OBJECTIVES: Alzheimer's Disease (AD) is the most common form of dementia, leading to disability and death in older adults. Given the high costs of treatment and limited healthcare resources in developing countries, evaluating the cost-benefit and effectiveness of these treatments is crucial. Also, assessing patients’ improvement of independence and maintenance of quality of life due to these treatments according to the disease progression is essential. This study aims to analyse the economic impact of treatment from the perspective of the Brazilian Public Health System (SUS).

METHODS: This is a real-world evidence (RWE) study involving 133 outpatients of both sexes followed-up for mild, moderate, and severe AD. Comparators were Donepezil, Galantamine, Rivastigmine, and Memantine monotherapies, and/or their concomitant use with Memantine for mild, moderate, and severe AD. Economic analysis was conducted from the perspective of a public healthcare payer, with reference to SUS.

RESULTS: Donepezil was the dominant treatment for mild AD. Rivastigmine associated with memantine was more effective and expensive than other treatments for moderate AD. It’s cost per QALY also exceeded the Brazilian cost-effectiveness threshold of $15,810.28 per QALY. Otherwise, Donepezil was the cost-effective alternative, as the cost per QALY falls within the threshold when compared to Memantine. Galantamine associated with Memantine was the most effective and expensive amongst the compared treatments for the severe stage. It´s cost per QALY compared to others also exceeded the threshold. Hence, Donepezil was also the cost-effective treatment for this stage.