[A version of this item appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 2 Issue 8, March 2012; and later in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 3 Issue 1, August 2012].
This economic evaluation of the alternatives to antipsychotic drugs for people with dementia assembles the economic evidence about the benefits of behavioural approaches. NICE guidelines recommend the first line of treatment for behavioural and psychological symptoms of dementia (BPSD) should be psychosocial interventions, whereas until recently antipsychotic drugs have been used as the first line of treatment in practice.
While there are a broad range of behavioural interventions available, this analysis examined the costs and benefits of cognitive stimulation therapy. This report strongly suggests that behavioural interventions are a more efficient use of public money than antipsychotic drugs. This study was commissioned by South Tees Hospitals Foundation Trust and written by Matrix Evidence.
Behavioural interventions cost £27.6 million more per year than antipsychotic drugs for the 133,713 individuals with dementia requiring antipsychotic drugs in England. This additional investment needs to be offset by approximately £70.4 million savings in health care through the reduction in strokes and falls which would otherwise result from the use of antipsychotics. Behavioural interventions would avoid nearly 1,348 cases of stroke and 118 falls compared to using antipsychotic drugs, every year. Behavioural interventions also promise to generate quality of life improvements, which even if difficult to value monetarily, are estimated to generate a minimum £12.0 million in benefits per annum further.
The report concludes on balance that, combining health care cost savings and quality of life improvements, behavioural interventions might generate a net benefit of £54.9 million per year (taking cognitive stimulation therapy as the model).
Matrix Evidence (2012). An economic evaluation of alternatives to antipsychotic drugs for individuals living with dementia. Coventry: NHS Institute for Innovation and Improvement, October 2011.
Rees, E. (2011). A little-known drug-free treatment can have an amazing effect on Alzheimer’s sufferers. So why does a top charity refuse to endorse it? London: Daily Mail, December 13th 2011.