1.1

Michalowsky et al. 2019 [63]

Dementia Care Management (Delphi-MV trial) vs Usual Care (Community-based: home)

Germany

RCT CUA (24 months)

444 / 0 (315 / 129)

Health and social care system Societal

• Health related Quality of life (SF-12) • Cognitive impairment (MMSE) • Depression and anxiety (GDS) • I-ADL • Comorbidity (CCI) • Service utilisation (CSRI) • Time to institutionalisation

—

In the base-case analysis, Incremental cost per QALY < 0

High

In the base-case analysis, DCM dominated the usual care in PwDs living alone while the ICER of the DCM for those living with a caregiver valued €26,851 per QALY (below the NICE’s threshold of €30,000 per QALY). The probability of the DCM being cost-effective is 56% at €0 WTP and increases to 88% at a WTP of €40,000 per QALY (close to the NICE’s threshold).

High

1.2

Rädke et al. 2020 [116]

Dementia Care Management (Delphi-MV trial) vs Usual Care (Community-based: home)

Germany

RCT CUA (24 months)

444 / 0 (315 / 129)

Health and social care system

• Health related Quality of life (SF-12) • Cognitive impairment (MMSE) • Depression and anxiety (GDS) • I-ADL • Comorbidity (CCI) • Service utilisation (CSRI)

—

In the base-case analysis, Incremental cost per QALY < 0

High

DCM dominated usual care in PwDs >80, female, living alone, with functional impairment (I-ADL), with cognitive deficit (MMSE). The probability of the DCM being cost effective at a WTP of €40,000 per QALY (close to the NICE’s threshold of €30,000 per QALY) was higher in females (96% versus 16% for males), in those living alone (96% versus 26% for those living not alone), in those being moderately to severely cognitively (100% versus 3% for patients without cognitive impairment) and functionally impaired (97% versus 16% for patients without functional impairment), and in PwDs having a high comorbidity (96% versus 26% for patients with a low comorbidity).

High

2

Wimo et al. 1995 [67]

Group living for dementia patients vs Home living and Institutional living (Group living)

Sweden

Prospective study with Markov model CUA (Expected life-length of 8 years)

108 / 0 (46 / 39 home; 23 instit.)

Health and social care system Societal

• Degree of dementia (GDS) • QALYs gained (TWB scale)

—

Incremental cost per QALY gained < 0 (compared to both institutionalisation and living at home)

High

Dominant (better outcomes and lower costs) even at a low WTP. Additional evidence needed since the study was not a RCT.

Medium