| dc.description.abstract | Objective: To identify, review and critically appraise model-based economic evaluations of all
types of interventions for people with dementia and their carers.
Design: A systematic literature search was undertaken to identify model-based evaluations
of dementia interventions. A critical appraisal of included studies was carried out using
guidance on good practice methods for decision-analytic models in health technology
assessment, with a focus on model structure, data, and model consistency.
Setting: Interventions for people with dementia and their carers, across prevention,
diagnostic, treatment and disease management.
Results: We identified 67 studies, with 43 evaluating pharmacological products, 19 covering
prevention or diagnostic strategies, and five studies reporting non-pharmacological
interventions. The majority of studies use Markov models with a simple structure to represent
dementia symptoms and disease progression. Half of all studies reported taking a societal
perspective, with the other half adopting a third-party payer perspective. Most studies follow
good practices in modelling, particularly related to the decision problem description,
perspective, model structure and data inputs. Many studies perform poorly in areas related to
reporting of pre-modelling analyses, justifying data inputs, evaluating data quality, considering
alternative modelling options, validating models and assessing uncertainty.
Conclusions: There is a growing literature on model-based evaluations of interventions for
dementia. The literature predominantly reports on pharmaceutical interventions for
Alzheimer’s disease, but there is a growing literature for dementia prevention and nonpharmacological
interventions. Our findings demonstrate that decision-makers need to
critically appraise and understand the model-based evaluations and their limitations to ensure
they are used, interpreted and applied appropriately. | en_GB |
