Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Nov;35(11):664-672.
doi: 10.1017/S1041610223000327. Epub 2023 Apr 17.

Cost consequence analysis of Apathy in Dementia Methylphenidate Trial 2 (ADMET 2)

Krista L Lanctôt  1 , Clara Chen  2 , Ethan Mah  1 , Alex Kiss  1 , Abby Li  1 , Dave Shade  3 , Roberta W Scherer  3 , Danielle Vieira  1 , Hamadou Coulibaly  3 , Paul B Rosenberg  4 , Alan J Lerner  5 , Prasad R Padala  6 , Olga Brawman-Mintzer  7 , Christopher H van Dyck  8 , Anton P Porsteinsson  9 , Suzanne Craft  10 , Allan Levey  11 , William J Burke  12 , Jacobo Mintzer  7 , Nathan Herrmann  1
Affiliations
Randomized Controlled Trial

Cost consequence analysis of Apathy in Dementia Methylphenidate Trial 2 (ADMET 2)

Krista L Lanctôt et al. Int Psychogeriatr. 2023 Nov.

Abstract

Background: This paper used data from the Apathy in Dementia Methylphenidate Trial 2 (NCT02346201) to conduct a planned cost consequence analysis to investigate whether treatment of apathy with methylphenidate is economically attractive.

Methods: A total of 167 patients with clinically significant apathy randomized to either methylphenidate or placebo were included. The Resource Utilization in Dementia Lite instrument assessed resource utilization for the past 30 days and the EuroQol five dimension five level questionnaire assessed health utility at baseline, 3 months, and 6 months. Resources were converted to costs using standard sources and reported in 2021 USD. A repeated measures analysis of variance compared change in costs and utility over time between the treatment and placebo groups. A binary logistic regression was used to assess cost predictors.

Results: Costs were not significantly different between groups whether the cost of methylphenidate was excluded (F(2,330) = 0.626, ηp2 = 0.004, p = 0.535) or included (F(2,330) = 0.629, ηp2 = 0.004, p = 0.534). Utility improved with methylphenidate treatment as there was a group by time interaction (F(2,330) = 7.525, ηp2 = 0.044, p < 0.001).

Discussion: Results from this study indicated that there was no evidence for a difference in resource utilization costs between methylphenidate and placebo treatment. However, utility improved significantly over the 6-month follow-up period. These results can aid in decision-making to improve quality of life in patients with Alzheimer's disease while considering the burden on the healthcare system.

Keywords: Alzheimer’s disease (AD); apathy; dementia; health economics.

PubMed Disclaimer

Conflict of interest statement

KLL has received research grants from the National Institutes of Aging, Alzheimer’s Drug Discovery Foundation, the Alzheimer Society of Canada, Alzheimer’s Association, Canadian Institutes of Health Research, Weston Brain Institute; honoraria from BioXcel, Cerevel, Eisai, and Praxis.

NH has received peer-reviewed research grants from the Alzheimer Drug Discovery Foundation, the Alzheimer Society of Canada, the National Institute of Health, Canadian Institutes of Health Research.

PBR has received research grants from the National Institutes of Aging, Alzheimer’s Clinical Trials Consortium, Richman Family Precision Medicine Center of Excellence on Alzheimer’s Disease, Eisai, Functional Neuromodulation, and Lilly; honoraria from GLG, Leerink, Cerevel, Cerevance, Bioxcel, Sunovion, Acadia, Medalink, Novo Nordisk, Noble Insights, TwoLabs, Otsuka, Lundbeck, Acadia, MedaCorp, ExpertConnect, HMP Global, Synaptogenix, and Neurology Week.

The remaining authors have nothing to disclose.

Comment in

References

    1. (2021). 2021 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 17, 327–406. - PubMed
    1. Barber JA and Thompson SG (1998). Analysis and interpretation of cost data in randomised controlled trials: review of published studies. BMJ, 317, 1195–1200. - PMC - PubMed
    1. Coretti S, Ruggeri M and Mcnamee P (2014). The minimum clinically important difference for EQ-5D index: a critical review. Expert Review of Pharmacoeconomics & Outcomes Research, 14, 221–233. - PubMed
    1. Dauphinot V, Delphin-Combe F, Mouchoux C et al. (2015). Risk factors of caregiver burden among patients with Alzheimer’s disease or related disorders: a cross-sectional study. Journal of Alzheimer’s Disease, 44, 907–916. - PubMed
    1. Doshi JA, Glick HA and Polsky D (2006). Analyses of cost data in economic evaluations conducted alongside randomized controlled trials. Value in Health, 9, 334–340. - PubMed

Publication types

Substances

Associated data