Importance of Drug Therapy in Management of Alzheimer’s Disease

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Table of Contents

Introduction
Discussion
Conclusion
Reference

Introduction

Alzheimer’s disease is a form of dementia characterized by decreased cognitive and functional abilities. Mostly, it affects elderly people from the age of 50-65. Alzheimer’s progresses gradually and early symptoms are not easily identified.

Some of the early symptoms of the disease include memory impairment where the individual experiences difficulty remembering new information (Cappel et al., 2010). Moderate stage of the disease is characterized by confusion, functional impairment and behavioral changes.

The economic burden associated with Alzheimer’s disease is high. This includes both direct and indirect medical costs. Rapid disease progression is the main catalyst for escalated medical costs. One method that can be used to curb the escalation of the cost associated with the disease is early introduction of drug therapy.

Several drugs have licensed by FDA in the treatment and management of the disease. They include Memantine, Donepezil, Rivastigmine and Galantine (Cappel et al., 2010).

Although they do not cure the disease, these drugs are instrumental controlling the progression of the disease. The paper explores the economic burden associated with Alzheimer’s disease and importance of early introduction of drug therapy

Discussion

Economic Burden associated with Alzheimer’s disease

The economic burden associated with Alzheimer’s disease can be put into two major categories including clinical severity and residential status. Clinical severity explores the disease’s impact on the individual cognitive abilities and consequent behavioral changes.

The mini-mental state examination (MMSE) is used establish the severity of Alzheimer’s disease (Cappel et al., 2010). The test’s total score is 30 points where 21-26 score is considered mild Alzheimer’s, 10-20 is considered moderate Alzheimer’s and >10 score is considered severe Alzheimer’s.

Several studies in countries such as the UK and France have indicated that one point increase in MMSE results in cost increase.

Therefore, early introduction of drug therapy derails the progression of the disease and thus results in substantial cost savings. Cost savings are established on the basis of comparison of cost of drugs to the cost incurred in absence of drug therapy.

Alzheimer’s disease results in increased behavioral changes (Cappel et al., 2010).. Behavioral changes caused by dementia are measured using the Neuro-psychiatric inventory (NPI).

Most studies indicate that an increase one point results in increased costs associated with the disease. However, most studies focused on mild Alzheimer’s patients thus limited data on moderate and severe Alzheimer’s patients.

Residential status is associated with the transfer of Alzheimer’s patients to such places as nursing homes. This is the case for severe Alzheimer’s patients needing round- the- clock care (Cappel et al., 2010). Direct costs incurred as a result of placement in a nursing home include caregiver fees that are charged by the home.

In other cases, Alzheimer patients remain at home where family members are assigned duties to take care of them. In this case, the concept of opportunity cost applies where the family member has to forego a productive activity to take care of the Alzheimer’s patient.

Drug Therapy

Drug therapy can be analyzed using both clinical and pharmaeconomical outcomes. Memantine controls the production of glutamate. Increased levels of glutamate can cause neuronal dysfunction (Cappel et al., 2010).

Studies have shown that patients who switch from placebo to memantine showed reduced progression of the disease especially the effect on their cognitive abilities. Donepezil has been associated with decreased disease progression affecting such areas as cognitive and functioning abilities.

Continued administration of rivastigmine among patients with moderate Alzheimer’s resulted in improved MMSE scores. Galantamine effects have not been well explored but patients under the drug reported improved SIB scores (Cappel et al., 2010).

Pharmaeconomical outcomes are related to the either drug therapy in comparison to cost incurred by patients on placebo trial. Use of drugs increased the treatment costs incurred by the Alzheimer’s patients.

However, in comparison to costs associated with rapid progression such placement and caregiver cost, significant cost savings were identified. This underscores the importance of early intervention that results in cost savings.

Conclusion

The effects of Alzheimer’s disease can be controlled by early detection. This includes introduction of drug therapy that inhibits the disease’s progression.

Most studies are based on the effects of drug therapy mild Alzheimer’s patients. Therefore, there is need for more research on effect of drug therapy on moderate and severe Alzheimer’s disease patients.

Reference

Cappel, J., Hermann, N., Cornish, S., & Lanctot, K. (2010). The Pharmacoeconomics of Cognitive Enhancers in Moderate to Severe Alzheimer’s Disease. CNSDcugs, 24(ll), 909-927

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