Excess Costs Associated with Possible Misdiagnosis of Alzheimer's Disease Among Patients with Vascular Dementia in a UK CPRD Population

Michael Happich, Noam Y Kirson, Urvi Desai, Sarah King, Howard G Birnbaum, Catherine Reed, Mark Belger, Alan Lenox-Smith, David Price

Research output: Contribution to journalArticle

3 Citations (Scopus)
3 Downloads (Pure)

Abstract

BACKGROUND: Prior diagnosis of Alzheimer's disease (AD) among patients later diagnosed with vascular dementia (VaD) has been associated with excess costs, suggesting potential benefits of earlier rule-out of AD diagnosis.

OBJECTIVE: To investigate whether prior diagnosis with AD among patients with VaD is associated with excess costs in the UK.

METHODS: Patients with a final VaD diagnosis, continuous data visibility for≥6 months prior to index date, and linkage to Hospital Episode Statistics data were retrospectively selected from de-identified Clinical Practice Research Datalink data. Patients with AD diagnosis before a final VaD diagnosis were matched to similar patients with no prior AD diagnosis using propensity score methods. Annual excess healthcare costs were calculated for 5 years post-index, stratified by time to final diagnosis.

RESULTS: Of 9,311 patients with VaD, 508 (6%) had prior AD diagnosis with a median time to VaD diagnosis exceeding 2 years from index date. Over the entire follow-up period, patients with prior AD diagnosis had accumulated healthcare costs that were approximately GBP2,000 higher than those for matched counterparts (mostly due to higher hospitalization costs). Cost differentials peaked particularly in the period including the final VaD diagnosis, with excess costs quickly declining thereafter.

CONCLUSION: Potential misdiagnosis of AD among UK patients with VaD resulted in substantial excess costs. The decline in excess costs following a final VaD diagnosis suggests potential benefits from earlier rule-out of AD.

Original languageEnglish
Pages (from-to)171-183
Number of pages13
JournalJournal of Alzheimer's Disease
Volume53
Issue number1
DOIs
Publication statusPublished - 22 Jun 2016

Fingerprint

Vascular Dementia
Diagnostic Errors
Alzheimer Disease
Costs and Cost Analysis
Population
Health Care Costs
Propensity Score
Hospitalization

Keywords

  • Journal Article
  • Alzheimer's disease
  • cost and cost analysis
  • diagnosis
  • health resources
  • vascular dementia

Cite this

Excess Costs Associated with Possible Misdiagnosis of Alzheimer's Disease Among Patients with Vascular Dementia in a UK CPRD Population. / Happich, Michael; Kirson, Noam Y; Desai, Urvi; King, Sarah; Birnbaum, Howard G; Reed, Catherine; Belger, Mark; Lenox-Smith, Alan; Price, David.

In: Journal of Alzheimer's Disease, Vol. 53, No. 1, 22.06.2016, p. 171-183.

Research output: Contribution to journalArticle

Happich, Michael ; Kirson, Noam Y ; Desai, Urvi ; King, Sarah ; Birnbaum, Howard G ; Reed, Catherine ; Belger, Mark ; Lenox-Smith, Alan ; Price, David. / Excess Costs Associated with Possible Misdiagnosis of Alzheimer's Disease Among Patients with Vascular Dementia in a UK CPRD Population. In: Journal of Alzheimer's Disease. 2016 ; Vol. 53, No. 1. pp. 171-183.
@article{ae656158aaf147d2972a5a711cfb9e67,
title = "Excess Costs Associated with Possible Misdiagnosis of Alzheimer's Disease Among Patients with Vascular Dementia in a UK CPRD Population",
abstract = "BACKGROUND: Prior diagnosis of Alzheimer's disease (AD) among patients later diagnosed with vascular dementia (VaD) has been associated with excess costs, suggesting potential benefits of earlier rule-out of AD diagnosis.OBJECTIVE: To investigate whether prior diagnosis with AD among patients with VaD is associated with excess costs in the UK.METHODS: Patients with a final VaD diagnosis, continuous data visibility for≥6 months prior to index date, and linkage to Hospital Episode Statistics data were retrospectively selected from de-identified Clinical Practice Research Datalink data. Patients with AD diagnosis before a final VaD diagnosis were matched to similar patients with no prior AD diagnosis using propensity score methods. Annual excess healthcare costs were calculated for 5 years post-index, stratified by time to final diagnosis.RESULTS: Of 9,311 patients with VaD, 508 (6{\%}) had prior AD diagnosis with a median time to VaD diagnosis exceeding 2 years from index date. Over the entire follow-up period, patients with prior AD diagnosis had accumulated healthcare costs that were approximately GBP2,000 higher than those for matched counterparts (mostly due to higher hospitalization costs). Cost differentials peaked particularly in the period including the final VaD diagnosis, with excess costs quickly declining thereafter.CONCLUSION: Potential misdiagnosis of AD among UK patients with VaD resulted in substantial excess costs. The decline in excess costs following a final VaD diagnosis suggests potential benefits from earlier rule-out of AD.",
keywords = "Journal Article, Alzheimer's disease, cost and cost analysis, diagnosis, health resources, vascular dementia",
author = "Michael Happich and Kirson, {Noam Y} and Urvi Desai and Sarah King and Birnbaum, {Howard G} and Catherine Reed and Mark Belger and Alan Lenox-Smith and David Price",
note = "The authors would like to acknowledge Julie von Ziegenweidt and Annie Burden (Research in Real Life, UK) for assistance with processing and interpretation of CPRD data, and Gillian Gummer and Caroline Spencer (Rx Communications, Mold, UK) for medical writing assistance with the preparation of this article, funded by Eli Lilly and Company. Authors’ disclosures available online (http://j-alz. com/manuscript-disclosures/15-0685r2).",
year = "2016",
month = "6",
day = "22",
doi = "10.3233/JAD-150685",
language = "English",
volume = "53",
pages = "171--183",
journal = "Journal of Alzheimer's Disease",
issn = "1387-2877",
publisher = "IOS Press",
number = "1",

