Happich_2005_Psychiatr.Prax_32_142

OBJECTIVE: The application of acetylcholinesterase (AChE) inhibitors seems to be constrained in the German health care system. We investigate the cost-effectiveness of the AChE inhibitor Galantamine for patients with Alzheimer's disease (AD) in a German context. METHOD: A Markov model as the decision theoretic framework is applied to compare two treatment scenarios (Placebo vs. Galantamine). The incremental cost-utility ratio based on different sources of data is calculated as decision criteria.
RESULTS: In the base case, the application of the AChE inhibitor Galantamine is a dominant scenario with cost savings along with gained quality adjusted life years. It is not cost saving from the perspective of third party payers in Germany. Results are sensitive regarding assumptions about efficacy of the drug and mortality in the analysed cohort. CONCLUSION: The German reimbursement system places an obstacle to the application of Galantamine. Further research is needed to tackle uncertainties in the model.