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What are the current and projected future cost and health-related quality of life implications of scaling up cognitive stimulation therapy?

Knapp, Martin ORCID: 0000-0003-1427-0215, Bauer, Annette ORCID: 0000-0001-5156-1631, Wittenberg, Raphael ORCID: 0000-0003-3096-2721, Comas-Herrera, Adelina ORCID: 0000-0002-9860-9062, Cyhlarova, Eva, Hu, Bo, Jagger, Carol, Kingston, Andrew, Patel, Anita, Spector, Aimee, Wessel, Audrey and Wong, Gloria (2022) What are the current and projected future cost and health-related quality of life implications of scaling up cognitive stimulation therapy? International Journal of Geriatric Psychiatry, 37 (1). ISSN 0885-6230

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Identification Number: 10.1002/gps.5633

Abstract

Objectives: Cognitive stimulation therapy (CST) is one of the few non-pharmacological interventions for people living with dementia shown to be effective and cost-effective. What are the current and future cost and health-related quality of life implications of scaling-up CST to eligible new cases of dementia in England? Methods/design: Data from trials were combined with microsimulation and macrosimulation modelling to project future prevalence, needs and costs. Health and social costs, unpaid care costs and quality-adjusted life years (QALYs) were compared with and without scaling-up of CST and follow-on maintenance CST (MCST). Results: Scaling-up group CST requires year-on-year increases in expenditure (mainly on staff), but these would be partially offset by reductions in health and care costs. Unpaid care costs would increase. Scaling-up MCST would also require additional expenditure, but without generating savings elsewhere. There would be improvements in general cognitive functioning and health-related quality of life, summarised in terms of QALY gains. Cost per QALY for CST alone would increase from £12,596 in 2015 to £19,573 by 2040, which is below the threshold for cost-effectiveness used by the National Institute for Health and Care Excellence (NICE). Cost per QALY for CST and MCST combined would grow from £19,883 in 2015 to £30,906 by 2040, making it less likely to be recommended by NICE on cost-effectiveness grounds. Conclusions: Scaling-up CST England for people with incident dementia can improve lives in an affordable, cost-effective manner. Adding MCST also improves health-related quality of life, but the economic evidence is less compelling.

Item Type: Article
Official URL: https://onlinelibrary.wiley.com/journal/10991166
Additional Information: © 2021 The Authors
Divisions: Personal Social Services Research Unit
Health Policy
Subjects: R Medicine > RA Public aspects of medicine
Date Deposited: 30 Sep 2021 10:00
Last Modified: 10 Jan 2022 17:21
URI: http://eprints.lse.ac.uk/id/eprint/112156

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