Abstract
Severe dementia is a devastating condition causing great impairment in cognition and functional capacity. The costs associated with severe dementia are very high and the disease can have a major impact on the next of kin. Thus, any treatment that can influence the course of severe dementia would be of great value. Memantine (1amino3,5dimethyladamantane hydrochloride, CAS 4100521, Ebixa®) is a noncompetitive N-methyl-D-aspartate antagonist. It has been suggested that by inhibiting excessive stimulation of NMDA receptors, memantine may have the potential to provide both symptomatic improvement and neuroprotective effects in Alzheimer’s disease. In clinical trials on patients with moderate-to-severe Alzheimer’s disease, memantine has shown significant effects on clinical global impression of change, behavior and activities in daily life. In this survey, pharmacoeconomic results of memantine treatment from a prospective randomized 6-month US clinical trial are reviewed. Caregiver time was significantly lower in the memantine group and the resulting costs were also lower in the memantine group as compared with placebo. Combined with efficacy results, this may indicate cost-effectiveness. However, such a conclusion should be judged with some care since the long-term effects on resource utilization, costs and survival are not known.