Direct costs of Alzheimer's disease in Germany.

Objectives: The aim of this analysis was to determine the direct costs for patients with Alzheimer's disease (AD) based on data supplied by a large German statutory health insurance (BARMER). Focus of the present evaluation is the exposure of total direct costs, survival rates and the types of care distribution of patients with AD.
Methods: The analysis was based on anonymised data of patients with Alzheimer's disease who were insured by a large German statutory health insurance (Barmer Ersatzkasse-BEK) in 2005 over 12 months (n = 35.684). The study population was classified into three treatment groups: patients who received memantine and no other antidementia drugs, psychotropic drugs or sedatives/hypnotics (memantine group); patients who neither received memantine nor other antidementia drugs but psychotropic drugs and/or sedatives/hypnotics (PHS group); and patients who received no antidementia drugs and no psychotropic drugs or sedatives/hypnotics (no AT group). A Markov model was designed to assess the costs of each treatment group depending on the type of care over a 5-year period.
Results: The results obtained for the PHS group were the following: after 5 years, 25.1% were in inpatient health care, 1.1% in partial inpatient care, 5.4% in outpatient care, and 64.5% of patients died. Only 3.9% did not require care. On average, direct costs to the amount of 7.948 € incurred per patient and year and 13.099 € per surviving patient. In the group without pharmacotherapy, 20.6% were in inpatient care, 0.3% in partial inpatient care, 12.8% in outpatient care, and 52.5% of the patients died. For 13.8% of the patients, care was not necessary. The annual costs amounted to 6.760 € per patient and 9.926 € per surviving patient. The results obtained for the memantine group were more beneficial: annual costs per patient amounted to 6.100 € and to 8.376 € per surviving patient.
Conclusions: The results demonstrate that non-antidementive therapy for Alzheimer's disease causes higher costs especially for care. The memantine group proved to be superior compared to PHS group and no AT group, despite higher costs in the specific drug category.