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首页> 外文期刊>Journal of Alzheimer's disease: JAD >Cost-effectiveness of a health intervention program with risk reductions for getting demented: results of a Markov model in a Swedish/Finnish setting.
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Cost-effectiveness of a health intervention program with risk reductions for getting demented: results of a Markov model in a Swedish/Finnish setting.

机译：降低患痴呆症风险的健康干预计划的成本效益：瑞典/芬兰环境中的马尔可夫模型的结果。

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摘要

Risk scores based on modifiable factors have recently been developed for dementia. This study aims to estimate the cost-effectiveness of a potential preventive intervention program meant to lower the score related to increased dementia risk. Analyses were based on a Markov model adapted to Swedish circumstances. Risk score categories and risk probabilities were derived from the Cardiovascular Risk Factors, Aging and Incidence of Dementia (CAIDE) study in Finland. Figures of costs, utilities, and mortality were obtained from literature or databases. One-way sensitivity analysis and probabilistic sensitivity analysis were carried out to investigate the robustness of the model and to identify which model inputs had most impact on the results. In the base case, the usual care had a cost of 621,000 SEK and utilities of 11.8438 quality-adjusted life year (QALYs). The intervention had a cost of 599, 026 SEK and utilities of 11.8950 QALYs. The cost was 21,974 SEK lower in the intervention with 0.0511 QALYs gained over a 20 years horizon, indicating absolute dominance. The support for cost-effectiveness was insensitive to changes in the value of QALY for demented, mortality, and risk of dementia. If the intervention program was assumed to run every year, the incremental cost-effectiveness ratio did not show absolute dominance but was still under the willingness-to-pay level. The probabilistic sensitivity analysis indicated cost effectiveness in 67% of the samplings given a willingness-to-pay level of 600,000 SEK/year. This is a promising outlook for future research on preventive interventions in dementia, emphasizing the need of conducting multi-domain randomized trials.
机译：最近针对痴呆症开发了基于可修改因素的风险评分。这项研究旨在评估潜在的预防干预计划的成本效益，该计划旨在降低与痴呆症风险增加相关的评分。分析基于适应瑞典情况的马尔可夫模型。风险评分类别和风险概率来自芬兰的心血管风险因素，痴呆的年龄和发病率（CAIDE）研究。成本，公用事业和死亡率的数字是从文献或数据库中获得的。进行了单向敏感性分析和概率敏感性分析，以研究模型的鲁棒性并确定哪些模型输入对结果影响最大。在基本情况下，常规护理的费用为621,000瑞典克朗，公用事业费用为11.8438质量调整生命年（QALYs）。该干预措施的成本为599、026瑞典克朗，公用事业费用为11.8950 QALY。干预期间的成本降低了21974瑞典克朗，在20年的时间范围内获得了0.0511 QALY，表明绝对的优势。对成本效益的支持对痴呆症，死亡率和痴呆症风险的QALY值变化不敏感。如果假定干预计划每年运行一次，那么成本效益比的增加并不是绝对的优势，而是仍在支付意愿的水平之下。概率敏感性分析表明，在支付意愿为每年60万瑞典克朗的情况下，67％的样本具有成本效益。这是对痴呆症预防干预措施未来研究的有希望的前景，强调需要进行多领域随机试验。

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