http://orcid.org/0000-0002-8663-0630
![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
ABSTRACT
Objective: We aimed to review health-economic evaluations of (hypothetical) intervention programmes for the primary prevention of dementia, and highlight challenges and provide recommendations for future research to estimate its cost-effectiveness.
Methods: We searched the databases PubMed, MODEM, CEA and NHS for publications on the cost-consequence, -effectiveness, -utility or -benefit analysis of (hypothetical) interventions to reduce the risk of developing dementia for persons without dementia, and described the study characteristics.
Results: Three publications described the evaluation of a hypothetical risk reduction due to physical activity or a multidomain intervention programme. Two studies reported a reduction of care costs. One study yielded two scenarios of increased care costs and one scenario of reduced care costs. Only one study reported the impact in QALY terms, and found a QALY gain.
Conclusion: A few studies have evaluated a hypothetical multidomain prevention intervention, and reported that primary dementia prevention is potentially cost-saving or cost-effective. Various challenges remain to evaluate the health-economic impact of prevention interventions, including extrapolation of short-term trial effects, care costs in the dementia-free and life years gained, and accurate representation of usual care. We recommend extensive sensitivity analyses to examine the impact of assumptions regarding these aspects on the outcomes of cost-effectiveness studies.
Acknowledgments
This is an EU Joint Programme - Neurodegenerative Disease Research (JPND) project. The project is supported through the following funding organisations under the aegis of JPND - www.jpnd.eu: Finland, Suomen Akatemia (Academy of Finland, 291803); France, L'Agence Nationale de la Recherche (The French National Research Agency, ANR-14-JPPS-0001-02); Germany, Bundesministerium für Bildung und Forschung (BMBF) (The Federal Ministry of Education and Research, FKZ01ED1509); Sweden, Vetenskapsrådet (VR) (Swedish Research Council, 529-2014-7503), The Netherlands, ZonMw (The Netherlands Organisation for Health Research and Development, 733051041).
Disclosure statement
AW: related to this research: none; outside this research: Eli Lilly (advisory board), Nutricia (consultant), Novartis (consultant), Lundbeck (consultant).
RH: related to this research: none; outside this research: personal fees from Nutricia Medical Nutrition (consultant), personal fees from Piramal (consultant), grants from CTMM Grant 02 N-101.