INTRODUCTION: Alzheimer's disease (AD) is the leading cause of dementia in the world, representing the fifth leading cause of death in people over 65 years of age. It is estimated that the hours of unpaid care provided is valued at almost US$244 billion in the United States, and this cost is even higher when considering the negative physical and mental health outcomes of caregivers and family members. Health technology assessment for reimbursement of new technologies often comprehends economic assessments (EA). Each HTA agency has its own guidelines for EA, but mostly it involves the comparison of clinical benefits and costs through a defined perspective of analysis.

OBJECTIVES: To analyze the reimbursement decisions and verify whether the societal perspective of health interventions for AD were used in EA.

METHODS: A systematic search was carried out in the following HTA agencies: PBAC (Australia), Conitec (Brazil), CADTH (Canada), NICE (England and Wales) and SMC (Scotland). We assessed all available documents on Alzheimer's disease technologies. Restrictions on the year or type of technology were not applied.

RESULTS: Five technologies with an indication of AD were identified (donepezil, galantamine, rivastigmine, memantine and souvenaid), with most of them being submitted between 2003 and 2012. Among these technologies, four were evaluated by PBAC, three by Conitec, two by CADTH, four by NICE, and four by SMC. The societal perspective was not the base-case nor was presented as an alternative analysis in any of the reports assessed. Dossiers submitted to NICE until 2014 contained EA considering the clinical outcomes for patients and caregivers and the costs for the individual and their family.

CONCLUSIONS: Given the absence of a societal costs in EA and faced with the burden of AD, considering these costs in future HTA appraisals may be an important assessment to ensure that all perspectives are addressed.