Alzheimers Dement. 2024 Dec;20 Suppl 7:e086754. doi: 10.1002/alz.086754.
ABSTRACT
BACKGROUND: This post-hoc subgroup analysis aimed to estimate the potential cost-effectiveness of a Japanese multimodal intervention trial for the prevention of dementia (J-MINT) from a societal perspective.
METHOD: Using a Markov model, we estimated the economic impact of J-MINT on disease prevention, drawing on data from the 2019 J-MINT trial and relevant published literature. The trial, a randomized controlled trial (RCT), focused on participants aged 65 to 85 years with mild cognitive impairment. Participants were randomly assigned either a multidomain intervention group (comprising management of vascular risk factors, physical exercise, nutritional counseling, and cognitive training) or a standard care group (involving vascular risk factor management and receipt of health-related information every two months). The Markov model consists of five states: at-risk, mild, moderate, severe dementia, and death. By simulating care costs and quality-adjusted life years (QALYs), we estimated the incremental cost-effectiveness ratio (ICER). The simulation spanned from ages 65 to 100, utilizing the Simpson 1/3 rule for correction, with a discount rate of 0.02. The intervention effect was assumed to persist for the remaining lifetime post-program. Care costs encompassed medical care, public long-term care, and informal care. The intervention cost was derived from the J-MINT trial data. In addition to the base case analysis, sensitivity and scenario analysis were conducted to evaluate uncertainty and heterogeneity.
RESULT: Costs were JPY 18,493,579 and JPY 18,056,997 and QALYs were 12.37 and 12.46 for standard of care and J-MINT, respectively. This translated to savings of JPY 436,582 (US$ 2,952.01) and QALY gain of 0.09 per person, affirming the dominance of the J-MINT.
CONCLUSION: Our estimation supports the potential cost-effectiveness of multimodal intervention trials, exemplified by J-MINT, for dementia prevention.
PMID:39785154 | DOI:10.1002/alz.086754