%0 Journal Article %J J Alzheimers Dis %D 2021 %T A Cost-Consequence Analysis of Different Screening Procedures in Alzheimer's Disease: Results from the MOPEAD Project. %A Wimo, Anders %A Belger, Mark %A Bon, Jaka %A Jessen, Frank %A Dumas, Annette %A Kramberger, Milica G %A Jamilis, Laura %A Johansson, Gunilla %A Rodrigo Salas, Adrián %A Rodríguez Gómez, Octavio %A Sannemann, Lena %A Stoekenbroek, Malou %A Gurruchaga Telleria, Miren %A Valero, Sergi %A Vermunt, Lisa %A Waterink, Lisa %A Winblad, Bengt %A Visser, Peter Jelle %A Zwan, Marissa %A Boada, Merce %X

BACKGROUND: For care planning and support, under-detection and late diagnosis of Alzheimer's disease (AD) is a great challenge. Models of Patient-Engagement for Alzheimer's Disease (MOPEAD) is an EU-funded project aiming at testing different strategies to improve this situation.

OBJECTIVE: To make a cost-consequence analysis of MOPEAD.

METHODS: Four screening strategies were tested in five countries (Germany, the Netherlands, Slovenia, Spain, and Sweden): 1) a web-approach; 2) Open-House initiative; 3) in primary care; and 4) by diabetes specialists. Persons-at-risk of AD in all strategies were offered referral to a hospital-based specialist. The primary health-economic outcome was the cost per true-positive case (TP) of AD from the screened population.

RESULTS: Of 2,847 screened persons, 1,121 screened positive (39%), 402 were evaluated at memory clinics (14%), and 236 got an AD diagnosis (8%). The cost per TP of those screened was 3,115€ with the web-approach, 2,722€ with the Open-House, 1,530€ in primary care, and 1,190€ by diabetes specialists. Sensitivity analyses that more likely reflect the real-world situation confirmed the results. The number-needed-to-screen was 30 with the web-approach, 8 with the Open-House and primary care, and 6 with the diabetes specialists.There were country differences in terms of screening rates, referrals to memory clinics, staff-types involved, and costs per TP.

CONCLUSION: In primary care and by the diabetes specialist, the costs per TP/screened population were lowest, but the capacity of such settings to identify cases with AD-risk must be discussed. Hence new diagnostic strategies such as web-solutions and Open-House initiatives may be valuable after modifications.

%B J Alzheimers Dis %V 83 %P 1149-1159 %8 2021 Sep 28 %G eng %N 3 %1 https://www.ncbi.nlm.nih.gov/pubmed/34420954?dopt=Abstract %R 10.3233/JAD-210303