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A cost effectiveness analysis of maintenance cognitive stimulation therapy (MCST) for people with dementia: examining the influence of cognitive ability and living arrangements

Author

Listed:
  • Brown, Heather
  • D'Amico, Francesco
  • Knapp, Martin
  • Orrell, Martin
  • Rehill, Amritpal
  • Vale, Luke
  • Robinson, Louise

Abstract

Objectives: Identify if cost-effectiveness of Maintenance Cognitive Simulation Therapy (MCST) differs by type of living arrangement and cognitive ability of the person with dementia. Next, a value of information analysis is performed to inform decisions about future research. Methods: Incremental cost-effectiveness analysis applying seemingly unrelated regressions using data from a multicentre RCT of MCST versus treatment as usual in a population which had already received 7 weeks of CST for dementia (ISRCTN: 26286067). The findings from the cost-effectiveness analysis are used to inform a value of information analysis. Results: The results are dependent upon how quality adjusted life years (QALYs) are measured. MCST might be cost-effective compared to standard treatment for those who live alone and those with higher levels of cognitive functioning. If a further RCT was to be conducted for this sub-group of the population, value of information analysis suggests a total sample of 48 complete cases for both sub-groups would be required for a two-arm trial. The expected net gain of conducting this future research is £920 million. Conclusion: Preliminary results suggest that MCST may be most cost-efficient for people with dementia who live alone and/or who have higher cognition. Future research in this area is needed.

Suggested Citation

  • Brown, Heather & D'Amico, Francesco & Knapp, Martin & Orrell, Martin & Rehill, Amritpal & Vale, Luke & Robinson, Louise, 2019. "A cost effectiveness analysis of maintenance cognitive stimulation therapy (MCST) for people with dementia: examining the influence of cognitive ability and living arrangements," LSE Research Online Documents on Economics 100841, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:100841
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    Cited by:

    1. Knapp, Martin & Wong, Gloria, 2020. "Economics and mental health: the current scenario," LSE Research Online Documents on Economics 102717, London School of Economics and Political Science, LSE Library.

    More about this item

    Keywords

    cognitive functioning; cost-effectiveness; expected value of sample information; Maintenance cognitive simulation therapy; residency;
    All these keywords.

    JEL classification:

    • E6 - Macroeconomics and Monetary Economics - - Macroeconomic Policy, Macroeconomic Aspects of Public Finance, and General Outlook

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