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The clinical and cost-effectiveness of donepezil, rivastigmine, galantamine and memantine for Alzheimer's disease

Loveman, E., Green, C.J., Kirby, Julie, Takeda, A., Picot, J., Payne, E. and Clegg, A. (2006) The clinical and cost-effectiveness of donepezil, rivastigmine, galantamine and memantine for Alzheimer's disease Health Technology Assessment, 10, (1), pp. 1-183. (doi:10.3310/hta10010). (PMID:16409879).

Record type: Article


Although results from the clinical effectiveness review suggest that these treatments may be beneficial, a number of issues need to be considered when assessing the results of the present review, such as the characteristics of the participants included in the individual trials, the outcome measures used, the length of study duration, the effects of attrition and the relationship between statistical significance and clinical significance. Many included trials were sponsored by industry. For donepezil, rivastigmine and galantamine, the cost savings associated with reducing the mean time spent in full-time care do not offset the cost of treatment sufficiently to bring estimated cost-effectiveness to levels generally considered acceptable by NHS policy makers. It is difficult to draw conclusions on the cost-effectiveness of memantine; it is suggested that further amendments to the potentially optimistic industry model (measure of effect) would offer higher cost per QALY estimates. Future research should include: information on the quality of the outcome measures used; development of quality of life instruments for patients and carers; studies assessing the effects of these interventions of durations longer than 12 months; comparisons of benefits between interventions; and research on the prediction of disease progression.

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Published date: January 2006
Organisations: Faculty of Medicine


Local EPrints ID: 194799
ISSN: 1366-5278
PURE UUID: 62d5d606-647b-44ee-a02a-2d50dd58aebe
ORCID for J. Picot: ORCID iD
ORCID for E. Payne: ORCID iD

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Date deposited: 11 Aug 2011 10:52
Last modified: 18 Jul 2017 11:26

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Author: E. Loveman
Author: C.J. Green
Author: Julie Kirby
Author: A. Takeda
Author: J. Picot ORCID iD
Author: E. Payne ORCID iD
Author: A. Clegg

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