The Cost-Effectiveness of Adding Uwhangchungsimwon to Donepezil With Respect to Mild Alzheimer's Behavioral and Psychological Symptoms in Korea: A Decision-Tree Model Based on Clinical Trial

OBJECTIVES: Behavioral and Psychological Symptoms of Dementia (BPSD) are common complications and major contributors to increased caregiving costs. The combination therapy of Uwhangchunsimwon (UCW) and donepezil has the potential to alleviate BPSD. This study aims to evaluate the cost-effectiveness of UCW add-on treatment compared to donepezil alone in mild Alzheimer’s disease (AD).

METHODS: A decision tree model was developed from healthcare system and societal perspectives and input data were drawn from a clinical trial (KCT0005669) carried out in two institutions. The proportion of patients with improved BPSD (△NPI<0) after a 24-week treatment was considered for effectiveness. Medical and indirect costs were collected from the survey of patients.

RESULTS: Over 24 weeks, 80% (25/31) in the combination group showed improved BPSD compared to 60% (19/32) in the donepezil-alone group. While medical costs were 1.4 times greater, informal care costs were approximately 25% lesser in UCW add-on treatment. As a result, additional KRW 3.4 million (US$2,430) medical costs were needed for improved BPSD in one out of 100 mild AD patients. From the societal perspective, the combination therapy incurred an additional KRW 910,000 (US$650) compared to donepezil-alone treatment.

CONCLUSIONS: The add-on of UCW to donepezil positively improve BPSD of mild AD patients. Considering the reduced caregiving costs in UCW combination treatment, UCW is expected to help reduce societal cost burdens of AD.