Sensitivity analysis
Cost of dementia
by Anders Wimo, MD, PhD, professor, Karolinska Institutet, Linus Jönsson, PhD, I3 Innovus and Anders Gustavsson, Senior Analyst, I3 Innovus
Due to the different approaches for undertaking COI studies, the varying quality of the underlying sources, the different approaches for quantification and costing and the different ways of organizing and financing care for demented, it is obvious that COI estimates may vary. Key assumptions may vary a lot. Thus an extensive sensitivity analysis including different approaches for the COI estimates is presented her.
Transparency is crucial for comparisons since the results vary a lot. This section includes approaches: firstly some key assumptions in the base model is varied, secondly, two other cost models are presented and thirdly cost figures from several nation specific COI studies are presented.
Sensitivity analysis of the base model
In the base option, the new Eurocode age specific prevalence figures of dementia were used. However, there are other prevalence sources that can be used: The Eurodem (1) The Delphi-analysis by Ferri et al (2), the Swedish health technology assessment institute SBU (3), and the meta analysis by Lobo et al (4). All other prevalence spources result in lower prevalence figures, and, as consequence, lower costs (table 12).
Table 12. Sensitivity analysis of the cost of illness of Alzheimer´s disease and other dementias(billions €) in 2008.
| Base option Eurocode | Prevalence (millions) | Direct costs | Informal care | Total costs |
| EU 27 | 7.22 | 71.7 | 88.6 | 160.3 |
| EU27 + candidate countries , EEA countries and Switzerland | 7.82 | 76.3 | 91.2 | 167.5 |
| Europe (including Turkey) | 10.11 | 80.6 | 96.6 | 177.2 |
| Eurodem (1) | ||||
| EU 27 | 6.39 | 59.6 | 75.1 | 134.7 |
| EU27 + candidate countries , EEA countries and Switzerland | 6.93 | 63.7 | 77.4 | 141.1 |
| Europe (including Turkey) | 8.99 | 66.3 | 80.7 | 147.0 |
| Ferri et al (2) | ||||
| EU 27 | 6.07 | 56.5 | 71.4 | 127.8 |
| EU27 + candidate countries , EEA countries and Switzerland | 6.58 | 60.4 | 73.6 | 134.0 |
| Europe (including Turkey) | 8.53 | 62.8 | 76.7 | 139.5 |
| SBU (Sweden) (3) | ||||
| EU 27 | 6.36 | 59.8 | 75.1 | 134.9 |
| EU27 + candidate countries , EEA countries and Switzerland | 6.89 | 63.8 | 77.5 | 141.3 |
| Europe (including Turkey) | 8.87 | 66.4 | 80.6 | 147.0 |
| Lobo et al* (4) | ||||
| EU 27 | 5.27 | 49.2 | 62.2 | 111.4 |
| EU27 + candidate countries , EEA countries and Switzerland | 5.71 | 52.5 | 64.1 | 116.6 |
| Europe (including Turkey) | 7.39 | 54.6 | 66.8 | 121.4 |
Including only demented 65+
References
- Hofman A, Rocca WA, Brayne C, Breteler MM, Clarke M, Cooper B, et al. The prevalence of dementia in Europe: a collaborative study of 1980-1990 findings. Eurodem Prevalence Research Group. Int J Epidemiol. 1991 Sep;20(3):736-48.
- Ferri, C. P., M. Prince, et al. (2005). "Global prevalence of dementia: a Delphi consensus study." Lancet 366(9503): 2112-7.
- SBU (2008). Dementia. A systematic review. Stockholm, Staten beredning för medicinsk utvärdering (SBU) (The Swedish Council on Technology Assessment in Health Care).
- Lobo, A., L. J. Launer, et al. (2000). "Prevalence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group." Neurology 54(11 Suppl 5): S4-9.
Last Updated: Thursday 08 October 2009
