The economic impact of galantamine vs placebo: An analysis based on functional capacity in a Swedish cohort study

Abstract

Objective:

To analyse the economic impact of galantamine, based on basic activities of daily living (ADL).

Methods:

Data were derived from Swedish patients enrolled in a 6-month placebo-controlled trial of galantamine (GAL-INT-1; n = 80), and from the Kungsholmen–Nordanstig Project, a longitudinal study of 919 elderly persons in Sweden. Basic ADL were assessed using the Katz’ Index of Independence in Activities of Daily Living (ADL) (number of ADL lost [dependency in 0, 1–2, 3–4, or 5–6 ADL]). Costs were appraised based on regression analysis and on costs directly linked to ADL. Six-month costs for galantamine and placebo were calculated.

Results:

In the regression analyses, each increase in a Katz stage was associated with an annual cost increase of SEK 81,415–83,683 (∼€8000). Results were similar using stage-specific costs. Overall, there was a small, non-significant numerical cost benefit for galantamine indicating cost neutrality.

Limitations:

The small number of Swedish patients in the GAL-INT-1 study, which was not powered for economic outcomes, limits the statistical power of the analysis. In addition, long-term outcomes are difficult to assess in persons with dementia because of practical and logistical problems.

Conclusions:

The benefits of galantamine in patients with AD can be achieved with no increase in cost. Combined with positive effects in terms of outcome, treatment with galantamine can be regarded as cost-effective using a cost–consequence approach.

Keywords::

• Economic impact
• Functional capacity
• Galantamine

Transparency

Declaration of funding

The GAL-INT-1 study was sponsored by Janssen Research Foundation, Beerse, Belgium.

Declaration of financial/other relationships

Anders Wimo has acted as consultant to drug companies that are purchasing or developing drugs for treatment of Alzheimer’s disease or other dementias (Janssen–Cilag, Pfizer, Astra–Zeneca, Novartis, Merz, Lundbeck, Forest, GSK, Wyeth, Sanofi, Elan, Neurochem). Maren Gaudig and Barbara Schäuble are employees of Janssen–Cilag EMEA. Erik Jedenius is an employee of Janssen–Cilag AB.

Acknowledgements

Medical writing assistance with this manuscript was provided by Daniel Booth (BioScript Stirling Ltd, London, UK) and funded by Janssen-Cilag EMEA. This analysis was made possible by unrestricted support from Swedish brainpower.