IPECAD open-source model
Within the IPECAD modelling group we are developing an open-source health-economic model. This model includes a mathematical simulation model that enables a description of symtoms of persons with Alzheimer’s disease (from a mild cognitive impairment, through stages of cognitive, functional and behavioural symptoms in dementia). The model connects these sympsoms to quality-adjusted life years and care costs, as well as the mortality risk.
For the RECAGE project we are estimating the cost-effectiveness of a special medical care unit for patients with Behavioural and Psychological Symptoms of Dementia (BPSD). This will be done in a prospective cohort study, comparing the activity of the centres endowed with a typical special medical care unit with that of the other participating centres lacking this facility.
We expect an improved quality of life of persons with dementia, lessening caregivers’ burden, and possibly delaying institutionalisation.
As part of the PRODEMOS project we are developing a health-economic model to estimate the life years saved and dementia-free years as a result of a lifestyle intervention for the primary prevention of dementia.
The aim of the PRODEMOS project is to make an evidence-based dementia prevention strategy using mobile Health accessible to those at increased risk of dementia who are usually not reached by preventive medicine.
Alzheimer Netherlands fellowship
In 2017 I have received a second fellowship from Alzheimer Netherlands to develop an open-source model to simulate the natural disease progression of Alzheimer’s disease. The model will describe progression from pre-dementia states such as at-risk or Mild Cognitive Impairment to dementia and death. The goal of the model is to enable the estimation of the impact of various innovations in Alzheimer’s disease. We are currently developing this in collaboration with the IPECAD open source modelling work group.
JPND’s MIND-AD project aims to identify effective prevention strategies for Alzheimer’s disease and related dementia disorders tailored to different “at-risk” groups in our population. We are specifically developing a simulation model to estimate the cost-effectiveness of the FINGER lifestyle and cardiovascular risk management program to prevent dementia.
IMI’s ROADMAP project (2016-2018) aims to provide the foundation for an integrated data environment and framework for real-world evidence in Alzheimer’s disease. Part of the project is to develop a model that describes and simulates the natural progression of Alzheimer’s disease and to develop a proof-of-concept health-economic model that simulates the corresponding impact on care use and quality-adjusted life years. In order to do this we are closely interacting with HTA and reimbursement bodies.
European Brain Council
The goal of the Dementia Case Study (2016-2017) of European Brain Council‘s was to estimate the value of treatment for Alzheimer’s Disease from a health-economic viewpoint. In order to do so we have developed a model to simulate the progression from persons with cognitive complaints to a cognitive impairment and the state dementia. The results indicated the potential of treatment to reduce the burden of dementia.
The ACcess to TImely Formal (ACTIF) care project (2014-2017) is a joint programming European dementia research project. It aimed to analyse the pathways to care for people with dementia and their families, in an attempt to better understand the reasons for inequalities in access to healthcare. In collaboration with Prof. Dr. A. Wimo at the Karolinska Institutet we focused on the health-economic effects of unmet needs on health-related quality of life and resource use. Results indicated a potential to improvement quality of life if unmet needs would be prevented. We are currently attempting to follow-up our participants for a longer time period to assess the long-term effects of untimely access to care on the use of care resources and quality of life.
The study protocol has been published and various manuscripts are being drafted.
Joint program’s BIOMARKAPD project (2012-2015) aimed to standardize collecting, measuring and interpreting Alzheimer’s disease and Parkinson’s disease biomarker measurements across Europe. Together with colleagues around Europe we have developed a health-economic decision model to evaluate the added value of biomarkers in clinical practice.
Results indicated an improvement of the prediction of any-type dementia as well as the potential cost-effectiveness (to-be published soon) of the lumbar puncture.
Alzheimer Netherlands Fellowship
In March, 2012, I received a fellowship from Alzheimer-Nederland to build a long-term disease progression model for Alzheimer’s disease. This research is a collaboration with Prof. Dr. A. Wimo at Karolinska Institutet. The model will serve as the back-bone of a decision analytic model to evaluate the cost-effectiveness of advanced biomarkers for AD.
CTMM’s LEARN project (2009-2014) aimed to develop new instruments that enable an earlier and more reliable diagnosis of Alzheimer’s Disease (AD) during life. We developed a decision analytic model for the evaluation of advanced biomarkers for AD in mild cognitive impairment. In combination with a hypothetical disease-modifying treatment we evaluated the position of advanced biomarkers in clinical practice when treatment becomes available.
- Handels RL, Aalten P, Wolfs CA, OldeRikkert M, Scheltens P, Visser PJ, Joore MA, Severens JL, Verhey FR. Diagnostic and economic evaluation of new biomarkers for Alzheimer’s disease: the research protocol of a prospective cohort study. BMC Neurol. 2012 Aug 10;12:72. PubMed.
- Handels RL, Joore MA, Tran-Duy A, Wimo A, Wolfs CA, Verhey FR, Severens JL. Early cost-utility analysis of general and cerebrospinal fluid-specific Alzheimer’s disease biomarkers for hypothetical disease-modifying treatment decision in mild cognitive impairment. Alzheimers Dement. 2015 Aug;11(8):896-905. doi: 10.1016/j.jalz.2015.02.009. PubMed.
- CTMM’s LEARN outcomes report.
- A simple version of this model is available open source at www.smard.org.