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A cost effectiveness analysis of maintenance cognitive stimulation therapy (MCST) for people with dementia: examining the influence of cognitive ability and living arrangements

Lookup NU author(s): Dr Heather BrownORCiD, Professor Luke ValeORCiD, Professor Dame Louise Robinson



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Objectives: Identify if cost-effectiveness of Maintenance Cognitive Simulation Therapy (MCST) differs by type of living arrangement and cognitive ability of the person with dementia. Findings are used to perform a value of information analysis to inform decisions about future research on the effectiveness and cost-effectiveness of MCST in people with these characteristics. Methods: Incremental cost-effectiveness analysis applying seemingly unrelated regressions using data from a multicentre RCT of MCST versus treatment as usual in a population which had already received 7 weeks of CST for dementia (ISRCTN: 26286067). The findings from the cost-effectiveness analysis are used to inform a value of information analysis. Results: The results are dependent upon how quality adjusted life years (QALYs) are measured but suggest that MCST might be cost-effective compared to standard treatment for those who live alone and for individuals with higher levels of cognitive functioning. If a further RCT was to be conducted evaluating the cost-effectiveness of MCST for those with higher cognitive functioning and those who lived alone, value of information analysis suggests a total sample of 48 complete cases for both sub-groups would be required for a two-arm trial. The expected net gain of conducting future research for these two population sub-groups is £920 million. Conclusion: Preliminary results suggest that MCST may be most cost-efficient for people with dementia who live alone and/or who have higher cognition. Future research in this area is needed.

Publication metadata

Author(s): Brown H, D'Amico F, Knapp M, Orrell M, Rehill A, Vale L, Robinson L

Publication type: Article

Publication status: Published

Journal: Aging & Mental Health

Year: 2019

Volume: 23

Issue: 5

Pages: 602-607

Print publication date: 01/05/2019

Online publication date: 12/03/2018

Acceptance date: 04/02/2018

Date deposited: 05/02/2018

ISSN (print): 1360-7863

ISSN (electronic): 1364-6915

Publisher: Routledge


DOI: 10.1080/13607863.2018.1442410


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