Objective: To compare the effect of donepezil versus placebo on the health and associated costs of caregivers of patients with mild to moderate Alzheimers disease (AD).
Design: In this multicenter clinical trial, 286 patients with mild to moderate AD were randomized to donepezil (n=142) or placebo (n=144) for 1 year.
Methods: The healthcare resource utilization by the caregivers of these patients was evaluated using the Resource Utilization in Dementia (RUD) questionnaire. Costs are reported in Swedish krona (SEK) and US dollars (US$) (conversion rate 8.38).
Results: Caregivers in both treatment groups were similar for age, marital status and proportion living with the patient. Caregivers of donepezil-treated patients reported 16 hospitalizations (69 nights) versus 20 hospitalizations (122 nights) in placebo group caregivers. Caregiver hospitalization costs were placebo group: 432,821 SEK (US$ 51,649); donepezil group: 254,536 SEK (US$ 30,374) (P=0.39). Caregivers of the placebo group contacted healthcare professionals more often than donepezil group (811 vs 613), with almost twice as many general practitioner visits (329 vs 170). Average cost of healthcare professional contact per caregiver was significantly higher (P=0.04) for caregivers of placebo- versus donepezil-treated patients. Reported caregiver medication use during study was lower for caregivers of the donepezil group, 815, than caregivers of the placebo group, 1025. Caregivers of placebo-treated patients reported statistically higher use of antihypertensives (P=0.015), antipsychotics (P=0.019) and anxiolytics (P=0.004) versus donepezil.
Conclusions: Significant global, cognitive and functional benefits were previously reported in donepezil-treated patients from this study. This analysis suggests that donepezil treatment benefits both donepezil-treated patients and their caregivers. Caregivers of donepezil-treated patients have lower associated healthcare costs.
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