2024-03-29T09:50:44Zhttps://ebiltegia.mondragon.edu/oai/requestoai:ebiltegia.mondragon.edu:20.500.11984/19642024-03-04T15:18:37Zcom_20.500.11984_473col_20.500.11984_478
eBiltegia
author
Soto-Gordoa, Myriam
other
Mar Medina, Javier
other
Gorostiza, Ania
other
Ibarrondo Olagüenaga, Oliver
other
Arrospide, Arantzazu
other
Martinez-Lage, Pablo
2020-12-14T11:26:05Z
2020-12-14T11:26:05Z
2020
1758-9193
https://katalogoa.mondragon.edu/janium-bin/janium_login_opac.pl?find&ficha_no=162066
https://hdl.handle.net/20.500.11984/1964
Background: The LipiDiDiet trial showed that Souvenaid, a medical food, might delay progression to dementia in prodromal Alzheimer’s disease (AD). The objective of this study was to assess the cost-utility of Souvenaid compared to placebo in patients with prodromal AD under the conditions applied in that trial.
Methods: A discrete event simulation model was developed based on the LipiDiDiet trial and a literature review to assess the cost-utility of Souvenaid from a societal perspective considering direct and indirect costs. For both intervention and control groups, patient trajectories in terms of functional decline on the Clinical Dementia Rating Sum of Boxes (CDR-SB) scale in LipiDiDiet were reproduced statistically with mixed models by assigning time until events to simulated patients. From the societal perspective, four scenarios were analysed by combining different options for treatment duration and diagnostic test cost. Univariate sensitivity analysis assessed parameter uncertainties.
Results: Validation results at year 2 of disease progression fit with CDR-SB progression in LipiDiDiet. The incremental cost-utility ratio (ICUR) in the baseline case was €22,743/quality-adjusted life year (QALY). All scenarios rendered an ICUR lower than €25,000/QALY (the societal threshold). Moreover, the treatment option was costsaving and increased health benefits when diagnostic costs were not considered and treatment was only administered during the prodromal stage.
Conclusions: Treating prodromal AD with Souvenaid is a cost-effective intervention in all scenarios analysed. The LipiDiDiet trial showed a modest improvement in disease course but as the social costs of AD are very high, the intervention was efficient. Assessing small benefits at specific stages of AD is relevant because it is reasonable to expect that no effective, safe and affordable disease-modifying therapies will become available in the short to medium term.
eng
© The Author(s). 2020
Prodromal Alzheimer’s disease
Souvenaid
Cost-utility
dementia
Clinical dementia rating
Economic evaluation of supplementing the diet with 1 Souvenaid in patients with prodromal Alzheimer's disease
info:eu-repo/semantics/article

EBILTEGIA-N, MONDRAGON UNIBERTSITATEKO GORDAILU IREKIAN, MATERIALAK UZTEKO ERABILERA LIZENTZIA ETA ESKUBIDEEN LAGAPEN EZ-ESKLUSIBOA

Gordailuan utzitako materialaren egile edo egile eskubideen titular naizen aldetik, Mondragon Unibertsitateari erabilera-baimena eta/edo LAGAPEN EZ-ESKLUSIBOA ematen diot, doan, mundu eremuan eta legezko gehieneko epean, material horren gaineko erreprodukzio, banaketa, komunikazio publiko –elektronikoki eskuragarri jartzeko eskubidea barne– eta eraldatzeko eskubideetarako, hirugarren batzuen esku jartzeko aukera emanez, gordailuan utzitako material horri lotutako dagokion lizentzian ezarritako erabilera baldintzen arabera.

ONARTZEN DUT Mondragon Unibertsitateak, edukia aldatu gabe, gordailuan utzitako materiala gordetzeko beharrezkoak diren beste formatu edo bitarteko batzuetara eraldatzea edo egokitzea. Era berean, ONARTZEN DUT Mondragon Unibertsitateak gordailuan utzitako materialaren kopia bat baino gehiago gordetzea, segurtasun kopiak egiteko eta materiala etorkizunerako gordetzeko.

ZIURTATZEN DUT eta BERMATZEN DUT gordailuan utzitako materiala nik sortutako jatorrizko obra dela, eta nik dudala Lizentzia honetan jasotako lagapena emateko beharrezko egile eskubidearen titulartasuna.

Titulartasuna partekatzen den kasuetan, onartzen dut gainerako titularren baimena dudala Lizentzia hau emateko. Eskubideak hirugarren batzuei aurrez lagata izanez gero, ZIURTATZEN dut haien baimena dudala edo lizentzia honetan aurrez ikusitako moduan eskubideak erabiltzeko gaitasuna mantentzen dudala.

Lagatako materialak egile eskubideen titular ez naizen bestelako material batzuk izango balitu, ZIURTATZEN DUT eta BERMATZEN DUT dagokion titularraren baimena lortu dudala aurrez Lizentzia hau eman ahal izateko eta, era berean, ZIURTATZEN DUT eta BERMATZEN dut gordailuan utzitako materialaren edukian behar bezala identifikatuta eta aitortuta dagoela egile eskubidearen titular hori.

Azken batean, ZIURTATZEN DUT eta BERMATZEN DUT eBiltegian gordailuan utzitako materialak EZ DUELA HAUSTEN hirugarren batzuen eskubiderik, ez jabetza intelektualekorik ez industrialekorik, ohore, intimitate eta irudi eskubiderik, edo bestelako edozein eskubiderik.

Gordailuan utzitako materiala Mondragon Unibertsitatea ez den beste agentzia edo erakunderen batek finantzatutako ikerketan oinarrituta baldin badago, ZIURTATZEN DUT eta BERMATZEN DUT bete ditudala erakunde horrekin sinatutako kontratuak edo akordioak eskatutako betebehar guztiak.

Mondragon Unibertsitateak konpromisoa hartzen du gordailuan utzitako materialaren egile edo egile eskubideen titular gisa zu identifikatzeko, eta ez du material horretan Lizentzia honek espresuki ahalbidetutakoa ez den aldaketarik egingo.

Gordailuan utzitako materialaren egile edo egile eskubideen titular zaren heinean, obra eBiltegitik kentzeko eska dezakezu justifikatutako arrazoi batekin. Horretarako, arduradunekin harremanetan jarri beharko duzu.

Era berean, eBiltegiak gordailuan utzitako materiala kendu ahal izango du behar bezala justifikatutako kasuetan edo jabetza intelektualeko eskubideei lotuta hirugarren batzuen erreklamaziorik jasoz gero. Bi kasuetan aurretiaz espresuki jakinaraziko da.


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