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Early cost-utility analysis of general and cerebrospinal fluid-specific Alzheimer’s disease biomarkers for hypothetical disease-modifying treatment decision in mild cognitive impairment


Handels, R. L., Joore, M. A., Tran-Duy, A., Wimo, A., Wolfs, C. A., Verhey, F. R., Severens, J. L.


Alzheimers Dement, Volume: 11, No.: 8, Pages.: 896-905

Year of Publication



INTRODUCTION: The study aimed to determine the room for improvement of a perfect cerebrospinal fluid (CSF) biomarker and the societal incremental net monetary benefit of CSF in subjects with mild cognitive impairment (MCI) assuming a hypothetical disease-modifying Alzheimer’s disease (AD) treatment. METHODS: A decision model compared current practice to a perfect biomarker and to two strategies positioning CSF as add-on test when current practice concluded the presence or absence of AD. RESULTS: The simulated MCI population was aged on average 68.3 and 49% had AD. The room for improvement by the perfect CSF test was 0.39 quality adjusted life years, euro33,622 ($43,372) savings, 2.0 potential beneficial treatment years, and 1.3-year delay in dementia conversion. DISCUSSION: The results indicated more potential benefit from a biomarker positioned to verify subjects who are not expected to have AD (i.e., to prevent undertreatment) rather than to verify subjects expected to have AD (prevent overtreatment). Sensitivity analyses explored different CSF positions.

Bibtex Citation

@article{Handels_2015, doi = {10.1016/j.jalz.2015.02.009}, url = {}, year = 2015, month = {aug}, publisher = {Elsevier {BV}}, volume = {11}, number = {8}, pages = {896--905}, author = {Ron L.H. Handels and Manuela A. Joore and An Tran-Duy and Anders Wimo and Claire A.G. Wolfs and Frans R.J. Verhey and Johan L. Severens}, title = {Early cost-utility analysis of general and cerebrospinal fluid-specific Alzheimer{textquotesingle}s disease biomarkers for hypothetical disease-modifying treatment decision in mild cognitive impairment}, journal = {Alzheimer{textquotesingle}s {&} Dementia} }


aged, aged, 80 and over, alzheimer disease, cerebrospinal fluidcomplicationseconomics, cognition disorders, cognitive, cohort studies, community health planning, costbenefit analysis, etiologytherapy, female, humans, impairment, male, medline, mild, models statistical, outcome assessment (health care), statistics & numerical data

Countries of Study


Types of Dementia

Dementia (general / unspecified), Mild Cognitive Impairment (MCI)

Types of Study

Economic evaluation

Type of Outcomes

Quality of Life of Person With Dementia, Service use or cost reductions (incl. hospital use reduction, care home admission delay)

Type of Interventions

Diagnostic Target Identification

Risk Factor Modifications

At risk population