as high a s $US4839 per patient after 2 years of treatment. Furthermore, the probabil ity of institutionalisation increases steadily as MMSE score falls. Among o ur study individuals, age, race, level of education and marital status were significant predictors of institutionalisation, whereas gender had little effect. Conclusions: Using rivastigmine to treat AD results in a delay in disease p rogression for patients who begin treatment during the mild or moderate sta ges of the disease. By delaying the probability that a patient will be inst itutionalised, the cost of caring for AD patients can be significantly redu ced.