Cost consequence analysis of Apathy in Dementia Methylphenidate Trial 2 (ADMET 2)

• Type of Material: Article
• Authors: Krista L. Lanctôt, Sunnybrook Research Institute; Clara Chen, Western University; Ethan Mah, Sunnybrook Research Institute; Alex Kiss, Sunnybrook Research Institute; Abby Li, Sunnybrook Research Institute; Dave Shade, Johns Hopkins University; Roberta W. Scherer, Johns Hopkins University; Danielle Vieira, Sunnybrook Research Institute; Hamadou Coulibaly, Johns Hopkins University; paul B. Rosenberg, Johns Hopkins University; Alan J. Lerner, Case Western Reserve University; Prasad R. Padala, University of Arkansas; Olga Brawman-Mintzer, University of South Carolina; Christopher H. van Dyck, Yale University; Anton P. Porsteinsson, University of Rochester; Suzanne Craft, Wake Forest University; Allan I Levey, Emory University; William J. Burke, Banner Alzheimer's Institute; Jacobo Mintzer, University of South Carolina; Nathan Herrmann, Sunnybrook Research Institute
• Language: English
• Date: 2023-04-17
• Publisher: Cambridge University Press
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2023, Cambridge University Press
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1017/S1041610223000327
• Title of Journal or Parent Work: International Psychogeriatric
• Volume: 35
• Issue: 11
• Start Page: 664
• End Page: 672
• Grant/Funding Information: ADMET 2 was funded by NIA, NIH, R01AG046543.
• Keywords: health economics; Alzheimer’s disease (AD); apathy; dementia
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Public Health

Abstract

Background: This paper used data from the Apathy in Dementia Methylphenidate Trial 2 (NCT02346201) to conduct a planned cost consequence analysis to investigate whether treatment of apathy with methylphenidate is economically attractive. Methods: A total of 167 patients with clinically significant apathy randomized to either methylphenidate or placebo were included. The Resource Utilization in Dementia Lite instrument assessed resource utilization for the past 30 days and the EuroQol five dimension five level questionnaire assessed health utility at baseline, 3 months, and 6 months. Resources were converted to costs using standard sources and reported in 2021 USD. A repeated measures analysis of variance compared change in costs and utility over time between the treatment and placebo groups. A binary logistic regression was used to assess cost predictors. Results: Costs were not significantly different between groups whether the cost of methylphenidate was excluded (F(2,330) = 0.626, ηp2 = 0.004, p = 0.535) or included (F(2,330) = 0.629, ηp2 = 0.004, p = 0.534). Utility improved with methylphenidate treatment as there was a group by time interaction (F(2,330) = 7.525, ηp2 = 0.044, p < 0.001). Discussion: Results from this study indicated that there was no evidence for a difference in resource utilization costs between methylphenidate and placebo treatment. However, utility improved significantly over the 6-month follow-up period. These results can aid in decision-making to improve quality of life in patients with Alzheimer’s disease while considering the burden on the healthcare system.