Non-drug Interventions for Alzheimer's are Cost Effective

Non-drug interventions for patients with Alzheimer's disease (AD) may be clinically effective and cost-effective according to a computer simulation model. The corresponding research was published in Alzheimer's & Dementia.

Public attention concerning AD usually focuses on the effectiveness of new drug treatments. However, studies show that non-drug interventions are also well-researched and effective in improving the quality of life of people with dementia.

In the current research, investigators evaluated the clinical efficacy and cost-effectiveness of four non-drug interventions compared to usual care: 

• Maximizing Independence at Home (MIND): an at-home intervention consisting of care planning, skill building, referral to services, and care monitoring
• NYU Caregiver: an outpatient clinic providing caregivers with access to counseling sessions and support groups
• Alzheimer's and Dementia Care (ADC), providing patients and their caregivers with a needs assessment, individual care plans, and round-the-clock access to a care manager
• Adult Day Services Plus (ADS Plus): a service augmenting adult day-care services with staff providing face-to-face caregiver support, disease education, care management, and skill building

For the study, the researchers used healthcare data from Medicare and Medicaid, clinical trials, and national surveys of families of people with Alzheimer's. They assessed the probability of nursing home admissions for the abovementioned interventions compared to usual care via a computer simulation model. In particular, they evaluated the societal costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. 

In the end, they found that all four measures significantly reduced nursing home admission rates and improved patient quality of life. The interventions were all cost-effective from a societal and familial point of view, requiring little to no extra cost to the healthcare payer compared to usual care. ADS Plus was especially cost-effective, costing less than usual care. While MIND, NYU Caregiver, and ADC were slightly more expensive to deliver, they nevertheless reduced costs associated with nursing home care. 

While this study adds to increasing research on non-drug interventions, such interventions are rarely clinically implemented. From these findings, the researchers conclude that health insurance policies should incentivize providers and health systems to implement non-drug interventions.

Sources: ScienceDaily, Alzheimer's Association