摘要

Authors' objectives: Background: Currently, no disease-modifying treatment is available for Alzheimer disease (AD) or Parkinson’s disease dementia (PD). Professional societies in Switzerland generally recommend symptomatic treatment using non-pharmacological therapies, and to add antidementia drugs when needed. However, scientific literature is inconclusive about the clinical benefit of antidementia drugs. A health technology assessment (HTA) was requested to compare the available evidence on Acetylcholinesterase (AChE) inhibitors and memantine for the symptomatic treatment of AD and PD. Objective: This HTA examines the efficacy, effectiveness, safety and cost-effectiveness of antidementia drugs compared to treatment without antidementia drugs or placebo in AD and PD and presents the health economic impact of a potential removal of these drugs from the list of pharmaceutical specialties in Switzerland. Furthermore, ethical, legal, social and organizational aspects are considered. Research questions: Is it efficacious, effective, safe and cost-effective 1) to treat mild to moderately severe AD patients with donepezil, galantamine or rivastigmine compared to not treating them with antidementia drugs? 2) to treat moderate to severe AD patients with memantine compared to not treating them with memantine? 3) to treat mild to moderately severe PD patients with rivastigmine compared to not treating them with rivastigmine? What is the budget impact of donepezil, rivastigmine, galantamine and memantine? Are there ethical, legal, social, or organizational issues related to antidementia drugs?