Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Cost Effectiveness Analysis of Alzheimer's Disease
Alzheimer Hastalığı'nın Maliyet Etkililik Analizi
Selin EROYMAKa, Vahit YİĞİTa
aSüleyman Demirel University Economics and Administrative Sciences of Faculty, Department of Health Management, Isparta, TURKEY
Turkiye Klinikleri J Health Sci. 2020;5(1):99-111
doi: 10.5336/healthsci.2019-66536
Article Language: EN
Full Text
ABSTRACT
 Objective: Chronic diseases, comparing to the other type of diseases, consume most of the resources in the health systems. Alzheimer's Disease (AD) is a chronic cerebral disorder and is the most common type of dementia. The purpose of this research is to analyze cost effectiveness according to stages of AD from the perspective of Social Security Institution (SSI) and the society and to determine the burden of the disease on the country's budget. Material and Methods: Using the Markov Model, three parameters were calculated in the study: lifelong cost, average survival time (ST) (year), and quality adjusted life year (QALY). Results: According to the cost-effectiveness analysis, treatment in early-stage causes additional ₺ 41.237,55 cost and provides additional 1.10 QALY comparing to the treatment in severe-stage. Likewise, treatment in moderate-stage causes an additional ₺ (-) 40.439,83 cost and provides additional 1.07 QALY comparing to the treatment in severe-stage. According to the results of the budget impact analysis made from the SSI perspective for AD, 0.66% of the total health expenditures were spent on the treatment of this disease. The social cost of AD was estimated as ₺ 14.462.457,106. Conclusion: The study was concluded that early and moderate-stage treatment of AD is cost-effective compared to severestage treatment. As a result of the study, it was revealed that the social and economic costs increased and the quality of life of the patients decreased in the progress stages of AD. The results of this study are thought to be important in terms of the assessment of the economic impact of AD in the Turkey.

Keywords: Cost effectiveness analysis; Alzheimer's disease; Markov model
ÖZET
 Amaç: Diğer hastalıklar ile karşılaştırıldığında kronik hastalıklar, sağlık sistemi içinde kaynakların çoğunu tüketmektedir. Alzheimer Hastalığı (AH) kronik bir beyin rahatsızlığıdır ve en sık görülen demans tipidir. Bu araştırmanın amacı, AH'nin evrelerine göre Sosyal Güvenlik Kurumu (SGK) ve toplum perspektifinden maliyet etkililiğini analiz etmek ve hastalığın ülke bütçesi üzerindeki yükünü belirlemektir. Gereç ve Yöntemler: Araştırmada Markov modeli kullanılarak üç parametre hesaplanmıştır. Bunlar; yaşam boyu maliyet, ortalama yaşam süresi (year) ve kaliteye ayarlı yaşam yıllarıdır (QALY). Bulgular: Maliyet etkililik analizi sonucuna göre, AH'yi erken evrede tedavi etmek ileri evrede tedavi etmeye göre ilave ₺ 41.237,55 maliyet ve 1,10 QALY sağlamaktadır. AH'yi orta evrede tedavi etmek ileri evrede tedavi etmeye göre ise ilave ₺ (-) 40.439,83 maliyet ve 1,07 QALY sağlamaktadır. SGK perspektifinden yapılan bütçe etki analizinin sonuçlarına göre toplam sağlık harcamalarının %0,66'sının bu hastalığın tedavisine harcandığı tespit edilmiştir. AH'nin sosyal maliyeti ise ₺ 14.462.457.106 olarak tahmin edilmiştir. Sonuç: Çalışmada AH'nin erken ve orta evrede tedavi edilmesinin ileri evrede tedavi edilmesine göre en maliyet-etkili seçenek olduğu sonucuna varılmıştır. Araştırma sonucunda, AH'nin ilerleyen aşamalarında sosyal ve ekonomik maliyetlerin arttığı, hastaların yaşam kalitesinin düştüğü ortaya çıkmıştır. Bu çalışmanın sonuçlarının, AH'nin Türkiye'deki ekonomik ve sosyal etkisinin değerlendirilmesi açısından önemli olduğu düşünülmektedir.

Anahtar Kelimeler: Maliyet etkililik analizi; Alzheimer hastalığı; Markov modeli
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