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16/100

⚠ Report — not peer-reviewed alzhub usefulness score 16 out of 100. Costs and economics

Topic: Drug trials: efficacy and safety

Plain-language summary

For mild to moderately severe AD, the results of the study suggested that all three treatments were beneficial when assessed using cognitive outcome measures. Global outcome measures were positive for donepezil and rivastigmine, but mixed for galantamine. Results for measures of function were mixed for donepezil and rivastigmine, but positive for galantamine. Behaviour and mood measures were mixed for donepezil and galantamine, but showed no benefit for rivastigmine. For memantine, two published RCTs were included; in one of these trials the participants were already being treated with donepezil. The results suggest that memantine is beneficial when assessed using functional and global measurements. The effect of memantine on cognitive and behaviour and mood outcomes is, however, less clear. Literature on the cost-effectiveness of donepezil, rivastigmine and galantamine was dominated by industry-sponsored studies, and studies varied in methods and results. Of the three UK studies, two report donepezil as not cost-effective, whereas a third study reports an additional cost (1996 pounds sterling) of between 1200 pounds sterling and 7000 pounds sterling per year in a non-severe AD health state (concerns over these estimates are raised, suggesting that they may underestimate the true cost-effectiveness of donepezil). Cost-effectiveness analysis undertaken in this review suggests that donepezil treatment has a cost per quality-adjusted life-year (QALY) in excess of 80,000 pounds sterling, with donepezil treatment reducing the mean time spent in full-time care (delays progression of AD) by 1.42-1.59 months (over a 5-year period). From four published cost-effectiveness studies, two UK studies report additional costs associated with rivastigmine treatment. Cost-effectiveness analysis undertaken in the current review suggests that rivastigmine treatment has a cost per QALY in excess of 57,000 pounds sterling, with rivastigmine treatment reducing the mean time spent in full-time care (delays progression) by 1.43-1.63 months (over a 5-year period). From five published cost-effectiveness studies, one UK study reports a cost per QALY of 8693 pounds sterling for 16-mg galantamine treatment and 10,051 pounds sterling for 24-mg galantamine treatment (concerns raised suggest that this may underestimate the true cost-effectiveness of galantamine). Cost-effectiveness analysis undertaken in the present review suggests that galantamine treatment has a cost per QALY in excess o

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Loveman, E., Green, C., Kirby, J., Takeda, A., Picot, J., Payne, L., et al. (2006). The clinical and cost-effectiveness of donepezil, rivastigmine, galantamine and memantine for Alzheimer's disease. Health Technology Assessment. https://doi.org/10.3310/hta10010

Vancouver

Loveman E, Green C, Kirby J, Takeda A, Picot J, Payne L, et al. The clinical and cost-effectiveness of donepezil, rivastigmine, galantamine and memantine for Alzheimer's disease. Health Technology Assessment. 2006. doi:10.3310/hta10010. PMID: 16409879.

BibTeX

@article{loveman2006-16409879,
  author  = {Loveman, Emma and Green, C and Kirby, J and Takeda, Andrea and Picot, Joanna and Payne, Liz and Clegg, Andrew Paul},
  title   = {{The clinical and cost-effectiveness of donepezil, rivastigmine, galantamine and memantine for Alzheimer's disease}},
  journal = {Health Technology Assessment},
  year    = {2006},
  doi     = {10.3310/hta10010},
  pmid    = {16409879},
  url     = {https://doi.org/10.3310/hta10010}
}

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.

How to read this study

Design: this is a pooled review. It combines earlier studies, so it is only as good as the studies it pools. Check how many were included, whether they were similar enough to combine, and whether the authors report inconsistency between them.
Size: the record gives no participant count. Look for one in the original before trusting a pattern.
Effect: the record gives no effect size, so the summary above cannot say how large any difference was.

What the evidence grade means here

This page is graded high. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. High means the abstract mentions a randomized design, a meta-analysis or a systematic review. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

For mild to moderately severe AD, the results of the study suggested that all three treatments were beneficial when assessed using cognitive outcome measures.
Global outcome measures were positive for donepezil and rivastigmine, but mixed for galantamine.
Results for measures of function were mixed for donepezil and rivastigmine, but positive for galantamine.
Behaviour and mood measures were mixed for donepezil and galantamine, but showed no benefit for rivastigmine.
For memantine, two published RCTs were included; in one of these trials the participants were already being treated with donepezil.

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Study details

Study designsystematic review
Evidence strengthHigh

How this study scored 16/100

Report — not peer-reviewed. It scored 44 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for sample size, effect reported and studied in people because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 27 of the 62 points we could judge it on, which is 44 out of 100.

Component	Points	Why
Journal tier	2 / 10	Tier 4 — not a peer-reviewed journal (Health Technology Assessment)
Journal's citation record	0 / 4	Not a journal article, so the journal's record does not count
Study design	12 / 12	A systematic review of all the studies on the question
Strength of evidence	5 / 5	Rated “high” in our summary
Peer-review validation	3 / 10	Report — not peer-reviewed. Named source is an organizational report, not a journal article.
How recent	1 / 5	2006 — older than 20 years, still counted
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomized / blinded	0 / 2	A review of other studies — randomization is not credited here
Times cited	— / 7	No citation count (not found in OpenAlex) — left out of this score
Citations per year	— / 5	No citation count or no year — left out of this score
Impact for its field and year	— / 6	No field-weighted citation impact (OpenAlex has none yet) — left out of this score
Cited by studies here	— / 6	Not yet checked against this library's citation graph — left out of this score
Still being cited	— / 4	No yearly citation counts — left out of this score
Senior author's track record	— / 4	Senior author's record not available — left out of this score
Institution's track record	— / 3	No institution listed in OpenAlex — left out of this score
Multicenter collaboration	— / 3	Institutions not listed — left out of this score
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 16409879)
Free to read	2 / 2	Free to read
Points	27 / 62	Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 27 of the 62 points we could judge it on is 44 out of 100.
Total	44 / 100	Capped to 16 because this is not a peer-reviewed article.

What each of these 20 components measures, and what this score is not →

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