}

TY - JOUR

T1 - Excess Costs Associated with Possible Misdiagnosis of Alzheimer's Disease Among Patients with Vascular Dementia in a UK CPRD Population

AU - Happich, Michael

AU - Kirson, Noam Y

AU - Desai, Urvi

AU - King, Sarah

AU - Birnbaum, Howard G

AU - Reed, Catherine

AU - Belger, Mark

AU - Lenox-Smith, Alan

AU - Price, David

N1 - The authors would like to acknowledge Julie von Ziegenweidt and Annie Burden (Research in Real Life, UK) for assistance with processing and interpretation of CPRD data, and Gillian Gummer and Caroline Spencer (Rx Communications, Mold, UK) for medical writing assistance with the preparation of this article, funded by Eli Lilly and Company. Authors’ disclosures available online (http://j-alz. com/manuscript-disclosures/15-0685r2).

PY - 2016/6/22

Y1 - 2016/6/22

N2 - BACKGROUND: Prior diagnosis of Alzheimer's disease (AD) among patients later diagnosed with vascular dementia (VaD) has been associated with excess costs, suggesting potential benefits of earlier rule-out of AD diagnosis.OBJECTIVE: To investigate whether prior diagnosis with AD among patients with VaD is associated with excess costs in the UK.METHODS: Patients with a final VaD diagnosis, continuous data visibility for≥6 months prior to index date, and linkage to Hospital Episode Statistics data were retrospectively selected from de-identified Clinical Practice Research Datalink data. Patients with AD diagnosis before a final VaD diagnosis were matched to similar patients with no prior AD diagnosis using propensity score methods. Annual excess healthcare costs were calculated for 5 years post-index, stratified by time to final diagnosis.RESULTS: Of 9,311 patients with VaD, 508 (6%) had prior AD diagnosis with a median time to VaD diagnosis exceeding 2 years from index date. Over the entire follow-up period, patients with prior AD diagnosis had accumulated healthcare costs that were approximately GBP2,000 higher than those for matched counterparts (mostly due to higher hospitalization costs). Cost differentials peaked particularly in the period including the final VaD diagnosis, with excess costs quickly declining thereafter.CONCLUSION: Potential misdiagnosis of AD among UK patients with VaD resulted in substantial excess costs. The decline in excess costs following a final VaD diagnosis suggests potential benefits from earlier rule-out of AD.

AB - BACKGROUND: Prior diagnosis of Alzheimer's disease (AD) among patients later diagnosed with vascular dementia (VaD) has been associated with excess costs, suggesting potential benefits of earlier rule-out of AD diagnosis.OBJECTIVE: To investigate whether prior diagnosis with AD among patients with VaD is associated with excess costs in the UK.METHODS: Patients with a final VaD diagnosis, continuous data visibility for≥6 months prior to index date, and linkage to Hospital Episode Statistics data were retrospectively selected from de-identified Clinical Practice Research Datalink data. Patients with AD diagnosis before a final VaD diagnosis were matched to similar patients with no prior AD diagnosis using propensity score methods. Annual excess healthcare costs were calculated for 5 years post-index, stratified by time to final diagnosis.RESULTS: Of 9,311 patients with VaD, 508 (6%) had prior AD diagnosis with a median time to VaD diagnosis exceeding 2 years from index date. Over the entire follow-up period, patients with prior AD diagnosis had accumulated healthcare costs that were approximately GBP2,000 higher than those for matched counterparts (mostly due to higher hospitalization costs). Cost differentials peaked particularly in the period including the final VaD diagnosis, with excess costs quickly declining thereafter.CONCLUSION: Potential misdiagnosis of AD among UK patients with VaD resulted in substantial excess costs. The decline in excess costs following a final VaD diagnosis suggests potential benefits from earlier rule-out of AD.

KW - Journal Article

KW - Alzheimer's disease

KW - cost and cost analysis

KW - diagnosis

KW - health resources

KW - vascular dementia

U2 - 10.3233/JAD-150685

DO - 10.3233/JAD-150685

M3 - Article

C2 - 27163798

VL - 53

SP - 171

EP - 183

JO - Journal of Alzheimer's Disease

JF - Journal of Alzheimer's Disease

SN - 1387-2877

IS - 1

ER -